مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال هجدهم شماره 4 (پیاپی 72، زمستان 1399)

  The strategies of hospitals in confronting the Covid-19 crisis is extremely important in the control and management of this epidemic. Exploring the challenges and suitable strategies for controlling biological epidemics in Tehran University of Medical Sciences (TUMS) hospitals might pave the way for better management of possible similar crises in the future.

This was a qualitative, exploratory and inductive study including 22 health professionals from TUMS involved in the management of the disease. Data were collected using semi-structured interviews and analysed by thematic analysis, using MAXQDA.

The most important challenges identified were related to the lack of preparedness at the macro-level, impracticability of controlling the use of personal protection equipment (PPE)  and the consumption of medications, as well as provision of equipment, medications and protecting medical devices. The effective strategies and interventions in the pandemic were grouped into the following categories: manpower, education, communications, clinical work, decision-making and organizational activities.

Preventive measures and preparedness before the onset of the crisis have not received sufficient attention. Hospitals could have an important role in confronting the crisis through promoting work efficiency and standards. Timely prevention and preparedness before a pandemic as regards medications, personal protection equipment and diagnostics are extremely essential, as are timely and flexible decisions by crisis committees and the control of manpower emotions flux during crisis management.

The health system financing is the process of collecting, pooling and managing financial resources and purchasing healthcare services. Health financing plays an important role in achieving the health system goals. The aim of this study was to strategically analyze the Iranian health financing system and recommend strategies to strengthen it.

The method in this research was the scoping review method. All the published studies about strengths, weaknesses, opportunities and threats of the Iranian health financing system were, using suitable keywords, searched in databases including "PubMed", "Scopus", "Science Direct", "Embase", "ProQuest", "SID" and "Magiran", as well as  the "National Database of Medical Science Theses" and two search engines, namely, "Google" and "Google scholar". Finally, 29 studies were selected and anlyzed using the framework analysis method, the software being MAXQDA. 

Increased population health insurance coverage, reduced out-of-pocket payments following the national health transformation plan, and increased healthcare tariffs were found to be the strengths of the Iranian health financing system. On the other hand, regressive financing, high out-of-pocket payments and increased health insurance funds were weaknesses of the national Iranian health financing system. Political sanctions, financial crises and increased healthcare demands by consumers were the threats, while supportive laws, the NGO’s financial participation/support, increased health services delivery centers and modern technologies were among the important opportunities in the health financing system. Increasing the health system financial resources through prepayments, structural and policy unification of health insurance system, health service tariff reform and increasing health system efficiency were found to be essential to strengthen the Iranian health financing system.

The Iranian health financing system is not resilient and faces several challenges. The health system policy-makers and senior managers should adopt the recommended strategies to strengthen the national health financing system.

One of the dimensions of health is mental health that could be affected by the quality of occupational life. The purpose of this study was to determine the effect of job satisfaction on teacherschr('39') mental health with due consideration of the moderating role of gender and the subjects taught.

This was a quantitative survey using a questionnaire including a sample of 373 teachers, selected by multistage random sampling, from among all (n = 1500) the secondary school first- and second-grade teachers in Najafabad city, Isfahan Province, Iran. Data analysis was done using the software AMOS and SPSS.

The confirmatory factor analysis of the items showed that these items could explain 63.25% of the variance of the mental health construct. In addition, the standard effect of job satisfaction on mental health was found to be 0.37 (p <0.001), explaining 13% of the mental health construct variance. Further analysis of the data showed that the teachers’ mean mental health construct (66.64) and their mean of job satisfaction (73.90) were lower and higher than the means of the respective spectra (p <0.001), respectively.

Job satisfaction, which has been proven to affect the teachers’ mental health, can improve their personal and social life and make them more efficient in education. In this regard, gender and the type of subject taught can have moderating effects on the relationship between job satisfaction and mental health of the teachers. Based on the beta-values (0.55 for the women group and 0.68 for the experimental science teachers group), the gender female and teaching experimental science can have a stronger effect on the teachers’ mental health than gender male and teaching subjects other than experimental science.

In 2020 the rank of Iran in happiness index and gender inequality were reported to be rather low, they being, among 153 countries, 118 and 113, respectively. This study aimed to investigate the relationship between gender inequality and happiness in Iranchr('39')s provinces.

This ecological study was conducted based on secondary analysis of data on happiness index, as the dependent variable, and gender inequality, as the main independent variable, in 31 Iranian provinces, the statistical population being people over 10 years old. The sources of data on other background variables were previous national studies and the national statistical yearbook. Analysis of the data was done using descriptive statistics, Pearson correlation coefficient and multiple linear regression.

No significant relationship was found between gender inequality and happiness (p<0.05) in the provinces. Neither was found any relationship between the background variables and happiness. However, the mean age of the population and gender inequality were inversely associated (p<0.05), meaning that with an increase in the mean age gender inequality would decrease.

