Validation of the Persian version of the Stanford health assessment questionnaire [HAQ] in patients with rheumatoid arthritis

Evaluation of functional disability using proper instruments, like Health Assessment Questionnaire [HAQ] in patients with rheumatoid arthritis [RA], is necessary not only for quality of life assessment, but also as a useful marker for disease activity. HAQ has been translated into many languages. To validate the Persian version of Stanford HAQ. Persian version of the HAQ [PE-HAQ] with culturally necessary modifications of the arising, eating, hygiene, reach and activities category questions was administered to 872 RA patients [87% female; mean age 57.5 years; mean onset age 51.5 years; mean disease duration 6.1 years]. The arising, hygiene and activities scores were higher in the PE-HAQ than in the original HAQ, because futons and squat toilets are very common in Iranian culture and most of patients are bound to praying even in the standing position. Arising from a futon, squatting in a squat toilet and kneeling are generally more difficult for disabled individuals than are arising from a bed, getting on and off the toilet and doing chores, respectively. The overall disability index was higher in the PE-HAQ [0.89 +/- 0.84] than in the original HAQ [0.82 +/- 0.79], although the correlation coefficient was high [r=0.881]. The test-retest reliability value studied at a 10-day interval, showed a strong correlation coefficient of 0.90 measured on the two occasions. PE-HAQ showed excellent internal consistency [Cronbach's alpha= 0.892]. The PE-HAQ is a reliable and valid instrument that can be self-administered to Iranian RA patients to evaluate their functional disability

[ investigation of the managers' need to learn management skills and principles in health care networks in Esfahan province in 1380]

Introduction: management is a specialized science and since most of the health managers are not familiar with scientific management methods and direct their organization on the basis of their own experiences and assumptions , it is necessary to devise comprehensive educational programs according to the results of needs assessment in order to promote the quality of health care services

Materials and methods: the health network managers, deputy managers, health care assistants, the managers of rural and urban health care centers of nineteen health networks in Isfahan province were selected. To evaluate their educational needs, the researcher asked them to fill in questionnaires

Results: the majority of the managers [54%] were between 25 to 35 years old. Most of them [34.7%] had between five to nine years of service and 59% worked as manages between one to four years. 52% did not receive any training and 30% had participated in training courses. They mostly required executive [48.5%] and planning [46%] skills. There was a meaningful relationship between years of management services and all aspects of management skills

Discussion: since the years of management services are related to all management skills, the level of experience can influence the individuals ' skills. The years of service affect the executive skills and participation in training courses affect the planning quality