Exploring Challenges of Health System in Iranian Traditional Medicine: A Qualitative Study

Background: Traditional medicine is a complete system, including diagnostic methods, etiology and treatment based on interpersonal differences.Owing to a lack of investigations in the field of Iranian traditional medicine as well as its many present challenges, certain studies in this area can prove quite practical in identifying and solving ongoing challenges. This study investigates the challenges of the health system in Iranian traditional medicine in the context of control levers. Methods: The study was qualitative content analysis. A framework analysis, "Control Knob Approach", was considered appropriate to promote apprehension of challenges of health systems in Iranian traditional medicine. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 35 experts of Iranian traditional medicine. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis. Results: Upon analysis of data by Iranian medicine experts, five main categories including financing, payment system, regulations, behavior and organization were defined alongside 13 subcategories. Conclusion: According to current challenges and the tendency of society to receive traditional medicine services, as well as the long history of traditional medicine in Iran, fair access to traditional medicine services should be provided. This access must be through the production of indigenous knowledge and the formulation of regulatory and educational policies and guidelines and the empowerment of relevant, healthy, effective, evidence-based and cost-effective forces. © 2020 Marziye H, et al

The Effect of an Educational Plan Based on the Roy Adaptation Model for Fatigue and Activities of Daily Living of Patients with Heart Failure Disease

Background: Cardiac failure is one of the most common chronic diseases with high rate of morbidity and mortality. Fatigue and decreased ability to perform daily activities are of the most common complications of this disease. The purpose of this study was to determine the effect of an educational plan based on Roy adaptation model on fatigue and daily activities in patients with heart failure. Methods: This experimental study was performed on 60 heart failure patients admitted in two educational hospitals supervised by the Kerman University of Medical Sciences in 2019. Sample was randomly assigned into two intervention and control groups. The intervention group received the care plan through a face-to-face and group training program in 6 sessions at one month. Interval followed by a follow-up period for 4 weeks later. Fatigue level was calculated based on piper fatigue scale, and daily activities were calculated by Barthes scale. Results: The finding indicated that there was a significant difference between the two groups (control and intervention) after the intervention. The result showed that the intervention group had significantly lower mean scores in fatigue and higher mean scores in daily activities compared to the control group after intervention P � .05. There was a significant relationship between fatigue and daily activities of life with frequency of hospitalization and duration of disease in both groups, P � .05. Conclusion: Implementation of Roy model-based education program as a low-cost, effective, and non-aggressive nursing intervention can reduce fatigue, and improve daily activities in patients with heart failure. Copyright: © 2020 Abdolahi M, et al

A proactive risk assessment through healthcare failure mode and effect analysis in pediatric surgery department

Background: Patient safety is the first step to improve the quality of care. Objectives: Therefore, the present study aimed to examine the risk assessment of processes in a pediatric surgery department using the Health Failure Mode and Effect Analysis (HFMEA) in 2017 - 2018. Methods: In this research, a mixed-method design (qualitative action and quantitative descriptive cross-sectional study) was used to analyze failure mode and their effects. The nursing errors in the clinical management model were used to classify failure modes, and the theory of inventive problem solving was used to determine a solution for improvement. Results: According to the five procedures selected by the voting method and their rating, 25 processes, 48 sub-processes, and 218 failure modes were identified with HEMEA. Eight risk modes (3.6) were found as non-acceptable risks and were transferred to the decision tree. The main root causes (hazard score � 4) were as follows: Technical-related factors (14.34), organizational-related factors (31.9), human-related factors (45.3), and other factors (7.6). Conclusions: The HFMEA method is very effective in identifying the possible failure of treatment procedures, determining the cause of each failure mode, and proposing improvement strategies. © 2020, Journal of Comprehensive Pediatrics. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited

Mothers and nurses' perceptions of the family-centered care barriers in pediatric departments of an educational hospital in Iran

Problem: Family-centered care (FCC) is a concept used to describe an approach to caring for children and their families within health services. This study compared mothers and nurses' perceptions of barriers to FCC. Methods: This cross-sectional study was conducted in an educational hospital affiliated to Kerman University of Medical Sciences at the southeast of Iran in 2019. Using a researcher-designed questionnaire, we assessed mothers' and nurses' perceptions of barriers to FCC with a census method (60 nurses and 82 mothers). Findings: Mothers (49.8 ± 21.1) and nurses' (49.2 ± 16.4) mean scores of the perception of FCC barriers were at a moderate level. No significant difference was found between mothers' and nurses' perceptions of barriers to FCC. A significant relationship was observed between age, child's admission history, and the perception of FCC barriers in the mothers' group. Conclusion: Findings suggest that national and regional policies of educational hospitals should assess factors contributing to the FCC barriers, focus on how to reduce these barriers, and provide appropriate collaborative care by nurses and the family of patients. © 2021 Wiley Periodicals LL

Emotional intelligence and learning strategies of postgraduate students at Kerman University of Medical Sciences in the southeast of Iran

