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1.
BMC Geriatr ; 20(1): 364, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32962635

RESUMO

BACKGROUND: Measuring self-care ability in elderly people needs specific instruments. The Self-care Ability Scale for Elderly (SASE) is one of the common instruments used for assessing self-care ability. The aim of this study was to assess the psychometric properties of the SASE among Iranian elderly population. METHODS: This cross-cultural adaptation study was carried out at Shahid Chamran and Shadpour Health Complex in Tabriz, Iran. The forward-backward procedure was applied to translate the SASE from English into Persian. Then, it was completed to 220 elderly people. A systematic random sampling method was used for sampling. Content validity was calculated through modified Kappa coefficient (modified CVI) based on clarity and relevance criteria. Reliability was measured by internal consistency and test-retest analysis. The construct validity also was assessed using Exploratory Factor Analysis (EFA). All the statistical analyses were performed using SPSS 21 statistical software package. RESULTS: The mean of self-care ability was 61.14 ± 21.08. The CVI and modified kappa were 0.91 and 0.92 for relevance and clarity, respectively. The Cronbach's alpha coefficient was 0.73 and Intra-class correlation coefficient was 0.97. The results of EFA revealed a three-factor solution ('ability to take care of personal responsibility', 'ability to take care for the goals', and 'ability to take care of the health') that jointly explained for 64.61% of the total variance. CONCLUSION: Results of the study showed that the Iranian version of the SASE has good psychometric properties and can be used in assessing the self-care ability of elderly people.

3.
J Inj Violence Res ; 12(3)2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32779637

RESUMO

BACKGROUND: Healthy city and safe community programs are the most common initiatives gaining increasing appeal in various communities to improve safety and health, independently. The aim of this study was to develop a joint application model of safe community and healthy city. METHODS: A comprehensive literature review was conducted on healthy city and safe community programs using PubMed, Web of Science, Scopus and Science Direct and also related websites such as WHO regional offices in 2018. The preliminary list of joint model dimensions and topics were extracted and then assessed by the expert through two rounds of decision Delphi and four expert panel sessions. Eventually, the visual model was developed and approved by the experts. RESULTS: Literature review resulted in the identification of 11 programs on safety and health promotion in the community of which 35 topics were extracted. After investigating the topics accordance, they were judged (correction, merging or eliminating) by experts through Delphi rounds and panel sessions. Eventually a joint model comprising 14 dimensions, 3 core principles and 4 values called "Safe and Health Promoting Community, SHPC_ model" was developed. CONCLUSIONS: SHPC model provides a parallel and comprehensive view on safety and health topics in a community. The implementation of an integrated model could be one possible way to enhance the commitments on behalf of state and local government, and health system leaders to prioritize injuries and non-communicable disease prevention to address promotion, prevention, treatment and social consequences of mutual community-based interventions.

4.
Materials (Basel) ; 13(11)2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32516909

RESUMO

In the present study, Inconel 718 (IN718) superalloy fabricated by laser powder bed fusion (LPBF) has been characterized focusing on the effect of both homogenization and solution treatment time on grains structure, crystallographic texture, precipitates formation/dissolution and material hardness. For this purpose, a heat-treatment time window with a wide range of soaking times for both treatments was established aiming to develop the optimal post-treatment conditions for laser powder bed fused IN718. It was found that the as-printed IN718 is characterized by very fine columnar/cellular dendrites with Laves phase precipitating at the grain boundaries as well as inter-dendritic regions, which differs from the microstructure of wrought and cast materials and requires special heat-treatment conditions different from the standard treatments. The results reveal that the relatively short homogenization treatment at 1080 °C for 1 h was not enough to significantly change the as-printed grain structure and completely dissolve the segregates and Laves phase. However, a completely recrystallized IN718 material and more Laves phase dissolution were obtained after homogenization treatment for 4 h. A further increase in time of the homogenization treatment (7 h) resulted in grain growth and coarsening of carbides precipitates. The solution treatment time at 980 °C did not cause noticeable changes in the crystallographic texture and grain structure. Nevertheless, the amount of δ-phase precipitation was significantly affected by the solution treatment time. After applying the heat-treatment time window, the hardness increased by 51%-72% of the as-printed condition depending on the treatment time due to the formation of γ' and γ″ in the γ-matrix. The highest material hardness was obtained after 1 h homogenization, whereas the prolonged time treatments reduced the hardness. This study provides a comprehensive investigation of the post heat-treatments of the laser powder bed fused IN718 that can result in an optimized microstructure and mechanical behavior for particular applications.

