Publications by authors named "Ali Soroush"

57 Publications

Comparing the Associated Factors on Lifestyle Between Type 2 Diabetic Patients and Healthy People: A Case-Control Study.

Int Q Community Health Educ 2021 Jun 7:272684X211022158. Epub 2021 Jun 7.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: the most important way to control diabetes is to follow a preventive lifestyle and if a diabetic individual follows a preventive lifestyle which he or she has accepted. The main objective of the current study is to compare the factors affecting the lifestyle in patients suffering from Type II diabetes and the healthy individuals in Kermanshah City.

Methods: this study is based on a case-control design where using simple random sampling, 110 patients suffering from type II diabetes are selected as the case group and 111 healthy subjects among the companions of other patients are selected as the control group from the Center for Diabetics in Kermanshah City. The average age of the participants is . The questionnaires used for collecting the data included the following: the demographic information questionnaire and the lifestyle questionnaire which covers diet, physical activity, coping with stress, and smoking. Software applications including STSTA14 and SPSS23 were used for performing statistical computations and logistic regression or linear regression tests were used for analyzing the collected data.

Results: in the subscales of diet, physical activity, spiritual growth, and stress management, there was a significant difference between the diabetic and healthy groups in a wat that the average score for these subscales was higher in the healthy individuals. While the average score for "health responsibility" was higher in the diabetic group compared to the healthy subjects, the difference was not significant (). Moreover, there was a significant statistical relationship between the two groups, i.e. the diabetic and healthy groups, and the variables of age, education level, and occupation (P > 0.05).

Conclusion: healthy lifestyle including proper diet and athletic activity is effective in preventing type II diabetes. Accordingly, implementing policies in the urban transportation system such as providing a special lane for bikers in the cities, increasing the tax for harmful foods, considering subsidies for healthy food products, and self-care of individuals can be effective.
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http://dx.doi.org/10.1177/0272684X211022158DOI Listing
June 2021

The characteristics of an effective clinical instructor from the perspective of nursing students: a qualitative descriptive study in Iran.

BMC Nurs 2021 Mar 4;20(1):36. Epub 2021 Mar 4.

Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Clinical instructors have an important role in advancing nursing students to achieve the program objectives. Nursing student perceptions about the characteristics of an effective clinical instructors may help programs improve clinical instruction. As such, the purpose of this study was to understand the characteristics perceived by students to define an effective clinical instructor.

Methods: In this qualitative descriptive study, semi-structured interviews were conducted with undergraduate and postgraduate nursing students. The sample was purposefully selected. MAXQDA software was used for the content analysis. The codes were organized into subcategories and consolidated into categories.

Results: Data saturation was reached with twelve participants, including seven women and five men, between 21 and 36 years of age. General and special characteristics were the two main categories that emerged from the data. These categories were defined by nine subcategories including internal motivation, professional acceptability, clinical competency, teaching skill, clinical experience, values, being a faculty member, appropriate appearance, and communication skills.

Conclusions: Effective clinical instructors have a specific characteristics identified by student. The most important characteristics of effective clinical instructors were related to communication and teaching skills, internal motivation, and professional appearance. More research is necessary to determine the relationship between the characteristics, instructor competency, and student learning outcomes.
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http://dx.doi.org/10.1186/s12912-021-00556-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934364PMC
March 2021

Increasing Prevalence of Frailty and Its Association with Readmission and Mortality Among Hospitalized Patients with IBD.

Dig Dis Sci 2021 Jan 1. Epub 2021 Jan 1.

Department of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 1468 Madison Ave, Annenberg RM 5-12, New York, NY, 100329, USA.

Background: Although age is often used as a clinical risk stratification tool, recent data have suggested that adverse outcomes are driven by frailty rather than chronological age.

Aims: In this nationwide cohort study, we assessed the prevalence of frailty, and factors associated with 30-day readmission and mortality among hospitalized IBD patients.

Methods: Using the Nationwide Readmission Database, we examined all patients with IBD hospitalized from 2010 to 2014. Based on index admission, we defined IBD and frailty using previously validated ICD codes. We used univariable and multivariable regression to assess risk factors associated with all-cause 30-day readmission and 30-day readmission mortality.

Results: From 2010 to 2014, 1,405,529 IBD index admissions were identified, with 152,974 (10.9%) categorized as frail. Over this time period, the prevalence of frailty increased each year from 10.20% (27,594) in 2010 to 11.45% (33,507) in 2014. On multivariable analysis, frailty was an independent predictor of readmission (aRR 1.16, 95% CI: 1.14-1.17), as well as readmission mortality (aRR 1.12, 95% CI 1.02-1.23) after adjusting for relevant clinical factors. Frailty also remained associated with readmission after stratification by IBD subtype, admission characteristics (surgical vs. non-surgical), age (patients ≥ 60 years old), and when excluding malnutrition, weight loss, and fecal incontinence as frailty indicators. Conversely, we found older age to be associated with a lower risk of readmission.

