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Mirzania M, Shakibazadeh E, Hantoushzadeh S, Panahi Z, Bohren MA, Khajavi A. An investigation into the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companionship in Tehran: a qualitative inquiry on mitigating mistreatment of women during childbirth. BMC Public Health 2024; 24:1292. [PMID: 38741128 DOI: 10.1186/s12889-024-18751-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A birth companion is a powerful mechanism for preventing mistreatment during childbirth and is a key component of respectful maternity care (RMC). Despite a growing body of evidence supporting the benefits of birth companions in enhancing the quality of care and birth experience, the successful implementation of this practice continues to be a challenge, particularly in developing countries. Our aim was to investigate the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companions to mitigate the mistreatment of women during childbirth in Tehran. METHODS This exploratory descriptive qualitative study was conducted between April and August 2023 at Valiasr Hospital in Tehran, Iran. Fifty-two face-to-face in-depth interviews were conducted with a purposive sample of women, birth companions, and maternity healthcare providers. Interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis, with a deductive approach based on the Implementation Outcomes Framework in the MAXQDA 18. RESULTS Participants found the implemented program to be acceptable and beneficial, however the implementation team noticed that some healthcare providers were initially reluctant to support it and perceived it as an additional burden. However, its adoption has increased over time. Healthcare providers felt that the program was appropriate and feasible, and it improved satisfaction with care and the birth experience. Participants, however, highlighted several issues that need to be addressed. These include the need for training birth companions prior to entering the maternity hospital, informing women about the role of birth companions, assigning a dedicated midwife to provide training, and addressing any physical infrastructure concerns. CONCLUSION Despite some issues raised by the participants, the acceptability, adoption, appropriateness, feasibility, and fidelity of the implementation strategies for birth companions to mitigate the mistreatment of women during childbirth were well received. Future research should explore the sustainability of this program. The findings of this study can be used to support the implementation of birth companions in countries with comparable circumstances.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Panahi
- Department of Obstetrics and Gynecology, Maternal-Fetal Neonatal Research Center, Tehran University of Medical Sciences, Valiasr Hospital, Tehran, Iran
| | - Meghan A Bohren
- Gender and Women's Health Unit, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Niazkar HR, Moshari J, Khajavi A, Ghorbani M, Niazkar M, Negari A. Application of multi-gene genetic programming to the prognosis prediction of COVID-19 using routine hematological variables. Sci Rep 2024; 14:2043. [PMID: 38263446 PMCID: PMC10806074 DOI: 10.1038/s41598-024-52529-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 01/19/2024] [Indexed: 01/25/2024] Open
Abstract
Identifying patients who may develop severe COVID-19 has been of interest to clinical physicians since it facilitates personalized treatment and optimizes the allocation of medical resources. In this study, multi-gene genetic programming (MGGP), as an advanced artificial intelligence (AI) tool, was used to determine the importance of laboratory predictors in the prognosis of COVID-19 patients. The present retrospective study was conducted on 1455 patients with COVID-19 (727 males and 728 females), who were admitted to Allameh Behlool Gonabadi Hospital, Gonabad, Iran in 2020-2021. For each patient, the demographic characteristics, common laboratory tests at the time of admission, duration of hospitalization, admission to the intensive care unit (ICU), and mortality were collected through the electronic information system of the hospital. Then, the data were normalized and randomly divided into training and test data. Furthermore, mathematical prediction models were developed by MGGP for each gender. Finally, a sensitivity analysis was performed to determine the significance of input parameters on the COVID-19 prognosis. Based on the achieved results, MGGP is able to predict the mortality of COVID-19 patients with an accuracy of 60-92%, the duration of hospital stay with an accuracy of 53-65%, and admission to the ICU with an accuracy of 76-91%, using common hematological tests at the time of admission. Also, sensitivity analysis indicated that blood urea nitrogen (BUN) and aspartate aminotransferase (AST) play key roles in the prognosis of COVID-19 patients. AI techniques, such as MGGP, can be used in the triage and prognosis prediction of COVID-19 patients. In addition, due to the sensitivity of BUN and AST in the estimation models, further studies on the role of the mentioned parameters in the pathophysiology of COVID-19 are recommended.