5.
J Inj Violence Res ; 12(2)2020 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-32535611

RESUMO

BACKGROUND: Unintentional injuries in the home are one of the threats to childhood quality of life which is considered as a social determinant of health. Regarding mother's leading role in taking care of the children in Iranian families, the present study was conducted to investigate mothers' home-injury prevention attitude and performance and its contributing factors in Sahand safe community, East-Azerbaijan, Iran. METHODS: This was a cross-sectional study conducted in 2017. Sampling was done using "Random Sampling method" among all mothers having at least one U-5 child and attended the health centers to receive childcare services. A valid attitude questionnaire and safety performance checklist were used for data collection. Data were analyzed by SPSS-24, using descriptive (frequency, mean, etc.) and inferential statistics (chi-square, Kruskal-Wallis). RESULTS: The mean age of mothers was 30.58 (±5.01). About 65% of the mothers had primary or secondary school education. The mean score of mothers' attitude was 72.12(±6.79). More than 58% of the mothers had an appropriate level of attitude. The mothers' injury prevention performance mean score was 66.59 (±12.85). Family's socioeconomic status, mother's age, educational level, and job, father's job, age, and gender of the child were the contributing factors (p less than 0.05). CONCLUSIONS: Most of the mothers have an appropriate level of home-injury prevention attitude but a low level of performance. Strengthening Primary Health Care system in safe communities would have a leading role in child safety promotion through increasing the mother's knowledge, attitude and performance level.

6.
BMC Public Health ; 20(1): 942, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539779

RESUMO

BACKGROUND: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma-Ata declaration. However, after forty years, it needs to be more trustful to achieve its predefined objectives. Public trust in PHC is one of the neglected issues in the context. The aim of this study is to evaluate public trust in PHC in Iran. METHODS: The present investigation is a household survey conducted in East Azerbaijan Province, Iran. Two-stage cluster sampling method with Probability Proportional to Size (PPS) approach was used. Totally, 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of Socio-Economic Status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA software (version 15) through descriptive statistics and linear regression. RESULTS: The mean ± SD age of the participants was 41.2 ± 15.1 and most (53.7%) were female. Mean score of PHC trust was 56.9 ± 24.7 (out of 100). It was significantly different between residents of Tabriz (the capital of province) and other cities in the province (p < 0.001). Linear regression showed that younger age, gender, insurance type, being married, and households higher socio-economic status had a significant positive effect on PHC trust level with R2 = 0.14383. CONCLUSIONS: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but key role in trust level. PHC trust cannot be only affected by individual's variables and experiences but also by health system and health providers' characteristics and public context in which PHC system exists. PHC trust level could be used as a public indicator in health systems especially in Low and Middle Income Countries (LMIC) to contribute in system strengthening policies at the national and international levels.


Assuntos
Assistência à Saúde/organização & administração , Satisfação do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Opinião Pública , Confiança/psicologia , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
7.
Chin J Traumatol ; 23(3): 152-158, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32278612

RESUMO

PURPOSE: Successful application experiences on public-private partnership (PPP) in different countries, suggest that PPP could be an option in road traffic injury (RTI) prevention. The present study aims at investigating the applicability of PPP policy in RTI prevention in Iran based on the experts' perspectives. METHODS: This is a qualitative study with grounded theory approach which has been conducted in Tabriz University of Medical Sciences, Iran in 2018. The participants were 22 experts in the field of RTIs selected using purposive sampling method. Data were collected by semi-structured interviews and analyzed with content-analysis method. RESULTS: The results were classified under 5 main themes (applicability, scopes and services, challenges, advantages, and strategies) for applying PPP policy and 37 sub-themes. Due to the prevalence of RTIs, the present challenges in public sector, existence of qualified private sector, and successful experiences in other areas, there are opportunities for private sector partnership in prevention of RTIs. Private sector could participate in different scopes and services regarding RTI prevention, including road construction and maintenance, maintenance and provision of vehicles safety and public education. The main challenges including legislation issues, ambiguities in collaboration, political and organizational unsustainability, government's financial hardship and lack of experienced experts in the field of RTI. However, there are significant advantages including high efficiency in program implementation, covering the weaknesses of public sector, effective and efficient management on application of PPP in RTI prevention. The strategies include identifying and prioritizing the assignable activities, identifying the qualified private sector, developing PPP policies and legal frameworks, creating a common language between public and private parties, trying to meet the expectations of the private sector by public sector, developing a comprehensive and sound contract, and cultivating public culture to accept private sector in the field of RTI prevention. CONCLUSION: This study sought to determine whether PPP could be used as strategy to reduce the burden of RTIs in Iran. But it requires a lot of preliminary studies to provide the context and conditions for applying this policy.


