ABSTRACT
Objective: To evaluate the prenatal care status to improve quality of prenatal care services in Shahid Beheshti university hospital and health canters
Method: This was a cross sectional descriptive study to evaluate status of provided prenatal care services in three domain of structure of the services, procedures of care and outcomes. Using nonrandomized Quota sampling, 600 subjects of care were assessed in 12 prenatal clinics of hospital and health centers of the university. Tools of the study were included: a questionnaire and a checklist to observe facilities and equipment, a check list to observe the care procedure and a questionnaire to assess clients' satisfaction. The tools were used to assess the percentages of conformity with desired situation. These tools were mainly provided by an instruction of ministry of health. Content and face validity of these tools were assessed by a team of reproductive health experts and concurrent inter-rater reliability of the checklists were demonstrated by correlation coefficient of 0.84. Reliability of the satisfaction questionnaire was also shown by correlation coefficient of 0.9 and 0.95 using half splitting and test-retest methods. Data was analyzed by SPSS version 16 and using descriptive statistics and student t test and using 95% confidence interval
Results: 600 subjects with average pregnancy duration of 29.32+/-9.42 weeks were assessed in the study. Assessment of different care procedures demonstrated the percentages of conformity with desired situation as follow: counseling procedures 55.49+/-21.24 percent, history-taking procedure 48.71+/-11.36 percent, vital signs assessment 53.41+/-10.55 percent, general examination for first time attended clients 30.22+/-13.23 percent, obstetrical examination 91.77+/-27.01 percent, blood tests 93.83+/-21.89 percent, urinary tests 86.85+/-26.29 percent and sonograhic assessment of 95.7+/-4.3 percent. The conformity with desired situation of education about individual health and perinatal-risk assessment were 6.54+/-17.10 and 39.67+/-27.09 percent respectively. The results demonstrated 73.76+/-15.04 percent of clients' satisfaction with the structure of prenatal care services and 70.54+/-13.13 percent of satisfaction with the care procedures
Conclusion: For the first time, this study assessed the prenatal care services in three dimensions of the services structure, care procedures and outcome of these services in the PNC clinics of Shahid Beheshti Medical Science University. The study aimed to provide a tool to assess quality of PNC area of reproductive health. Despite almost high quality obstetrical care and paraclinic tests, the quality of care in other care areas and the quality of clients' education and counseling was moderate or low. Counseling and education are among the most important objectives of prenatal visits that needs precise planning and implementation. Screening of clients with psychosocial risks also requires special attention in prenatal care assessments. Preparing comprehensive forms for history taking, general and obstetrics assessments and would help to improve quality of prenatal care
ABSTRACT
Objective[s]: Adolescents health needs are unique. An understanding of these needs will assist in the development of services, risk-reduction strategies and preventive health activities
Methods: This qualitative study was a part of a mixed method study about female adolescents health needs and conducted in Mazandaran province, a province in the north of Iran.67 female adolescents between 12-19 years of age participated in 8 focus group discussion. Inaddittion, semi structured interviews were done with 11 key informants including: 5 parents, 3 teachers and school counselors, 2 obstetricians and one midwife. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done
Results: Findngs of this research around the role of family in adolescents health needs emphasized on 4 overarching themes including: supportive family relationships, needs for responsible parents, well-informed parents and parental monitoring
Conclusion: In attention to the critical role of family relationships in adolescents health needs, Parents education in order to help them to improve their relationships with their adolescents is necessary
ABSTRACT
Objective[s]: To explore adolescents and key informants' perception and experiences regarding to RHS needs of adolescents to plan support services
Methods: This qualitative study was conducted in Sari in the North of Iran. Sixty-seven urban and rural female adolescents between 12-18 years of old participated in 8 focus group discussions. In addition, semi structured interviews were done with 11 key informants. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done to identify key themes
Results: Findings of this research around the adolescents' reproductive health services needs emphasized on 5 overarching themes including: general services, exclusive services, reinforcement of facilitators, reduce barriers and appropriate management of services
Conclusion: Provision of comprehensive services for adolescents and appropriate youth-friendly services at all level are needed to promote female adolescents' health and to prevent high risk behaviors
ABSTRACT
Objective [s]: Coping with stress is more important than the nature of stress itself. Coping with stress is a health promotion behavior and behavior is influenced by unintelligible factors. Theory of planned behavior makes a useful framework for understanding the health behavior and designing appropriate training. Integrating the theory of planned behavior with self-efficacy will increase the predictive capability of the theory
Methods: This research is a qualitative approach based on the "Integrated Model of Planned Behavior and Self-efficacy". Total 70 women aged between 20-45 works in industrial factories are chosen by purposeful sampling with maximum diversity to participate in focus group discussion. Ten group interviews in the form of seven groups of ten were conducted. After collecting information, analyzing data from the conventional method of content analysis was conducted
Results: Results showed that the majority of women workers have the attitude that stress is the effective factor on body and spirit health and also a cause of job absence and decreased quality of work in work places. Shouting, emptying stress on others, patience and silence, preying, listening to music and walking are the majority of techniques that women workers use to cope with stress. Significance and effects of understanding and social support are subjective norms of women workers. Susceptible morale, lack of job security, weakness, and working with pressure and lack of knowledge and skills of coping with stress are the most important barriers of coping with stress in women workers .results showed that training the methods and skills of coping with stress and increasing supports in work places and home; could empower women to have more self-efficacy and intention to cope with stress
Conclusion: By rehabilitations of regular sessions and consulting and persuasion of women to reflect the problems in workplace; and also by informing and training the methods and skills of coping with stress; we can move toward a way of promoting health in our society