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Affiliation(s)
- Hamid Reza Niazkar
- Gonabad University of Medical Sciences, Gonabad, Iran.
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Jalil Moshari
- Pediatric Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Community Medicine Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Ghorbani
- Laboratory hematology and Transfusion medicine, Department of Medical Laboratory Sciences, Faculty of Allied Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Majid Niazkar
- Faculty of Engineering, Free University of Bozen-Bolzano, Piazza Università 5, 39100 Bolzano, Italy
| | - Aida Negari
- Gonabad University of Medical Sciences, Gonabad, Iran
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Mirzania M, Shakibazadeh E, Bohren MA, Hantoushzadeh S, Babaey F, Khajavi A, Foroushani AR. Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study. Reprod Health 2023; 20:79. [PMID: 37226263 DOI: 10.1186/s12978-023-01620-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/14/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Mistreatment during labour and childbirth is a common experience for many women around the world. This study aimed to explore the manifestations of mistreatment and its influencing factors in public maternity hospitals in Tehran. METHODS A formative qualitative study was conducted using a phenomenological approach in five public hospitals between October 2021 and May 2022. Sixty in-depth face-to-face interviews were conducted with a purposive sample of women, maternity healthcare providers, and managers. Data were analyzed with content analysis using MAXQDA 18. RESULTS Mistreatment of women during labour and childbirth was manifested in four form: (1) physical abuse (fundal pressure); (2) verbal abuse (judgmental comments, harsh and rude language, and threats of poor outcomes); (3) failure to meet professional standards of care (painful vaginal exams, neglect and abandonment, and refusal to provide pain relief); and (4) poor rapport between women and providers (lack of supportive care and denial of mobility). Four themes were also identified as influencing factors: (1) individual-level factors (e.g., providers' perception about women's limited knowledge on childbirth process), (2) healthcare provider-level factors (e.g., provider stress and stressful working conditions); (3) hospital-level factors (e.g., staff shortages); and (4) national health system-level factors (e.g., lack of access to pain management during labour and childbirth). CONCLUSIONS Our study showed that women experienced various forms of mistreatment during labour and childbirth. There were also multiple level drivers for mistreatment at individual, healthcare provider, hospital and health system levels. Addressing these factors requires urgent multifaceted interventions.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farah Babaey
- Head of Department of Midwifery, Ministry of Health and Medical Education, Tehran, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Armanmehr V, Banafshe E, Hashemizadeh H, Alami A, Khajavi A. Midwives' Perception Regarding Conditions Influencing the Implementation of the Natural Childbirth Promotion Program in Iran: A Qualitative Study. Int J Community Based Nurs Midwifery 2023; 11:135-148. [PMID: 37114101 PMCID: PMC10126447 DOI: 10.30476/ijcbnm.2023.97165.2169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/31/2023] [Accepted: 03/05/2023] [Indexed: 04/29/2023]
Abstract
Background In Iran, the Natural Childbirth Promotion Program (NCPP) has been implemented as a component of the Health Transformation Plan (HTP) since 2014 and as an attempt to encourage natural childbirth practices and reduce cesarean section rates. The purpose of this qualitative study was to explore the perceptions of midwives about conditions influencing the implementation of NCPP. Methods In this qualitative study, data were collected through 21 in-depth semi-structured individual interviews with expert midwives who were selected using purposive sampling mainly from one medical university in Eastern Iran from October 2019 to February 2020. Based on the framework method as a thematic analysis approach, the data were analyzed manually. To enhance the rigor of the study, we followed Lincoln and Guba's criteria. Results Data analysis yielded 546 open codes. After the codes were reviewed and similar codes were removed, there remained 195 codes. Further analysis led to extraction of 81 sub-sub themes, 19 sub-themes, and eight main themes. These themes included: Responsive staff; Characteristics of the parturient; Recognition of midwifery role; Teamwork; The birthing environment; Effective management; Institutional and social context; and Social education. Conclusion Based on the perceptions of the studied midwives, the success of the NCPP is guaranteed by a set of conditions identified in this study. In practice, these conditions are complementary and interrelated, and they cover a wide range of staff and parturient characteristics to the social context. It seems that effective implementation of the NCPP also calls for the accountability of all stakeholders, from policymakers to maternity care providers.
