جستجوی مقالات مرتبط با کلیدواژه « barrier » در نشریات گروه « پزشکی »

Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs’ perspective.

The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing.

Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes.

HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.

Clinical practice guideline (CPGs) are highly valuable in enhancing healthcare efficiency as they lead to the selection of the best medical methods and reduction of their costs. Nevertheless, implementing CPGs in practice can be quite challenging, as they require alterations at individual, organizational, and health system levels. Therefore, we aimed to identify the outcomes, barriers, and facilitators associated with CPG implementation.

We conducted an extensive search using Web of Science, PubMed, Scopus, Embase, and various non-English databases to gather quantitative, qualitative, and review studies on the implementation of CPGs from Jan 1, 1990, to Dec 26, 2022. Our analysis focused on the outcomes, barriers, and facilitators of CPG implementation, which categorized into four groups: policy-making, health system and hospitals, professional experts, and clinical guidelines.

After conducting a thorough review of 37 studies, the most significant outcomes were found to be reduced costs and enhanced quality of care. However, certain challenges, such as inadequate support, insufficient education, high work pressure, tight schedules, and a lack of unified and clear guidelines, hindered these improvements. To overcome these barriers, it is essential to prioritize effective leadership, improve work conditions, allocate necessary resources, create a structured framework for the guidelines, and simplify their content to fit the clinical circumstances.

It is crucial to identify the outcomes and barriers associated with implementing CPGs to enhance professional performance, elevate the quality of care, and foster patient satisfaction. Developing effective strategies hinges on this awareness.

 After the difficulty of the pandemic process, managing the long-term effects that may occur after the coronavirus disease 2019 (COVID-19) is among the biggest concerns in the present era. This study aimed to explore factors affecting the physical activity level and investigate the relationship between physical activity level and stress perception of university students during the COVID-19 pandemic.

Study Design: 

A cross-sectional study.

 Study data were collected via online survey, and volunteer participants completed the survey through the survey link between October 21 and December 31, 2021. Physical activity level was evaluated by “The International Physical Activity Questionnaire- Short Form” (IPAQ-SF), and stress level was evaluated by “Perceived Stress Scale” (PSS). The participants were asked questions about barriers and motivators for physical activity before and during the pandemic.

 The study included 444 participants (81.3% female and 18.7% male) with an average age of 21±2.95 years. The results showed a negative-significant linear relationship between perceived stress score and total physical activity, vigorous-intensity physical activity, and walking scores (r=-0.157, P<0.01; r=-0.16, P<0.01; r=-0.13, P<0.05 respectively). During the pandemic, the perception of insufficient finance became less important as a barrier (P=0.029), and healthcare professional (HCP) recommendation became more important as a motivator for physical activity than the pre-pandemic conditions (P=0.035).

 The findings indicated that it is possible to reduce the level of perceived stress by increasing the level of physical activity. Current research will be a key for increasing and maintaining physical activity and reducing perceived stress.

Positive communication between staff and parents is considered a basic principle for the successful implementation of family-centered care (FCC) and the formation of a good relationship between parents and neonates. Moreover, involvement in care depends on the communication and interaction of parents with healthcare providers, and cooperation between them leads to high-quality care for neonates. However, interaction and communication are still considered major challenges in the neonatal intensive care unit (NICU) environment. Since these challenges and communication barriers are different in various cultures and environments, they should be identified in the field. A literature review shows that no study has assessed the views of different members of the treatment team and parents on communication barriers in Iran.

The present study aimed to investigate the communication barriers related to personnel and parents for implementing FCC from the perspective of parents, physicians, nurses, and nursing managers.

A qualitative study was conducted in 2021 - 2022 using the conventional content analysis approach in a NICU in Tehran, Iran. In this study, 26 semi-structured interviews and 10 field notes were used to collect data to reach data saturation.

Data analysis led to the emergence of two themes. The first theme was the unprofessional relationships of personnel, including two main categories of inappropriate professional behavior and lack of attention to personnel and working conditions of the ward. The second theme was mutually ineffective relationships between personnel and parents, including twomain categories of the inappropriate attitude of personnel and parents toward each other and unsympathetic communication between personnel and parents. The themes showed the participants’ experiences of communication barriers to the implementation of FCC in NICUs in Iran.

