فهرست مطالب reza ebrahimoghli

Objectives :

Psychological support is one of the basic aspects of care for patients with cancer. It has been emphasized in literature and clinical practice for many years. This study aims to explore the experiences and perceptions of healthcare providers in Ardabil, Iran, about psychological support to patients with cancer.

Methods :

The research was conducted using conventional qualitative content analysis in cancer treatment centers in Ardabil, Iran, in 2021. Participants were 19 healthcare providers who were purposefully selected and interviewed to explore their experiences. After transcribing the recorded data, analysis was carried out based on Graneheim and Lundman’s content analysis method. 

Results :

Based on the content analysis results, four main themes, including “highlighting positive mental connection with oneself and others”, “positive awareness”, “positive change in the patient’s point of view,” and “strengthening the perceived value” were extracted. These categories reflected the healthcare providers’ efforts to “strengthen the positive mindsets” of patients and showed the formation of psychological support for patients with cancer.  

Conclusion:

 Strengthening of the positive mentality in patients with cancer is needed for their psychological support, and should be used as a strategic plan in the development of training programs for healthcare providers. It can be an indicator for evaluating psychological support to these patients and be a step towards providing quality care to them. The findings can be useful for designing a tool to measure the status of psychological support for patients with cancer in Iran or assess the care quality and performance of healthcare providers in giving psychological support to these patients.

Hepatitis B virus [HBV] infection is one of the most important public health concerns. The present study was conducted to provide a descriptive analysis of detected HBV infection in Ardabil province.

In this retrospective longitudinal study, the hepatitis B surveillance database of Ardabil province was examined from 2014 to 2018. The frequency of hepatitis B virus infections was presented based on age, gender, marital status, place of residence, primary symptoms, and reporting sources. Also, the trend of changes in the number of detected cases over time was investigated using time series analysis.

A total of 817 positive cases with a mean age of 43.1 years were reported. Most of them were male [n=503, 61.5]. The Frequency of identified positive cases decreased over time. Most of the infections were asymptomatic [87.5%]. Almost 90.0% of patients with HBV were married and the majority of the identified patients were resided in urban settings [n=598, 73.2%]. Most diagnostic tests were done voluntarily [n=219, 26.8%] or during prenatal care [n=109, 13.3%]. Most cases were identified and reported by the health network [n=292, 35.7%] and blood transfusion organization [n=190, 23.2%].

Decision-makers of the health sector of the province can use this information as a source for evidence-based decision-making in the effective management of the disease.

Student life is one of the most sensitive stages of people's lives, which can also be prone to some behavioral damage, like risky behaviors. The present study was conducted in order to investigate the relationship between Quranic Intimacy and the incidence of risky behaviors among students. 

The present study is a descriptive and analytical study of correlational and cross-sectional type. The research community was all students of Hamadan and Tabriz Universities of Medical Sciences, and the sample population was selected using stratified and random sampling. The tools used in this research included: the Quranic intimacy scale and the risk taking of Iranian youth scale. To analyze the data, the statistical test of percentage and frequency, mean and standard deviation, Kolmogorov–Smirnov test for normality of data, independent t-test, one-way analysis of variance and Pearson correlation were used. All analyzes were performed using SPSS software version 24.

690 students participated in the study (50% male). The results of the statistical analysis showed that familiarity with the Holy Quran has a significant and meaningful effect on reducing the occurrence of risky behaviors. This effect was observed in all dimensions of risky behaviors including: dangerous driving, violence, smoking, unsafe sexual behavior, alcohol and drugs abuse and psychotropic substances (P<0/05). 

According to the positive effect of intimacy with the Holy Quran on risky behaviors, the reduction of these behaviors in each of its dimensions, it is necessary to strengthen and improve the relationship with the Qur'an. Therefore, in this direction, short-term and long-term planning and the implementation of various educational programs and the promotion of the Qur'an and intimacy with it at the micro and macro levels and in various age groups, especially students, are necessary.

 Polypharmacy is a significant patient safety concern.

 This study aims to estimate the prevalence of polypharmacy, its continuity and associated factors, and common medication classes among a large outpatient population in East Azerbaijan province, Iran.

