Explore pre-hospital emergency challenges in the face of the COVID-19 pandemic: A quality content analysis in the Iranian context.

Background: pre-hospital emergency is a community-oriented system that responds to the medical needs of the injured or patients with acute and emergency illnesses outside of health care facilities until they are transferred to a medical center. This study aimed to explore pre-hospital emergency challenges in the face of the COVID-19 pandemic. Material and methods: This study was conducted as a qualitative content analysis in Iran. Using the purposive sampling method, data were collected through in-depth individual interviews with 28 prehospital paramedic personnel from November 2020 to November 2021. Graneheim and Lundman's conventional content analysis methods were used to analyze the data and for the trustworthiness of the data, this study used Lincoln and Guba's recommendations. Results: After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, four main categories and 10 subcategories were created based on the results of the data analysis and including (1) Culture and Community. (2) Service delivery (3) Human resources; (4) Medical supplies and equipment. Conclusion: According to the findings of this study emergency medical system employees are suffering from a range of psychiatric problems as a result of a lack of equipment and job overload, which has a detrimental impact on the quality of pre-hospital emergency care. Therefore, emergency care senior management should develop comprehensive guidelines, provide more equipment and minimize professional challenges to improve the quality and safety of pre-hospital emergency care services.

Design and validation of a preparedness evaluation tool of pre-hospital emergency medical services for terrorist attacks: a mixed method study.

INTRODUCTION: Terrorist attacks are one of the human problems that affect many countries, leaving behind a huge toll of disabilities and deaths. The aim of this study was to use a mixed-method analysis to design and validate an evaluation tool for pre-hospital emergency medical services for terrorist attacks. METHODS: The present study is a mixed-method (qualitative and quantitative) study that was conducted in two phases. In the qualitative phase (item generation), semi-structured interviews were conducted with 34 Iranian emergency medical technicians who were selected through a purposive sampling method and a scoping literature review was conducted to generate an item pool for the preparedness evaluation of Emergency Medical Services (EMS) in terrorist attacks. In the quantitative phase (item reduction), for validity of tool face, content and construct validity, were performed; for tool reliability, the test and retest and intra-class correlation coefficient were evaluated. RESULTS: At the first stage, 7 main categories and 16 subcategories were extracted from the data, the main categories including "Policy and Planning", "Education and Exercise "," Surge Capacity", "Safety and Security", "Command, Control and Coordination", "Information and Communication Management "and "Response Operations Management". The initial item pool included 160 items that were reduced to 110 after assessment of validity (face, content and construct). intra-class correlation coefficient (ICC = 0.71) examination and Pearson correlation test (r = 0.81) indicated that the tool was also reliable. CONCLUSION: The research findings provide a new perspective to understand the preparedness of pre-hospital emergency medical services for terrorist attacks. The existing 110-item tool can evaluate preparedness of pre-hospital emergency medical services for terrorist attacks through collecting data with appropriate validity and reliability.

Exploring the challenges of Iranian government hospitals related to Covid-19 pandemic management: a qualitative content analysis research from the nurses perspective.

BACKGROUND: The COVID-19 pandemic poses a major threat to global public health. As a result, to prepare healthcare systems for this unprecedented threat, a coordinated worldwide response is required. This study aimed to explore the hospitals challenges related to covid-19 pandemic management from the iranian nurses perspective. METHODS: This study was conducted as a qualitative content analysis in Iran. Using the purposive sampling method, data were collected through in-depth individual interviews with 35 nurse personnel. Graneheim and Lundman's conventional content analysis methods were used to analyze the data and for the trustworthiness of the data, this study used Lincoln and Guba's recommendations. RESULTS: After multiple rounds of analyzing and summarizing the data and taking into consideration similarities and differences, 5 main categories and 14 subcategories created based on the results of data analysis and including1) Leadership and management 2) Service delivery management 3) Human resources management 4) Equipment and Supplies Management and 5) Economic resources management. CONCLUSION: Identifying the most important challenges of nursing can play an important role in improving the management of COVID-19pandemic. The analysis of the challenges by managers at local, provincial and national levels can lead to the presentation of effective solutions to address these challenges and improve the pandemic management process in the country.

Prevalence of workplace violence against health care workers in hospital and pre-hospital settings: An umbrella review of meta-analyses.