Conclusions: Frailty, independent of age, comorbidities, and severity of admission, is associated with a higher risk of readmission and mortality among IBD patients, and is increasing in prevalence. Given frailty is a potentially modifiable risk factor, future studies prospectively assessing frailty within the IBD patient population are needed.
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http://dx.doi.org/10.1007/s10620-020-06746-wDOI Listing
January 2021

Barriers to the success of cardiopulmonary resuscitation from the perspective of Iranian nurses: A qualitative content analysis.

Int Emerg Nurs 2021 Jan 24;54:100954. Epub 2020 Dec 24.

Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran; Health Institute, Social Development and Health Promotion Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address:

Background: The survival rate following Cardiopulmonary Resuscitation (CPR) has been reported to be 7-26.7%. Various studies have shown that CPR failure is high in many countries. This study was aimed to explore the barriers to the success of CPR from the perspective of Iranian nurses.

Methods: Participants were 14 Iranian nurses recruited through purposive sampling. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis.

Results: The barriers to successful CPR were developed in three main categories and nine subcategories. Some of the barriers to CPR success were: "delayed attendance of the CPR team and start of CPR", "inadequate experience and skill of the CPR team", "poor access to special units", "insufficient and deficient CPR equipment", "poor CPR location", "critical clinical conditions of the patient", and "interference of the patient's family members.

Conclusion: The results showed that human and environmental factors can result in CPR failure. These barriers can be minimized by measures such as empowerment of the CPR team, and providing the necessary facilities and equipment.
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http://dx.doi.org/10.1016/j.ienj.2020.100954DOI Listing
January 2021

Factors Affecting the Desire to Undergo Cosmetic Procedures Among the Nurses of Kermanshah, Iran: A Cross-Sectional Study.

Plast Surg Nurs 2020 Oct/Dec;40(4):205-210

Maryam Janatolmakan, MSc, is a Nurse Researcher, Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The number of people undergoing cosmetic procedures (CP) has been growing around the world in recent years. The aim of this study was to determine factors involved in the desire of nurses to undergo CP. A total of 360 nurses were recruited in this cross-sectional study. Stratified random sampling was used to select the samples. The data were collected using the Social Appearance Anxiety Scale and a questionnaire addressing social factors affecting the desire to undergo CP. More than half of the nurses (56.7%) were willing. Gender, social factors, and social appearance anxiety (SAA) were associated with undergoing CP. The results of logistic regression indicated that women were four times more willing to undergo CP than men, and for each unit increase in SAA score, the odds of desiring to undergo CP increased by 1.04. The Hosmer-Lemeshow test confirmed the goodness-of-fit of the regression model. Moreover, 3 independent variables of gender, SAA, and social factors were powerful predictors of the desire to undergo CP that could explain 39.9%-53.6% of changes in the desire to undergo CP. Further studies are needed to investigate the amount of CP and motivations to undergo CP in nurses.
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http://dx.doi.org/10.1097/PSN.0000000000000324DOI Listing
December 2020

Hospital managers' skills required and onward challenges: A qualitative study.

J Educ Health Promot 2020 28;9:228. Epub 2020 Sep 28.

Life Style Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Introduction: The qualification of managers in terms of management skills is one of the most important factors in the continuous success of each organization, and utilizing such skills can have a positive contribution in the effectiveness of the organization while improving the performance of the employees in line with the objectives and goals of the organization. The study's primary objective was to examine the necessary skills of the hospital managers and their capabilities to manage the challenges in providing health care facilities to their patients and employees.

Materials And Methods: This study is a qualitative that deep interviews were performed with 22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and the sample size was 22 individuals. The interviews were analyzed by a MAXQDA software application after transcription.

Results: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptive skill, the human relations skill, work experience, and personal characteristics were among the skills necessary for hospital managers. Some of the challenges facing the hospital managers included rapid changes in the policies, the limitations of financial resources, and lack of proportion between the educational and occupational spheres.

Conclusion: Because of their existential philosophy and differences with other service sectors, managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is very important. Therefore, in order to meet the satisfaction of those receiving services, decision-makers and policy-makers must think twice when selecting and appointing hospital managers and evaluate and appraise this group in terms of abilities and skills necessary for managing such an important service section.
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http://dx.doi.org/10.4103/jehp.jehp_171_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652088PMC
September 2020

Clinical significance of recurrent gastroesophageal junction intestinal metaplasia after endoscopic eradication of Barrett's esophagus.

Gastrointest Endosc 2021 06 2;93(6):1250-1257.e3. Epub 2020 Nov 2.

Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA. Electronic address:

Background And Aims: After endoscopic eradication of Barrett's esophagus (BE), recurrence of intestinal metaplasia at the gastroesophageal junction (GEJIM) is common. The clinical significance of this finding is unclear. We assessed whether recurrent GEJIM is associated with increased risk of subsequent dysplasia and whether endoscopic treatment lowers this risk.

Methods: A retrospective, multicenter, cohort study was performed of treated BE patients who achieved complete eradication of intestinal metaplasia (IM). Postablation follow-up was performed at standard intervals. Recurrent GEJIM was defined as nondysplastic IM on gastroesophageal junction biopsy specimens without endoscopic evidence of BE. Patients were categorized as "never-GEJIM," "GEJIM-observed," or "GEJIM-treated." Endoscopic treatment for recurrent GEJIM was at the endoscopists' discretion. The primary outcome was dysplasia recurrence. Analyses were performed using log-rank tests and Cox proportional hazards modeling.

