Iranian Journal of Health Sciences
Volume:11 Issue: 2, Spring 2023

In recent decades, research has shown that social determinants of health (SDH) affect population health more than medical care. Therefore, identifying the SDH has become a top priority. 

It is an explanatory-sequential mixed-method study. We used the meta-synthesis method in the first step to identify and prioritize social determinants of population health in Iran. Then, the identified factors were shown in a semantic map. Afterward, we used fuzzy Delphi to screen and determine each factor’s importance in Iran. 

A total of 172 factors were identified and classified into 4 levels: individual, local, national, and global. After screening items, parental competence, hope, addiction, types of pollution, inflation, and unemployment rate (the crisp value of defuzzification 9-10) are generally the most important determinants of population health at the individual and national levels in Iran. 

The resulting semantic map of SDH demonstrates the substantial effect of non-health policies on the health of Iran’s population. This finding proposes health as a complex and comprehensive system needing an interdisciplinary approach to address its multiple determinants. Specifically, the comparative analysis of this research shows that among the determinants of health in Iran, parental competence, individual behaviors such as addiction, and spiritual and mental health, including depression, suicide, and stress, are the most important SDH in Iran.

Numerous comorbidities are involved in the severity of the new coronavirus disease 2019 (COVID-19). Hypothyroidism’s impact on COVID-19 is yet to be adequately understood. Thyroid disorders are thought to play a role in the development and progress of COVID-19. This study aimed to determine the frequency of hypothyroidism among COVID-19 patients in hospitalized patients.

This retrospective cross-sectional study was conducted at a tertiary hospital in Tehran City, Iran. Demographic information and other specified data related to our research, mainly comorbidities, were collected using a structured questionnaire from electronic patient health records. A total of 493 medical records of COVID-19 patients were used for this study according to the inclusion criteria. Subsequently, the data were analyzed with SPSS, version 25, using descriptive and analytic statistics.

The prevalence of hypothyroidism was 13.2% (n=65) in hospitalized COVID-19 patients. This was higher (13.4% vs 2.3%) compared with the prevalence of hypothyroidism in the general Iranian population. Overall, in patients with hypothyroidism, about 21 patients (32.3%) expired, of whom 14 patients (66.7%) were female, and 7 (33.3%) were male. In these patients, no statistically significant difference was observed between the expired and discharged groups (Adjusted Odds Ratio: 1.04; 95% CI 0.59-1.83; P=0.87). As a result, hypothyroidism was not linked to an increased risk of death.

Hypothyroidism in hospitalized COVID-19 patients appears to be low. However, it seems more prevalent in the female gender but without significant adverse effects on the risk of mortality from this disease.

Chronic low back pain (CLBP) is one of the most common reasons for confining daily activities and functional disability at work, which can reduce people’s mental health. The research was conducted to assess the efficacy of cognitive-behavioral therapy (CBT) in the psychological distress and coping strategies of employees with CLBP.

The current research approach is a clinical trial with a pre-test-post-test design and a control group. The statistical population included employees of private offices suffering from CLBP in the 8 districts of Tehran City, Iran, in 2021. The study sample consisted of 30 patients with CLBP selected by the available sampling and randomly assigned to control (n=15) and experimental groups (n=15). The study tools included psychological distress and coping strategies. The experimental group received eight 90-minute sessions of CBT, but the control group did not receive any intervention. The obtained information was analyzed using multivariate covariance analysis using SPSS software, version 24.

The outcomes of the present study confirmed that CBT significantly reduces depression, anxiety, stress, and emotional and avoidance coping strategies in patients with CLBP (P<0.01). Also, CBT increased the problem-oriented coping strategy in the employees who received the treatment (P<0.01).

The studies conducted showed the efficacy of CBT on depression, anxiety, stress, and coping styles of CLBP. Considering the impact of mental health in reducing the physical and social consequences of CLBP, it is necessary to pay special attention to the psychological variables of employees in addition to medical treatments.

Women with urinary incontinence (UI) during pregnancy may have a greater of experiencing postpartum UI symptoms than women who do not. Pelvic floor muscle exercises can reduce the symptoms of urinary stress incontinence. This policy brief concisely summarizes research findings and policy recommendations to improve antenatal and postnatal pelvic floor muscle training. However, this policy does not work automatically and must be incorporated in primary health care service design and delivery. This policy brief discusses a clear recommendation based on the best evidence to improve prenatal care services. It argues that the key is high-quality prenatal care that is available, affordable, accessible, and compatible with the needs of pregnant women and health care providers.

One of the significant complications of angioplasty is the pain at the catheterization site. These complications will increase the hospitalization duration and hospital costs. The objective of this study is to investigate the combined impact of using sand and ice bags on mitigating pain following percutaneous coronary intervention (PCI).

In this clinical trial research, we recruited 60 patient candidates for femoral PCI who were referred to Imam Reza Hospital of Mashhad City, Iran, in 2017. The patients were assigned to the control and intervention groups by simple randomization. The statistical analyst was blind to the study. The arterial sheath was removed 4 hours after coronary intervention. Then, a sandbag was placed on the site in control group subjects for up to 4 hours. The ice and sand bags were placed on the site for 15 minutes in the intervention group. Using a numerical pain measurement tool, the pain intensity was recorded at the beginning of the patient’s admission and 3, 6, and 12 hours after the sheath removal. The obtained data were analyzed by descriptive statistics (mean & SD) and inferential statistics (The Chi-Square, Fisher exact, Mann-Whitney, Friedman, and t-tests).