Introduction: Workplace violence (WPV) is associated with adverse consequences for patients and health care workers (HCWs). The aim of this study was to assess the prevalence of WPV against HCWs in the hospital and pre-hospital settings. Methods: Using PRISMA guidelines, data resources including Scopus, PubMed, Web of Science, and Google Scholar were used for the search. The searches were conducted without any time limit until the end of December 2021. The random-effects model was used for this meta-analysis. I 2 index was used to examine heterogeneity and the Egger test was used to examine publication bias. Results: Of the 255 studies identified, 14 studies entered the umbrella review. The overall prevalence was as follows: WPV (58.7%); physical violence (20.8%); verbal violence (66.8%); and sexual harassment (10.5%). Conclusion: The prevalence of WPV and its types against HCWs is relatively high. WPV is associated with physical, psychological, and occupational consequences. Measures should be taken to reduce the consequences of WPV.

Evaluation of the Prevalence of Malaria and Cutaneous Leishmaniasis in the Pre- and Post-Disaster Years in Iran.

BACKGROUND/OBJECTIVE: Natural disasters (NDs) are calamitous phenomena that can increase the risk of infections in disaster-affected regions. This study aimed to evaluate the frequency of malaria and cutaneous leishmaniasis (CL) before and after earthquakes, floods, and droughts during the past four decades in Iran. METHODS: Malaria and CL data were obtained from the reports of the Ministry of Health and Medical Education in Iran for the years 1983 through 2017. The data of NDs were extracted from the Centre for Research on the Epidemiology of Disasters (CRED). Interrupted time series analysis with linear regression modeling was used to estimate time trends of mentioned diseases in pre- and post-disaster conditions. RESULTS: For the periods preceding the disasters drought and flood, a decreasing time trend for malaria and CL was found over time. The time trend of malaria rate preceding the 1990 earthquake was stable, a downward trend was found after 1990 disaster until 1997 (ß coefficient: -10.7; P = .001), and this declining trend was continued after 1997 disaster (ß coefficient: -2.7; P = .001). The time trend of CL rate preceding the 1990 earthquake had a declining trend, an upward trend was found after 1990 earthquake until 1999 (ß coefficient: +8.7; P = .293), and a slight upward trend had also appeared after 1999 earthquake (ß coefficient: +0.75; P = .839). CONCLUSION: The results of the current study indicated the occurrence of earthquakes, floods, and droughts has no significant effect on the frequency of malaria and CL in Iran.

A qualitative content analysis for determining indexes and factors affecting for evaluation of disaster exercises immediate feedback stage.

BACKGROUND: Taking exercise in health sector is one of the important steps to implement the disaster risk management programs, especially preparedness phase. The present study aimed to identify indexes and factors affecting successful evaluation of disasters preparedness exercises in hot wash stage. MATERIALS AND METHODS: This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in the field of disasters. The data were analyzed using directed content analysis method by which the initial codes were extracted after transcribing the recorded interviews and immersing them in the data analysis. The initial codes were reviewed, classified, and subdivided into several stages to determine the main classes. RESULTS: The data analysis resulted in the production of 24 initial codes, 5 subcategories, 2 main categories of "evaluation and exercise debriefing" and "modification of programs and promotion of exercise operational functions" under the original theme of "exercise immediate feedback." CONCLUSION: This study can be considered a suitable standard guide for health care organizations to evaluate successfully disasters exercises in hot wash stage, maintain and promote their preparedness, and properly respond to disasters.

Investigating the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with COVID-19 patients in Iran.

BACKGROUND: The caregivers of patients with covid-19 face constant responsibilities such as providing personal, health, and social care to family, which can be physically, and emotionally exhausting resulting in a considerable stress burden. Therefore, given the importance of the subject, this study aimed to investigate the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with covid-19 patients in Iran. METHODS: This cross-sectional study was conducted one year after the onset of the Covid-19 outbreak in Iran. Family caregivers of Covid-19 patients discharged from the hospitals in Kerman city, Iran, were chosen by simple randomization (n = 1500). Data were collected utilizing a demographic characteristics inventory created by the researcher as well as the Novak and Guest Caregiver Burden Inventory. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as Kolmogorov-Smirnov, T-test, ANOVA, and Multivariate Linear Regression were used for data analysis using the 20, SPSS Inc., Chicago, IL Software at the level of P < 0.05. RESULTS: The results demonstrated that the mean score of family caregiver burden was 2.61±0.6 and the severity of this burden was in a moderate range. The finding showed a statistical difference was seen between the family caregiver burden mean score of participants in terms of gender, duration of treatment, age and employed status. The multivariable linear regression model showed demographic variables of caregivers included (female, married, employed, elderly, low income and poor education) had a beneficial influence on family caregiver burden. CONCLUSION: The findings of this study can increase the awareness of health managers, about the level of burden of disease among family caregivers from the covid-19 patients and can help to provide economic, social and psychological support programs for improvement and reducing the burden of disease of caregivers during the covid-19 outbreaks.

