ABSTRACT
Background: Professional regulation is one of the strategies of the governments which protect the public's right. Nursing practice is not an exception; hence, it is regulated to protect the public against nursing services' adverse effects. Although modern nursing in Iran started from 100 years ago, documents show that there was no regulation mechanism for nursing in Iran till 2016. Hence, this study was conducted to illuminate the contextual factors affecting the nursing regulation process in Iran
Methods: To explore the contextual elements of late establishment of nursing registration as an important part of nursing regulation, we applied directed qualitative content analysis. For this purpose, all the historical events and related materials including articles published in scientific journals, gray literature, statements, news articles, and interviews in the period of 2006-2016 were reviewed and analyzed by expert panel and categorized in predetermined groups
Results: Pooled analysis data showed four contributing elements that affected the emerging nursing regulation in Iran. These elements include 1] cultural determinants, 2] structural determinants, 3] situational determinants, and 4] international or exogenous determinants
Conclusion: Nursing regulation is an important health policy issue in Iran which needs to be facilitated by contextual factors. These factors are complicated and country-specific. Political willingness should be accompanied by nursing association willingness to establish and improve nursing regulation. Other researches are recommended to explore actors and process and content of nursing regulation policy in Iran
Subject(s)
Humans , Legislation, Nursing , Education, Nursing , Policy Making , Qualitative ResearchABSTRACT
Background: Quality of life [QoL] is a broad construct and can be influenced by many factors. Perceived stigma is inevitable in patients with HIV. Therefore, it is an important factor to understand their QoL
Objectives: The current study was conducted to investigate the relationship between the perceived stigma among HIV-positive women and their QoL in Shiraz, Iran
Patients and Methods: In this quantitative study, 110 HIV-positive women were selected by simple random sampling method. A questionnaire was designed and used as a tool for data collection. The questionnaire included demographic information, internal stigma scale, and the ACTG short form-21 [SF-21] for measuring QoL. Data were collected from March to August 2015 and analyzed using t- test, Pearson's correlations, and the multiple regression test with the SPSS software version 21
Results: The mean age of the women was 37.86 +/- 9.03 years. Most of the participants were infected with HIV/AIDS through sex with their spouse [78.2%]. About one-third of the women had physical symptoms [29.1%] of the HIV disease. The prevalence rate of perceived stigma in the sample was 69.7%. Quality of life was significantly different in terms of employment status, emotional support and physical symptoms [P < 0.05]
Conclusions: A higher level of perceived stigma among HIV-positive women is associated with a considerable decrease in all QoL dimensions. Thus, more efforts should be considered to reduce the perceived stigma and improve the QoL of such patients
ABSTRACT
Despite the success of developed countries in preventing the spread of HIV/AIDS, the disease is expanding in developing countries where an unfavorable attitude exists among people, health professionals and employees. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV [PLWHA]. The study is a cross-sectional survey. The data were gathered using a structured questionnaire. The study sample included 575 health care providers of public and private hospitals in Shiraz. The data were gathered using a structured questionnaire in spring 2014. Data analysis was carried out using the Statistical Package for Social Sciences, version 21. The most dominant attitude of the health care providers toward HIV/AIDS patients was related to fear [42.42%]. According to the results of this study, there was a significant relationship between stigmatized attitude of the health care providers and their religious beliefs, society stigmatized attitude, and knowledge of transmission routes. The relationship between social stigmatized attitude of health care providers and their knowledge of transmission routes, with their willingness to provide services to patients is significant, as well [P<0.05]. 39.6% and 46.2% of the respondents preferred not to provide services to the prostitutes and homosexual patients. Fear of contamination and social stigmatized attitude are the main impediments to dealing with patients and providing services to them. Hence, it seems that creating an effective knowledge about transmission and correcting the socio-cultural beliefs of health providers are two key strategies to tackle this problem
Subject(s)