Assuntos
Lesões Acidentais/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Prova Pericial , Parcerias Público-Privadas , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Parcerias Público-Privadas/organização & administração , Pesquisa Qualitativa
9.
BMC Med Educ ; 19(1): 449, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31796038

RESUMO

BACKGROUND: Scientometric studies are one of the most important and useful tools to assess the research performance and knowledge impact of researchers. The aim of this study was to map out the scientific performance of the Iranian medical academics with respect to a detailed range of scientometric indicators. METHODS: Using scientometric approach, individual and scientific performance data of medical academic staff were extracted from the Iranian Scientometric Information Database (ISID). Total number of publications, total number of citations, citation per paper, h-index, international collaboration, self-citation, SJR decile, i10-Index, Quartile distribution were the studied scientometric variables. Out of the registered 19,023 academic staff, 746 were included in the study through simple random sampling method using random sample extraction function in STATA. Data were analyzed using STATA 14 statistical software package. RESULTS: Most of the included academicians were men (60%). A total of 13,682 articles were published by them until 2018, being cited 114,928 times with a mean of 5.77 citation per paper. H-index median was three and about 90% of the staff had an H-index below 10. Number of published papers, cite per paper and H-index metrics were significantly different with respect to gender, academic position/degree, and general field of study (p < 0.05). About 2.5% of published articles were contributed through international collaboration. The scientometric performance of academic staff was highly diverse with respect to the employing institution and its national classification group (type 1, 2, 3). CONCLUSIONS: Nevertheless to the great scientific production of medical academics, individual and institutional characteristics were identified as effective variables in academics research performance and should be considered in their assessment. Academicians affiliated with type 2 and 3 universities (based on national ranking of medical universities) had weaker research performance compared to those affiliated with type 1 universities. However, low rate of international research collaborations was a common challenge in medical universities.


Assuntos
Pesquisa Biomédica/estatística & dados numéricos , Docentes de Medicina/estatística & dados numéricos , Bibliometria , Docentes/estatística & dados numéricos , Feminino , Humanos , Irã (Geográfico) , Fator de Impacto de Revistas , Masculino
10.
BMC Health Serv Res ; 19(1): 502, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324170

RESUMO

BACKGROUND: Trust has been introduced as the cornerstone of the public and health providers' relation. Public trust in primary health care (PHC) is crucial and must be measured. The aim of this study was to develop and validate PHC trust measurement tool. METHODS: This was a psychometric study to develop PHC trust measuring tool done in Tabriz, East-Azerbaijan with participation of 600 households in 2016. Item generation was done through literature review and experts opinions. The content validity, reliability and construct validity of the PHC trust tool were assessed using several statistical methods including modified Kappa, Kendall's Tau and intra-class correlation coefficient (ICC) as well as exploratory factor analysis (EFA). Data were analyzed using STATA 14 statistical software package. RESULTS: A 30-item questionnaire was developed. The Modified Kappa coefficient as an indicator of content validity assessment was 0.94. With respect to reliability assessment, a high internal consistency was observed with 0.98 Cronbach-Alpha score and the test-retest reliability for overall scale (assessed by ICC) was 0.94 (CI: 0.87-0.97). Exploratory factor analysis emerged 2 factors. Factor 1 consisted of 25 items accounting for 74.1% of the variance (eigenvalue = 22.47) followed by Factor 2 consisting of 5 items accounting for 19.2% of the variance (eigenvalue = 1.6). CONCLUSION: PHC trust measuring tool could be used as a valid and reliable tool by health systems in Iran and similar contexts to investigate how they are trustful from the public viewpoint.


