Evaluation of Health Literacy and Its Associated Factors in Paramedical Students

Introduction: Low levels of health literacy lead to reduced health, increased length of hospital stays, and increased use of emergency services in patients and impose higher medical costs on individuals. Considering the effect of paramedical students' health literacy on community health promotion, this study aimed to determine the level of health literacy and its associated factors in paramedical students. Material and Methods: This cross-sectional study was performed on 310 paramedical students during a two-month period from January to March 2021. The data collection tool was the Health Literacy for Iranian Adults (HELIA) questionnaire. Due to the COVID-19 pandemic, the questionnaire was designed online, and its link was provided to students. Results: Among the participants, 247 (79.7%) cases were female, and 63 (20.3%) cases were male with a mean age of 21.16 ± 1.97 years. According to the results, 3.9% of the students had inadequate health literacy, 37.3% had not so adequate health literacy, 46.6% had adequate health literacy, and 12.2% had excellent health literacy. The results of ANOVA and t-test showed a significant association between the mean total health literacy score of students and their age, gender, and semester (P <0.05). Conclusion: This study findings showed that more than half of the participating students had adequate and excellent levels of health literacy. Since paramedical students are promoters of health in the community, more attention should be paid to the education of these individuals. Therefore, it is necessary to empower them in the field of health literacy

Usability evaluation of obstetrics and gynecology information system using cognitive walkthrough method

Background and aim: Obstetrics and gynecology information system is a critical component of the HIS in social security organization health centers. The objective of this study was to evaluate the usability of this system using the cognitive walkthrough method. Also, the present study provided a detailed formal description of how the cognitive usability evaluation can be applied and reported for a health care information system. Methods: This study was conducted at the Mashhad University of Medical Sciences' usability lab from March 2016 to June 2017. A two-phase approach was used to conduct the cognitive walkthrough evaluation: preparatory and evaluation. The preparation was done in three stages: first, we investigated users’ capabilities and background knowledge through a semi-structured interview. Second, the evaluation scenario was developed based on the most common tasks in routine workflow of users. Finally, each task was broken down into sequences of actions. In the evaluation phase, three usability experts independently assessed each action using a four-item checklist. Problems were categorized thematically and were reported from three different perspectives: Question-based, Task-based, and Evaluator-based. The data were then analyzed to understand the contribution of each task, along with its mean severity score. Results: Evaluators’ responses were compared and any conflict was resolved in an expert panel. A total of 116 usability problems were identified based on the consensus of the evaluators. Inadequate system feedback was found to be the main source of 43% of the problems, and resulted in users confusion. Conclusion: Since the system was evaluated in its pilot implementation phase, there was an opportunity to prevent future potential usability problems. The use of a mixed quantitative and qualitative approach in this usability study provided a more comprehensive perspective of the system problems. This study provided a detailed description of conducting CW usability evaluation which can be used as a practical guide for future studie

A telemonitoring system to support CPAP therapy in patients with obstructive sleep apnea: a participatory approach in analysis, design, and evaluation

Background: Continues positive airway pressure (CPAP) therapy is a gold standard treatment for moderate to severe cases of OSA (obstructive sleep apnea). The present research aimed to describe the analysis, design, and evaluation of a telemonitoring system to improve CPAP adherence in patients afflicted with OSA. Methods: The telemonitoring system was developed in five phases. In the exploratory phase, the body of related literature was reviewed. Then a need analysis was conducted through a focus group discussion with sleep medicine specialists and sales company representatives and an interview with patients. The third phase involved data integration. Then the content and system development were done based on the previous phases. Finally, usability and functionality tests were used to evaluate the system. Results: The exploratory phase and the needs analysis were conducted by four sleep medicine specialists, two medical informatics specialists, six key figures of the sales companies, two system developers, and 46 patients in different phases. Based on the results obtained from the data integration phase, the telemonitoring system involved three main parts: a patient’s application, a doctor’s portal, a selling companies’ portal (operator’s portal) along with facilitating software for patients to send the CPAP data. Usability and functionality tests were given to 7 and 10 patients, respectively. The total number of usability issues reported by users in the evaluation process was 18, with an average of 2.5 issues per user. The installation problems, disrupted links and improper playing of videos were the main functionalities problems that were solved. Conclusion: The telemonitoring system, as a means of communication between patients, doctors, and selling companies, can be used to support patients clinically and technically. It has the potential to improve CPAP adherence in patients with OSA

Usability testing of bed information management system: A think-Aloud method

Not considering the usability in designing clinical information systems causes problems in human-computer interaction and patient dissatisfaction. Therefore, in this study, the usability of the bed information management system (BIMS) was examined by think-Aloud method. This cross-sectional study was conducted on the BIMS in 50 noneducational hospitals. Participants consisted of three groups including users, facilitators, and technical support. To carry out the study, a scenario consisting of four tasks was designed. Three researchers analyzed the recorded files to identify the usability problems and their severity. The mean time of the evaluation process was 20:33 ± 4:47 s. The total number of the problems identifies by users was 80 cases. Data entry and layout problems with 38 (48%) and 33 (41%) cases were the most frequently found problems, respectively. About 61% and 55% of the data entry and layout problems had a minor severity (Severity 2), respectively. Furthermore, 43 (54%) cases of the problems were resolved by the users and 32 (40%) cases by the facilitator assistance. This study showed that a large number of the problems were due to the system poor design. Furthermore, by increasing the users' level of knowledge about the system, it is possible to enhance user-system interaction. It is recommended that before designing and implementing a system, the system should be evaluated for usability, and the users should be educated in clinical information systems