Identifying and Explaining the Components Affecting for Design Preparedness Exercises of the Health System in Emergencies and Disasters: A Quality Content Analysis.

OBJECTIVE: Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters. METHODS: This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method. RESULTS: The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of "Coordination, Command, and Guidance of Exercise," "Hardware and Software Requirements of Exercise," "Organizational Exercise Resources," and "Communication and Exercise Public Information" with the original theme of "Exercise Design." CONCLUSION: This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises.

Providing telenursing care for victims: a simulated study for introducing of possibility nursing interventions in disasters.

INTRODUCTION: Uncertainty occurrence of disasters requires special attention and a shortage of health care specialists is a challenge for health care systems; therefore, the use of telenursing care during a disaster is an appropriate way to provide care. This study aimed to investigate telenursing operational possibilities in disasters. METHODS: A cross-sectional study was performed by implementing a functional exercise (Drill) for the possibility of nursing interventions in the response phase to disasters at Kerman University of Medical Sciences in 2021. Two evaluators examined and scored the possibility of providing telenursing care using a researcher-made checklist and we surveyed Inter-rater agreement between two evaluators by Cohen's kappa coefficient. Data were analyzed using descriptive tests and SPSS 20 software. RESULTS: Findings showed that implementation of telenursing care would be helpful in future disasters. The scores received from assessment of the evaluation checklist for this simulated exercise program by the first evaluator was 83.25 and for the second evaluator was 72.00. The results of the study showed that the mean score of the possibility of telenursing in disasters was at a high level 77.50. Thus, the quality of the telenursing care in simulated conditions was satisfactory. CONCLUSION: Today, disaster management is almost impossible without using new technologies. This study found that due to the lack of specialized nursing staff in the deprived areas affected by disasters, the most important way to provide health care for a large group of the population is to develop effective health services so that everyone can use these services equally and fairly.

Developing and psychometric testing of the evaluation tool for disaster exercises design stage: A mixed method study.

BACKGROUND: Exercise in different health sectors is an important step in preparing programs for disaster risk management. The present study aimed to develop and validate a tool for evaluating disaster exercises during the design stage in the health sector. METHODS: This methodological study was conducted in two phases using an explanatory sequential mixed method approach. Semi-structured interviews with 25 disaster-related health professionals were conducted during the qualitative phase (item generation), and a systematic review was done to evaluate items pool of disaster exercises design stage tool. The quantitative phase (item reduction) assessed both face and content validity, as well as reliability using Cronbach's alpha and intra-class correlation coefficient. RESULTS: At the first stage four main categories and eleven subcategories were extracted from the data, the main categories including "coordination, command and guidance of exercise", "hardware and software requirements of exercise ", "organizational exercise resources", and "communication and exercise public information". The initial items pool included 164 items that were reduced to 50 after the assessment of validity (face and content). Cronbach's alpha (0.89) and intra-class correlation coefficient (ICC = 0.72) tests indicated that the tool is also reliable. CONCLUSION: The research findings provide a new categorization perspective to understand the disaster exercises evaluation in the health sector. The existing 50-item tool can evaluate disaster exercises design stage in the health sector through collecting data with appropriate validity and reliability.

Prevalence of postpartum depression in women amid the COVID-19 pandemic: A systematic review and meta-analysis.