Results: Six hundred thirty-three patients were analyzed; median follow-up was 47 months (interquartile range, 24-69). Most patients (81%) had high-grade dysplasia or intramucosal adenocarcinoma before treatment. Dysplasia recurrence was 2.2% per year. GEJIM-observed patients had the lowest rate of recurrence (.6%/y) followed by GEJIM-treated (2.2%/y) and never-GEJIM (2.6%/y) (log-rank P = .07). In multivariate analyses, compared with never-GEJIM, the risk of dysplasia recurrence was significantly lower in GEJIM-observed patients (adjusted hazard ratio, .19; 95% confidence interval, .05-.81) and not different in GEJIM-treated patients (adjusted hazard ratio, .81; 95% confidence interval, .39-1.67). Older age and longer initial BE length were independently associated with recurrence.

Conclusions: Recurrent GEJIM after endoscopic eradication of BE was not associated with an increased risk of subsequent dysplasia. Future studies are warranted to determine if observation is appropriate for this finding.
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http://dx.doi.org/10.1016/j.gie.2020.10.027DOI Listing
June 2021

Emotional Intelligence and Quality of Life in Elderly Diabetic Patients.

Int Q Community Health Educ 2020 Oct 21:272684X20965811. Epub 2020 Oct 21.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Coordination of various physical and mental aspects of individuals, including the ability to control difficult conditions and situations has an effect in the prevention and development of various diseases, such as diabetes, and the improvement of the quality of life. Therefore, the purpose of this study was is to determine the effect of emotional intelligence on the quality of life of elderly diabetic patients.

Methods: This study was conducted in 2018. The statistical population in this cross-sectional study consisted of elderly people referred to the health centers of Kermanshah province in western Iran, who were divided via available sampling into two groups with diabetes and without diabetes. Data gathering tools were a couple of LIPAD Quality of Life and Shrink Emotional Intelligence standard questionnaires. The Data was analysed using software SPSS, 23 th version. Tests were used (T-test, Chi-square, Anova and regression).

Results: Most of them were male (52.72%) and the mean age of the patients was 65.01(±6.08) years old and married. The quality of life score in diabetics and non-diabetics was respectively 51.9 and 50.37 with a standard deviation of 17.73 and 20.54. The mean total score of emotional intelligence in the elderly with diabetes was 99.42 with a standard deviation of 10.37 and non-diabetic subjects were 97.18 with a standard deviation of 18.4.

Conclusion: There was no significant difference between the mean scores of quality of life (0.652) and emotional intelligence (0.421) in diabetic and non-diabetic individuals. But, the emotional intelligence has an effect on the quality of life of the elderly people.
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http://dx.doi.org/10.1177/0272684X20965811DOI Listing
October 2020

Knowledge, Attitude, and Performance of ICU, CCU, and Emergency Wards Nurses in Kermanshah, Iran, regarding Organ Donation.

Crit Care Res Pract 2020 27;2020:5167623. Epub 2020 Sep 27.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Providing an organ for donation is a major problem worldwide and nurses play an important role in facilitating the process of organ donation. This study is aimed at investigating the knowledge, attitude, and performance of nurses working in the ICU, CCU, and emergency wards regarding organ donation.

Methods: In this descriptive-analytical study, 185 nurses working in ICU, CCU, and emergency wards were studied through systematic random sampling. The data collection was done by a self-administered questionnaire.

Results: The mean knowledge of nurses was 8.9 ± 1.4 out of 10. There was a significant relationship between knowledge of nurses regarding donation and religion and having organ donation card ( < 0.001). The mean attitude of nurses was 7.8 ± 2.2 out of 8. The variables, including "having a donation card and marriage," were associated with attitude of nurses toward organ donation. The mean performance of nurses was 0.4 ± 0.7 out of 3. There was a significant relationship between performance of nurses and having a donation card ( < 0.001). Knowledge was the strongest predictor of nurses' performance ( < 0.01).

Conclusion: The studied nurses showed sufficient knowledge and favorable attitude toward organ donation; however, they had poor performance. It is suggested to hold training courses to improve performance of nurses. The revision of the nursing students' curriculum as future nurses should also be considered.
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http://dx.doi.org/10.1155/2020/5167623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537714PMC
September 2020

Nursing students' perceived consequences of self-medication: a qualitative study.

BMC Nurs 2020 25;19:71. Epub 2020 Jul 25.

Doolat abaad, Nursing Department, School of Nursing and Midwifery, student research committee, Kermanshah University of Medical Sciences, Dolat Abad Street, Kermanshah, Kermanshah province 6718996511 Iran.

Background: Self-medication associates with many problems and complications, and is considered as a global health issue. Regarding a lack of information about perception of nursing students, as a part of healthcare workers, in this issue, the current study was aimed to explore the perceived consequences of self-medication from the perspective of nursing students.

