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1.
Breastfeed Med ; 14(5): 298-306, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30896254

RESUMO

Introduction: Mother's own milk has long been accepted as the best source of nutrition for the newborn. In those cases where mother's milk is not available, the best choice is the human milk provided by selected donors. Human milk banks are the most institutionalized method of milk sharing and play a vital role for neonates that cannot be breastfed. This study aims at systematically reviewing factors influencing donation to human milk banks. Materials and Methods: A systematic review of the literature was performed on authentic electronic resources, including PubMed, Scopus, Embase, ScienceDirect, and Web of Science with no time limitation. To increase the sensitivity and to find additional studies for systematic review, the reference list of the published studies was examined as well. Data extraction and quality appraisal were carried out by two independent reviewers. The study was qualitatively summarized to generate descriptive and explanatory themes that emerged from the literature. Results: From a total of 1,157 articles, 31 met the inclusion criteria in which 64 factors are extracted. From these, 26 factors act as barriers and 38 factors act as facilitators of milk donation. Having excess milk, altruism, and helping other babies are found to be the most important facilitators of milk donation, while the most important barriers are religious and cultural concerns. Conclusion: Developing practical strategies to attract milk donors are crucial for successfully establishing human milk banks. These include providing reliable information regarding the milk bank goals and functions and developing breastfeeding polices with regard to differences in countries' contexts and trying to resolve any uncertainties regarding milk donation, especially those arising for religious concerns.

2.
Health Policy Plan ; 33(10): 1065-1072, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30535054

RESUMO

Health equity has become a progressively popular research topic in recent years. Therefore, this study was made to identify the contributions made by socioeconomic determinants in order to quantify their roles to healthcare utilization inequity and to show their status especially after the recent reform in Iran, i.e. Health Transformation Plan, which one of its main goals is providing access to healthcare for all people. This study is a cross-sectional study conducted on a national level in Iran in 2015. For the sampling frame, three-stage cluster sampling was used. A total of 22 470 households from the whole country were surveyed by questionnaires through face-to-face interviews. A total of 78 378 subjects responded to the survey, 18 984 subjects (24.2%) reported the need to outpatient healthcare services in the 2 weeks preceding the interview and 12 944 (68.2%) of them had utilized the outpatient services. In addition, 5928 participants (7.6% of total population) reported the need to inpatient healthcare in the 15-month interval prior to the interview. Of these, 5405 subjects (91.2%) had received the inpatient cares. Several factors such as age group, education, marital status and status of household economy play significant roles in seeking inpatient cares. In addition, age group and household economic status have significant impacts on the utilization of outpatient services. While there are several variables that have different effects in determining the need for both outpatient and inpatient services, most of them are not any more significant than what are on the receiving end of these services.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Fatores Etários , Assistência Ambulatorial/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Irã (Geográfico) , Masculino , Estado Civil , Pessoa de Meia-Idade , Inquéritos e Questionários
3.
Epidemiol Health ; 40: e2018037, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30081620

RESUMO

OBJECTIVES: This study investigated the knowledge of Iranian women about HIV/AIDS and whether they had accepting attitudes towards people living with human immunodeficiency virus (HIV), and sought to identify factors correlated with their knowledge and attitudes. METHODS: The data analyzed in the present study were taken from Iran's Multiple Indicator Demographic and Health Survey, a national survey conducted in 2015. In total, 42,630 women aged 15-49 years were identified through multi-stage stratified cluster random sampling and interviewed. Associations of the socio-demographic characteristics of participants with their knowledge and attitudes were examined using multiple logistic regression analysis. RESULTS: The majority (79.0%) of Iranian women had heard about HIV/AIDS, but only 19.1% had a comprehensive knowledge. In addition, only 15.4% of women had accepting attitudes toward people with HIV. Being older, married, more highly educated, and wealthier were factors associated with having more comprehensive knowledge of HIV/AIDS, and living in urban areas was associated with having more positive attitudes toward people with HIV. CONCLUSIONS: The relatively poor knowledge of Iranian women and the low prevalence of accepting attitudes toward people living with HIV highlight the need to develop policies and interventions to overcome this issue, which would be a basis for further prevention of HIV/AIDS in Iran.