COVID-19 outbreaks appear to be related to exacerbation of psychological problems such as depression and anxiety in high-risk population such as pregnant women and the postpartum period due to stress and life-threatening illnesses. The aim of this study was to evaluate the prevalence of postpartum depression (PPD) during COVID-19. This study protocol is registered in PROSPERO with CRD42021278425 code. Data sources including Google Scholar, ISC, Magiran, Scopus, PubMed, Embase, and Web of Science and reference list of included articles were used to identify related studies. Observational studies that reported the prevalence of PPD in both Persian and English during COVID-19 between January 20, 2020 and August 31, 2021 were included. Data were collected and analyzed with a random effects model for meta-analysis. In this study, 671 initial articles were identified and after removing duplicates, 454 studies were screened and finally 24 studies entered the meta-analysis stage. According to this study results PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥9, EPDS ≥10, EPDS ≥11, EPDS ≥12, EPDS ≥13, Postpartum Depression Screening Scale-Short Form (PDSS-SF) ≥17 and total prevalence was reported 12% (95% confidence interval [CI] = 0.07-17, I2  = 97%), 27% (95% CI = 15-39, I2  = 99%), 44% (95% CI = 40-49, I2  = 0.0%), 27% (95% CI = 0.06-49, I2  = 97.4%), 28% (95% CI = 18-39, I2  = 98.5%), 37% (95% CI = 32-42), 28% (95% CI = 23-33, I2  = 98.5%). The findings of this study showed that the prevalence of PPD in women is relatively high during COVID-19. Therefore, considering the psychological consequences of the COVID-19 pandemic and the importance of pregnancy and the postpartum period in terms of the emergence of mental disorders, especially depression, it seems necessary to perform interventions and physical and psychological support.

Determination risk factors for severe and profound hearing loss in child candidates for cochlear implantation in southeast of Iran during 2014-2020.

BACKGROUND: Hearing loss can have a major impact on children's language development, academic success and hearing comprehension. The aim of the present study was to determinate risk factors for severe and profound hearing loss in child candidates for cochlear implantation in southeast of Iran during 2014-2020. MATERIALS AND METHODS: This case-control study consisted of 400 children referring to a cochlear implant center (in southeastern Iran) from Bandar Abbas, Zahedan and Kerman during the years 2014-2020 as cases. The subjects were selected using the random sampling method; 200 children hospitalized in Shafa and Afzalipour hospitals were selected as controls. RESULTS: Based on the results of the multivariate logistic regression, weight less than 1500 g (OR = 4.40: p < 0.05), hospitalization in NICU (OR = 7.21: p < 0.05), family history of hearing loss (OR = 11.47: p < 0.05), Gestational age over 35 (OR = 9.63: p < 0.05), intracranial hemorrhage (OR = 5.18: p < 0.05), consanguineous marriage (OR = 12.48: p < 0.05) and high fever and seizures (OR = 3.02: p < 0.05) were recognized as risk factors for sensorineural deafness in children. CONCLUSION: Most of the risk factors for deafness are preventable, and hereditary factors play an important role in congenital deafness in children. Therefore, genetic counseling before consanguineous marriage, early diagnosis, timely intervention can prevent many cases of hearing loss in children.

Response capability of hospitals to an incident caused by mass gatherings in southeast Iran.

BACKGROUND AND OBJECTIVES: Hospitals are expected to provide a safe environment for patients, visitors, and employees during emergencies and disasters, as well as provide health care to disaster survivors. The aim of this study was to evaluate the response capability of hospitals to an incident caused by mass gatherings (MG) in Kerman province. METHODS: This cross-sectional study was performed among hospitals of Kerman city in 2021. To collect data, the emergency response checklist-WHO (2011) was utilized with 90 questions prepared in nine domains. Data analysis was carried out using SPSS version 20 with descriptive tests. RESULTS: In this incident, 438 people were injured and 61 killed (31 women and 30 men). Of the 438 injured taken to hospitals, 193 were treated on an outpatient basis, 146 were hospitalized and 99 were treated at Advanced Medical Post (AMP) and mobile hospital in the scene. Results showed a moderate response level of hospitals to an incidence (151.50±18.28). Among the components of hospitals' response to incidence, the command and control component had the highest mean score (159.16 ± 22.39) while the surge capacity component had the lowest mean score (129.78 ± 25.21). CONCLUSION: Our hospitals faced new challenges in this incident; therefore, policymakers and executives managers of the health system in Iran should develop a comprehensive strategic plan to promote hospitals' preparedness for suitable and timely response to MG incidences and improve risk perception of mass gathering participants and hospitals personnel through training and implementing discussion and operation-based exercises.

Does workplace spirituality enhance motivation of hospitals social workers? The scrutiny in Iran.