Assuntos
Atitude Frente a Saúde , Atenção Primária à Saúde , Inquéritos e Questionários , Confiança/psicologia , Adulto , Análise Fatorial , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes
11.
BMC Public Health ; 19(1): 911, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288783

RESUMO

BACKGROUND: Providing comprehensive and high-quality services is one of the most important goals of the health systems and a basic principle for Universal Health Coverage (UHC). Fulfilling this important task would be feasible through continuous evaluation and improvement of the health services quality. The aim of this study was to develop a framework for quality assessment of Primary Health Care (PHC) in Iran's health system. METHODS: This study is a literature review which continued by a qualitative research. The extracted quality dimensions and indicators for initial screening were reviewed and discussed in two panel meetings attended by the experts with regard to the current package of health system in Iran. Using Delphi method, the dimensions and Quality Indicators(QIs) were evaluated and approved by 39 national health professionals in two rounds. Finally, after 4 panel sessions at ministerial level, the selected QIs were categorized in form of the final dimensions of the quality of care. RESULTS: The literature review emerged 13 Primary Health Care Quality Assessment Frameworks (PHCQAF) including 20 and 698 QIs. Delphi study resulted in developing Iranian PHCQAF comprising 7 dimensions and 40 QIs. Among these, 8 QIs of the dimension of access and equity, 5 QIs of safety dimension, 2 QIs of efficiency dimension, 13 QIs of effectiveness dimension, 2 QIs of patient-centeredness dimension, 3 QIs of governance dimension and 7 QIs of appropriateness dimension were presented. CONCLUSIONS: The presented PHCQAF can be used as a comprehensive and practical tool for continuous improvement of the quality of PHC services at local, national and regional levels. Moreover, it can give some useful information to the health managers and policy makers on how the services are provided.


Assuntos
Atenção Primária à Saúde/normas , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Técnica Delfos , Humanos , Irã (Geográfico)
12.
Bull Emerg Trauma ; 7(1): 1-8, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30719460

RESUMO

Objective: To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran. Methods: This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian in the time period of 2000 to 2016. The retrieved studies were screened and reviewed then quality assessed. Random Effect model was applied for meta-analysis. The qualitative data were analyzed by content analysis method. Results: After literature screening, 39 studies included in the analysis. Women were subject to self-immolation more than men. The rate of self-immolation estimated to be 4.5 cases in every 100,000 populations and it was the reason of 16% of hospitalized burns. The average length of hospital stay calculated to be 12.24 (95% CI: 8.85-15.59) days. The total burnt surface area was 65.3% (95% CI: 56.71-73.89). Death due to self-immolation was 62.1%. The major risk factors of self-immolation were having mental health issues, family problems and characteristics and problems in relation/communication with spouses. Conclusion: Despite the low rate of self-immolation in Iran, it comprises one sixth of the hospitalized burns. The mortality rate of self-immolation also is high and this highlights the importance of providing special care. Psychological consultations and mental health screening in the primary health care would help to prevent the self-immolation.

13.
Int J Health Plann Manage ; 34(2): 773-779, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30657199

RESUMO

OBJECTIVE: Patient safety walkround (PSWR) is an appropriate technique for senior managers' participation and collaboration with frontline staff to promote safety culture in hospitals. This study was conducted to assess the 5-year PSWR experience in Shahid Mahallati Hospital in Tabriz, Iran. METHODS: This was a triangulated cross-sectional study. All documents, instructions, reports, action plans, protocols, and verbal feedbacks on PSWRs were reviewed from 2013 to 2017. Data were extracted using goal-driven extraction form and analyzed using Excel 2016 software. RESULTS: A total of 174 90-minute PSWRs were conducted during the study period, and 1372 safety issues were identified. Work environment factors (32.5%), organization and management (18.14%), and tasks (18.07%) were the most frequent identified issues, respectively. About 75.5% of the issues were resolved through corrective interventions implementation. CONCLUSIONS: PSWRs provide a great opportunity to identify and resolve the safety issues in the hospitals. Senior managers' participation and their support of staffs opinions and innovations were reinforced through PSWRs. Moreover, it creates mutual trust and safety responsiveness at all organizational levels in the hospital.


