فهرست مطالب
Shiraz Emedical Journal
Volume:24 Issue: 3, Mar 2023
- تاریخ انتشار: 1402/01/05
- تعداد عناوین: 8
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Page 1Background
Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge.
ObjectivesThis study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs.
MethodsThis qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study.
ResultsThree main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis.
ConclusionsClarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical trainingandadopting effective teaching-learning strategies to promote nurses’ educationandimprove their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers.
Keywords: Emergency Nursing, Education, Qualitative Research -
Page 2Background
Obsessive-compulsive disorder is identified by intrusive thoughts and related compulsive behaviors. Memory complaints are controversial among obsessive-compulsive disorder patients.
ObjectivesThe present study compared verbal, visual, episodic, and semantic memory between obsessive-compulsive disorder patients and healthy controls.
MethodsThis is a case-control study. The participants included 31 newly diagnosed obsessive-compulsive disorder outpatients and 30 healthy controls. The patients were selected using targeted sampling from Emam Reza Polyclinic, affiliated with blinded for peer review. They responded to a demographic checklist, structured clinical interview for DSM-IV (SCID-I), verbal and visual episodic memory from theWechsler Memory Scale-Revised (WMS-R), and autobiographical memory interview (AMI).
ResultsThe results indicated that patients with obsessive-compulsive disorder compared with the controls had lower scores in visual (P = 0.0001), verbal (P = 0.006), semantic (P = 0.3), and episodic memory (P = 0.001).
ConclusionsAll types of memory which were evaluated in the present study were impaired in obsessive-compulsive disorder. Memory impairment might explain the psychiatric symptoms of the disorder.
Keywords: Episodic Memory, Obsessive-Compulsive Disorder, Memory Disorder -
Page 3Background
National indicators have been defined for the satisfaction and efficiency of emergency services and for evaluating their functionality. These indicators enlighten strengths and areas where improvements can help improve emergency ward quality.
ObjectivesThis study assessed the knowledge of medical specialists and their experiences, especially concerning the effects of these protocols.
MethodsThis qualitative study was conducted in 2019 in the emergency departments of hospitals affiliated with the Iran University of Medical Sciences. During semi-structured interviews with 20 professors of emergency medicine in 2019, their experiences regarding the effects of these indicators on providing emergency services were evaluated. The data were collected until saturation. All interviews were recorded with the participant’s permission and then transcribed verbatim and analyzed by content analysis method, and their semantic codes were extracted.
ResultsBy analyzing the interviews, 14 subcategories, and four main categories were obtained. Categories and subcategories consisted of providing services to patients (with three subcategories: Improving the quality of medical services, waiting time reduction, and increasing satisfaction), improving emergency efficiency and performance (with five subcategories: Improving conditions, services, communication improvement, resource management, and facilities and equipment), accreditation (with three subcategories: Performance improvement, management and planning, and service quality improvement), and proposed indicators (with three subcategories: Time, capacity, and resources).
ConclusionsThe recognition of emergency medicine specialists in hospital emergencies is below average, which can affect the manner of providing health services and upgrading national indicators. With more and more familiarity of emergency medicine specialists with the indicators, a step can be taken to improve the status of hospital emergencies, thus determining patients’ tasks faster, reducing the length of stay in the emergency department, increasing patient satisfaction, and improving the performance of the emergency department.
Keywords: Recognition, Specialists, Emergency Medicine, National Hospital Emergency Indicators -
Page 4
Background:
This study aimed to investigate the epidemiology of basal cell carcinoma (BCC) and the probability of having another lesion in patients diagnosed with BCC.
Methods:
This descriptive-analytical study was conducted from 2015 to 2017, based on the data from patients with definitive diagnoses of BCC in two university hospitals in Birjand. In this study, 85 patients with BCC were selected based on pre-defined inclusion criteria and then divided into two groups, including single and subsequent asynchronous lesions in another anatomic area. In this study, the information was collected by census method from diagnosed patients two years after surgery. The subsequent lesions in other anatomical areas were investigated, then tumor risk factors were compared in the two groups.
Results:
The mean age of the patients was 67.83 ± 12.29, and the youngest and the oldest patients were 38 and 92 years old, respectively. Among the studied patients, 75.3% had a history of sun exposure. The most common occupations of the patients were farmer, rancher, and housekeeper. Head and neck regions were involved in 96.5%. The patients with subsequent asynchronous BCC in another facial skin region were 10.6% (CI95: 4.06 - 17.14). These patients have been subject to several simultaneous risk factors in their medical history; most of them were farmers older than 65 years. Two patients experienced three lesions in three different anatomical regions at different times. There was no statically significant difference between the two groups regarding mean age (P = 0.47), gender (P = 0.73), pathologic subtype (P = 0.06), and other risk factors (P > 0.05).
Conclusions:
This study confirms the likelihood of having a subsequent lesion in other anatomical regions in patients diagnosed with BCC. Patients with a history of BCC require prolonged follow-up because of the probability of new BCC developing.