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Affiliation(s)
- Vajihe Armanmehr
- Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Elahe Banafshe
- Department of Midwifery, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Ali Alami
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Khajavi A, Moshki M, Minaee S, Vakilian F, Montazeri A, Hashemizadeh H. Chronic heart failure health-related quality of life questionnaire (CHFQOLQ-20): development and psychometric properties. BMC Cardiovasc Disord 2023; 23:165. [PMID: 36991337 PMCID: PMC10061999 DOI: 10.1186/s12872-023-03197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is an important outcome indicator for chronic diseases. This study aimed to develop a new instrument for assessment of HRQoL in chronic heart failure (CHF) and evaluate its psychometric properties. METHODS This study included two steps of conceptualization and item generation, and assessment of the psychometric properties of an instrument for measuring HRQoL in patients with CHF. A sample of 495 patients with confirmed diagnosis of heart failure participated in the study. In addition to content validity, exploratory and confirmatory factor analyses, concurrent validity, convergent validity, known groups comparison were performed to assess construct validity. Internal consistency, and stability were estimated by the Cronbach's alpha, the MacDonal's Omega, and intraclass correlation coefficients. RESULTS The content validity of the developed chronic heart failure quality of life questionnaire was assessed by 10 experts. The exploratory factor analysis indicated a four-factor solution for the instrument containing 21 items that jointly accounted for 65.65% of variance observed. The confirmatory factor analysis confirmed the four factor solution with the following fit indexes (χ2/df = 2.214, CFI = 0.947, NFI = 0.91, TLI = 0.937, IFI = 0.947, GFI = 0.899, AGFI = 0.869, RMSEA = 0.063). However, at this stage one item was removed. The concurrent and convergent validity of the CHFQOLQ-20 were established using the Short Form Health Survey (SF-36), and the MacNew Heart Disease Quality of Life Questionnaire, respectively. The known-groups validity as assessed by using the New York Heart Association (NYHA) functional classification showed that the questionnaire discriminated well between patients who differed in functional classification. The internal consistency and test-retest reliability of the CHFQOLQ-20 were satisfactory, with a Cronbach's alpha and intraclass correlation coefficient (ICC) values of 0.93 and 0.84, respectively. CONCLUSION The results confirmed that CHFQOLQ-20 is a valid and reliable instrument for measuring quality of life (QoL) in patients with CHF. It is a short and easy-to-use instrument that is also capable of assessing the cognitive functioning, which has been overlooked in previous questionnaires.
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Affiliation(s)
- Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran.
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
| | - Shima Minaee
- Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran
| | - Farveh Vakilian
- Department of Cardiology, Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Sciences & Culture, Tehran, Iran
| | - Haydeh Hashemizadeh
- Department of Nursing, Quchan Branch, Islamic Azad University, Quchan, Iran.