Assuntos
Países em Desenvolvimento , Segurança do Paciente , Estudos Transversais , Administração Hospitalar/métodos , Hospitais/normas , Humanos , Irã (Geográfico) , Cultura Organizacional
14.
Fam Med Community Health ; 7(1): e000007, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32148689

RESUMO

Objective: The aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province, Iran. Design: A cross-sectional household study as part of a larger research on primary healthcare system. Setting: We carried out the study in East Azerbaijan Province, northwest Iran from July to September 2015. Participants: A total of 1318 households were included. Results: Most of the participating households had social security health insurance. Heart failure or hypertension care, general outpatient care and arthritis care were the most used services. High services cost and inadequate medicine and medical equipment were introduced to be the main barriers to health services utilisation in Tabriz and province representative sample (PRS), respectively. Health system responsiveness mean score (the maximum is 100) was 33.71±16.15 (95% CI 32.45 to 34.97) in Tabriz and 32.02±14.3 (95% CI 30.9 to 33.13) in PRS, which showed significant difference (p≤0.02). Conclusions: Differences in the utilisation and responsiveness of health services and distribution of health resources were observed between Tabriz and PRS. Evidently, health system responsiveness in both Tabriz and PRS was at low level. The results demonstrate the need for changing resource distribution policies and employing reactive health policies to response the public health.

15.
BMC Health Serv Res ; 18(1): 886, 2018 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-30470214

RESUMO

BACKGROUND: Delivering interventions is the main task of health systems whose accurate measurement is an essential input into tracking performance. Recently, the concept of effective coverage was introduced by World Health Organization to incorporate into health system performance assessment. The aim of present scoping review was mapping the key elements and steps of effective coverage assessment in practical efforts including kinds of interventions, criteria for selecting them and the need, use and quality estimation approaches and strategies of each intervention. METHODS: We conducted a scoping review of health system/program assessments which assessed effective coverage till May 2017. Seven databases were systematically searched with no time and language restriction through applying combined keyword of "effective coverage". RESULTS: Eighteen studies contributed findings on monitoring effective coverage of health interventions and they all were included in the review. Only 4 contributed findings on health system and the others were related to specific intervention(s) assessment. The interventions monitored by effective coverage were mainly in child health, prenatal and antenatal care and delivery, and chronic conditions areas. Potential impact on the burden of disease, leading causes of mortality and morbidity, and high occurrence and prevalence rate were among the main intervention selection criteria. Availability of data was the critical prerequisite, especially, in all of the studies applied ex post approach in estimating effective coverage. Estimation based on a norm, self- reporting from surveys and biomarkers were the main strategies and methods of need, utilization and quality measurement, respectively. CONCLUSIONS: More studies are needed to contribute to the ongoing improvement in the development of effective coverage concept and increasing practical efforts, especially through defining prospective approaches and strategies into estimation of composite measures based on the effective coverage framework. Also, further attention needs to be paid to quality measures of effective coverage in a manner that better conceptualizes and measures the connection between coverage rates and interventions' effectiveness. At the administrative system level, more innovation is needed to develop data systems in order to enhance capacity of routine health service information.


Assuntos
Serviços de Saúde/normas , Qualidade da Assistência à Saúde/normas , Criança , Serviços de Saúde da Criança/normas , Feminino , Programas Governamentais , Humanos , Assistência Médica , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/normas , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos
16.
Int J Health Care Qual Assur ; 31(7): 855-863, 2018 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-30354883

RESUMO

PURPOSE: Accreditation helps to ensure safe and high-quality services in hospitals. Different occupational groups have various hospital accreditation experiences. The purpose of this paper is to investigate nurses' accreditation experience and its effects on Iranian teaching hospital service quality. DESIGN/METHODOLOGY/APPROACH: This was a qualitative study involving a phenomenological approach to studying nurses' hospital accreditation experience and understanding the effects on Iranian teaching hospital service quality. Data were collected using two focus groups in which nurses were selected using purposive sampling. Transcripts were analyzed using content analysis. FINDINGS: Nurses' experiences showed that hospital administrators and nurses had greater role in implementing accreditation than other occupational groups. Accreditation improved patient-centeredness, patient safety, logistics and managerial processes and decision making. However, a weak incentive system, extra documentation and work stress were negative experiences. PRACTICAL IMPLICATIONS: Nurse experience, as the most important care team member, reveals accreditation's strengths and weaknesses and its effects on service quality. ORIGINALITY/VALUE: The author used a phenomenology approach to measure accreditation effects on service quality - a valuable tool for understanding a phenomenon among those that experience hospital accreditation processes.