Removing communication barriers between healthcare providers and parents requires developing a coherent, comprehensive, and unified training program to prepare and create integrated coordination among the treatment team and the family, creating a positive attitude toward FCC and the presence of parents, improving relationships, and giving further attention and support by managers to personnel and the conditions of the ward.

A virtual classroom allows learner and educator to connect online in real time through digital learning environment. The present study sought to identify the barriers perceived by medical and nursing faculty members for the implementation of virtual classroom which was executed in Nepal to stay up with the scholarly schedule after nationwide lockdown due to COVID -19. This descriptive cross-sectional study was conducted from December 2020 to April 2021 among 77 faculty members of National Medical College, Teaching Hospital, Parsa, Nepal using convenience sampling technique. Data were collected using a semistructured, self-administered questionnaire. The obtained data were analyzed through SPSS version 23, using descriptive statistics. The study findings revealed that the mean age of 77 faculty members was 35.35±6.46 years, with a minimum of 25 and maximum of 72years. The majority of the participants (59.7%) were male faculty members. As to academic qualification, 87% had completed postgraduate level. Regarding their current academic position, 74% were lecturer. Similarly, 38.9% of the faculty members were from clinical department. The results revealed that the faculty members perceived “Difficult to teach the practical content which requires demonstration” as a major barrier under technological barrier domain with a mean value of 4.30±1.027. “Difficulties in working from home” was as a major barrier under institutional barrier with a mean value of 3.44±1.164. Similarly, “Lack of control over students’ cheating” was found to be a major barrier under interpersonal barrier domain with a mean value of 4.14±0.884. This study identified the barriers felt by medical and nursing educators while implementing virtual classes as an alternative to physical classroom. It is important to plan effective strategies to overcome the potential challenges in implementing quality virtual classes

 The International Classification of Functioning, Disability, and Health (ICF) can identify body function, structure impairment, activity limitation, participation restriction, and contextual factors.

 Considering the importance of the role of environmental barriers in disability and function, this study aimed to investigate the environmental barriers affecting the function of individuals with multiple sclerosis (MS) based on the Comprehensive ICF Core Set for MS.

 This cross-sectional study was conducted on individuals with MS who are registered in the ICF Medical Commission. The participants completed the consent form, the Persian version of the Craig Hospital Inventory of Environmental Factors, Functional Independence Measure (FIM), and a demographic questionnaire based on the ICF Core Set for MS. The data were analyzed using SPSS software (version 25).

 A total of 140 individuals with MS (34 males and 106 females) participated in this study. The most frequently reported environmental barriers were structural and physical, and the least frequently reported barriers were related to work and school. The barriers related to attitudes and support were significantly associated with the motor function (P = 0.003) and total FIM score (P = 0.002). The variables of attitudes and support and policies were the main predictors of motor function (RS = 0.093, P < 0.001) and the total FIM score (RS = 0.109, P < 0.001), respectively. None of the barriers was significant and predictive of cognitive function.

 Since environmental barriers can affect the function of MS patients, authorities should implement the necessary strategies to eliminate these barriers and facilitate participation.

Heart failure (HF) is an important public health issue whose prevalence, hospitalization rate, and costs have increased over the years. Treatment adherence is the behavior of the patient in taking medications, correcting diet, and ability to change lifestyle with the recommendations of the health care provider. Poor treatment adherence contributes to worsening disease outcomes. Currently, according to the literature, no specific instrument is available to measure treatment adherence of HF patients.

The aim of this study was to develop and evaluate the heart failure treatment adherence questionnaire (HFAQ) for military personnel and their family.

Items were generated by literature review, patient field interviews, and expert opinions. Content validity was assessed by measuring CVR and CVI, while face validity was evaluated by measuring the impact score of each item. The research team performed EGA, bootEGA, and CFA to assess the construct validity, and reliability was assessed by measuring ICC and Cronbach’s alpha.