Evaluation of patient satisfaction of the status of appointment scheduling systems in outpatient clinics: Identifying patients' needs

Appointment scheduling systems are potentially useful tools for enhancing the patient satisfaction. This study was conducted to inspect patient's needs and satisfaction of the current status of appointment scheduling systems in outpatient clinics. This cross-sectional study was conducted in 10 outpatient clinics with different specializations. The outpatient clinics were selected based on the stratified randomization method. Data were collected using a questionnaire from December 2016 to March 2017. The questionnaire reliability was measured with the participation of 15 patients using the test-retest method. The content validity was also evaluated by 13 experts. A total of 319 patients completed the survey. The mean score of overall patient satisfaction and the patient satisfaction of the clinic environment were 6.73 ± 0.16 and 8.30 ± 0.12, respectively. The average waiting time was 64.2 ± 3.45 min. The service time took on an average 9.85 ± 0.37 min. The patient satisfaction of the clinic environment (P = 0.023), length of waiting time (P = 0.001), and duration of service time (P = 0.005) had a statistically significant association with overall patient satisfaction. Based on the results, the need for improving overall patient satisfaction score was felt. The patient satisfaction of waiting time, service time, and clinic environment had the greatest influence on overall patient satisfaction. Furthermore, it is recommended that a web-based appointment scheduling system should be implemented

Effect of an Online Appointment Scheduling System on Evaluation Metrics of Outpatient Scheduling System: a before-after MulticenterStudy

Online appointment scheduling systems have been designed in response to the problems of the traditional ones. In Iran, most outpatient clinics and our study population suffer from high patient’ no-show rate and long waiting times because of not using online appointment scheduling system. In this study, the effect of an online appointment scheduling system was investigated by comparing the evaluation metrics of appointment scheduling before and after the intervention. This before-after pilot study was conducted on ten outpatient clinics with different specializations. Five clinics were selected as the intervention group and five clinics as the control group. A checklist was designed to evaluate appointment scheduling metrics. These checklists were completed from April to July 2017 in the pre-implementation phase and from September to December 2017 in the post-implementation phase. The evaluation metrics were evaluated before and after the implementation of the online appointment scheduling system. A total of 470 checklists containing 9034 patients’ information and 460 checklists containing 9130 patients’ information were completed at the pre- and post-implementation phases, respectively. There were significant positive effect on the improvement of the three metrics means, including Patient waiting time (38.2 min before vs. 23.8 min after the intervention), No-show rate (25% before vs. 11% after the intervention), and Physician punctuality (−30 min before vs. -14.2 min after the intervention). The use of an online appointment scheduling system was successful in improving several evaluation metrics in our target population and resulted in continued usage in intervention group clinics

Investigating the role of mobile health in epilepsy management: A systematic review

Epilepsy is the most common chronic neurologic disease which is characterized by recurrent attacks of headache after seizure. Researches show that self-management is an important factor in improving the quality of life and quality of care of people affected by epilepsy. Mobile phone technologies play a potential role in patient care assistance and treatment of epilepsy. This systematic review was conducted with an aim to study the role of mobile health in the management of epilepsy. This study was conducted by searching databases such as PubMed, Scopus, Web of Science, and Google scholar search engines using the following keywords: “m-health,” “mobile health,” “Telemedicine,” “Mobile Application,” “Smartphone,” “epilepsy,” and “epilepsy management.” Articles published from January 1, 1990 to September 1, 2021 were searched. Inclusion criteria included all articles published in English with a focus on the role of mHealth in the management of epilepsy. Review articles and studies that were not about patients were omitted. In this study, of a total of 4225 retrieved articles, 10 studies met the full-text inclusion criteria. Three types of researches (30%) were done in the USA, five studies (50%) were conducted as randomized controlled trials, and eight articles (80%) had the highest quality. Among the considered articles, three articles (30%) were engaged in training users in epilepsy management. Five articles (50%) reported improvement in seizure control in patients with epilepsy and two articles (20%) did not report any significant improvement. Mobile technologies have a promising role in providing health assessment, education, and other services for patients, and they also help in controlling seizures attack and improvement of epilepsy management. These technologies enjoy great attractiveness, and utilizing them will lead to patient satisfaction

Effect of an Online Appointment Scheduling System on Evaluation Metrics of Outpatient Scheduling System: a before-after MulticenterStudy

Online appointment scheduling systems have been designed in response to the problems of the traditional ones. In Iran, most outpatient clinics and our study population suffer from high patient’ no-show rate and long waiting times because of not using online appointment scheduling system. In this study, the effect of an online appointment scheduling system was investigated by comparing the evaluation metrics of appointment scheduling before and after the intervention. This before-after pilot study was conducted on ten outpatient clinics with different specializations. Five clinics were selected as the intervention group and five clinics as the control group. A checklist was designed to evaluate appointment scheduling metrics. These checklists were completed from April to July 2017 in the pre-implementation phase and from September to December 2017 in the post-implementation phase. The evaluation metrics were evaluated before and after the implementation of the online appointment scheduling system. A total of 470 checklists containing 9034 patients’ information and 460 checklists containing 9130 patients’ information were completed at the pre- and post-implementation phases, respectively. There were significant positive effect on the improvement of the three metrics means, including Patient waiting time (38.2 min before vs. 23.8 min after the intervention), No-show rate (25% before vs. 11% after the intervention), and Physician punctuality (−30 min before vs. -14.2 min after the intervention). The use of an online appointment scheduling system was successful in improving several evaluation metrics in our target population and resulted in continued usage in intervention group clinics