میزان رضایتمندی گیرندگان خدمت از مراکز مدیریت حوادث و فوریت های پزشکی شهرهای یزد و بیرجند؛ یک مطالعه مقطعی

Introduction: The satisfaction rate of patients is a valuable tool for evaluating the quality of providing health care and gives important data regarding the expectations of patients and the degree to which they are being met. Considering the importance emergency medical service (EMS) centers in providing proper care, this study was carried out aiming to evaluate the satisfaction rate of those receiving services from EMS centers of Yazd and Birjand. Methods: The present cross-sectional study was carried out on 150 of EMS recipients registered on the list of EMS centers of Yazd and Birjand in 2012. Systematic sampling was used and required data were gathered using the standard questionnaire of satisfaction for EMS center recipients that consisted of 2 parts; demographic data and 16 questions regarding satisfaction of recipients. Data were analyzed using SPSS 18 and descriptive tests. Results: 150 participants were studied (56.7% male). The most common reason for calling was trauma due to motor vehicle accidents (32%) in Yazd and weakness and nervous system diseases (18%) in Birjand. 10% of the participants in Yazd province had low satisfaction, 39% had intermediate, and 51% had high satisfaction. In Birjand satisfaction rate was intermediate in 16% and high in 84% of those studied in Birjand. The highest satisfaction rate in Yazd was regarding cooperation of emergencies center with the patient and their manners in facing them. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival. In Birjand, the lowest satisfaction rate belonged to the quality and existence of equipment in the emergency team. Conclusion: The results of the present study showed that satisfaction level of EMS recipients in Yazd and Birjand was intermediate. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival in Yazd, and the quality of equipment in Birjand. مقدمه: میزان رضايتمندي بيماران ابزار سنجش مهمي براي ارزیابی كيفيت ارائه خدمات بهداشتي درماني است و اطلاعات مهمي راجع به انتظارات بيماران و ميزان برآورده شدن آنها فراهم مي كند. با توجه به اهمیت و جایگاه مهم مراکز مدیریت حوادث و فوریت های پزشکی و ارائه موثر خدمات از سوی آنها، این مطالعه با هدف بررسی میزان رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی در شهرستان های یزد و بیرجند انجام پذیرفته است. روش کار: مطالعه مقطعی حاضر در سال 1391 بر روی 150 نفر از گیرندگان خدمت موجود در لیست مرکز مدیریت حوادث و فوریت های پزشکی شهر های بیرجند و یزد انجام پذیرفت. نمونه گیری به صورت سیستماتیک و اطلاعات مورد نیاز توسط پرسشنامه استاندارد رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی که شامل دو قسمت؛ مشخصات دموگرافیک و 16 سؤال مربوط به رضایتمندی گیرندگان خدمت بود، جمع آوری گردید. داده ها با استفاده از نرم افزار SPSS 18 و آزمون های توصیفی مورد تجزیه و تحلیل قرار گرفتند. يافته ها: 150 نفر مورد مطالعه قرار گرفتند (7/56 درصد مرد). شایعترین دلیل برقراری تماس در شهر یزد، ترومای ناشی از تصادفات رانندگی (32درصد) و در شهر بیرجند ضعف و بیحالی و بیماری عصبی (18درصد) بود. 10 درصد از پاسخگویان در استان یزد رضایتمندی کم، 39 درصد رضایتمندی متوسط و 51 درصد رضایتمندی مطلوبی داشتند. به همین ترتیب 16 درصد از پاسخگویان در شهر بیرجند رضایتمندی متوسط و 84 درصد رضایتمندی مطلوب داشتند. بالاترین میزان رضایتمندی در استان یزد از همکاری مرکز فوریت ها با بیمار و رفتار پرسنل با بیمار بود. همچنین کمترین میزان رضایتمندی نیز متعلق به پیگیری وضعیت بیمار تا رسیدن آمبولانس و زمان انتظار بیمار تا رسیدن آمبولانس بود. در شهر بیرجند نیز کمترین میزان رضایتمندی مربوط به کیفیت امکانات و تجهیزات تیم اورژانس بود. نتيجه گيری: نتایج حاصل از این مطالعه نشان داد که میزان رضایتمندی گیرندگان خدمات از مراکز مدیریت حوادث و فوریت های پزشکی، در شهر یزد و بیرجند در سطح متوسطی بوده است. کمترین میزان رضایتمندی از خدمات مرکز مدیریت حوادث و فوریت های پزشکی در شهر یزد مربوط به حیطه پیگیری وضعیت بیمار تا رسیدن اورژانس و نیز زمان انتظار بیمار تا رسیدن آمبولانس و در شهر بیرجند مربوط به کیفیت امکانات و تجهیزات بود

Relationship between platelet count and platelet width distribution and serum uric acid 1 concentrations in patients with untreated essential hypertension