Methods: This qualitative study was conducted using semi-structured individual face-to-face interviews. Purposeful sampling method was used for selection of participants. Twelve nursing students in the age range of 21-36 years were enrolled. Five participants were male and seven were female, seven master's degree and five were undergraduate of bachelor degree. Data were collected using semi-structured interviews and analyzed as content analyses.

Results: Two categories and seven sub-categories were emerged from the data analysis. The main categories included; positive consequences and negative consequences, and subcategories included; time saving, cost savings, disease treatment, harming the health system, drug resistance, physical complications and death.

Conclusion: The participants believed that self-medication has some positive and negative consequences in viewpoints of nursing students. Regarding, Self-medication that potentially has dangerous consequences, it is suggested the students will be educated and warned about the adverse effects of self-medication, and the nursing teachers should try to rectify students' misconceptions about self-medication.
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http://dx.doi.org/10.1186/s12912-020-00460-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382074PMC
July 2020

Cultural Challenges Using Technology Following the Kermanshah Earthquake, Western Iran November 2017.

Iran J Public Health 2019 Aug;48(8):1547-1548

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145932PMC
August 2019

Gender-based difference in early mortality among patients with ST-segment elevation myocardial infarction: insights from Kermanshah STEMI Registry.

J Cardiovasc Thorac Res 2020 19;12(1):63-68. Epub 2020 Feb 19.

Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

This study aimed to evaluate the in-hospital mortality of patients with ST-segment elevation myocardial infarction (STEMI), according to gender and other likely risk factors. This study reports on data relating to 1,484 consecutive patients with STEMI registered from June 2016 to May 2018 in the Western Iran STEMI Registry. Data were collected using a standardized case report developed by the European Observational Registry Program (EORP). The relationship between in-hospital mortality and potential predicting variables was assessed multivariable logistic regression. Differences between groups in mortality rates were compared using chi-square tests and independent t-tests. Out of the 1484 patients, 311(21%) were female. Women were different from men in terms of age (65.8 vs. 59), prevalence of hypertension (HTN) (63.7% vs. 35.4%), diabetes mellitus (DM) (37.7% vs. 16.2%), hypercholesterolemia (36.7% vs. 18.5%) and the history of previous congestive heart failure (CHF) (6.6% vs. 3.0%). Smoking was more prevalent among men (55.9% vs. 13.2%). Although the in-hospital mortality rate was higher in women (11.6% vs. 5.5%), after adjusting for other risk factors, female sex was not an independent predictor for in-hospital mortality. Multivariable analysis identified that age and higher Killip class (≥II) were significantly associated with in-hospital mortality rate. In-hospital mortality after STEMI in women was higher than men. However, the role of sex as an independent predictor of mortality disappeared in regression analysis. The gender based difference in in-hospital mortality after STEMI may be related to the poorer cardiovascular disease (CVD) risk factor profile of the women.
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http://dx.doi.org/10.34172/jcvtr.2020.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080341PMC
February 2020

Risk Factors and Psychosocial Correlates of Emotionally Negative Dreams in Patients Referred to a Cardiac Rehabilitation Centre.

Malays J Med Sci 2020 Feb 27;27(1):97-105. Epub 2020 Feb 27.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Introduction: Dream, as a kind of mental activity, includes various functions such as mood regulation, adjustment and integration of new information with the available memory system. The study was done for assessing the relationship between physiological and psychological components of cardiac diseases with emotionally negative dreams in cardiac rehabilitation.

Methods: At the baseline of this cross-sectional study, 156 patients from Western Iran participated during April-November 2016. People 20 years-80 years able to recall the emotional content of dreams after cardiac surgery entered the study. The Beck depression inventory (BDI), Beck anxiety inventory (BAI), Buss and Perry's aggression questionnaire (BPAQ) and Schredl's dream emotions manual were used for collecting data. A binary logistic regression analysis used for the study of the relationship between risk factors and emotionally negative dreams.

Results: The mean age of participants was 59 (SD = 9) years (men: 64.1%). The results showed that 25% of patients have negative emotional content. After adjustment for demographic variables, the results showed that increased anxiety [adjusted odds ratio (adj OR) = 1.08 [1.01-1.16], = 0.020] and anger (adj OR = 1.03 [1.00-1.06], = 0.024) and hypertension (adj OR = 2.71 [1.10-6.68], = 0.030) can predict the dreams with negative content significantly.

Conclusion: The increasing rates of anxiety and anger and history of hypertension are related to increasing dreams with the negative emotional load. The control of risk factors of dreams with negative emotional load can be the target of future interventions.
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http://dx.doi.org/10.21315/mjms2020.27.1.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053550PMC
February 2020

Comparison of Sexual Knowledge between Patients Prepared for Cardiac Surgery and Patients Prepared for Cardiac Rehabilitation in Iran.