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Yadollahzadeh M, Shakeri S, Heydari I, Khajavi A, Shirvani SH, Sarkheyl E, Eskandari M, Farrokhpour M. IMPACT OF COVID-19 ON THYROID FUNCTION: EVIDENCE FROM IRAN. Acta Endocrinol (Buchar) 2023; 19:68-72. [PMID: 37601713 PMCID: PMC10439317 DOI: 10.4183/aeb.2023.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Context We assessed the association between the severity of COVID-19 and the thyroid function, and the relationship of thyroid hormones with inflammatory markers in COVID-19 patients. Subjects and methods This observational study contained 95 COVID-19 patients. The covariates of interest included the thyroid-stimulating hormone (TSH) and the total form of thyroid hormones thyroxine and triiodothyronine. Furthermore, the inflammatory markers including C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase (LDH), and lymphocyte were measured. To analyze the data, the t-test, the nonparametric test for comparing the medians, and the Spearman correlation were used. Results The median (interquartile range) of ages was equal to 53 (41-66) years old, including 54 men (56.8%). As the severity of COVID-19 progressed from moderate to severe, increasing, though non-significant, trends of thyroid dysfunction were observed, the most remarkable for TSH. The only significant association between thyroid hormones and inflammatory markers was a Spearman correlation of -0.28 between TSH and LDH. Moreover, a direct association was found between the severity of COVID-19 and the LDH levels (p-value<0.001). Conclusions A direct relation between the severity of COVID-19 and the LDH level and a reverse association between the LDH level and the thyroid hormone, TSH was obtained.
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Affiliation(s)
- M. Yadollahzadeh
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
| | - S. Shakeri
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
| | - I. Heydari
- Iran University of Medical Sciences, Institute of Endocrinology and Metabolism, Endocrine Research Center, Tehran, Iran
| | - A. Khajavi
- Shahid Beheshti University of Medical Sciences, School of Allied Medical Sciences, Department of Biostatistics, Student Research Committee, Tehran, Iran
| | - S. Hosseini Shirvani
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
| | - E. Sarkheyl
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
| | - M. Eskandari
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
| | - M. Farrokhpour
- Iran University of Medical Sciences, Firoozgar Medical and Educational Hospital, Department of Internal Medicine, Tehran, Iran
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Khandehroo M, Dorri M, Paykani T, Khajavi A, Joshani-Kheibari M, Esmaeili R. Direct Inpatient Cost and Payments of COVID-19 in Iran: Quantile Regression Analysis. Med J Islam Repub Iran 2022; 36:101. [PMID: 36447539 PMCID: PMC9700402 DOI: 10.47176/mjiri.36.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Indexed: 11/03/2023] Open
Abstract
Background: COVID-19 pandemic imposes a substantial medical and socioeconomic burden on health systems. The study aimed to estimate the direct inpatient costs of COVID-19 in Iran. Methods: This is a Cost of Illness (COI) study with the bottom-up method. Provider perspective and prevalence approach were applied for cost identification. Data included inpatient charges and clinical characteristics of all COVID-19 cases (2015 patients) admitted to a teaching hospital during a financial year (March 2020 to February 2021). We extracted data from Hospital Information System (HIS) and applied the quantile regression to estimate determinant factors of COVID-19 inpatient cost using STATA software. Results: 1026 (50.92%) of admitted COVID-19 patients were female, and 42.3% were older than 65 years. More than 82% of discharged COVID-19 patients in this study recovered. 189 (9.38%) patients admitted to ICUs. Length of Stay (LOS) for about 70% of admitted COVID-19 cases was 7 days or less. The Total Inpatient Charges (TIC) was 155,372,056,826 Rials (5,041,836 PPP USD). The median charge was 42,410,477 Rials, and Average Inpatient Charges (AIC) was 77,107,720±110,051,702 (2,461 PPP USD) per person. Drugs and supplies accounted for 37% of total inpatient charges. Basic insurance companies would pay more than 79% of total claims and the share of Out-of-Pocket Payments (OOP) was 7%. ICUs admission and LOS of more than 3 days are associated with higher costs across all percentiles of the cost distribution (p<0.001). Conclusion: This study call attention to the substantial economic burden based on real-world data. According to the broad socio-economic impacts of COVID-19 and also multiple components of COI study designs, conducting meta-analysis approaches is needed to combine results from independent studies.