Hematological parameters have emerged as independent determinants of high serum concentrations of uric-acid and predictive-factors in the evaluation of the total cardiovascular-risk in patients with essential-hypertensive. Here we have investigated the possible relationships between hematological-factors and serum uric-acid levels in hypertensive-patients recruited as part of Mashhad-Stroke and Heart-Atherosclerotic-Disorders cohort study. Two-thousand three-hundred and thirty four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum uric acid concentrations. Demographic, biochemical and hematological characteristics of population were evaluated in all the subjects. Logistic-regression-analysis was performed to determine the association of hematological-parameters with hypertension. Of the 2334 hypertensive-subjects, 290 cases had low uric-acid, and 2044 had high serum uric acid concentrations. Compared with the low uric acid group, the patients with high serum uric acid, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum hs-CRP were correlated with serum uric acid level. Stepwise multiple logistic regression model confirmed that PDW and gender were independent determinant of a high serum uric acid. PDW and PLT appear to be independently associated with serum uric acid level in patients with hypertension

Factors Associated with The Incidence of Coronary Heart Disease in The Mashad: A Cohort Study

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Accurate assessments of Coronary heart disease (CHD) incidence is very necessary for public health. In current study we aimed to investigate the incidence of CHD and importance of several classical, modifiable and un-modifiable risk factors for CHD among an urban population in eastern Iran after 6 years of follow-up. Methods The population of MASHAD cohort study were followed up for 6 years, every 3 years in two step by phone and who reported symptoms of CVD were asked to attend for a cardiac examination, to estimate the incidence of CHD with 95% confidence interval (95% CI) as well multiple logistic regression analysis was performed to assess the association of several baseline characteristics with incidence of CHD event. Evaluation of goodness-of-fit was done using ROC analysis. CHD cases divided into four different classes which include: stable angina, unstable angina pectoris, myocardial infarction and sudden cardiac death. Results In the six years\u27 follow-up of Mashhad study, the incidence rate of all CHD event in men and women in 100,000 people-years with 95% confidence intervals were 1920 (810-3030) and 1160 (730-1590), respectively. The areas under ROC curve (AUC), based on multivariate predictors of CHD outcome, was 0.7825. Conclusion Our findings indicated that the incidence rate of coronary heart diseases in MASHAD cohort study increases with age as well as our final model designed, was able to predict approximately 78% of CHD events in Iranian population

Recipients Satisfaction of Emergency Medical Service Centers of Yazd and Birjand; a Cross-sectional Study

Introduction: The satisfaction rate of patients is a valuable tool for evaluating the quality of providing health care and gives important data regarding the expectations of patients and the degree to which they are being met. Considering the importance emergency medical service (EMS) centers in providing proper care, this study was carried out aiming to evaluate the satisfaction rate of those receiving services from EMS centers of Yazd and Birjand. Methods: The present cross-sectional study was carried out on 150 of EMS recipients registered on the list of EMS centers of Yazd and Birjand in 2012. Systematic sampling was used and required data were gathered using the standard questionnaire of satisfaction for EMS center recipients that consisted of 2 parts; demographic data and 16 questions regarding satisfaction of recipients. Data were analyzed using SPSS 18 and descriptive tests. Results: 150 participants were studied (56.7% male). The most common reason for calling was trauma due to motor vehicle accidents (32%) in Yazd and weakness and nervous system diseases (18%) in Birjand. 10% of the participants in Yazd province had low satisfaction, 39% had intermediate, and 51% had high satisfaction. In Birjand satisfaction rate was intermediate in 16% and high in 84% of those studied in Birjand. The highest satisfaction rate in Yazd was regarding cooperation of emergencies center with the patient and their manners in facing them. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival. In Birjand, the lowest satisfaction rate belonged to the quality and existence of equipment in the emergency team. Conclusion: The results of the present study showed that satisfaction level of EMS recipients in Yazd and Birjand was intermediate. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival in Yazd, and the quality of equipment in Birjand

Socioeconomic Inequality in Health Care Utilization: A Study of Service Utilization in Yazd, Iran

Background: Determining the inequality in health and the gap level among various socio-economic groups and factors affecting it were always concerns of most politicians and social scientists. This study investigated inequality in utilization of health care among Yazd residents in 2014. Methods: This analytic and cross-sectional study was conducted in 2014. The participants were all households of Yazd. The data were collected through a three-part questionnaire including demographic factors, socio-economic factors, and utilization of health services. The number of samples was estimated to be 1037 households selected by random stratified sampling. After administrating the questionnaire in the form of interview, data were entered into the SPSS software.  Later, factor analysis method was carried out and participants were categorized based on their social and economical status. Afterwards, using the logistic regression method, the correlation among variables was calculated and finally, for measuring the concentration index, the stratified data were fed into Stata11 software version 12/SE and analyzed. Results: According to the findings, there was no meaningful inequality in the distribution of contagious and non-contagious decreases in the population under study. Inequality in utilization of services for inpatient and outpatients during the past 6 months in the five socio-economic groups was significant (P-value = 0.000). This shows that accumulation of visits occurred in richer groups of society. Also, it can be claimed that self-treatment has greater accumulation in the poorer quintiles (CI = -0.09). Conclusion: Inequality in benefitting from health services reflects the economical situation of households. As a result, it is expected that by taking steps to improve the living conditions, the equity in service utilization will be increased. &nbsp