J Tehran Heart Cent 2019 Jul;14(3):103-108

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Although sexual death during intercourse occurs rarely in patients with cardiovascular diseases (CVDs), most such patients avoid it because they fear a dangerous event. Given the significance of awareness about this issue among patients with CVDs, we sought to compare sexual knowledge between 2 groups of patients prepared for cardiac surgery and patients prepared for cardiac rehabilitation (CR). This cross-sectional study, conducted between April and July 2016, recruited 157 patients with CVDs (107 candidates for surgery and 50 patients prepared for CR) in Imam Ali Hospital, in the Iranian city of Kermanshah. The cases, selected through entire counting according to our inclusion criteria, responded to a standard sexual knowledge inventory. Sexual knowledge and professionals responsible in providing sexual rehabilitation from the perspective of patients were compared using the independent t-test and the χ test. The participants' mean age was 55.39±9.82 years (male: 58.6%). Overall, the 2 groups had poor sexual knowledge. Although the CR program started 57.85±13.92 days after surgery, the sexual knowledge of this group of patients was not significantly different from that of the patients prepared for surgery (P=0.904). This difference was not significant between the 2 genders (P=0.077). Finally, concerning the professionals responsible in providing sexual rehabilitation, the patients selected psychologists (P=0.006) and nurses (P=0.012) more frequently in the initial phase of CR program. Sexual knowledge was poor in our CR patients at the outset of the program. Given the poor knowledge in these patients 2 months after surgery and the lack of significant difference in knowledge between these patients and those prepared for surgery, it is advisable that they be provided with the necessary information in this regard in this golden time before hospital discharge.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981344PMC
July 2019

Causes and Predictors of Hospital-Death among Elderly Patients in Western Iran; a Hospital-Based Cross-Sectional Study.

Adv J Emerg Med 2020 11;4(1):e3. Epub 2019 Jul 11.

School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Introduction: Identifying the death reasons amongst elderly, may help prioritizing the research projects and interventions.

Objective: This study purpose was to determine the death pattern and causes, and also its likely associated factors, in a mega hospital in western Iran.

Method: This retrospective cross-sectional study, conducted on elderly died from April 2011 to March 2016, in Imam Reza hospital in Kermanshah, Iran. The data were collected about the demographic characteristics, medical information, and the main death causes. The causes-of-death was classified adopting the International Classification of Diseases, Tenth Revision (ICD-10). The relationships between outcome and predicting variables were assessed by using Chi-square and Tukey's test in SPSS.

Results: Totally, 2415 died elderly were registered during the study period. The participants mean age at the time of their death was 75.35±9.15 years old. The diseases of circulatory system (dominancy of stroke), infectious diseases (leading by septicaemia and septic shock, respectively), and respiratory system diseases were the most common death causes, respectively. Age was the most important associated factor for the all-cause mortality related to the cardiovascular diseases (p=0.001).

Conclusion: The majority of deaths were the premature, which requires paying more attention. Although, cardiovascular diseases were the leading death causes and that is predictable, but the fatality of infectious diseases is still causing concerns.
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http://dx.doi.org/10.22114/ajem.v0i0.162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955032PMC
July 2019

Partitioning Stroke Patients, Determining Related Factors, and Comparing Derived Clusters Based on 12-Month Health Outcomes.

Arch Iran Med 2019 12 1;22(12):708-715. Epub 2019 Dec 1.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: (i) Cluster analysis and partitioning samples based on cardio-cerebrovascular histories and length of stay (LOS); (ii) Determining related demographic and medical factors in individual clusters; and (iii) Comparing clusters based on 12-month health outcomes.

Methods: The statistical population of the study included 2,293 stroke patients hospitalized in Imam Reza hospital of Kermanshah city from January 1, 2015, to December 31, 2016. After a one-year follow-up, the data collection window was closed on December 31, 2017. The patients' data were extracted from the electronic hospital information system (HIS). Two-step cluster analysis (TSCA), chi-square, Fisher exact, Kruskal-Wallis, and Mann-Whitney U tests, as well as multinomial logistic regression analysis were the analysis methods.

Results: This model suggested five distinct clusters: the patients (i) without any cardio-cerebrovascular history and LOS = 5 days (36.2%); (ii) without any cardio-cerebrovascular history and LOS = 6 days (21.6%); (iii) with cerebrovascular history and LOS = 6 days (18.6%); (iv) with cardiovascular history and LOS = 6 days (16.1%); and (v) with cardio-cerebrovascular history and LOS = 6 days (7.5%). Hypertension, diabetes, and smoking were respectively the most significant modifiable risk factors, while sex, cerebrovascular diseases in the family, and age were respectively the most significant non-modifiable risk factors in high-risk clusters and LOS = 6 days. Compared to Cluster 1 (reference), during a one-year follow-up, a larger number of members in Clusters 3 and 5 were readmitted and/or expired.

Conclusion: Considering the modifiable risk factors identified in the current study, providing programs for preventing readmission and potential death caused by stroke for Clusters 3 and 5 seems essential.
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December 2019

Investigation the correlation between psychological empowerment and assertiveness in nursing and midwifery students in Iran.

Nurse Educ Pract 2020 Jan 9;42:102667. Epub 2019 Nov 9.

Health Institute, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address:

Background: Assertiveness is a key skill for nurses and midwives, and should be considered in the students' education. In this regard, variables such as psychological empowerment, which may have a significant correlation with assertiveness, should be identified and studied.

Objectives: The aim of this study was to investigate the correlation between psychological empowerment and assertiveness in nursing and midwifery students.

Design: A cross-sectional and correlational study.