Keywords: Basal Cell Carcinoma, Skin Neoplasm, Non-melanoma Skin Cancer -
Page 5Background
Quality of life (QOL) in the elderly has not been investigated as much as their life expectancy.
ObjectivesThe present study aimed to evaluate the elders’ QOL.
MethodsIn this study, 386 elders were selected using the multistage cluster random sampling method. The Leiden-Padua (LIEPAD) questionnaire, consisting of the core components (CCQOL) and moderators (MQOL) of QOL, was used and analyzed with SPSS software.
ResultsThe interviewees’ mean age was 68.12 ± 6.24 years. The QOL score was 83.67 ± 13.75 (out of 127), consisting of 27 (6.9%) elders with low, 316 (81.8%) elders with moderate, and 43 (11%) elders with high levels of QOL. The CCQOL and MQOL scores were 70.68 ± 9.42 (out of 93), and 20.94 ± 2.30 (out of 34), respectively. According to the multivariate analysis, sleep disorders (B = -0.15), osteoporosis (B = -0.14), female gender (B = -0.13), and not being the source of family income (B = -0.13) were inversely correlated with QOL. In contrast, sleep disorders, facing violence, female gender, migraine, psychological diseases, and not being the source of family income were inversely correlated with CCQOL. Sexual problems, facing violence, no supplementary insurance coverage, inability to walk, and migraine had inverse correlations with MQOL.
ConclusionsSeven out of ten elders had a moderate level of QOL, while elderly females and elders with chronic diseases or those who were not the source of family income had lower levels of QOL. Accordingly, the elders’ QOL can be improved by integrating the elders’ care programs in the health centers.
Keywords: Quality of Life, Life Expectancy, Elderly, LIEPAD, Core, Moderator -
Page 6Background
Promoting the immunity of pregnantwomenduring the Covid-19 pandemic through vaccination against SARS-CoV-2 infection is one of the main challenges. It is important to manage the information related to receiving the vaccine and its possible complications for surveillance of its safety and to deal with the challenges. Based on this, it is necessary to design a national information management system for the COVID-19 vaccination.
ObjectivesTo promote the safety of pregnant women by providing a national model of an information management system for pregnant women’s COVID-19 vaccination in Iran.
MethodsThe present research was of applied descriptive type. Based on the review of articles and information sources and a comparative study of the information management and surveillance system for the vaccination of pregnant women in developed countries, and according to the country’s organizational structure, the national model of the information management system for pregnant women’s COVID-19 vaccination was designed for Iran. Then the validation of the model was examined in two steps using the Delphi technique. Finally, after analyzing the data, the final model was presented.
ResultsThe findings were categorized into two main groups, including the structural components (responsible organization and databases, surveillance center, participating organizations, and data sources) and informational process (data set, data collection, quality control, data exchanges, data processing, reporting) that reached 100% consensus of experts.
ConclusionsFor developing IMS for the COVID-19 vaccination of pregnant women, it is necessary to specify the responsible organization and the participating centers, create surveillance centers and databases, and define the information management system process.
Keywords: COVID-19 Vaccine, Information System, Pregnancy, Safety, Surveillance System -
Page 7Background
Both low-level laser therapy (LLLT) and platelet-rich plasma (PRP) are demonstrated to promote the repair of mandibular defects.
ObjectivesThis study investigated the mechanical properties and calcium content at the tooth extraction site in a rat model exposed to LLLT ( = 808 nm) with or without PRP.
MethodsIn this experimental rat model study, the left first molar maxillary teeth were extracted in twenty male rats. Then, the animals were randomly divided into four groups. Group one: after extraction, the extraction sockets were treated with 0.9Wgalliumaluminum- arsenide (GaAlAs) diode laser irradiation for five minutes every 72 hours for the next 12 days (4 times overall); group two: PRP was placed in the extraction sockets; group three: a combination of both treatments (LLLT+PRP) was applied; group four: the extraction sockets remained untreated (the control group). All rats were sacrificed 30 days post-operative. All bone blocks of the extracted socket were prepared for mechanical strength and calcium content analyses. Mann-Whitney test, one-way ANOVA test, and post hoc Fisher’s least significant difference (LSD) were used to analyze the data. A P-value less than 0.05 was considered significant. All analyses were performed by SPSS 16.0. The graph is illustrated in the graph pad 5.
ResultsThe compressive strength in the laser group was significantly higher than in the control and PRP-treated groups (P = 0.0001 and 0.00044, respectively). Compared to the control and PRP groups, the effects of a combination of PRP and LLLT mechanical strength were statistically similar. Calcium content was influenced by none of the treatments.
ConclusionsThe mechanical strength of the bone blocks was significantly stronger in the LLLT group than in the other groups. Platelet-rich plasma alone or combined with LLLT demonstrated a synergistic impact on neither mechanical strength nor calcium content.
Keywords: Low-level Laser Therapy, Platelet-rich Plasma, Alveolar Bone, Tooth Extraction