The mean score of pain intensity in the sandbag combined with the ice bag group (1.1±1.0) was significantly lower than the sandbag group (2.4±0.9) at the 3 hours after the sheath removal (P<0.001). The mean pain intensity scores at the 6 hours after the sheath removal were 0.7±0.7 in the sandbag combined with the ice bag group and 1.0±0.8 (P=0.407) in the sandbag group. Also, 12 hours later, the pain difference between groups was not significant (0.2±0.4 in the sandbag combined with the ice bag group and 0.4±0.6 in the sandbag group (P=0.482).

Although both interventions reduced the patient’s pain, the group with the combination of ice bag and sandbag tolerated less pain 3 hours after removing the sheath. Thus, this method can be applied as an available, effective, and cost-effective technique in angiography units of hospitals for reducing local pain.

Smartphones offer easy access to the Internet and a good platform for all kinds of Internet activities. This study analyzed the relationship between social networking site (SNS) addiction and nomophobia among Iranian higher education students. 

This is a cross-sectional study. The participants were selected through a stratified sampling approach: the questionnaire comprised demographic information, Nomophobia Questionnaire, and Bergen Social Media Addiction Scale. The impact of SNS addiction on nomophobia was assessed using structural equation modeling. Then, the relations between SNS addiction and the 4 dimensions of nomophobia were examined using regression coefficients.

A total of 418 SNS users (279 females) took part in this work. SNS addiction showed a significant positive correlation with nomophobia and its 4 dimensions. A model with SNS addiction predicting nomophobia showed an adequate fit. The results showed that SNS addiction has a significant positive relationship with all dimensions of nomophobia. Among dimensions of nomophobia, SNS addiction was related to giving up convenience at the highest level, followed by losing connectedness and inability to access information and communicate. 

Therefore, SNS addiction explains nomophobia successfully. This study has important implications for health and education providers. Taking into account the efforts to enhance students’ mental health through educational interventions regarding responsible uses of the SNSs and making healthy online habits in policymaking is recommended.

Selection of the appropriate performance shaping factors (PSFs) is a vital challenge encountered by all experts in human reliability analysis (HRA) and plays a significant role in achieving reliable results. The main purpose of this research is to present a comprehensive set of staff PSFs that affect the emergence of errors and incidents in the healthcare system, referred to as healthcare- (H)-PSFs.

In this study, the set of H-PSFs was extracted using the PSFs presented for other fields and through consultation with HRA and healthcare experts. For investigation of whether the set of H-PSFs was comprehensive and appropriate, 318 reports of errors and incidents that had arisen at 14 hospitals during 12 months were examined, and the frequency values of each factor were obtained in two modes: where a PSF could and where it could not be repeated in an incident. The most significant H-PSFs were identified using Pareto charts. Also, using Minitab software, the Chi-square goodness of fit test was used to validate the proposed set of PSFs and demonstrate the appropriate accuracy of their frequency of occurrence.

According to experts, 43 PSFs were identified for the healthcare system. Using the medical error reports, the number of times that errors and mistakes were related to each PSF was calculated in two cases with and without repetition. To identify the most important PSFs, the Pareto principle has been used. According to the Pareto principle, 14 out of the 43 presented PSFs affected 80% of the errors and incidents that had arisen where PSF repetition was allowed, which amounted to 15 where repetition was not allowed.

The Chi-square goodness of fit test result showed that the proposed H-PSFs have sufficient validity to be generalized to other healthcare systems. The results of this article can be of great help to healthcare system managers so that they can make better decisions with the help of the results of this article in formulating general and healthcare system policies. Also, the findings of this study can be used in the healthcare system to analyze and improve human reliability, direct resources more efficiently to improve the performance of safety management systems, and reduce errors and incidents.

Denture stomatitis is an inflammatory condition in the oral mucosa which develops under the removable denture and affects a considerable percentage of denture users. Due to insufficient studies on this issue in Iran, we investigated the prevalence of denture stomatitis in patients using dentures.

In the current descriptive-analytical cross-sectional study, 130 patients referred to the dental school clinic and other dental clinics in Sari City, Iran, were examined using the census method. Demographic information about the patients, such as age, sex, systemic problems, and type of denture stomatitis (based on Newton’s classification), were recorded. The denture was also clinically examined for its suitability in the mouth. After entering the data in SPSS, version 20, the study variables were analyzed through bivariate correlation, descriptive analysis, and frequency analysis.

A total of 130 patients using dentures (85 male, 45 female) were studied. About 26.2% (n=34) of the patients had denture stomatitis, of whom 58.8% (n=20) were type II and 41.2% (n=14) were type III. There were significant differences between denture’s age (P<0.001), patient’s age (P=0.049), denture use during the day (P=0.002), diseases (P<0.001), denture cleaning frequency (P<0.001), and duration of denture use (P<0.001). Cigarette (P=0.093) and alcohol consumption (P=0.905), and sex (P=0.349) were not significantly associated with the prevalence of denture stomatitis.

The results of the current study presented a high prevalence of denture stomatitis in patients using dentures. Also, the denture’s age, patient’s age, cleaning frequency, duration of denture use, and appropriate denture significantly affected the prevalence of denture stomatitis.