Settings: /Participants: This study was carried out on 200 Iranian nursing and midwifery students.

Methods: The students were randomly selected for the study. The study tools were The Rathus' Assertiveness Schedule and Spreitzer's Psychological Empowerment Scale. Data were analyzed by descriptive and inferential statistics.

Findings: There was a positive and significant correlation between psychological empowerment and assertiveness. The components of meaning and self-determination had a positive and significant correlation with the assertiveness.

Conclusions: Since psychological empowerment and assertiveness in decision-making and interaction with colleagues and patients are considered as essential skills for nurses and midwives, we recommend that, required measures should be taken to promote these skills in nursing and midwifery students.
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http://dx.doi.org/10.1016/j.nepr.2019.102667DOI Listing
January 2020

Interventions in Reducing Caesarean Section in the World: A Systematic Review.

Malays J Med Sci 2019 Sep 4;26(5):21-37. Epub 2019 Nov 4.

Life Style Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Caesarean section without medical indication imposes many problems to families, personnel and medical equipment causing some side effects to pregnant woman and foetus, compared to natural childbirth. The present study aimed to evaluate the interventions in reducing caesarean section in the world. This study was a systematic review using Embase, PubMed, Scopus, Web of Science, Science Direct, Magiran and SID databases and grey literature. All studies conducted during 2000-2018 were reviewed and finally the studies with inclusion and exclusion criteria were selected. A total of 19 studies were selected among 5,559 studies. The interventions conducted for reducing caesarean section included training the specialists and women by using Six Sigma method, changing the guidelines, reviewing the definition of natural childbirth various stages, encouraging the natural childbirth and expanding painless childbirth. All interventions were divided into educational strategy and managerial strategy. The interventions can be implemented to change the behaviour of physicians and attitude of pregnant women in order to reduce caesarean section. In this regard, the authorities are recommended to make more efforts.
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http://dx.doi.org/10.21315/mjms2019.26.5.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839664PMC
September 2019

Attitude of primiparous women towards their preference for delivery method: a qualitative content analysis.

Arch Public Health 2019 20;77:38. Epub 2019 Aug 20.

3Students Research Committee, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: The delivery method is one of the primary concerns of primiparous women. Today, due to the fear of delivery, the number of cesarean sections has increased significantly. Considering the importance of choosing the type of delivery and the lack of study in this regard, the present study was conducted to explain the attitude of primiparous women towards their preference for delivery method.

Method: In this qualitative study, in-depth interview was conducted with 12 primiparous women. The transcripts of the interviews were read carefully by the researcher for several times. Finally, using the analytical method, the codes were extracted and subsequent subcategories and main categories were determined. To assess the credibility of the data, the Denzin & Lincoln's criteria were used, which include Credibility, Transferability, Dependability, and Confirmability.

Results: Because of inexperience in delivery and ambiguity in process, most of the woman had a specific fear and they commonly affected by other advices and experiences. The majority of the participants had desire to vaginal delivery with announcing its advantages such as shortage of pain process, easy breast feeding, and mother ability to better carryout the newborn works. Other participants believed on adverse effects of normal vaginal delivery including bladder prolapse, uterus rupture, and probability of experience of both happenings (CS and NVD), frequent examination, pain and urine incontinence. Some stated cesarean section have benefits of less injury to neonate and preserving her/his beauty.

Conclusion: Results showed that, choosing a delivery method is difficult for primiparous women, and their attitude toward the type of delivery is influenced by subjective and internal factors. Giving awareness to primiparous women greatly enhances their tendency towards vaginal delivery.
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http://dx.doi.org/10.1186/s13690-019-0364-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700977PMC
August 2019

Role of perceived heart risk factors by outpatient population in predicting cardiovascular risk.

J Cardiovasc Thorac Res 2019 23;11(2):100-108. Epub 2019 May 23.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Regarding the expanding population in developing countries who are at risk for cardiovascular diseases (CVDs), identification and management of effective factors are important in reducing the risk of CVDs. So, the present study aimed to assess the role of perceived heart risk factors (PHRFs) in the prediction of cardiovascular risk among outpatient patients. The samples of this cross-sectional study included 150 outpatient patients who attend the clinic of Imam Reza hospital during October-December 2016. The participants were completed the Perceived Heart Risk Factors Scale (PHRFS) and Cardiovascular Risk Assessment Questionnaire (CRAQ). Data analyzed through Pearson correlation and multiple regression analyses. Based on the findings, 28%, 40%, 22.7%, and 9.3% of patients were low, medium, high, and severely high-risk, respectively. The strongest predictors of the cardiovascular risk were physiological (β=-0.273; =0.004), psychological (β=0.236; =0.020), and biological risk factors (β=0.209; =0.016), respectively. In addition, the strongest predictor of the lifestyle risk was physiological risk factors (β=-0.264; =0.007). Other variables do not play a significant role in predict the lifestyle risk (>0.05). Our model was able to explain 9.2% of cardiovascular risk variance and 5.7% of cardiovascular risk caused by lifestyle variance. The higher patients' perception about biological and psychological risk factors is concerned as an alarm for increased cardiovascular risk while higher perception about physiological risk factors is associated with reduced cardiovascular risk caused by lifestyle and total cardiovascular risk. The programs reducing cardiovascular risk should target the high-risk groups to save cost and time.
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http://dx.doi.org/10.15171/jcvtr.2019.18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669426PMC
May 2019

Indirect Health Policy by Sports Media: The Positive Effects of the Live Broadcast of the FIFA World Cup in the General Population.