Assuntos
Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Síndrome de Imunodeficiência Adquirida/psicologia , Adolescente , Adulto , Demografia , Feminino , Infecções por HIV/psicologia , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Adulto Jovem
4.
Med J Islam Repub Iran ; 30: 425, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28210590

RESUMO

Background: Breastfeeding has been recognized to have a great deal of benefits for both the mothers and infants. Moreover, the importance of exclusive breastfeeding in the first six months of life has been greatly acknowledged. Therefore, this study aimed to determine the prevalence of starting breastfeeding in the first hour after delivery and the exclusive breast milk feeding as well as the age at which complimentary foods are provided to the child and duration of breastfeeding in Iran. Methods: This nationwide cross-sectional study was conducted in the frame of a national survey, Iran Multiple Indicator Demographic and Health Survey (IrMIDHS), in 31 provinces of Iran. Participants were selected by multistage cluster sampling. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural families. Data were collected using a questionnaire through face-to-face interviews. Results: The rate of exclusive breastfeeding was 53.13% with higher prevalence in rural (67.76%) than in urban areas (47.79%) (P = 0.04), and among girls (56.35%) compared to boys (50.60%). The prevalence of breastfeeding as the main diet of Iranian infants under six months old was 70.72% and the prevalence of initiation of breastfeeding (up to the first hour after delivery) was 68.70%. The probability of breastfeeding continuance among twelve to fifteen months children was 84.22%; the corresponding figure was 51% among twenty to twenty three months old babies (p=0.03). Conclusion: Exclusive breastfeeding should be encouraged; and strategies that are more effective should be designed to protect, train and support young mothers to breastfeed their infants. The importance of early beginning of breastfeeding and its continuation should be underscored.

5.
Iran Red Crescent Med J ; 17(1): e17505, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25763258

RESUMO

BACKGROUND: The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient's trust is the service quality. OBJECTIVES: This study aimed to examine the effect of quality of services provided in private hospitals on the patient's trust. PATIENTS AND METHODS: In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. RESULTS: The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P < 0.001) were the strongest factors in predicting patient's trust, but the quality of the environment had no significant effect on the patients' degree of trust. CONCLUSIONS: The interaction quality and process quality were the key determinants of patient's trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff.

6.
J Health Organ Manag ; 28(6): 795-810, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25420357

RESUMO

PURPOSE: In the ever-increasing competitive market of private hospital industry, creating a strong relationship with the customers that shapes patients' loyalty has been considered a key factor in obtaining market share. The purpose of this paper is to test a model of customer loyalty among patients of private hospitals in Iran. DESIGN/METHODOLOGY/APPROACH: This cross-sectional study was carried out in Tehran, the capital of the Islamic Republic of Iran in 2010. The study samples composed of 969 patients who were consecutively selected from eight private hospitals. The survey instrument was designed based on a review of the related literature and included 36 items. Data analysis was performed using structural equation modeling. FINDINGS: For the service quality construct, three dimensions extracted: Process, interaction, and environment. Both process and interaction quality had significant effects on perceived value. Perceived value along with the process and interaction quality were the most important antecedents of patient overall satisfaction. The direct effect of the process and interaction quality on behavioral intentions was insignificant. Perceived value and patient overall satisfaction were the direct antecedents of patient behavioral intentions and the mediators between service quality and behavioral intentions. Environment quality of service delivery had no significant effect on perceived value, overall satisfaction, and behavioral intentions. ORIGINALITY/VALUE: Contrary to previous similar studies, the role of service quality was investigated not in a general sense, but in the form of three types of qualities including quality of environment, quality of process, and quality of interaction.


Assuntos
Comportamento , Hospitais Privados , Intenção , Satisfação do Paciente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Satisfação do Paciente/estatística & dados numéricos , Pacientes/psicologia , Qualidade da Assistência à Saúde , Inquéritos e Questionários
7.
Int J Prev Med ; 5(5): 632-42, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24932396

