The Causes of Discharge against Medical Advice from the Emergency Department of a Teaching Hospital of Tehran in 2012

Background: Discharge against medical advice (DAMA) occurs when a patient leaves the hospital against the physician’s advice. The aim of this study was to investigate the causes of discharge against medical advice. Methods: In this cross-sectional study, all patients who were discharged against medical advice from the Emergency Department of Shohada-e-Tajrish teaching hospital in the second half of 2012, were included. Data were collected by a researcher-made checklist that its validity and reliability had been confirmed. Data were analyzed by using Chi square and independent two-sample t-test. Results: The results show that among all the units of Emergency Department, the units of general surgery (14.4%), internal medicine (11.9%), and neurosurgery (11.9%) had the highest rate of discharge against medical advice, respectively. The main causes of discharge against medical advice were partial recovery according to patients’ opinion, the distance from home to hospital, and patients’ exhaustion from the hospital environment. However, there was no statistically significant relationship between discharge against medical advice and the type of Emergency Department unit, work shifts, or income. Conclusion: Due to the high rate of discharge against medical advice in teaching hospitals of Iran, it is essential to pay more attention to this important issue as the main issue emphasized on in clinical governance in teaching hospitals of Iran, and also prioritize providing high quality services in order to increase patients’ satisfaction and decrease the rate of discharge against medical advic

The Survey of Independency Status Living in Elderly Referring to Tehran Civil Servants Pension Organization in 2015

AbstractIntroduction: elderly is one of the most sensitive ages in everyone’s life, thus regarding the everyday growth of the elderly population, caring for this vulnerable part of society is a necessity. Having in mind the confronting limitations in this era and lack of flexibility with environment, as well as decreasing independency status in the elderly, this study aims at evaluatin the amount of independent living in the elderly referring to Tehran Civil Servants Pension Organization (C.S.P.O) in 2015.Methods and Materials: This descriptive study was conducted on 260 elderly people referring to Tehran Civil Servants Pension Organization. Samples are selected via sapling method available in Civil Servants. The obtained data in this study were collected by standard questionnaire, including demographic characteristics and physical activity questionnaire in two sections, i.e. Activity Daily Living and Instrumental Activity Daily Living. After completing two questionnaires, the obtained data were analyzed using SPSS (ver. 23) through descriptive statistics, independent t-test, as well as One-way Anova.Results: The total mean score of age for the studied objects was 68.08 ± (7.63) years. The total mean score of independence in this group of elderly people has been independent (ADL= 13.61±1.14 & IADL= 14.77±3.79). Moreover, the total mean score of independence living in elderly with aging 60-74 years with incomes above 750 to 1 million dollars per month and the elderly with married, were higher.Discussion And Conclusion: elderly is a normal stage in the normal path of life for human beings, which is very different from other life stages. In general with increasing age decrease the level of independent living, and consequently the degree of dependence on others increases in the elderly. Also the elderly married who lives with wife and children and have better economic situation are more independent than the other. furthermore the obtained data in the current study and other studies reveals that the elderly people have the highest amount of independence in Activity Daily Living such as eating and sleeping, and Instrumental Activity Daily Living such as taking medicine and using telephone

Mentors' and Postgraduate Students' Perception about Characteristics of Effective Education, Kerman University of Medical Sciences, Iran

Background & Objective: Little attention has been paid to generating systematic evidence-based qualitative approaches to effective education. This study aimed to explore postgraduate students' and mentors' view points, experiences and perceptions about effective education and its related factors in Kerman University of Medical Sciences, Iran. Methods: In this qualitative study, using content analysis method and purposive sampling, 32 postgraduate students and 7 mentors were recruited. An interview guide was used to collect data through focus groups via in-depth interviews. After obtaining verbal informed consent, data were recorded, transcribed and analyzed using content analysis method. To ensure validity of the data, the acceptability and confirmability criteria were utilized. Results: Two main themes were extracted from the viewpoint of postgraduate students and the mentors, the direct and indirect factors related to effective education. Direct factors included the factors related to student, mentor, educational environment and motivation. Indirect factors were national educational system, evaluation system for students and economic factors. Conclusion: Both postgraduate students and mentors believe that effective education is a complex issue and macro-factors such as educational system and micro-ones such as mentors, and students, characteristics are important. In addition, there is inconsistency in students' and the mentors' perception about the roles of the other one; mentors believe that this is the responsibility of the students to learn and be self-motivated, while the students mentione that this is mainly the mentor' responsibility. This is an important topic which should be considered for planning effective education. Key Words: Effective education, Perception, Postgraduate student

The Effect of Students'Role on Parents' Performance on Waste Disposal in Maragheh