The fact that no statistically significant association was found between the various variables and happiness in Iran’s provinces could be due to the small sample size.We would recommend to investigate further this topic at the individual level and with a larger sample size.

Despite the increasing prevalence of infection with some blood-borne viruses, no standard precautions have been developed so far based on the Health Belief Model (HBM). This study aimed to assess, based on the HBM, the predictors of adherence to standard precautions in preventing needle stick injuries among the Personnel of Sanandaj Teaching Hospitals, Sanandaj City, Iran in 2020.

This cross-sectional study included 444 medical and non-medical staff members of the Sanandaj teaching hospitals in Sanandaj City, Iran, using a researcher-developed questionnaire. Descriptive and analytical data analysis was performed using Mann-Whitney U and Kruskal-Wallis tests, Pearson correlation coefficient, one-way analysis of variance, multivariate regression and the chi-square test, the software being SPSS version 22.

The results of multivariate regression analysis showed that from among the HBM constructs, three constructs, namely perceived sensitivity (p=0.033), perceived benefits (p=0.032) and self-efficacy (p=0.001), were the predictors of staff duty performance (implementation of  standard precautions) in preventing needle stick injuries. As regards the implementation of standard precautions, 22%, 75.3% and 2.7% of the staff members had a low, medium and high performance level, respectively.

The constructs of perceived sensitivity, perceived benefits and self-efficacy are the strongest predictors in adherence to standard precautions.

Burnout in couples is a gradual and rarely sudden process in which intimacy and love gradually fade and general fatigue becomes apparent. On the other hand, most marital therapy interventions seek to reduce marital conflict. Therefore, the aim of this study was to investigate the effect of acceptance and commitment therapy on marital burnout in couples with marital conflicts.

This experimental study was conducted with a pretest-posttest design and a control group with a 45-day follow-up. The statistical population included all the couple with marital conflicts referring to the counseling centers in Karaj city, Iran in 2019. The sample was a group of 14 couples who had got a score of over 111 in the marital-conflicts questionnaire, assigned randomly to an experimental (n = 7) or a control (n = 7) group. The experimental groups received an acceptance and commitment therapy (twelve 90-minutes sessions), but the control group received no intervention and remained in the waiting list. Data were collected using the marital-conflicts questionnaire of Barati and Sanaee (1994) and analyzed using analysis of variance with repeated measures and the Bonferroni post-hoc test.

Analysis of the data showed that the acceptance and commitment therapy significantly decreased marital burnout in the couples, and the results were found to be consistent enough in the follow-up period (P<0.05).

Based on the results of this study, it can be said that acceptance and commitment therapy can be used as an intervention option in decreasing marital problems.

Insects associated with dead bodies are very diverse and very important in decomposition and recycling of the carcasses.  The present study was conducted in the Margoon region of Kohgiluyeh and Boyer Ahmad province (Iran) to determine the species diversity of carrion insects associated with decomposing remains of different animals.

Different cadavers of domestic goat, rat and chicken were collected and carrion insects were sampled from them in different seasons during one year.

In total, 21 species of carrion insects including 13 necrophages, 3 predators, 3 omnivores and 2 casual species were collected and identified.

Based on the data, the order Coleoptera (beetles) was the most diverse group as regards species among the orders collected, and the highest diversity was observed during spring. Two species, namely, Thanatophilus rugosus and Saprinus maculatus were reported to be new in the south west of Iran. Furthermore, our results show that the species diversity of carrion insects in the region studied was rather high.

Systematic review of research suggests that different variables can affect the treatment of anxiety and that, although many therapies can be effective, the role of schema therapy in the perfectionism of anxious people has been neglected. Therefore, the aim of this study was to determine the effect of anxiety treatment through schema therapy on perfectionism of anxious people. The study was an applied quasi-experimental study with a pretest-posttest design and a control group.

From among all the women with anxiety aged 20 to 30 years referring to the New Presence Clinic in Tehran, a sample of 30 were selected by purposive sampling and randomly assigned to either an experimental (n =15) or a control (15 people) group. Initially they all completed the Terry-Short et al. (1995) Perfectionism Questionnaire. Then the experimental group received education in schema therapy, followed by a post-test for both groups. The data were analysed using multivariate analysis of covariance the software SPSSV19.

Statistically significant differences were found between the two groups as regards the two components of positive (p<0.019; F=6.275) and negative (p<0.006; F=9.136) perfectionism. Based on the descriptive findings it can be said that, compared with the control group, the experimental group could, after the schema therapy intervention, obtain lower scores in the perfectionism components post-test.

Based on the findings of this study, it can be said that schema therapy in the treatment of anxiety can reduce the perfectionism of individuals. Therefore, a knowledge of this training can help psychologists, counsellors, students and other professionals to improve the positive and negative perfectionism variables in people suffering from anxiety.