Adult , Female , Humans , Male , Social Stigma , Stereotyping , Attitude , Health Personnel , Health Services , Cross-Sectional Studies , Surveys and Questionnaires , Acquired Immunodeficiency SyndromeABSTRACT
Background: Prevention of unwanted pregnancy is a key strategy to improve the women's health through spacing of birth and avoiding pregnancy at high-risk maternal ages. Unmet need by definition is the percentage of fecund married women who are not using contraceptives while they do not want to get pregnant. They do this due to unavailable quality services, limited choice of methods, lack of information, safety concerns or side-effects and partner disapproval. The present study aimed to assess the magnitude of unmet need for prevention of unwanted pregnancy in Shiraz
Methods: In this descriptive cross-sectional study, 2000 married women of childbearing age [10-49 years] were selected randomly in a survey in Shiraz. Data collection was done using a researcher-made questionnaire and the results were reported using descriptive statistical methods
Results: In the present study, 85.6% of the women used a contraceptive method. 58.7% of them used modern methods of contraception. Reported reasons for not using contraceptives included recent delivery [25%], intention to have more children [20.6%], lack of awareness about contraceptive methods or where such services were offered [6.3%] and irregular sexual intercourse with husband [4.5%]. Interrupted intercourse ranked the highest among the methods used. Finally, the unmet need for prevention of unwanted pregnancy in this study was reported to be 4.3 percent
Conclusion: Women in Shiraz had a relatively lower level of unmet need. Counseling is recommended for higher risk women with unmet need in order to keep the descending trend of unmet need for prevention of unwanted pregnancy in Shiraz
ABSTRACT
Background: The United Nations has predicted that the population of slum dwellers will have grown from one billion people worldwide to 2 billion by 2030. This trend is also predictable in Iran. In the Iranian metropolis of Shiraz, more than 10% of the residents live in slum areas. There are several problems regarding the delivery of social services in these areas. The aim of this study was to evaluate slums dwellers' access to and coverage of health care
Methods: This cross-sectional face-to-face study included 380 household of slum dwellers via stratified random sampling. Demographics, accessibility of health services, coverage of health care, and route of receiving health services were recorded through interviews
Results: Approximately, 21.6% of the households had no physical access to health centers. The coverage rate of family planning programs for safe methods was 51.4% [95% CI: 48.86-53.9%]. Vaccination coverage among children under 5 years old was 98% [95% CI: 97-99%]. Furthermore, 34% of pregnant women had not received standard health care due to a lack of access to health centers
Conclusion: Limited access to health services along with inadequate knowledge of slum residents about health care facilities was the main barrier to the utilization of the health care in the slums
ABSTRACT
Background: The purpose of this study was to determine the prevalence of depression symptoms and the effect of various demographic characteristics on its severity in an elderly population in Fars province, southern Iran
Methods: This cross-sectional study was conducted during May and September 2009. A sample of 1461 men and women, aged more than 60 years were selected using a multistage stratified random sampling method. Levels of depression symptoms were measured using the Geriatric Depression Scale [GDS]. Data were analyzed using SPSS software. Also, analysis of variance [ANOVA] and correlation analysis were performed to find the correlation between the variables and GDS score
Results: Overall, 1443 people completed the questionnaire. The prevalence of the symptoms mild to moderate depression [GDS: 5-10] was 51.1%, while that of severe depression symptoms [GDS >10] was 19.7%. There were significant relationships between sex, marital status, educational level, occupation, residential place and the GDS scores
Conclusion: The prevalence of depression symptoms was high among the elderly in Fars Province. Therefore, if properly trained, primary care teams could help these patients
ABSTRACT
<p><b>OBJECTIVE</b>To identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran.</p><p><b>METHODS</b>This cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level.</p><p><b>RESULTS</b>Of the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death.</p><p><b>CONCLUSIONS</b>Head injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.</p>
Subject(s)