Item pool with 86 items was generated consisting of 45 medications, 10 lifestyles, nine diet items, and 22 common items between these three categories. Forty-three items with CVR score lower than 0.62 were removed from the HFAQ. All remained items had acceptable face validity. Cronbach’s alpha and ICC of HFAQ were reported as 0.73 and 0.97, respectively. EGA results represented a four-dimension model for HFAQ with a relatively narrow confidence interval (CI 95% [3.769, 4.231]), and the stability of items, in constructs, ranged from 0.96 to 1. Goodness-of-fit results was reported as χ2 = 535.657, df = 293, χ2/df = 1.828, P-value < .001, CFI = 0.851, and RMSEA = 0.050.

HFAQ is the first treatment adherence questionnaire developed specifically for assessing treatment adherence of HF patients and is a valid and reliable 26-item questionnaire that evaluates patients' treatment adherence in three main contexts of medication, physical activity, and diet. HFAQ has four dimensions of health literacy, social and economic, barrier, and patient-provider relationship, which can be used as an intervention for improving treatment outcomes and disease burden.

 Virtual learning is not without challenges. It can cause stress, lack of motivation, and social isolation. Due to COVID‑19 pandemic, our college shifted from face‑to‑face to virtual teaching–learning style. the aim was to find out the barriers in virtual learning among medical students and provide solutions to overcome them.

This cross‑sectional study was conducted among 3rd‑ and 4th‑year Bachelor of Medicine and Bachelor of Surgery students in 2020. Prevalidated electronic survey forms on institutional barrier, technical barrier, and individual barrier were sent to students, 160 students responded. SPSS version 12 was used to calculate descriptive statistics and independent t‑test.

 The students had the highest mean score in individual barrier (mean: 2.82 [standard deviation (SD): 0.72]) followed by institutional barrier (mean: 2.79 [SD: 0.74]) and technological barrier (mean: 2.72 [SD: 0.75]). Regarding technological barriers, 38.6% of the students agreed difficulty in procurement of the laptop and 66.4% faced slow Internet connection. Regarding institutional barriers, 75.9% were stressed to join one lecture to another lecture as the lectures were continuous, 69.6% had limited opportunity to interact with lecturers, and 62.7% had poor communication between lecturers and students. Regarding individual barriers, 74.1% of the students were not motivated for online learning, 71.5% of the students could not learn as well as they were in the classroom, and 58.2% disagreed taking online courses in future.

Low motivation, communication, Internet connectivity, and technical problems were the main barriers. Smaller size class, highly motivated and well‑trained lecturers, and interactive lectures may help in breaking the barriers of virtual learning.

Kangaroo mother care (KMC), as a complement to incubator care, is one of the ten recommendations of the World Health Organization (WHO) for the care of preterm infants. The KMC stabilizes the heart rate, improves oxygen saturation, makes weight gain better, and reduces crying in the infant. In order to launch KMC unit, the barriers for implementing this type of care should be recognized.

This qualitative research was conducted using a focus group discussion and individual semi-structured interview with nurses, doctors, executive and management staff of a neonatal unit of a third level teaching hospital in Tabriz, northwest Iran. The participants were selected using purposeful sampling. Content analysis was used for analyzing data. Data were analyzed by MAXQDA 10 software.

After analyzing data, four main themes were extracted including mother-related barriers, father-related barriers, physician- related barriers, and system-related barriers.

Based on the findings of the research, it seems that in order to facilitate practicing continuous KMC, much emphasis should be placed on training the parents and health care providers. Furthermore, in some cases, reforming the payment system for physicians, providing an instruction for performing continuous KMC, and continuous assessment of hospitals annually are necessary.

Aim and Scope: 

Health monitoring is important component of the employee health maintenance program, which is performed by periodic examinations in accordance withArticle 92 of the Labor Law. Thus, the aim of this study was to investigate the barriers of performing periodic examinations in the industries of Kashan in 2019.

This descriptive study was conducted on 200 people (employer, health inspector, and medicine physician and industry health experts). A researcher‑made questionnaire used to collect the data. Barriers were prioritized based on the scores of each group. Then, a weighting technique was used to accumulate the opinions and final prioritization. To analyze the data, SPSS 16 software was used.

Out of 200 subjects the number (percentage) of employers, inspectors, occupational medicine physicians and industry experts were 103 (51.5%), 31 (15.5%), 5 (2.5%) and 61 (31.5%) respectively. Using AHP (hierarchical analysis) and Expert Choice software. Final weight for the perspective of occupational health inspectors, employer, occupational medicine physician, and industry expert was obtained at 0.38, 0.257, 0.195, and 0.168, respectively. After applying the weight from the perspective of the four groups, the final priorities were obtained as the high cost of examinations, lack of awareness of workers about the importance of examinations, and lack of a comprehensive plan to reduce occupational diseases in industry, respectively.