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Affiliation(s)
- Masoud Khandehroo
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mehdi Dorri
- Clinical Research Development Unit, Bohlool Hospital, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Toktam Paykani
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Reza Esmaeili
- Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Mirzania M, Khajavi A, Kharazmi A, Moshki M. Health literacy and quality of life among Iranian pregnant women: The mediating role of health locus of control. Med J Islam Repub Iran 2020; 34:161. [PMID: 33816360 PMCID: PMC8004579 DOI: 10.47176/mjiri.34.161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Main health challenge of the 21st century is improving quality of life (QoL). This study aimed to investigate the mediating role of health locus of control (HLC) between health literacy and QoL among Iranian pregnant women. Methods: In this cross sectional survey, 400 pregnant women referred to the community health centers of Gonabad, Iran, and completed the demographic, health literacy, QoL, and multidimensional HLC questionnaires during 2015-2016. Descriptive statistics and structural equation modeling were conducted using SPSS 22.0 version and AMOS 24.0 software. Results: The findings showed that health literacy has a significant positive effect on the physical (β= 0.54, p< 0.001) and mental (β= 0.57, p< 0.001) health. Also, it has a significant positive effect on internal subscale (β= 0.42, p< 0.001) and a significant negative effect on the chance (β= -0.51, p< 0.001) and powerful others (β= -0.33, p< 0.001) subscale of HLC. From HLC subscales, internal HLC had a significant positive effect on physical (β= 0.26, p< 0.001) and mental (β= 0.12, p= 0.010) health, while the effects of chance and powerful others on QoL dimensions were not significant. The findings indicated that internal HLC is a partial mediator between health literacy and physical dimension of QoL. Conclusion: The results indicate that health literacy can be considered as an effective factor in HLC orientations and can improve QoL. This reflects the need for more attention on health literacy and the recognition of the type of HLC beliefs, especially the internal belief in health promotion programs for pregnant women.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Akram Kharazmi
- Faculty of Nursing, Kashmar, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Moshki
- Department of Health Education and Promotion, School of Health; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Moshki M, Khajavi A, Sadeghi-Bazargani H, Vahedi S, Pour-Doulati S. Developing Pedestrians' Red-light Violation Behavior Questionnaire (PRVBQ); Assessment of Content Validity and Reliability. Bull Emerg Trauma 2020; 8:98-106. [PMID: 32420394 PMCID: PMC7211388 DOI: 10.30476/beat.2020.46449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To develop a self-completion pedestrians' red-light violation behavior questionnaire (PRVBQ) based on the theory of planned behavior (TPB) and assess the content validity and reliability. Methods This study was conducted in three phases of (i) PRVBQ development study; (ii) Content validity study including face validity; and (iii) Reliability assessment. The directed content analysis method was used for the analysis of the qualitative interviews. The item impact score was used for face validity. Content validity index (CVI) in the item level and average scale level, and content validity ratio (CVR) were determined. Intra-class Correlation Coefficient (ICC), and Cronbach's alpha was assessed for test-retest reliability and internal consistency respectively. Results Draft questionnaire including 86 items was constructed. Sixteen items were eliminated due to low face and content validity, remaining 70 items in total. The PRVBQ was rated as having good content validity (individual items CVI ranged from .80 to 1, and overall PRVBQ CVI-Average=0.95, p=0.05). The direct measures (reflective indicators) showed excellent internal consistency with Cronbach's alpha=0.9. All items showed excellent agreement. Conclusion This study using a comprehensive process of development and assessment of content validity and reliability developed a content valid and reliable questionnaire predicting pedestrians' red light violation behavior.
