Self-care behavior and its related factors in the community-dwelling elderlies in Sari, 2014

Background and aim: With increasing age in old era, happen changes in dimensions including physical weakness, reduce brain power and psychopathy in elderilies. So under the effect of such factors some actions must be done for elderlies. One of the best actions is self-care. The aim of this study was to determine the level of self-care behaviors and its related factors in community dwelling elderlies in Sari, 2014. Methods: This cross-sectional study was conducted in 2014 on 120 elderlies in Sari city. Multi-stage randomized sampling metod was done from 10 health centers. Data collection was done with self-care questionnare (standard by Ministry of Health). Reliability of this questionnaire calculated 0/83 with Cronbach's alpha test on 30 elderlies. Data analyzed by SPSS.v.16 software with using descriptive statistics( such as mean, abundance and median) and inferential statistics (such as t-test, Spearman and Pearson correlation and chi-square tests). Results: From 120 elderlies 50% were man that the most of them were married (64.5%), with average economic status (56.7%) and illiterate (60 persons). The mean and standard deviation of total self-care and physical, mental, emotional and spiritual dimensions were 128.42±11.98, 39.10 ± 4.22,18.15 ± 3.07, 34.75 ± 4.35 and 36.40 ± 5.16 respectively. There is a significant relationship among psychological self-care with education level (p=0.001) and lifestyle of elderlies (p=0.026). Also there is a significant and meaningful relationship among spiritual self-care with educational level of elderlies (p=0.001) and lifestyle of them (p=0.003). Conclusion: According to results of this study, the most level of elderlies self-care was good and demographic factors such as level of education, economic efficiency and life style were effective on self-care. based on the possible effects of education and economic efficiency on aspects of self-care, recommended provided some actions to improve quality of life and education of this people

The Workplace Bullying in Nurses: A Psychometric Propertises of Iranian Version of Negative Acts Questionnaire-Revised

AbstractIntroduction: Workplace bullying is a persistent amount of negative conduct which one individual is subjected to by another, and it is emotionally and psychologically aggravating. Nurses are exposed to a greater risk of bullying, due to their direct contact with patients and their associates. The present study aims to investigate the factor structure of Iranian version of Negative Acts Questionnaire-Revised.Methods: The present methodological study was conducted amongst 400 nurses working in various hospitals affiliated to the Gorgan University of Medical Sciences, over a three month period in 2017. Construct validity of the questionnaire was assessed, and its reliability was also verified for internal consistency, and construct reliability.Results: Exploratory factor analysis led to the extraction of the following three factors: Physically intimidating bullying, person-related bullying, and work-related bullying. The model's good fit indices confirmed the workplace bullying in nursing tool as follows: PCFI= 0.767, PNFI= 0.721, CMIN/DF= 2.325, RMSEA= 0.081, AGFI= 0.815, IFI= 0.912, and CFI= 0.918. The convergent validity and discriminant validity of the construct of workplace bullying in nursing as well as its internal consistency and construct reliability (>0.7) were confirmed.Conclusions: The present study results showed that the three-factor construct of workplace bullying in nursing has good validity and reliability. Given its favorable psychometric properties, this questionnaire can be effective in assessing the incidence rate of workplace bullying in the nursing profession

Self-blame Attributions of Patients: a Systematic Review Study

Introduction: Psychological aspects are important issues in patients that will have significant effects on disease progression. A new and important psychological concern is self-blame. This review was performed with the aim of systematic review on studies around patient’s self-blame.Methods: This is a systematic review using international databases including PubMed (since 1950), Scopus (since 2004), Web of Sciences (since 1900), and ProQuest (since 1938) and Iranian databases including SID (since 2004) and Magiran (since 2001). Mesh terms including “patient,” “regret,” and “guilt” and non-Mesh terms including “self-blame attribution,” “characterological self-blame,” “behavioral self-blame,” and “blame” were used in Iranian and international databases with OR and AND operators.Results: The review yielded 59 articles; 15 articles were included in the present study. The ages of patients ranged from 29-68.4 years. Most of studies (86.6%) had cross-sectional design and use characterological self-blame and behavioral self-blame variables for assessing self-blame attributions. The results showed that in most studies, a significant relationship among self-blame and psychological distress, anxiety, and depression were reported.Conclusion: A significant relation was reported between self-blaming and the degree of distress, anxiety, and depression in patients in most of the studies

Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS).This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. Thiscross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to theMazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac DepressionScale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear modelmultivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49(CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate,and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a differencebetween cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients,it is necessary to develop measures for routine screening in cardiac treatment units

The relationship among positive body image, body esteem, and eating attitude in Iranian population

Background and aimThe correlation between eating attitudes, positive body image, and body esteem is a pivotal area of research that has garnered substantial attention in recent years, given its implications for both mental and physical well-being. The objective of this study was to examine the interplay between positive body image, body esteem, and eating attitudes within an Iranian population.Materials and methodsThis study employed a cross-sectional study design and was conducted in the year 2022. A convenience sample of 752 participants residing in Tehran, Iran, was included in the study. The data collection tools were comprised of a demographic registration form, the Adolescence/Adults Scale (PBIAS), the Eating Attitudes Test (EAT), and the Body Esteem Scale (BES) as measurement instruments.ResultsMean age of participants was 26.36 (SD = 8.49). Significant relationships were found among positive body image (B = − 0.095, β = −0.150, p < 0.001), and body esteem (B = 0.175, β = 0.149, p < 0.001) with eating attitudes.ConclusionThese findings suggest that individuals with positive body image and high body esteem may have healthier eating attitudes, while those with negative body image and low body esteem may be more likely to have unhealthy eating attitudes

The Accreditation of Human Resources and Physical Space of the Iranian Heart Centre: Comparison to the national and international standards

Objective: Standardization of hospital resources and physical space can be an important strategy to increase productivity and effectiveness of services. The study was conducted with the aim of comparative accreditation of human resources and physical space in Mazandaran heart centre compared with the standards. Method: This comparative descriptive study was carried out in Sari city (centre of Mazandaran province) during 2016-2017. The data collection tool consists of two checklists for investigating the physical space and human resources of the hospital. To evaluate the quality of the content, a checklist was distributed to 5 experts from Mazandaran University of Medical Sciences. After corrections the checklist was applied. Data were analyzed by SPSS software version 16 and descriptive statistics. Findings: The total number of nurses in this hospital was 288 and the total number of beds was 171. The human resources in the nursing, nutrition, operating room, anaesthesia departments were not standard. The ratio of total human resource to the number of beds was also estimated as 4.04. Results showed that the physical conditions in the hospital were moderately standard. The physical conditions of the hospital in most dimensions based on checklist, except the physical location of hospital and the features of its doors, were in accordance with the standard requirements. Conclusion: Considering the inappropriate distribution of human resource in the hospital and the non-standard design of physical space for providing services with better quality and increasing patients' satisfaction, it is recommended that experts control more carefully standard requirements

A Rare Case Report of Acute Necrotizing Encephalopathy of Childhood

Background: Acute Necrotizing Encephalopathy in childhood (ANEC) is a kind of fast growing illness accompanied with progressive Encephalopathy. The aim of this article is to report a rare case of ANEC in a 4-year-old boy with bilateral thalamic necrosis and a nonfatal outcome. Case Report: The patient was a 4-year-old Iranian boy who had no prior history of health problems and hospitalization except for a period of jaundice and phototherapy as a neonate. In the neurological consultation a brain MRI was requested for the patient to analyze the possibility of brain damage, which showed the involvement of cerebellum, thalamus and the existence of  basal ganglia which led to the diagnosis of ANEC. Conclusion: In conclusion, although ANEC is a rare disease, it should not be underestimated

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC