Barriers of pre-hospital services in road traffic injuries in Tehran: the viewpoint of service providers

Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents. The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure, Barriers related to the profession and Barriers related to managerial issues. Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries

Everyday life condition in stroke survivors and their family caregivers in Iranian context

Stroke is an unexpected major life incident that effect on physical functioning and can lead to changes in lifestyle and inability to manage self care, work or leisure. To explore the everyday life situation as experienced by stroke survivors, and their family caregivers, this study was conducted 3-6 month after stroke. Twelve stroke survivors and thirteen family caregivers were interviewed and a qualitative content analysis was conducted to analyze data. The results were categorized into two central themes that were identified as; [1] Being challenged by changes in everyday life situation including; the struggle with physical dysfunctions, inappropriate daily plan for leisure activities, changes in mood, being faced with economical problems and being worried about changing roles [2] striving to cope with new conditions including; trying to preserve self-worth, seeking to support from spirituality, learning and re-learning and regaining independency. Physical dysfunction was the major concern for both the survivors and their family caregivers in their everyday life situation. This problem led to, and forced them, to be dependent on others. Training is needed to teach stroke survivors and their families strategies of how to cope with and overcome ongoing challenges of everyday life after stroke and to re-organize their lives and improve skills of the survivors to deal with the new situation at home. A daily plan for spending their time and leisure activities would ease this work. More investigation will be needed to clarify the process of life after stroke to cover this gap

Post stroke life in Iranian people: used and recommended strategies

Stroke survivors develop their own strategies to combat disabilities, developing strategies to maintain or reestablish a sense of continuity after the disruptive life event that stroke represents, using strategies to foster hope during the process of adjusting to life after stroke and drawing on spiritual practices. The aim of this study is to identify the used and recommended strategies of life after stroke among Iranian people. A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors, 12 family caregivers and 6 formal care givers. Five main concepts emerged describing as the used and recommended strategies of the participants including, improving functional performance, re-learning life skills and educational support, accessing to rehabilitative services, socio-economical support and well-suited coping strategies. Participants valued better knowledge and skills regarding the adaptive strategies for stroke survivors and their family care givers are essential in accomplishing with activities of daily living and doing social roles for improving life after stroke. Also developing the socio- economic supports is crucial for assuring a more supportive approach to achieve rehabilitation services and design better educational program for them

Development of a community-based care system model for senior citizens in Tehran

In Iran a considerable percentage of old people "living" in society need to receive specialized health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as existing resources and facilities; social and cultural issues and characteristics of each group of elders [healthy elders, frails, home-bound] seems to be necessary. At the development phase of the care model in this study methodological triangulation is used including: 1. Comprehensive review of current and related literature. 2. Conduction of an ethnographic study on a number of Tehranian elders and their families. 3. Seeking opinions of a group of experts on this issue using nominal group technique, and analysis and synthesis of the collected data were employed to develop a community based care system for elders. The preliminary results of employing this care system and examination of expected outcomes such as enhancing quality of life and hope in elders, reflects the efficiency of this system, although further complementary studies and particularly cost benefit analyses are strongly recommended

Development of a community-based care system model for senior citizens in Tehran

In recent years a variety of system models for providing community based health care services for the elderly has been envisioned and implemented in the developed countries which meet the special care needs of different groups of elders .In Iran as a developing country, a considerable percentage of old people live in the society need to receive specialized care and health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as: existing and available resources and facilities[financial and human resources];social and cultural issues and characteristics of each groups of elders[healthy elders, frails,homebounds,…] seem to be necessary. At the development phase of the care model in this study Ellowing methodological triangulation must be considered:1. Comprehensive review of current and related literature.2. Conduction of an ethnographic study on a number of Tehranian elders and their families.3. Seeking opinions of a group of experts on this issue using nominal group technique, and analysis as well as synthesis of the collected data were employed to develop a community based care system for elders. The preliminary results of employing this care system and examination of expected outcomes such as promoting quality of life and expectancy in elders reflects the efficiency of this system, although further complementary studies and particularly cost benefit analysis are strongly recommended