Background and objective: Nowadays, recycling has attracted interest as an effective method in waste management. Teaching recycling to students is of great importance due to the important role this group plays in the participation of parents. This research dealt the effects of recycling educator students on operation of parents in the separation of waste. Methods: In this quasi-experimental study, a school as the experimental group and a school as the controls group were randomly selected. The parents of students selected, 100 Person (50 in the experimental group and 50 than the control group) participated in the study. After the needs assessment by researcher, a questionnaire was developed that included question on demographic, awareness, attitude, performance, and participation of the parents. One session of discussion with these parents was held to attract their cooperation with the students and also Educational program for students in the field of waste separation was performed. Then The effect of education on parents, one month and three months after intervention in both groups were assessed by questionnaire and data analyzed in spss16 with using descriptive and analytical statistics. Results: The results showed that, after the educational intervention, Separation of recyclable waste from non-recyclable, with 58%, was the highest scores. Also, after the intervention in the experimental group mean on awareness, attitude, performance, and participation of the parent’s changes were significant (P< 0.001).        Conclusion: Findings of this research showed the positive effects of the students on their parents’ participation in recycling at source. Paper Type: Research Article

Medication Errors in Hospitals: A Study of Factors Affecting Nursing Reporting in a Selected Center Affiliated with Shahid Beheshti University of Medical Sciences

Background: Medication errors are mentioned as the most common important challenges threatening healthcare system in all countries worldwide. This study is conducted to investigate the most significant factors in refusal to report medication errors among nursing staff. Methods: The cross-sectional study was conducted on all nursing staff of a selected Education& Treatment Center in 2013. Data was collected through a teacher made questionnaire. The questionnaires’ face and content validity was confirmed by experts and for measuring its reliability test-retest was used. Data was analyzed by descriptive and analytic statistics. 16th  version of SPSS was also used for related statistics. Results: The most important factors in refusal to report medication errors respectively are: lack of reporting system in the hospital(3.3%), non-significance of reporting medication errors to hospital authorities and lack of appropriate feedback(3.1%), and lack of a clear definition for a medication error (3%). there was a significant relationship between the most important factors of refusal to report medication errors and work shift (p:0.002), age(p:0.003), gender(p:0.005), work experience(p<0.001) and employment type of nurses(p:0.002). Conclusion: Factors pertaining to management in hospitals as well as the fear of the consequences of reporting are two broad fields among the factors that make nurses not report their medication errors. In this regard, providing enough education to nurses, boosting the job security for nurses, management support and revising related processes and definitions are some factors that can help decreasing medication errors and increasing their report in case of occurrence

Indicators Of Empowerment In Women Supported By Imam Khomeini Relief Committee Of Gorgan In Confrontation With Violence

Background and Aim: Violence against women is recognized internationally. Domestic Violence is a phenomenon as old as family history. The purpose of this study was to determine empowerment indicators of women covered by Imam Khomeini Relief Committee in Gorgan. Materials and Methods: The method of study was descriptive-analytical and the data collection tool was a questionnaire. To determine reliability, test-retest method was used, and a correlation coefficient of 0.883 was obtained. To determine validity, Cronbach's alpha was applied and the figure turned out to be 0.81. In total, 91 women participated in the study and completed the questionnaire. They had at least one child and each l ived with her husband. The data were then analyzed using SPPS software(version 16) as well as descriptive and inferential(Chi square) statistics. Results: The means and standard deviations&nbsp;of&nbsp;women's Knowledge, Attitude, Self-esteem and Self-efficacy were 6.5±2.49, 4.16±2.22, 5.25±1.92, 5.26±1.67. The means of all 4 indicators were either average or low for violence against women; moreover, they did not know much about anger management skills. Conclusion : Women should be empowered to prevent violence against them. To this end, they should be informed about how to enhance their K nowledge, Attitude, Self-esteem and Self-efficacy. &nbsp

The components of lifestyle in patients recovered from COVID-19: A phenomenological study

As the world is dealing with the COVID-19 pandemic, people’s lifestyles have also been affected. The present study was conducted to explain the components of lifestyle in patients who have recovered from COVID-19. This qualitative study was conducted with a phenomenological approach on 16 people recovered from COVID-19 living in Tehran. The participants were selected by purposive sampling, and in-depth unstructured interviews were held with them. The data were analyzed in MAXQDA. Four main categories were extracted as the components of the lifestyle of patients recovered from COVID-19, including physical problems (with the subcategories of frailty and feeling old, and post-recovery physical symptoms), physical activity (with the subcategories of inability to take a walk, and inability to exercise), nutrition (with the subcategories of loss of appetite, taking supplements, and compliance with healthy eating), psychological problems (sleep disorder, obsession, stress, anxiety about infecting family and friends, and neurological disorders). The alterations in people’s lifestyles due to the COVID-19 pandemic and the protocols imposed to prevent the disease transmission are undeniable. Health planners and policy-makers should therefore pay particular attention to these changes as new challenges, especially in designing lifestyle-related interventions