Necessity of Observing Patient’s Rights: A Survey on the Attitudes of Patients, Nurses and Physicians

Studying the situation of observance of patients' rights and interaction of those individuals who provide and/or receive health services are regarded as the most significant and salient parameters of qualitative evaluation of health services.The main aim of this study is to compare the attitudes of patients as recipients of healthcare services with those of physicians and nurses as representatives of healthcare providers regarding the necessity of observance of various aspects of patients' rights in three hospitals selected as representing the three models of providing medical service (teaching, private and public).This was a cross-sectional descriptive analytical study and the data were gathered using a questionnaire. Researchers helped the patients to fill in the questionnaire through interviewing and the physicians and nurses filled in their own questionnaires.The field consisted of three hospitals (a teaching general hospital, a private hospital and a public general one) all located in Tehran. The questionnaires included a set of general questions regarding demographic information and 21 questions about the necessity of observance of patients' rights. They were filled in by the interviewer for 143 patients and, after being sent to other groups, 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) filled them in. The criterion for necessity of each right was measured according to the Likert Scale [from 0 (not necessary) to 10 (absolutely necessary]. The data were analyzed using SPSS 11.5 software. Given the abnormal distribution of the data, non-parametrical tests were used.The results of this study showed that all of the study groups agreed wih the necessity of almost all aspects of patients' rights and the highest level of disagreement between groups was related to patients' right of access to information and right of choosing provision provider and deciding on treatment plan. However, these disagreements were not significant altogether.According to the results, it seems that healthcare providers, especially physicians, should be better familiarized with patients' right of access to information and right of choosing and deciding. Based on the disagreement between the attitudes of the patients and physicians in this study, it seems that the patients had a higher level of expectations concerning their rights compared to physicians

Drug use among Iranian population: results of a national household survey

Objective: The aim of this study was to assess the prevalence of drug use among Iranian general households. Methods: A cross-sectional household survey was conducted in a sample of 61,000 individuals between 15 and 64 years in 2017 urban areas and 623 rural areas of 31 provinces of Iran from February to November 2015. Multistage cluster random sampling method was used to draw the sample. Data were collected using a self-administered data collection form, which elicited demographic data, and data related to report of any kind of drug use or illicit use of pharmaceuticals in the past week, past month, past year, and ever life. Different measures were taken to ensure the accuracy of the study results. Results: The study showed that 8.5 of the population reported ever use of any drugs, and 4.3 reported past-week use of any drugs. Conclusions: This study showed that the drug use prevalence in Iran was more than twice the previous estimations. © 2019, © 2019 Taylor & Francis Group, LLC

Evaluation of some diet habit and physical activity in adolescents in Tehran (2011)

Background: Unhealthy lifestyle ends to some important health problems in adolescence, and also causes chronic non-communicable disease, hence increasing mortality and morbidity in adults. Objective: The aim of this study was to examine the components of lifestyle in adolescence. Methods: In this cross sectional study, 346 male and 197 female of adolescents aged 9 to 16 years were selected randomly from the 5th district of Tehran city in 2011. Data were gathered from the lifestyle questionnaires which were designed and consistent with the findings of studies. Questionnaire has the dimensions of nutrition and energy drink consumption, exercise and sleep patterns. The data were analyzed by the chi-square and t-test. Findings: 142 (72%) of girls and 260 (77%) of boys consumed daily dairy. Daily and weekly fast food intakes in girls were 8 (4.1%) and 52 (26.4%), while in the boys were 36 (10.4%) and 110(31.8%) respectively. Totally, more than 149 (75%) of girls and 295 (86%) of boys consumed soda. 17 (8.6%) of girls and 59 (17.1%) of teenage boys consumed energetic drink at least once a week. Adolescent girls and boys had a physical activity on average 3.2 and 4.2 days respectively in gymnasium in a week. Conclusion: According to the results, correction of nutritional behaviors is a mandatory task. In addition due to the trends of adolescence toward doing exercise in public places, the policy for the equipping of public place and gyms should be reconsidered in our society

Intersectoral Collaboration to Develop Health Equity Indicators in Iran

Background: Health equity is considered as one of the main objectives of health care systems. This study was carried out with the aim of determining health equity indicators in Iran. Through consideration of these indicators, differences in health status of different social groups and different geographical areas can be shown in different periods and based on that, effective interventions can be designed. This study is carried out through a main workshop and expert panels and final consensus on selected indicators. The first draft of indicators and inequity stratifying variables were prepared and then revised by working groups consisting of experts inside and outside Health system. Finally ideas were accepted or rejected after presenting enough reasons and deep examination through the Consensus-Oriented Decision-Making (COMD) model. Fifty two indicators have been determined as health equity indicators in five areas including health, social and human development, economic development, physical environment and infrastructure and governance. Furthermore, for each indicator the proper and practical stratifying variables of inequity were identified. By calculating such indicators, it becomes possible to determine differences in health status of different social groups and different geographical areas

The Application of Urban Health Equity Aassessment and Response Tool (Urban HEART) in Tehran; Concepts and Framework

Background:Inequalities in health are ever increasing among different communities of either affluent or disadvantaged especially in urban areas.To identify and address inequalities in health and its determinants among societies, urban health equity assessment and response tool (Urban HEART) in four 'policy domains' related to social determinants of health, has been developed by WHO Kobe Centre (WKC) and piloted in several countries. The tool was extended to six policy domains in Tehran and the number of indicators was doubled. This paper describes the concept of Urban HEART, its development, study protocol and pilot implementation in Tehran.   Methods/Design: Sixty five indicators in 6 domains related to inequalities in health and social determinants of health (SDH) namely 'physical and infrastructure','human and social', 'economic','governance', 'health',and'nutrition', were developed and approved in an international workshop held in Tehran in April 2008. Acomprehensive questionnaire with 12 sections was developed to be administered in a large population based survey in Tehran.Discussion: This is the first report of urban health equity assessment and response tool (Urban HEART) project which was conducted in Tehran. Year 2010 has been devoted to 'Urbanisation and Health' by the World Health Organisation, when 1000 cities are supposed to join a global plan to raise health in the urban areas. The Urban HEART project is supposed to play an important role henceforth

Response-oriented measuring inequalities in Tehran: Second round of Urban health equity assessment and response tool (Urban HEART-2), concepts and framework

Background: Current evidence consistently confirm inequalities in health status among socioeconomic groups, gender, ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health of the population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural, educational, political or environmental problems. Measuring inequalities, improving daily living conditions, and tackling inequitable distribution of resources are highly recommended by international SDH commissioners in recent years to 'close the gaps within a generation'. To measure inequalities in socio-economic determinants and core health indicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2) was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre). Method: For 'assessment' part of the project, 65 indicators in six policy domains namely 'physical and infrastructure', 'human and social', 'economic', 'governance', 'health and nutrition', and also 'cultural' domain were targeted either through a population based survey or using routine system. Survey was conducted in a multistage random sampling, disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households (118000 individuals) were collected. For 'response' part of the project, widespread community based development (CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013. Conclusion: Following the first round of Urban HEART project in 2008, the second round was conducted to track changes over time, to institutionalize inequality assessment within the local government, to build up community participation in 'assessment' and 'response' parts of the project, and to implement appropriate and evidence-based actions to reduce health inequalities within all neighborhoods of Tehran