A study of pre-hospital emergency care personnel's perception of ethical and clinical caring challenges in the field: a qualitative study

Introduction & Background: Due to their unpredictable and critical working conditions including Out-of-hospital cardiac arrest (OHCA) and Cardiopulmonary resuscitation (CPR), Pre-hospital emergency care personnel experience difficult and complicated situations in the field presenting them with various ethical and clinical caring challenges which affect their clinical decisions. Objectives: The present study aims to determine pre-hospital emergency care personnel's perception of the ethical and clinical caring challenges they face in the field. Methods: The present study is a work of qualitative research with a content analysis approach. Data were collected through semi-structured, in-depth interviews and field notes. The collected data were analyzed using conventional content analysis. The participants were 25 pre-hospital emergency care personnel members in Iran who met the inclusion criteria. They were selected via purposeful sampling which was continued to saturation point. The study lasted from February to November 2020. Results: Two main themes—paradox in decision-making and patients' ethics and values—with 8 categories were extracted from the collected data. Conclusion: The results of the present study show that, in the field, pre-hospital emergency care personnel confront various ethical and clinical caring challenges which create paradoxes in their professional performance and ethical decisions. Yet, they should make the best ethical decision and provide care combined with respect for patients' ethical identities and beliefs to achieve satisfactory medical care results. To provide high-quality care, pre-hospital emergency care personnel must be provided with a proper cultural, professional, and organizational environment which is free of ethical distress

Evaluation of acute myocardial infarction management guidelines` indicators (Stent save a life, code 247) in patients referred to cardiology Department of Valiasr Hospital in Fasa, Southwest of Iran 2019

Introduction: Acute myocardial infarction is one of themost common and major health problems in most societies.Implementation of acute myocardial infarctionmanagement guidelines will play a key role in preventinghigh-risk complications and improving treatmentoutcomes. The purpose of this study was to evaluate theindicators of acute myocardial infarction managementguidelines` indicators (Stent save a life, code 247) in patientsreferred to the cardiac ward of Vali Asr Hospital insouthwest Iran in 2019.Methods: This study was a cross-sectional study in whichthe indicators of acute myocardial infarction managementguidelines (code 247) were studied for 15 months fromApril 2018 until the end of June 2019. Sampling was doneby census. Accordingly, 153 patients were studied. A checklistconsisting of demographic data and information relatedto the implementation of the MI management guidelineswas used to collect the data. Data were analyzed by SPSS,version 23, software and descriptive statistics.Results: 77.1% (118) of patients were male and 22.9%(35) were female. Mean and standard deviation of age ofpatients were 60.58 ± 12.43. Regarding the timing indicesfor receiving services, the results of the study showedthat the Door to Code TIME (time duration of patient admissionto the hospital to activation of the code 247) was12.36 ± 6.25 in this study, which should be less than 10minutes. Also, the duration of the Door to Device Time(time duration between arrival of the patient with acutemyocardial infarction to performing the angioplasty) was180 minutes in the present study, which should be lessthan 90 minutes.Conclusion: The guidelines for the management of myocardialinfarction (247) were not ideal in some of the indicatorsin the studied unite that the effective barriers andchallenges needed to be studied and improved. It is alsorecommended that these protocols be continuously evaluatedto provide better efficacy

La relación entre la alfabetización en salud y la calidad de vida de los ancianos con enfermedades crónicas que viven en Fasa, Irán 2019

Introduction & Background.Health literacy is defined as cognitive and social skills determining motivation and ability of individuals to obtain, understand, and use healthcare information to improve and keep appropriate health. Low health literacy causes undesired health outcomes, harmful health behaviors, dissatisfaction of patients, and a higher death rate. The extant study was conducted to examine the relationship between health literacy and quality of life of elderlies with chronic diseases who live in Fasa, Iran during 2019. Methods. This cross-sectional study was done on 150 elderly with chronic diseases living in Fasa, 2019. Demographic information, quality of life, and health literacy questionnaires were employed to collect data. The gathered data were analyzed by using descriptive statistics, chi-square, one-way Analysis of Variance (ANOVA), and correlation coefficient through SPSS software. Results. Mean value and standard deviation of subjects’ ages equaled 67.68±6.92 in this research. The mean value and standard deviation of disease duration in this group equaled 12.47±9.71. More than half of the studied subjects (50.7%) had inadequate health literacy. There was a significant relationship between age, sex, education level, job, and health literacy. There was a significant association between the total score of quality of life and health literacy level. Moreover, there was a significant correlation between age, education, job, disease duration, and quality of life (P<0.05). Conclusion. Findings indicated the effect of health literacy score on the quality of life of elderlies with chronic diseases. Hence, it is recommended that healthcare system managers make appropriate plans to improve the health literacy level of society.Introducción y antecedents. la alfabetización en salud se define como las habilidades cognitivas y sociales que determinan la motivación y la capacidad de las personas para obtener, comprender y utilizar la información de salud para mejorar y mantener una salud adecuada. La baja alfabetización en salud causa resultados de salud no deseados, comportamientos de salud nocivos, insatisfacción de los pacientes y una mayor tasa de mortalidad. El estudio existente se realizó para examinar la relación entre la alfabetización en salud y la calidad de vida de los ancianos con enfermedades crónicas que viven en Fasa, Irán durante 2019. Métodos. Este estudio transversal se realizó en 150 adultos mayores con enfermedades crónicas residentes en Fasa, 2019. Para la recolección de datos se emplearon cuestionarios de información demográfica, calidad de vida y alfabetización en salud. Los datos recopilados se analizaron mediante estadística descriptiva, chi-cuadrado, análisis de varianza unidireccional (ANOVA) y coeficiente de correlación a través del software SPSS. Resultados: El valor medio y la desviación estándar de las edades de los sujetos fue de 67,68 ± 6,92 en esta investigación. El valor medio y la desviación estándar de la duración de la enfermedad en este grupo fue de 12,47 ± 9,71. Más de la mitad de los sujetos estudiados (50,7%) tenían conocimientos de salud inadecuados. Hubo una relación significativa entre la edad, el sexo, el nivel de educación, el trabajo y la alfabetización en salud. Hubo una asociación significativa entre la puntuación total de la calidad de vida y el nivel de alfabetización en salud. Además, hubo una correlación significativa entre la edad, la educación, el trabajo, la duración de la enfermedad y la calidad de vida (P <0,05). Conclusión. Los resultados indicaron el efecto del puntaje de alfabetización en salud sobre la calidad de vida de los ancianos con enfermedades crónicas. Por lo tanto, se recomienda a los administradores del sistema de salud que realicen los planes adecuados para mejorar el nivel de alfabetización en salud de la Sociedad