 A retrospective prescription data analysis was performed. The cohort included all ≥ 20 years old subjects with at least one prescription filled during the main three-month study period (2020 March 1 - 2020 May 31). Polypharmacy was defined as being exposed to more than four different medications during the main study period, and continuous polypharmacy was defined as being exposed to more than four medications during both the main study period and follow-up period (2020 October 1 - 2020 December 31). The frequency and prevalence of polypharmacy, along with predictive factors, were estimated. We performed multivariate logistic regression and estimated odds ratios (ORs) to investigate the risk factors for polypharmacy.

 307,820 patients included (mean age 49.8 years, 62.9% female, mean drug use 3.7 (SD = 2.6). Polypharmacy was observed in 28.3% (CI: 28.1 - 28.4), of which 36.6% experienced continuous polypharmacy. The odds of being exposed to polypharmacy increased with being female, increasing age, and exposure to chronic conditions. The groups of medications most utilized by polypharmacy patients were those indicated for gastro-esophageal reflux diseases, beta-blocking agents, antidepressants, blood glucose-lowering drugs, and antithrombotic agents.

 Strategies should be formulated to inform healthcare policymakers and providers about the magnitude of the polypharmacy phenomenon, associated factors, and the common medication classes involved.

Cardiovascular disease (CVD) is the most prevalent comorbid condition among patients with diabetes. The objective of this study is to determine the incremental healthcare resource utilization and expenditures (HRUE) associated with CVD comorbidity in diabetic patients.

In a cross-sectional study, patients receiving antidiabetic drugs were identified using the 2014 database of the Iran Health Insurance Organization of East Azerbaijan province (Iran). The frequency of HRUE was the main outcome. Outcome measures were compared between diabetic patients with and without CVD comorbidity during 2014-2016. The generalized regression model was used to adjust for cofounders because of a highly skewed distribution of data. Negative binomial regression and gamma distribution model were applied for the count and expenditure data, respectively.

A total of 34,716 diabetic patients were identified, of which 21,659 (63%) had CVD comorbidity. The incremental healthcare resource utilization associated with CVD compared to non-CVD diabetic patients for physician services, prescription drugs, laboratory tests, and medical imaging was 5.9±0.34 (28% increase), 46±1.9 (46%), 12.9±0.66 (27%), and 0.16±0.40 (7%), respectively (all P<0.001). Similarly, extra health care costs associated with CVD comorbidity for physician services, prescription drugs, laboratory tests, and medical imaging were 10.6±0.67 million IRR (294.4±18.6 USD) (50% increase), 1.44±0.06 million IRR (40±1.6 USD) (32%), 8.36±0.57 million IRR (232.2±15.8 USD) (58%), 0.51±0.02 million IRR (14.1±0.5 USD) (24%), and 0.29±0.02 million IRR (8±0.5 USD) (22%), respectively (all P<0.001).

CVD comorbidity substantially increases HRUE in patients with diabetes. Our findings draw the attention of healthcare decision-makers to proactively prevent CVD comorbidity in diabetic patients.

In May 2014, Iran launched the most far-reaching reform for the health sector, so-called Health Sector Evolution Plan (HSEP), since introduction of the primary health care network, with a systematic plan to bring about Universal Health Coverage. We aimed to analyze the time to first all-caused rehospitalization and all-caused 30-day readmission rate in the biggest referral hospital of Northwest of Iran before and after the reform.

We retrospectively analyzed discharge data for all hospitalization occurred in the six-year period of 2011-2017. The primary endpoints were readmission-free survival, and overall 30-day readmission rate. Using multivariate cox proportional hazards regression and logistic regression, we assessed between-period differences for readmission-free survival time and overall 30-day rehospitalization, respectively.        

Overall, 157969 admissions were included. After adjusting for available confounders including age; sex; ward of admission; length of stay; and admission in first/second half of year, the risk of being readmitted within 30 days after the reform was significantly higher (worse) compared to pre-reform hospitalization (odd ratio 1.22, P<0.001, 95% CI, 1.15-1.30 ). Adjusting for the same covariates, after-reform period also was slightly significantly associated with decreased (deteriorated) readmission-free time compared with pre-HSEP period (HR 1.06, P=0.005, 95% CI 1.01-1.11).

  HSEP seems insufficient to improve neither readmission rate, nor readmission-free time. It is advisable some complementary strategies to be incorporated in the HSEP, such as continuity of care promotion, self-care enhancement, effective information flow, and post-discharge follow up programs.