It is recommended that examinations be performed in clinics covered by the University of Medical Sciences at a lower cost. And train employers about the benefits and importance of occupational examinations.

Knowledge growth has been very rapid in recent years. Health centers can implement knowledge management in their organization to improve service quality, reduce costs and time, strengthen relationships among colleagues, and produce knowledge faster by reviewing barriers to knowledge management implementation at fasa health center.

Material & Methodes:

 In this qualitative study, some managers of Fasa Health Center were selected based on purposive sampling and the study continued until data saturation. Finally, 5 people were interviewed. Information gathering tools were MAXQDA software and data obtained from the semi-structured interview. Content analysis was used to analyze the data.

The findings lead to the extraction of a core theme as barriers to knowledge management implementation that consist of 5 categories: 1- Barrier of (with 5 subcategories), 2- Barrier of individual factor (with 3 subcategories) 3- Barrier of Organizational culture (with 4 subcategories) 4- Barrier of information technology (with 6 subcategories) 5-Barrier of management agent (with 4 subcategories)

The results showed that university authorities can provide appropriate culture, motivational factors to accelerate more case finding, expedite electronic health records, disease eradication, better cost management, disaster management, electronic submission of monthly data, eliminating the paper, and increasing staff productivity faster

the following strategies are suggested for using rehabilitation service for children with autism spectrum disorder: Collaborating and forming a conversation between all organization in charge of people with autism spectrum disorder, such as welfare organization, the ministry of health, autism associations, etc.  Participation and employment of individuals with autism spectrum disorder and their families.  Strengthen and empower NGOs related to autism spectrum disorder.  Increasing the media participation in order to raise awareness and improve public attitudes.  Holding the training courses for health care providers to become more familiar with the phenomenon of autism spectrum disorder.  Expand the special healthcare and rehabilitation centers for people with autism spectrum disorder.  Changing the insight, attitudes and approach of policy makers and managers in allocating credits and insurance coverage.

Knowledge sharing ensures the distribution of the best business methods within organizations and Knowledge sharing are being applied to enhance nursing education curriculum. The aim of present study was to identifying solutions and barriers to knowledge sharing in Universities from the viewpoint of the faculty members.

This cross-sectional study was conducted on 203 faculty members of Guilan University of Medical Sciences in 2017. Data was gathered using a questionnaire that measured the factors influencing the knowledge sharing behavior. The obtained data were analyzed in SPSS-21 software, using Pearson correlation. The significance level was set at P≤0.05.

The most influential factor was organizational factors (Mean=2.91, SD= 0.33), and the most influential index was “dependency”, and the index with the lowest score, “innovation” was revealed to be an important barrier to knowledge sharing. “The perceived organizational motivations,” known as authorities’ inattention to the significance of knowledge sharing. No significant relationship was observed between the effective factors and variables such as gender, professional background, and educational level.

Identification of the solutions and barriers to knowledge sharing by the current study and their presentation to the authorities would remove the current barriers as much as possible leading to greater propagation of effective solutions to knowledge sharing for the promotion of organizations and society.

Educating the staff in organizations is one of the most important issues in different countries, so concerning the necessity of nurses’ roles and scientific advancements in providing nursing care will not be achieved without in-service education.

The purpose of this study is to investigate intensive care unit nurses’ perception of the barriers to effective in-service education. Settings and Design: This qualitative study was conducted at Shiraz University of Medical Sciences (sums).

The researcher used the conventional content analysis method to evaluate nurses’ perception of the barriers to effective in-service education from March 2015 to June 2016. Statistical Analysis Used: Data analysis was done with a conventional content analysis method.

Three main themes of nurse’s in-service education barriers were extracted from the analysis of the data. The themes are ineffective teaching methods, inappropriate content of educational programs, and inappropriate scheduling of teaching programs.

Identifying the barriers to effective in-service education can guide nurses and nursing administrators in improving education in the nursing field and subsequently providing better treatments for patients.