BACKGROUND: In today's world as the globe of organizations, employees tend to show endeavor and more involvement in organizational goals and mission by creating workplace spirituality. AIM: The present study aimed to investigate the role of workplace spirituality in improving hospital social worker's motivation. METHODS: The study employed a cross-sectional design and was conducted in 19 private and governmental hospitals in Karaj city, Alborz province, north Iran in 2019. The statistical population included all 302 hospital social workers who were selected as the sample population according to Cochran's formula. Using two standard questionnaires of workplace spirituality and employee motivation, we assessed the role of workplace spirituality in improving the hospital' social workers' motivation. RESULTS: According to research findings, there were significant relationships between workplace spirituality, meaningful working, sense of community, forgiveness, and honesty with hospital social workers motivation p ⩽ .05. There was a significant difference between age group, gender, level of education and workplace spirituality, and motivation of hospital social workers p ⩽ .05. CONCLUSION: Findings suggest that health planners and authorities may need to examine factors that contribute to the promotion of workplace spirituality to increase the motivation of hospital social workers for improved performance of health organizations.

Workplace Violence Against Prehospital Paramedic Personnel (City and Road) and Factors Related to This Type of Violence in Iran.

Medical personnel such as those working in emergency medical systems are in direct contact with the patient or the injured and are exposed to workplace violence. This study aimed to determine workplace violence against prehospital paramedical personnel and factors related to this type of violence in Iran. The cross-sectional study was conducted in 72 prehospital emergency centers affiliated with Kerman University of Medical Sciences in 2019. Using a researcher-made questionnaire, we assessed workplace violence and factors associated with this type of violence in prehospital paramedical personnel with a census method (N = 308). Data were analyzed using descriptive statistics including mean and standard deviation (SD), frequency, percentage, and analytic statistics, such as the Kolmogorov-Smirnov, ANOVA, t test, and multiple linear regression tests. The results of this study showed that the most frequent types of workplace violence were verbal violence (47%), physical violence (32.50%), cultural violence (16%), and no violence (4.50%), respectively. From the perspective of paramedical personnel, the total mean score of workplace violence was at a moderate level (52.19 ± 10.72). The most important factors affecting workplace violence from the perspective of paramedical personnel were "lack of awareness of people about the duties of emergency medical personnel" and "lack of specialists in prehospital (city or road) bases." Majority of the paramedical personnel believed that "no reaction and observance of patients and their families' rights" were the most important types of reactions. They also believed that violence was normal at the workplace and should not be considered in emergency medical services. Results suggest that national and local policies in Iran should provide prehospital paramedical personnel with various training courses about how to decrease the rate of workplace violence, promote public health, and decrease their psychological stresses and occupational burnout.

Qualitative Study of Health System Preparedness for Successful Implementation of Disaster Exercises in the Iranian Context.

OBJECTIVES: Implementing disaster exercises in different parts of the health system is one of the important steps in providing and developing disaster risk management plans. Considering the importance of promoting health system preparedness through exercise, the present study aimed to identify and explain necessary and original components for successful implementation of preparedness exercises of the health-care system in disaster. METHODS: The study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disaster. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis. RESULTS: The data analysis resulted in the production of 100 initial codes, 14 subcategories, 6 main categories of "coordination and information management," "standards and indicators," "conduction and control of the process," "logistic management and supplies," "management of treatment operation," and "management of health operation," under the original theme of "implementation of exercise." CONCLUSIONS: The findings of this study can greatly increase the attention of senior managers to preparedness in all areas of the health system, especially managers of prehospitals and hospitals who are the forefront of the response to the disaster. The findings of this study can be considered as a guideline for the implementation of principle and standardized health system preparedness exercises.

Nursing Students' Competency to Attend Disaster Situations: A Study in Western Iran.

OBJECTIVE: The disaster preparedness of nurses is important as nurses are members of a health care team that needs to work systematically and collaboratively in all conditions. Although education and training naturally underpin effective practice, disaster nursing education is rarely provided to nurses in Iran. Because disaster situations, by definition, overwhelm health services, it is likely that nursing students will be required to join their colleagues in the response. The purpose of this study was to evaluate the competency of nursing students to attend disaster situations. METHODS: This descriptive, analytical study was conducted in western Iran in 2020. A total of 70 nursing students in the fourth (final) year of their undergraduate nursing education entered the study by a census sampling method. Data collection was undertaken using a validated disaster competency assessment questionnaire. The data were analyzed using SPSS version 21 (IBM Corp, Armonk, NY) with descriptive and analytic tests. RESULTS: The mean age of participants was 21.4 ± 2.14 and 57.1% of them were women; 45 participants (64.3%) had received no disaster-related training, and 88.6% had no history of participating in disaster exercises. The total score for nursing students' competence was 125.58 ± 14.19. There was a significant relationship between the mean score of nursing competence in response to disasters and student history of participating in an exercise and training course (P < 0.001). CONCLUSION: Students' competence in disaster situations is poor. Awareness of the competence condition of nurses is the first step to improve their preparedness as the most key members of the disaster health team. Conducting disaster-related training may be appropriate. The results of this study can provide evidence for the development of educational policies in disaster nursing education.