Assuntos
Acreditação , Hospitais de Ensino/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade da Assistência à Saúde , Grupos Focais , Irã (Geográfico) , Estudos de Casos Organizacionais , Pesquisa Qualitativa
17.
Int J Health Care Qual Assur ; 31(7): 697-703, 2018 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-30354888

RESUMO

PURPOSE: The purpose of this paper is to determine accreditation effects on Iranian military hospital health service quality through nurses' viewpoints. DESIGN/METHODOLOGY/APPROACH: The paper is a cross-sectional questionnaire-based study. Sampling drew from a hospital nurse census ( n=160). Descriptive statistics were used to analyze participant demographics and nurses' views. Linear regression analysis determined the independent variables' overall effect on the accreditation quality results dimension (dependent variable). FINDINGS: From the nurses' viewpoints, accreditation effects on services quality mean score was 3.60±0.61. Linear regression analysis showed that leadership and quality management were identified as the most important accreditation quality predictors. The R2 value (0.698) showed that nearly 70 percent of the dependent variable changes were affected by the independent variables. PRACTICAL IMPLICATIONS: This study gives hospital managers a deeper insight into accreditation and its effects on military hospital service quality. Military hospitals benefit from military organization such as hierarchy and command chain, so managers should employ these characteristics to adopt appropriate policies to promote human resource management as a competitive advantage. Furthermore, results will guide public and private hospital managers on how to manage organizational variables that benefit from accreditation. ORIGINALITY/VALUE: Accreditation was introduced as a hospital quality improvement program. However, implementing accreditation programs should be cost-effective. Hospital managers and employees should feel that accreditation can improve service quality. Nurses had positive viewpoints about accreditation and its effects on military hospital service quality.


Assuntos
Acreditação , Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade da Assistência à Saúde , Adulto , Estudos Transversais , Feminino , Hospitais Militares , Humanos , Irã (Geográfico) , Liderança , Masculino , Segurança , Inquéritos e Questionários
18.
Prim Health Care Res Dev ; : 1-6, 2018 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-30124179

RESUMO

AimTo improve the medical waste management (MWM) standards in Tabriz community health centers (CHCs) through clinical audit process. BACKGROUND: Management of medical waste is not only a legally necessity but also a social responsibility in health systems. Owing to the potential risks for human health and environmental impacts, MWM is a global concern. METHODS: This was an interventional research designed using clinical audit cycle that was implemented in Tabriz CHCs in 2016. MWM was assessed through observation, as well as reviewing relevant documents and interviews with waste workers in CHCs and completion of a researcher-made checklist. Intervention plans were developed and implemented based on the assessment results. To analyze the data, Excel 2016 software was used and information was reported as descriptive statistics through comparison of standards adherence before and after the interventions. RESULTS: Generally, 30% improvements in MWM standards adherence were experienced (45.8-75.1%) in the CHCs, after the interventions. The greatest improvement was observed in the dimensions of management and education, and separation and collection of medical waste, up to 30 and 28.5%, respectively. CONCLUSIONS: As the results demonstrated, standards of MWM processes were improved in Tabriz CHCs, due to the intervention. Moreover, it was experienced that using systematic method, stakeholders' participation and evidence-based planning would lead to process improvement. MWM was an ignored issue in primary care that must be more in attention.

19.
Iran J Public Health ; 47(2): 286-291, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29445640

RESUMO

Background: Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. Methods: In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. Results: The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Conclusion: Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

20.
Iran J Public Health ; 47(12): 1899-1905, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30788305

RESUMO

Background: Self-care ability was considered as a mechanism to improve the quality of life and reducing the high costs of medical services for elder people. Iran is experiencing increased elder people and healthy aging is one of the challenges. This study aimed to investigate self-care ability of elder people in Shahid Chamran and Dr. Shadpour health complexes, Tabriz- Iran. Methods: This was a cross-sectional study done in 2015. "The Self-care Ability Scale for the Elderly (SASE)" valid and reliable questionnaire (Persian version) was used for data collection. Totally, 220 samples were selected using G-Power 3.1.5 software. Sampling was conducted through systematic random method. Data were analyzed using SPSS 21 software. Descriptive statistics and independent t-test, one-way ANOVA, Mann-Whitney, Kruskal-Wallis test and Kolmogorov-Smirnov test were used. Results: The mean of self-care ability in elder people was calculated as 56.69± 15.07 (out of 100). 96.8% of participating elderlies, had poor self-care ability. Significant relations were found between elder people self-care ability and their educational level, life status, employment status, and marital status (P<0.05). However, gender, income source, and insurance status had no relations with self-care ability of the elder people (P>0.05). Conclusion: Self-care ability of elder people in Tabriz was at weak level. Regarding, health providers must employ the programs to promote older people self-care ability including improving self-esteem, receiving family help, improved nutrition and mental health improving elderly's quality of life.

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