Patterns of Physician-Patient Relationship: A Case Study in Shahid Sadoughi Hospital

Background: Appropriate relationship between physician and patient can increase patients' trust and prevent from their confusion and repeated visits to different doctors. Therefore, the purpose of this study was to determine the dominant pattern of physician-patient relationship among outpatients referring to Shahid Sadoughi Hospital. Methods: This research was an analytical and correlational study carried out on 300 patients referring to Baghaeipour Clinic. The data collection tool was a standard questionnaire including 10 general items and 19 attitude questions. SPSS16 software was applied for data analysis; Chi-square test, Pearson and Spearman correlation coefficients were used in this regard. Results: Based on the findings of this study, the most dominant pattern of physician-patient relationship was guidance-cooperation pattern (57.5 %) followed by mutual participation (37.8 %), and active-passive (4.7 %) patterns. The type of physician-patient relationship pattern had a significant relationship with the physician's specialty (P = 0.002).  Conclusion: Considering that the most effective pattern of physician-patient relationship was the mutual participation relationship pattern, increasing patients' awareness and encouraging them to get more involved in the process of treatment can facilitate better access to health

The Relationship between Participative Management and Resistance to Change from the Perspective of Administrators at Educational Hospitals in Yazd, 2013

Background: To maintain their survival, organizations are forced to keep pace with the changes that occur. Participative management could be one way of reducing resistance to change by increased participation and commitment of the employees. The present study aimed to evaluate the relationship between participative management and resistance to change from the perspective of administrators at educational hospitals of Yazd in 2013. Methods: This was a cross-sectional and analytical study performed in 2013. The subjects consisted of 81 senior, middle, and operational managers working in educational hospitals of Yazd Shahid Sadoughi University of Medical Sciences. Data were gathered through two questionnaires of participative management (19 questions) and resistance to change (13). The reliabilities were assessed by Cronbach's alpha coefficient to be 78% and 70%, respectively. The data were analyzed using SPSS 19, ANOVA, and Pearson correlation coefficient test. Results: The findings showed an inverse relationship between participative management and resistance to change which was meaningful (P ˂ 0.05, r = -0.3). Also, two parameters of participative management including participation in implementation (P = 0.004, r = -0.325), and control and supervision (P = 0.01, r = -0.292) indicated an inverse significant correlation with resistance to change. Conclusion: According to the results of this study applying participative management could be an appropriate and beneficial strategy to reduce staff resistance to change

A comparison of Obesity and Some Cardiovascular Risk Factors between Male Employees of Gas Refinery, Petrochemical Plant, and Non-Industrial Workplaces

Background and purpose: It is likely that industrial workplaces increase the chance of developing obesity and cardiovascular disease risk factors in the employees. The aim of this study was to compare obesity and some health markers between male employees of gas refinery (first exposure group) and petrochemical staff (second exposure group) compared to non-industrial male employees of general population (non-exposure group). Method: Seventy five male employees of a petrochemical plant in Assaluyeh, eighty eight male employee of a gas refinery, and eighty six non-industrial male employees of the general population participated in this study. Weight, height, waist circumference, fasting blood glucose, blood pressure, and serum total cholesterol and triglyceride were measured in all the participants. Statistical analyses were performed using the SPSS Software, version 16 (SPSS Inc., Chicago, IL, USA). Results: The mean body mass index, waist circumference, fasting blood glucose, and serum triglyceride level were significantly higher in gas refinery staff compared to petrochemical employees, and non-industrial employees (P-values <0.01). The number of subjects suffering from obesity, abdominal obesity, hypertriglyceridemia, and high fasting blood glucose in the gas plant staff was significantly more than the petrochemical plant staff and non-industrial employees (P-values <0.01). However, mean blood pressure and hypertension in non-industrial employees were significantly higher than the other two groups (P-values<0.01). Conclusion: The results of this study showed that obesity, high fasting blood glucose and hypertriglyceridemia were significantly higher in gas refinery staff. It is recommended to develop a health promotion program for weight management and prevention of obesity in the industrial work place staff.&nbsp

Is there any association between Serum anti-HSP27 antibody level and the presence of metabolic syndrome; population based case-control study

Background: Heat shock protein 27 (HSP27) is an intracellular chaperone constitutively expressed in many cell types including cardio myocytes and endothelial cells. Circulating levels of HSP27 and anti-HSP27 antibody are higher in patients with CVD. Anti-HSP27 antibody concentrations were also reported to be increased in atherogenesis. We aimed to evaluate serum anti-HSP27 antibody titers in individuals with, or without, MetS in the MASHAD study cohort with large sample size in 6,568 subjects