The Prevalence of Post-traumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis.

Introduction: Frontline health care workers (HCWs) have had an increased risk of developing health problems during the COVID-19 pandemic. In addition to physical illness, they have experienced mental health challenges, including post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD among HCWs during the COVID-19 pandemic via an umbrella review and meta-analysis. Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to perform a systematic literature search using various medical databases (Web of science, PubMed, Scopus, Cochrane, ProQuest, Science Direct, Embase, and Google scholar). The search included all articles published through the first of January 2020 the end of March 2021. The systematic review and meta-analysis studies that reported the prevalence of PTSD among health care workers were included in the study, and studies that reported the prevalence of PTSD in normal people or other epidemics were excluded. The random effects model was used to perform a meta-analysis, and the I 2 index was used to evaluate heterogeneity among studies. Publication bias was assessed using the Egger test. Data was analyzed using STATA (version 14) software. Results: The initial literature search yielded 145 studies. After excluding duplicates and assessing the quality of the studies, 7 studies were selected for meta-analysis. The results showed that the overall prevalence of PTSD among HCWs during the COVID-19 pandemic was 13.52% (95% CI: 9.06-17.98, I 2 = 65.5%, p = 0.008). Conclusion: There is a high prevalence of PTSD among frontline HCWs during the COVID-19 pandemic. It is important to invest in efforts to screen HCWs for mental health disorders such as PTSD and provide them with mental health support.

Hospital disaster preparedness in Iranian province: A cross-sectional study using a standard tool.

OBJECTIVE: Hospitals are the first place to refer the victims of emergencies and disasters. Hamadan province, as one of the provinces in western Iran, like other parts of this country is exposed to various emergencies and disasters. This study was conducted to evaluate the level of hospital disaster preparedness in the Hamadan province of Iran using a standard tool. METHODS: This study was conducted in Hamadan province's hospitals in Iran. The Persian version of the World Health Organization Hospital Emergency Response Checklist was used as an evaluation tool. It consists of nine key components: command and control, triage, human resources, communications, surge capacity, logistics/supply management, safety and security, continuity of essential services, and post-disaster recovery. Data entry and analysis were performed using IBM® SPSS® software (version 18). RESULTS: Fifteen hospitals participated in this study (response rate 83 percent). Most hospitals (53.33 percent) were in moderate preparedness level, 26.66 percent are in good, and 13.33 percent are at a poor level. There was no significant relationship between "the hospital type" and "the hospital size" (number of beds) and preparedness score (p > 0.05). CONCLUSIONS: This study showed that most of the hospitals in the Hamadan province regarding the components of "logistics" and "essential services" are at a poor disaster preparedness level. Accordingly, the hospital authorities and managers must adopt a comprehensive strategy for strengthening the hospital disaster preparedness measures, especially in these components.

The effect of bio ethical principles education on ethical attitude of prehospital paramedic personnel.

BACKGROUND: Ethical attitude of paramedic personnel is one of the most important factors in their effective and useful performance. Therefore, according to the importance of this issue and immense effect of religious culture on the formation of ethics, this study aimed to effect bio-ethical principles teaching on moral attitude of paramedic emergency personnel in Iran. MATERIAL AND METHODS: The present study was an experimental study carried out in 2020 on 60 of paramedic emergency personnel. Samples were available, randomly selected and assigned to two groups of control and intervention. The intervention was performed for a 2-h workshop of bioethical principles in 4 day based on Quran verses. Moral attitude of both groups was studied before and after each intervention. Data were analyzed using Kolmogorov-Simonov, Chi-square, t-test, one-way, and paired t-test with SPSS version 16 (P ≤ 0/05). RESULTS: Ethical attitude means for both groups of control and intervention demonstrated that ethical attitude has meaningfully increased after the workshop. Demographic variables such as age, gender, and work experience of participants in workshops were not different between these two groups (P < 0/05). The study of these two groups showed that there is no relationship among work experience, gender, marital status, age, and ethical attitude. CONCLUSION: Prehospital emergency is quite different from the other occupations in health-care system and the ethical issues of this field are more important. Therefore, teaching in workplace and through ethical principles based on religious teachings will have a profound effect on improving biological ethics of paramedic prehospital staffs.