RESUMO

BACKGROUND: There is an international emphasis on providing timely and high quality data to monitor progress of countries toward Millennium Development Goals. Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) aimed to provide valid information on population and health outcomes to monitor progress in achieving national priorities and health programs and to assist policy makers to design effective strategies for improving health outcomes and equity in access to care. METHODS: A cross-sectional multi-stage stratified cluster-random survey is conducted through face-to-face household interviews. The sampling frame is developed using Iran's 2006 population and housing census. Provincial samples ranging are from a minimum of 400 households per province to 6400 households in Tehran province. Cluster size is 10 households. The target sample includes 3096 clusters: 2187 clusters in urban and 909 clusters in rural areas. IrMIDHS instruments include three questionnaires: Household questionnaire, women aged 15-54 questionnaire, children under five questionnaire, supervision and quality assessment checklists and data collection sheets and standard weight and height measurement tools for under-five children. A cascading decentralized training method is used for training data collection and supervision teams. Quality assurance procedures are defined for the five steps of conducting the survey including: Sampling, training data collection and training teams, survey implementation, data entry and analysis. A multi-layer supervision and monitoring procedure is established. All the questionnaires are double entered. CONCLUSIONS: IrMIDHS will provide valuable data for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policy makers. The collaborative nature of the study may facilitate better usage of its results.

8.
Glob J Health Sci ; 7(3): 82-9, 2014 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-25948427

RESUMO

OBJECTIVE: Hospital services are the most expensive component of modern health care systems and inappropriate hospital stay is one of the most important challenges facing hospitals in many countries. The purpose of this study was to determine the extent of inappropriate hospital stay and investigate the related factors in Semnan city (Iran). METHODS: In this study, the Iranian version of Appropriateness Evaluation Protocol (AEP) was used in a representative sample of 300 hospital admissions and 905 hospital days. Data collection was performed during six weeks in January and February 2014 in four wards (two internal medicine and two surgical wards) of two hospitals in Semnan city (Iran). RESULTS: The results showed that 7.4% of admissions and 22.1% of stays have been inappropriate. Inappropriate stays were mainly concerned to the factors, including length of stay, inappropriate admissions, as well as factors related to hospitals. The most frequent causes of unjustifiable days were due to waiting for diagnostic or therapeutic procedures (35.1%), and 20.6% delay in discharge of patients by physicians due to conservative medical policy. CONCLUSION: In conclusion, this study confirms the existence of inappropriate hospital stays which may be due to patient characteristics and hospital factors. The most unjustifiable reasons for inappropriate hospital stay were related to internal processes of hospital, which mostly could be prevented through appropriate management Therefore, some steps must be taken to decrease inappropriate hospital stay and preserve hospital resources for patients who need them.


Assuntos
Administração Hospitalar/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Comorbidade , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Fatores Socioeconômicos , Adulto Jovem
9.
Int J Prev Med ; 4(12): 1371-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24498492

RESUMO

BACKGROUND: The mother-generated index (MGI) is one of only a few existing specific questionnaires for assessing the postnatal quality of life (QoL). MGI is a single-form questionnaire that asks postnatal mothers to specify up to eight areas of their lives which have been affected by giving birth to a baby. Using this tool, it is possible to score and rank the QoL of mothers. This study aimed to validate the questionnaire for use in Iran. METHODS: Forward translation was used to translate the questionnaire from English to Farsi (Persian). The questionnaire was then administered to a sample of postnatal women attending two teaching hospitals in Tehran, Iran. Face validity and criterion validity were performed to establish the validity for the Iranian version of the MGI. Face validity was assessed by asking women to indicate whether they understood the wording of the questions, how easy the questionnaire was, and so on. Criterion validity was examined using the Short Form 36-item (SF-36) Health Survey. It was hypothesized that the MGI would significantly correlate with the SF-36. RESULTS: In all, 124 women were approached. Of these, 119 women were eligible and 96 women agreed to take part in the study. Face validity was good and all of the women found the MGI straightforward to complete; as criterion validity, the MGI scores and the subscales of the SF-36 were moderately correlated (for all subscales: Pearson r > 0.4; P < 0.001). The mean MGI primary score was 5.38 (SD = 3.05). Women who had comorbidity had significantly lower MGI scores than women without comorbidity (P = 0.04). Correlation between aggregate of comments and primary score was high (r = 0.68, P < 0.01). CONCLUSIONS: In general, the Iranian version of the MGI performed well and our data suggest that it is a valid measure to assess health-related QoL among postnatal women.

10.
J Adv Nurs ; 69(4): 970-80, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22812385

RESUMO

AIM: To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland. BACKGROUND: Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English. DATA SOURCES: Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. DISCUSSION/IMPLICATIONS FOR NURSING: This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic. CONCLUSION: Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues.


Assuntos
Comparação Transcultural , Mães/psicologia , Qualidade de Vida , Feminino , Humanos
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