Afghan refugee women's experiences of communication apprehension and fear of physician in the iranian health care system, during covid-19 pandemic, rafsanjan, iran (2020)

Background: Information about the refugees' experiences in the health care system is needed to improve the quality of health care delivered. This study aimed to investigate the experiences of Communication Apprehension (CA) and Fear of Physician (FoP) in the Afghan refugee women referred to the Iranian health care clinics during the COVID-19 pandemic in the year 2020 in Rafsanjan, Iran. Materials and Methods: In this descriptive cross-sectional study, conducted between March-July 2020, two hundred forty Afghan women in Rafsanjan, Iran, were selected using convenience sampling. Data collection included the demographic, Personal Report of Communication Apprehension (PRCA-24: score range of 24-120), and Fear of Physician (FoP: score range of 5-20) questionnaires. Data were analyzed using an Independent t-test, as well as ANOVA, Chi-square, and Fisher exact tests. The significance level was p<0.05. Results: The mean age of the participants was 28.81 ± 7.21 years old, and their ages ranged from 16 to 60;further, 97.9% of them were married. Based on the results, the overall mean score of PRCA was 67.07±15.68. Moderate to severe communication apprehension was revealed in 199 participants (82.9%), while 235 participants (97.9%) had moderate to severe fear of physician. Conclusion: Although many factors could contribute to CA and FoP, as the COVID pandemic had just spread and fear of this unknown virus was at its very peak during this study, the researchers assume that the high rate of CA and FoP level could be related to the COVID pandemic. It is suggested that educational workshops should be held for medical care providers to prevent further communication problems. © The Author(s) 2021;All rights reserved.

The Impact of the Social Distancing Policy on COVID-19 Incidence Cases and Deaths in Iran from February 2020 to January 2021: Insights from an Interrupted Time Series Analysis

Background: In December 2019, a viral outbreak occurred in China, and rapidly spread out worldwide. Due to the lack of immediately available vaccines and effective drugs, many policy- and decision-makers have focused on non-pharmacological methods, including social distancing. This study was aimed at assessing the effects of the implementation of this policy in Iran, one of the countries most affected by COVID-19. We conducted a quasi-experimental study, utilizing the interrupted time series analysis (ITSA) approach. Methods: We collected daily data between February 20, 2020 and January 29, 2021, through governmental websites from 954 public hospitals and healthcare settings. The Iranian government launched the social distancing policy on March 27, 2020. Statistical analyses, including ITSA, were carried out with R software Version 3.6.1 (London, UK). Results: During the study period, 1,398,835 confirmed incidence cases and 57,734 deaths occurred. We found a decrease of -179.93 (95% CI: -380.11 to -20.25, P-value=0.078) confirmed incidence cases following the implementation of the social distancing policy, corresponding to a daily decrease in the trend of -31.17 (95% CI: -46.95 to -15.40, P-value=0.08). Moreover, we found a decrease of -28.28 (95% CI: -43.55 to -13.01, P-value=0.05) deaths, corresponding to a daily decrease in the trend of -4.52 (95% CI: -5.25 to -3.78, P-value=0.003). Conclusion: The growth rate of confirmed incidence cases and deaths from COVID-19 in Iran has decreased from March 27, 2020 to January 29, 2021, after the implementation of social distancing. By implementing this policy in all countries, the burden of COVID-19 may be mitigated.