فهرست مطالب bahram tahmasbi

For many years, the promotion and development of traditional medicine along with modern medicine has been the main focus of the WHO. In Iran, traditional medicine is not provided at the executive level of the health system. The aim of this study was to determine the viewpoints of managers and executors regarding the use of traditional medicine in the Iranian family physician program (FPP).

This cross-sectional study was conducted by holding 16 panels of experts in the winter of 2017. The research population including 481 managers and executers of the implementation of the urban family physician program in 28 cities of Fars province were selected by census. The data collection tool was a researcher-made questionnaire. Data were entered in Excel and analyzed in SPSS 23 at the significant level of p<0.05.

Among the 481 subjects, 56.5% were male and most of them had a bachelorchr('39')s degree. The familiarity level of 64.9% of people with traditional medicine was very low and low, 28.3% moderate as well as 6.8% high and very high. The mean viewpoint of the subjects was 2.98±0.7 in 5. The highest level of attitude was about avoiding haste and positive effect of empowerment. The lowest level of individuals’ attitude was regarding adequate supervision of traditional medicine providers and family physicians having the necessary knowledge and skills. There was a significant difference between age, level and field of study, residence and occupation of people with their familiarity and attitude toward the use of traditional medicine (P<0.05).

This study showed that the familiarity level of people with traditional medicine was low, and their attitude was moderate. Therefore, it is essential to implement the intervention programs.

Musculoskeletal disorders are prevalent and expensive diseases. This study was conducted to estimate and compare the costs of illness of three musculoskeletal conditions. Patients with rheumatoid arthritis (RA), knee osteoarthritis (OA), and fibromyalgia syndrome (FMS) who referred to a rheumatologist completed questionnaires about their socio-demographic condition, clinical status, and the costs of their disease (direct costs included visits, laboratory tests, imaging, and medications; indirect costs included absence from paid work, functional inability, and paid and nonpaid household help) in the preceding year. Statistical analyses were performed by descriptive analysis, and one way ANOVA and chi-square test were used for the comparison of three groups using SPSS ver 20. A p-value .

Background and Death depression is a common phenomenon among cancer patients that many factors could influence it. Therefore, the aim of this study was to determine the factors and finding an influencing path out of death depression.
A cross-sectional study (April to July, 2016) was done in 497 cancer patients who were recruited from those attending Cancer Centers in Sari (Imam Khomeini Hospital) and Kerman, Iran. The patients were selected by convenience sampling. Data was collected using demographic questionnaire, death depression scale, and Pargament`s religious coping scale (the RCOPE).
The mean age and death depression score of cancer patients were 48.38±15.22 and 69.92±18.40, respectively. Multiple linear regression analysis showed economic status (β=5.37), cancer stage (β=-2.80), and religious coping behaviors (β=-0.34) as predictive variables of death depression. Path analysis revealed that economic status and cancer stage had both direct and indirect impacts on death depression but religious coping behaviors directly influenced death depression.
According to the model identified by path analysis, religious coping behaviors is the only variable that has a direct impact on the level of death depression which is influenced by the stage of cancer. However, economic status and stage of cancer could explain the death depression by direct and indirect influences.

Background and The family physician is obliged to deliver qualified and comprehensive services according to the people`s need for provision, protection and improvement of their physical, mental, and social health. This study aimed at investigating patients’ satisfaction from urban family physician program in Mazandaran province, Iran, 2015.
In this cross-sectional study, 1500 patients were sampled through multi-level random method from several cities in Mazandaran province. Data was collected by a researcher-made questionnaire consisting of 6 dimensions and 30 items including services, services delivery, services accessibility, physicians, assistants and picture of services (5 items in each dimension). Its validity was confirmed by experts and its reliability was verified by internal consistency calculated for each dimension; 0.84, 0.86, 0.92, 0.79, 0.83, and 0.85, respectively.
We found that patients were only relatively satisfied with physicians (P According to this study, authorities in health care sector must work on increasing patients’ satisfaction with the urban family physician program to deliver better health care services.

Background and In urban health care system, pre-hospital emergency medical services are the first line to deal with critical patients. If a fast and accurate medical care is delivered, deaths and disabilities resulting from diseases reduce and trust of people to this system will increase. The purpose of this study was to determine the factors influencing the readiness of pre-hospital emergency care in Mazandaran province.
In this descriptive cross sectional study the population included 362 staff in pre-hospital emergency settings in Mazandaran province of whom 191 were selected by simple random sampling. Data was collected using a researcher-made questionnaire. Data was analyzed applying one sample t-test and Friedman’s test.
The most important effective factors on readiness of pre-hospital emergency care in Mazandaran province included human resources, equipment and logistics, training courses, information and communication technology, management and organization, and motivation. According to the staff in pre-hospital emergency care settings two factors including motivation (4.37 from 5) and human resources (2.26 from 5) had the most and least effects. Other effective factors included equipment and logistics (4.36), information and communication technology (3.30), training courses (3.19), and management and organization (3.15).
Motivation was found to be the most influencing factor affecting the readiness of pre-hospital emergency staff in Mazandaran province, therefore, policy-makers and managers should pay more attention to the incentives and all factors affecting the quality of services delivered.

Background and

Health care system is organized at three levels in order to increase efficacy and effectiveness and create justice and also people availability. Considering the three levels of primary health care، access of people to specialized services through referral system is possible. With regard to the importance of referral system in family physician program، this study was performed to evaluate the function of referral system and network system in Northern provinces of Iran.

This analytic study was performed in autumn and winter of 2012. Twenty five percent of health centers (139 centers from 552) which implement the family physician program and rural insurance coverage by medical universities of Golestan، Mazandaran، Babol and Guilan were randomly selected. In each center، 7-8 patients who were referred to level 2 by their family physician and received necessary services were evaluated. They were at their homes at inquiry time.

From 963 patients who received the level 2 services، 687 cases (71%) were females and 276 (29%) were males. Three hundred and twenty cases (33%) had referral form from health house. Only 299 (31%) persons referred to the centers because of diagnosis of family physician and in 161 (17%) of cases، the family physician had a role to choose a specialist of level 2. For 155 (16. 1%) of cases، the specialists wrote the results of their evaluation in feedback form. Only 149 (15. 5%) of patients returned to their family physicians. Six hundred ninety-seven (79. 6%) of patients did not return to their family physician because of lack of knowledge.

The results of this study showed that many principles for referral system from level 1 to higher levels and vice versa are not considered that require education، reformation and intervention in this field.