INTRODUCTION: Emotional intelligence and learning strategies are among the major requirements for success and academic achievement. The present research was designed and carried out to explore the relationship of emotional intelligence with learning strategies in postgraduate students. METHODS: The study employed a cross-sectional design and was conducted at Kerman University of Medical Sciences in 2018. Using the emotional intelligence questionnaire by Bradberry and Greaves and a researcher-made questionnaire of learning strategic, we assessed the relationship of emotional intelligence with learning strategies in postgraduate students using a census method (n = 338). Data were analyzed using descriptive statistics including mean and standard deviation and analytic statistics such as Kolmogorov-Smirnov test, ANOVA, t-test, and Pearson's correlation coefficient at P < 0.05 significance level. RESULTS: This study showed that the mean emotional intelligence score of postgraduate students was 91.12 ± 13.92 and also no significant relationship between the learning strategies and the emotional intelligence in the participants, but the emotional intelligence components showed a positive significant relationship with the learning strategy components, namely self-efficacy, rehearsal, critical thinking, cognitive self-regulation, time and study environment management, peer learning, and help-seeking. CONCLUSION: It could be stated that emotional intelligence components can be taught and fostered to improve the emotional intelligence of the learners, optimal learning, and the quality of educational outcomes. However, a learning strategy is a natural, habitual, unique, and fixed preferential method that serves to absorb, process, and maintain new information and skills. In other words, reinforcement of emotional intelligence facilitates learning. © 2020 IOS Press. All rights reserved

Workplace Violence Against Prehospital Paramedic Personnel (City and Road) and Factors Related to This Type of Violence in Iran

Medical personnel such as those working in emergency medical systems are in direct contact with the patient or the injured and are exposed to workplace violence. This study aimed to determine workplace violence against prehospital paramedical personnel and factors related to this type of violence in Iran. The cross-sectional study was conducted in 72 prehospital emergency centers affiliated with Kerman University of Medical Sciences in 2019. Using a researcher-made questionnaire, we assessed workplace violence and factors associated with this type of violence in prehospital paramedical personnel with a census method (N = 308). Data were analyzed using descriptive statistics including mean and standard deviation (SD), frequency, percentage, and analytic statistics, such as the Kolmogorov�Smirnov, ANOVA, t test, and multiple linear regression tests. The results of this study showed that the most frequent types of workplace violence were verbal violence (47), physical violence (32.50), cultural violence (16), and no violence (4.50), respectively. From the perspective of paramedical personnel, the total mean score of workplace violence was at a moderate level (52.19 ± 10.72). The most important factors affecting workplace violence from the perspective of paramedical personnel were �lack of awareness of people about the duties of emergency medical personnel� and �lack of specialists in prehospital (city or road) bases.� Majority of the paramedical personnel believed that �no reaction and observance of patients and their families� rights� were the most important types of reactions. They also believed that violence was normal at the workplace and should not be considered in emergency medical services. Results suggest that national and local policies in Iran should provide prehospital paramedical personnel with various training courses about how to decrease the rate of workplace violence, promote public health, and decrease their psychological stresses and occupational burnout. © 2020 SAGE Publications

Qualitative Study of Health System Preparedness for Successful Implementation of Disaster Exercises in the Iranian Context

Objectives:Implementing disaster exercises in different parts of the health system is one of the important steps in providing and developing disaster risk management plans. Considering the importance of promoting health system preparedness through exercise, the present study aimed to identify and explain necessary and original components for successful implementation of preparedness exercises of the health-care system in disaster.Methods:The study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disaster. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis.Results:The data analysis resulted in the production of 100 initial codes, 14 subcategories, 6 main categories of "coordination and information management,""standards and indicators,""conduction and control of the process,""logistic management and supplies,""management of treatment operation,"and "management of health operation,"under the original theme of "implementation of exercise."Conclusions:The findings of this study can greatly increase the attention of senior managers to preparedness in all areas of the health system, especially managers of prehospitals and hospitals who are the forefront of the response to the disaster. The findings of this study can be considered as a guideline for the implementation of principle and standardized health system preparedness exercises. © Society for Disaster Medicine and Public Health, Inc. 2020

Domestic Violence Against Women Working in Four Educational Hospitals in Iran

Domestic violence is a serious threat to the health of women in the world and derives from several factors. Therefore, due to the importance of this issue, this study aimed to determine domestic violence against women in four educational hospitals in Iran as a Muslim country. The study employed a cross-sectional design and was conducted in four educational hospitals supervised by the Kerman University of Medical Sciences in 2016. Using a researcher-made questionnaire, we assessed factors associated with domestic violence in female employees using a census method (N = 400). Data were analyzed using descriptive statistics including mean and SD and analytic statistics such as Kolmogorov�Smirnov, ANOVA, t test, and Pearson and multivariate regression tests using SPSS 16 and p �.05. This study showed that most common types of violence against women are psychological/verbal (58), physical (29.25), and sexual (10), respectively. There was a significant relationship between couples� age gap, forced marriage, husband addiction, income, and history of violence experienced by the husband with domestic violence against women. This study examines the basic prevalence of partner violence victimization among Iranian women who work in hospitals in southeast Iran. Findings suggest that national and local policies in Iran may need to examine factors that contribute to violence against women as well as focusing on how to reduce partner violence. © The Author(s) 2017