Challenges of Patients with Spinal Cord Injury During the COVID-19 Pandemic: A Qualitative Study

Background: Spinal cord injury (SCI) is a chronic condition leading to physical and psychological problems along with numerous economic burdens for patients. In late 2019, an unknown disease called COVID-19 broke out, which quickly spread throughout the world. Objectives: The aim of the present study was to determine the challenges of SCI patients during the COVID-19 pandemic. Methods: This was a qualitative study performed among SCI patients after obtaining the code of ethics from the Research Ethics Committee of Ilam University of Medical Sciences in 2021. Data were collected using semi-structured, face-to-face individual interviews, in accordance with health protocols, in a safe environment without stress until reaching data saturation. Data were saturated after interviewing nine patients; to ensure data saturation, two additional interviews were conducted. Each interview lasted between 30 and 45 minutes, depending on the condition of each patient. The written files of the interviews were analyzed using MAXQDA software. Results: The mean age of the participants was 54 years, and 68 of the participants were male. After analyzing the data obtained from in-person interviews, three main themes, including expectations (need for financial support, need for social support, and need for physical support), concerns (fear of loneliness and fear of death), and health needs (health literacy, access to services and how to transmit the disease), were extracted. Conclusions: Considering the challenges in the three areas of expectations, concerns, and health care, it is necessary to take some measures to reduce these challenges

Emergency Response to a Hospital Fire: A Report From the Field

As the most important centers providing medical services during disasters and emergencies, hospitals have special structural complexities. Furthermore, the hospitals are exposed to many intrinsic and extrinsic hazards, including fire. On November 28, 2018, at 9:25 am (local time), a fire started in Ayatollah Taleghani Hospital of Ilam, affiliated with Ilam University of Medical Sciences, Iran. Immediately, to save patients' lives and prevent injuries to them, the horizontal and then vertical evacuation was performed to transfer patients to other hospitals by helping the support organizations. No physical injuries or deaths were reported in this incident. The results of this case study showed that hospitals should be sufficiently prepared to respond effectively to accidents and disasters, so it is needed to prepare and practice response programs and train hospital staff and managers

Translating and validating the Iranian version of the Manchester Clinical Supervision Scale (MCSS)

Background and Aim: Evaluation research provides new perspectives for clinical supervision (CS), and international collaboration offers advantages to develop valid instruments for this purpose. Developing an instrument for the evaluation of CS is a timely and important issue in Iran today. The aim of this study was to examine the translation and the validation process of the Manchester Clinical Supervision Scale (MCSS) in Iran. Material and Methods: This study was performed at the ILAM Hospitals, IR, during the year 2008. The approach was to develop quantitative and qualitative methods. The study focused on the translation and the validation process of the Manchester Clinical Supervision Scale for testing in Iran. The instrument was a 36-item questionnaire with a Likert-type (1-5) scale, comprising of seven sub-scales: trust and rapport, supervisor advice and support, improved care and skills, importance and value of CS, finding time, personal issues and reflection and total score. At first, a licensed translator translated the instrument into the Iranian language. A native British language teacher performed the blind back-translation into English. The content validity and content equivalence of the instrument were tested after the translation process by five experts in clinical supervision (face validity). The experts were asked to rate the clarity and importance of each item using a 4-point rating scale (e.g. 1=not clear, 4=very clear). A pilot sample (n = 120) was collected to test the translated instrument. Result: Of the instrument's 36 items, the experts rated 34 as clear and 2 unacceptable. As for importance, 32 items were rated as good, and four as unacceptable. In the pilot sample test, the Cronbach's alpha value for the total score was 0.9547 and in the sub-scales it was 0.7193-0.9218. The mean values in the subscales were 12.18-27.45 and SD was 2.34-3.55. The British test sample had almost similar values. Discussion and Conclusion: The work presented here showed that the Iranian translation of the MCSS was culturally acceptable, relevant, sensitive to fluctuation and was consistent with the original MCSS. The statistical tests showed moderately high reliability between the translated and the original instrument. Translating an instrument into another language not only requires expertise in language, but also in practice. The cultural validation is the most important phase in the process that can be accomplished with pilot testing and statistical methods. However, further expert evaluation is required for the validity of the instrument

Emergency Response to a Hospital Fire: A Report From the Field

As the most important centers providing medical services during disasters and emergencies, hospitals have special structural complexities. Furthermore, the hospitals are exposed to many intrinsic and extrinsic hazards, including fire. On November 28, 2018, at 9:25 am (local time), a fire started in Ayatollah Taleghani Hospital of Ilam, affiliated with Ilam University of Medical Sciences, Iran. Immediately, to save patients' lives and prevent injuries to them, the horizontal and then vertical evacuation was performed to transfer patients to other hospitals by helping the support organizations. No physical injuries or deaths were reported in this incident. The results of this case study showed that hospitals should be sufficiently prepared to respond effectively to accidents and disasters, so it is needed to prepare and practice response programs and train hospital staff and managers

The association between nurses' moral distress and sleep quality and their influencing factor in private and public hospitals in Iran

BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress that is an underlying issue in the nursing profession, which can lead to problems such as reduced quality and quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, this study aimed to explore the association between nurses' moral distress and sleep quality and its comparison among nurses in private and public hospitals. MATERIALS AND METHODS: This was a descriptive-analytical study involving 150 nurses working in Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Data were collected through the questionnaire of sociodemographic characteristics, the Corley's Moral Distress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS software version 22. Descriptive statistics such as frequency, mean, ANOVA, independent t-test, multiple linear regression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated. RESULTS: The analysis revealed that moral distress was positively associated with sleep quality. Furthermore, the scores of nurses' moral distress and sleep quality were different in private and public hospitals, so that the level of moral distress in the public hospital and sleep quality in the private hospital was higher and lower, respectively, but the difference was not statistically significant. Moreover, sleep quality, and the type of employment was the most important predicting variables of moral stress (B = 1.86) and sleep quality (B = 2.39), respectively. CONCLUSION: According to the study results, a positive and significant association was found between moral distress and nurses' sleep quality. It is recommended that appropriate strategies and training program be formulated by the health-care system to increase nurses' ability to combat moral distress adverse effects