Iran J Public Health 2019 Mar;48(3):564-565

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570810PMC
March 2019

The relationship between social networking addiction and academic performance in Iranian students of medical sciences: a cross-sectional study.

BMC Psychol 2019 May 3;7(1):28. Epub 2019 May 3.

Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Social networks have had a major influence on students' performance in recent years. These networks create many opportunities and threats for students in various fields. Addiction to social networking and its impact on students' academic performance caused the researcher to design and conduct this study. The purpose of this study was to investigate the relationship between social networking addiction and academic performance of students in Iran.

Methods: In this cross-sectional study, 360 students were enrolled by stratified random sampling. The study tools included personal information form and the Bergen Social Media Addiction Scale. Also, the students' overall grade obtained in previous educational term was considered as the indicator of academic performance. Data were analyzed using SPSS-18.0 and descriptive and inferential statistics.

Findings: The mean social networking addiction was higher in male students (52.65 ± 11.50) than in female students (49.35 ± 13.96) and this difference was statistically significant (P < 0.01). There was a negative and significant relationship between students' addiction to social networking and their academic performance (r = - 0.210, p < 0.01).

Conclusions: The social networking addiction of the students was at moderate level and the male students had a higher level of addiction compared to the female students. There was a negative and significant relationship between the overall use of social networks and academic performance of students. Therefore, it is imperative that the university authorities take interventional steps to help students who are dependent on these networks and, through workshops, inform them about the negative consequences of addiction to social networks.
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http://dx.doi.org/10.1186/s40359-019-0305-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500070PMC
May 2019

Shorter time to achieve endoscopic eradication is not associated with improved long-term outcomes in Barrett's esophagus.

Dis Esophagus 2019 Aug;32(8)

Department of Medicine, Columbia University Medical Center, New York, USA.

Quality indicators have been proposed for endoscopic eradication therapy of Barrett's esophagus (BE). One such measure suggests that complete eradication of intestinal metaplasia (CE-IM) should be achieved within 18 months of starting treatment. The aim of this study was to assess whether achievement of CE-IM within 18 months is associated with improved long-term clinical outcomes. This was a retrospective cohort study of BE patients who underwent endoscopic eradication. Time to CE-IM was recorded and categorized as ≤ or > 18 months. The main outcome measures were recurrence of IM and of dysplasia after CE-IM, defined as a single endoscopy without endoscopic evidence of BE or histologic evidence of intestinal metaplasia. Recurrence was analyzed using the Kaplan-Meier method and multivariable Cox proportional hazards modeling. A total of 290 patients were included in the analyses. The baseline histology was high-grade dysplasia or intramucosal carcinoma in 74.2% of patients. CE-IM was achieved in 85.5% of patients, and 54.1% of the cohort achieved CE-IM within 18 months. Achieving CE-IM within 18 months was not associated with reduced risk of recurrence of IM or dysplasia in both unadjusted and adjusted analyses. In this cohort, older age and increased BE length were associated with IM recurrence, and increased hiatal hernia size was associated with dysplasia recurrence. Compared to longer times, achieving CE-IM within 18 months was not associated with a reduced risk of recurrence of IM or dysplasia. Alternative evidence-based quality metrics for endoscopic eradication therapy should be identified.
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http://dx.doi.org/10.1093/dote/doz026DOI Listing
August 2019

Applying Behavioural Incentives to Increase Adherence to Maintenance Treatment.

Malays J Med Sci 2018 Nov 28;25(6):137-140. Epub 2018 Dec 28.

Lifestyle Modification Research Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

A significant portion of the various communities, especially developing countries, is involved in drug abuse and receive formal drug treatments. Although the benefits of available therapeutics such as methadone maintenance treatment (MMT) for controlling infectious diseases have been confirmed, treatment failure has been seen in a large range of the patients. This review addresses the importance of a less attentive behavioural approach in reducing treatment withdrawal. The executive protocol, the outcomes and challenges, and the benefits of this approach are debatable.
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http://dx.doi.org/10.21315/mjms2018.25.6.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422568PMC
November 2018

What is the Most Serious Obstacle to Participation in Outpatient Cardiac Rehabilitation Programs among Iranian Patients?

Iran J Nurs Midwifery Res 2019 Mar-Apr;24(2):158

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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http://dx.doi.org/10.4103/ijnmr.IJNMR_67_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390440PMC
March 2019

Efficacy of Alternative Cardiac Rehabilitation Delivery Formats in Improving Psychological Symptoms after Coronary Artery Bypass Grafting.

J Tehran Heart Cent 2018 Jul;13(3):103-107

Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.