Humans , Accidents, Traffic , Cross-Sectional Studies , Iran , Epidemiology , Motorcycles , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran.</p><p><b>METHODS</b>This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medicine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS version 11.5. P value less than 0.05 was considered significant.</p><p><b>RESULTS</b>The mean age of decedents was (47.2+/-26.2) years, ranging from 6 months to 103 years old. Males accounted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality.</p><p><b>CONCLUSION</b>Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs coordination among trauma system organizations.</p>
Subject(s)
Humans , Accidents, Traffic , Cross-Sectional Studies , Iran , Pedestrians , Surveys and Questionnaires , Wounds and InjuriesABSTRACT
The burden of non-communicable diseases is rising globally. The present study was carried out to examine the relationship between different anthropometric indices and blood pressure in the Iranian population. A cross-sectional descriptive study was conducted on 3916 subjects including 1976 males and 1940 females, aged 15-64 years from a healthy population in Shiraz, IR Iran. Anthropometric variables of each person including weight, height, waist circumference [WC], waist to height ratio [WHR] and body mass index [BMI] were calculated along with measuring systolic and diastolic blood pressures [BP]. The relationship between blood pressure and different anthropometric variables was determined in both genders. The mean +/- SD systolic blood pressures were 123.9 +/- 20.0 and 121.2 +/- 17.7 mmHg while the mean diastolic blood pressures were 78.3 +/- 11.9 and 77.4 +/- 12.9 mmHg in men and women respectively [P<0.001]. The prevalence of hypertension in men [23.8%] was significantly more than that of women [21.1%]. Mean systolic and diastolic blood pressures increased with age and BMI in both genders. Anthropometric indices showed a positive association with systolic and diastolic blood pressures. The BMI and WC showed a strong association with systolic and diastolic blood pressure. The suggested lower cut-off values of the anthropometric indicators will cover maximum of the population with higher odds of having hypertension and may help reduce the levels of populations mean blood pressure
ABSTRACT
In recent years use of family physicians has been determined as a start point of health system reform to achieve more productive health services. In this study we aimed to assess the cost-efficiency of the implementation of this plan in Fars province, southern Iran. This cross-sectional descriptive study was done in 2007 in 18 provincial health centers as well as 224 rural health centers in Fars province. Data were collected using forms, statistics, and available evidence and analyzed by expert opinion and ratio techniques, control of process statistics, and multi indicator decision model. Although in the family physician plan more attention is paid to patients and the level of health training, availability, and equity has improved and the best services are presented, it has not only decreased the costs, but also increased the referrals to pharmacies, laboratories, and radiology clinics and the costs of healthcare. Although the family physician plan has led to more regular service delivery, it has increased the patients' referral to pharmacies, laboratories, and radiology centers and more referrals to family physicians. It seems that the possibility of setting regularity in health system can be gained in the following years of the family physician program mainly via planning, appropriate management and organizing correct health plans according to need assessments, and continual supervision on activities, which would happen according to current experiences in this plan
ABSTRACT
It seems that the incidence of pertussis-like illnesses is considerably increasing despite the wide coverage of immunization with the whole cell pertussis vaccine. We aimed to investigate the occurrence of pertussis in vaccinated children by measuring anti-pertussis antibodies. In this cross-sectional study, blood samples were taken from vaccinated children aged 2, 4, 6, 12, 18, and 72 months. Anti-pertussis IgG and IgA were measured by ELISA. P < 0.05 was considered significant. 725 children were enrolled in the study. Geometric mean titers for IgG that showed a slight decease after 2 months of age and increased distinctly in children aged 72 months. The frequency of the individuals whose IgG was above the determined cut-off [derived from mean+2SD] was observed in 1% of the 2, 4, and 6-month-old infants, 6% of the 12 and 18-month-olds and 12% of the 6-year -old children. Positive IgA titers were detected in 5, 9, 6, 23, 11, and 8% of children aged 2, 4, 6, 12, 18, and 72 months, respectively. Since a considerable percentage of children had high levels of anti-pertussis IgG antibodies [>/=2 SD], positive anti-pertussis IgA, and most importantly an increased level of anti-pertussis IgG geometric mean titer at 6 years of age, further investigations regarding the protection provided by the presently used pertussis vaccine seems necessary