Comparing the effect of drugs atorvastatin and rosuvastatin on the level of laboratory markers acute coronary syndrome patients

Pharmacotherapy is one of the most important measures for improving the health status of patients, which can play a key role in this regard. The present study was performed to compare the effect of atorvastatin plus rosuvastatin on the value of laboratory markers in CVD patients. This research is a clinical trial study, whose research population consisted of the patients with ACS in Ilam city in 2021. The patients were randomly assigned into three groups: control, intervention A (receiving atorvastatin), and intervention B (receiving rosuvastatin). The patients who met the inclusion criteria were enrolled in the study through available sampling, for all of whom the required tests were performed. The laboratory variables including tests of triglyceride, cholesterol, ALT, AST, ALP, LDH, and LDL, using a single device which was in the laboratory in Ilam city were completed and the documents related to them were considered as assessment criteria. The data analysis was done using SPSS 16 software. The table indicated the comparison of laboratory index scores before and after taking rosuvastatin. According to the findings, in all laboratory indices after taking rosuvastatin, the status of the index has changed significantly to improve the patient's health status (p <0.05). Considering the greater effect of rosuvastatin compared to atorvastatin on improving the laboratory variables, prescription of this drug is suggested for improving the status of CVD patients

The prevalence of substance use disorders among university students, a cross-sectional study

Background: Substance use disorders (SUD) are serious social problems that cause physiological and psychological disorders. Adolescents and youth are known as high-risk groups for SUD. Objectives: The present study aimed to investigate the pattern, prevalence, incidence, and etiology of SUD among all students studying at the Ilam University of Medical Sciences, Ilam (Iran), during the academic year 2018 - 2019. Methods: In a cross-sectional study, a multistage random sampling method was used to select the participants. A self-administered questionnaire was used to collect data. This questionnaire was designed to collect information about the participant’s demographic data, social data, medical and behavioral data. Data were analyzed using descriptive and inferential statistics in SPSS 16 software. Results: Participants’ ages mean ± SD was 23.5 ± 3.2 years old. The incidence of substance abuse was higher among men compared to women. The main observed pattern of SUD was Marijuana among consumers. The curiosity and increased memory had the highest and lowest incidence, respectively. Conclusions: The incidence of SUD is high among Iranian students, and most of them have begun SUD in adolescence and because of curiosity. It is necessary to augment adolescents’ and young people’s awareness of the SUD and addiction consequences. Copyright © 2020, Author(s)

The Prevalence of Generalized Anxiety Disorder Among Health Care Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Introduction: Health care workers, due to be involved in caring for COVID-19 patients may experience various psychological problems including anxiety disorders. This study aimed to investigate the prevalence of Generalized Anxiety Disorder (GAD) among health care workers during the COVID-19 pandemic by systematic review and meta-analysis. Methods: The PRISMA guideline was used for conducting this study. Related keywords were searched in credited resources including ISC, Magiran, PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase to find the articles published on the prevalence of GAD among health care workers during the COVID-19 pandemic from the first of January to the end of June 2020. Meta-analysis was conducted by the random effects model. Results: In this study, 553 articles were initially identified, from which 19 studies were finally included in the meta-analysis. The results showed that the prevalence of GAD in health care workers based on the GAD-7 and GAD-2 instruments were 32.04 (95 CI: 26.89-37.19, I-2 = 98.2, p < 0.001) and 22.62 (95 CI: 9.01-36.24, I-2 = 97.7, p < 0.001). The overall prevalence of GAD was obtained 30.5 (95 CI: 25.58-35.42, I-2 = 98.4, p < 0.001). Conclusion: This study showed a relatively high GAD prevalence, as one of the fundamental psychological problems, among health care workers during the COVID-19 pandemic. Therefore, health system managers should implement preventive strategies to protect health staff from contracting the virus and monitor them for psychological problems and provide them with supportive measures if necessary

The Prevalence of Post-traumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis

Introduction: Frontline health care workers (HCWs) have had an increased risk of developing health problems during the COVID-19 pandemic. In addition to physical illness, they have experienced mental health challenges, including post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD among HCWs during the COVID-19 pandemic via an umbrella review and meta-analysis.Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to perform a systematic literature search using various medical databases (Web of science, PubMed, Scopus, Cochrane, ProQuest, Science Direct, Embase, and Google scholar). The search included all articles published through the first of January 2020 the end of March 2021. The systematic review and meta-analysis studies that reported the prevalence of PTSD among health care workers were included in the study, and studies that reported the prevalence of PTSD in normal people or other epidemics were excluded. The random effects model was used to perform a meta-analysis, and the I-2 index was used to evaluate heterogeneity among studies. Publication bias was assessed using the Egger test. Data was analyzed using STATA (version 14) software.Results: The initial literature search yielded 145 studies. After excluding duplicates and assessing the quality of the studies, 7 studies were selected for meta-analysis. The results showed that the overall prevalence of PTSD among HCWs during the COVID-19 pandemic was 13.52 (95 CI: 9.06-17.98, I-2 = 65.5, p = 0.008).Conclusion: There is a high prevalence of PTSD among frontline HCWs during the COVID-19 pandemic. It is important to invest in efforts to screen HCWs for mental health disorders such as PTSD and provide them with mental health support