Health-care systems always strive for alternative cardiac rehabilitation (CR) models to ensure that options available to patients better fit their needs, risk factor profiles, and preferences. We assessed the effects of hospital-based cardiac rehabilitation (HBCR) and hybrid cardiac rehabilitation (HCR) on psychological symptoms (i.e., anxiety, depression, and stress) among patients following coronary artery bypass graft surgery (CABG). This cross-sectional study recruited 115 CABG patients who were referred to the Department of Cardiac Rehabilitation at Imam Ali Hospital in the Iranian city of Kermanshah between January and May 2016. The patients were assigned to 1 of the 2 programs of HBCR (26 sessions) and HCR (10 sessions). The study population's psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS) before and after the intervention, and the data were analyzed using paired t-tests and ANCOVA. A total of 105 (91%) patients concluded the CR program. Respectively, 50.8% and 26.2% of the participants in the HBCR and HCR programs were female. The mean age was 59.6±9.2 years in the HBCR group and 58.7±6.1 years in the HCR group. The ANCOVA results indicated that both HBCR and HCR programs were equally effective in reducing anxiety (P=0.001 vs. P=0.015) and stress (P=0.002 vs. P=0.003) among the CABG patients, while only HBCR was effective in alleviating depressive symptoms (P=0.001). Our results demonstrated the efficacy of HBCR and HCR in diminishing stress and anxiety levels among the CABG patients. However, depression was affected only by HBCR.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368916PMC
July 2018

The Unsolved Psychological Consequences of Earthquake Aftershocks in Kermanshah City, November 2017.

Iran J Nurs Midwifery Res 2019 Jan-Feb;24(1):81

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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http://dx.doi.org/10.4103/ijnmr.IJNMR_45_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298173PMC
January 2019

Dreams content and emotional load in cardiac rehabilitation patients and their relation to anxiety and depression.

Ann Card Anaesth 2018 Oct-Dec;21(4):388-392

Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: The assessment of a dream and its mechanisms and functions may help us to percept cognitions, emotions, and complex behaviors of patients. Hence, the present study aimed to assess (i) the rate of perceived dream and its emotional load and content and (ii) the relationship between functions of dream with anxiety and depression.

Methods: In this cross-sectional study, 167 cardiac patients who had undergone rehabilitation in the western part of Iran were assessed during May-October 2016. Research instrument included Beck depression inventory, Beck anxiety inventory, Schredl's dream emotions manual, and content analysis of dreams manual. The findings were analyzed through Pearson's correlative coefficient and multiple regression analysis.

Results: The mean age of participants (66.5% men) was 59.1 ± 9 years. The results indicated that the emotional content of patients' dreams included happiness (49.1%), distress (43.1%), sad (13.8%), fear (13.2%), and anger (3%). Although women report more sad dreams than men (P = 0.026), there was no difference between them in terms of other components of dreams, anxiety, and depression. Regression models showed that anxiety and depression were significantly able to predict perceived dream rates (P = 0.030) and emotionally negative dreams (P = 0.019).

Conclusion: The increased rates of depression, especially anxiety, are related to increasing perceived dreams with negative and harmful emotional load. Regarding severity and negative content of dreams are reflexes of stressful emotional daily experiences, the management of experienced psychological symptoms such as depression and anxiety is concerned as an undeniable necessity.
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http://dx.doi.org/10.4103/aca.ACA_210_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206785PMC
April 2019

High-efficiency Strategies to Improve Health Information of the General Population.

Iran J Nurs Midwifery Res 2018 Sep-Oct;23(5):409

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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http://dx.doi.org/10.4103/ijnmr.IJNMR_209_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111656PMC
September 2018

Exploring the perceived factors that affect self-medication among nursing students: a qualitative study.

BMC Nurs 2018 3;17:35. Epub 2018 Aug 3.

3Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Self-medication is the use of one or more medications without physician's diagnosis, opinion, or prescription and supervision, which includes the use of herbal or chemical drugs. Todays, self-medication is one of the biggest socio-health and economic problems among nursing students of various societies, including Iran, and because this issue can affected by contextual factors, this study aimed to explore the perceived factors that affect self-medication among nursing students.

Methods: In this qualitative study, a semi-structured interview was conducted with 11 nursing students. The transcript of each interview was reviewed several times and classified into main categories and sub-categories by content analysis. To evaluate this study, Guba and Lincoln's four criteria, including credibility, transferability, dependability, and confirmability were considered for trustworthiness.

Results: After analyzing the qualitative content of the interviews, four main categories, including educational backgrounds, nature of the disease, access to the media, and beliefs and personal experiences, and ten subcategories, including contact with clinical environment, relative knowledge about medications, simplicity of the disease, recurrence of the disease, influence of the media, use of the internet, believing in own knowledge, positive experiences of traditional medicine, and using own and others' experiences, were extracted.

Conclusions: It seems that, having a relative awareness about various diseases and medications, which is sometimes associated with taking a few educational courses with an internship, creates a false confidence in student for self-medication and prescribing drugs to others. It would be beneficial if the education system and associated tutors could inform the students about the possible consequences of this issue. By knowing the internal and subjective factors that influence the self-medication, this arbitrary practice can be largely prevented.
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http://dx.doi.org/10.1186/s12912-018-0302-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091042PMC
August 2018