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Affiliation(s)
- Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health Sciences; Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Community Medicine Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Shahram Vahedi
- Department of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Saeid Pour-Doulati
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Moshki M, Khajavi A, Minaee S, Vakilian F, Hashemizadeh H. Perceived benefits of the disease: A qualitative study of patients' experiences of heart failure. Nurs Health Sci 2020; 22:464-471. [PMID: 31943535 DOI: 10.1111/nhs.12682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/28/2019] [Accepted: 12/10/2019] [Indexed: 11/28/2022]
Abstract
Heart failure may bring about positive outcomes, which have not been adequately addressed in the literature. Therefore, this qualitative study sought to scrutinize the experiences of patients and the perceived positive effects of heart failure. The opinions of 19 patients with heart failure in Mashhad city (Iran) were collected via semistructured interviews from December 2017 to November 2018. After analyzing the data, six themes were identified by framework analysis: healthy lifestyle, effective interactions, appreciation of life, spirituality, reappraisal of life and priorities, and endurance. Such positive effects may lead to empowerment and better coping of patients with the disease. Therefore, nurses should consider the patients' perception of illness in addition to the disease manifestations and offer training focusing on the possibilities instead of limitations.
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Affiliation(s)
- Mahdi Moshki
- Health Education and Health Promotion Department, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shima Minaee
- Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran
| | - Farveh Vakilian
- Department of Cardiology, Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Haydeh Hashemizadeh
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.,Nursing Department, Quchan Branch, Islamic Azad University, Quchan, Iran
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Moshki M, Khajavi A, Vakilian F, Minaee S, Hashemizadeh H. The content comparison of health-related quality of life measures in heart failure based on the international classification of functioning, disability, and health: a systematic review. J Cardiovasc Thorac Res 2019; 11:167-175. [PMID: 31579455 PMCID: PMC6759616 DOI: 10.15171/jcvtr.2019.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 08/02/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: Due to the necessity of assessing the health-related quality of life (HRQOL) in heart failure (HF) and the increased use of the International Classification of Functioning, Disability, and Health (ICF) for making a content comparison of measurement instruments, the present study aimed to evaluate the relationship between the instruments and ICF. To this aim, the disease-specific HRQOL instruments in HF were identified, and then psychometric properties and content comparison of included instruments were conducted by linking to ICF. Methods: Disease-specific HRQOL instruments in HF were identified through a comprehensive and systematic search strategy. Then, the psychometric properties of included instruments were determined, and their contents were analyzed and compared based on the ICF coding system. In addition, each instrument was independently linked to ICF by two researchers based on standardized linking rules, and finally their degree of agreement was assessed by the Cohen's kappa coefficient. Results: Ten instruments including a total of 247 items and 417 concepts were linked to 124 different ICF categories. Further, 39 (31.5%), 65 (52.5%), 13 (10.4%), and 7 (5.6%) categories were linked to body function, activity and participation, environmental factors, and body structure, respectively. According to the content analysis approach and psychometric properties, the appropriate measurement instruments were Kansas City Cardiomyopathy and Minnesota living with HF questionnaires, respectively. Conclusion: Content comparison provides researchers with valuable information on the instrument heterogeneity and overlapping, which results in selecting the most appropriate measurement instrument based on a specific clinical context.
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Affiliation(s)
- Mahdi Moshki
- Department of Health Education and Promotion, School of Health; Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Farveh Vakilian
- Department of Cardiology, Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Minaee
- Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran
| | - Haydeh Hashemizadeh
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Mirzania M, Khajavi A, Moshki M. Validity and Reliability of Form C of the Multidimensional Health Locus of Control Scale in Pregnant Women. Iran J Med Sci 2019; 44:307-314. [PMID: 31439974 PMCID: PMC6661515 DOI: 10.30476/ijms.2019.44957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The health locus of control (HLC) can indirectly determine the health status. The current study aimed to assess the validity and reliability of Form C of the Multidimensional Health Locus of Control (MHLC-C) scale in pregnant women. Methods 554 pregnant women participated in this cross-sectional study conducted in 2017; they referred to community health centers affiliated with Mashhad and Gonabad Medical Sciences Universities. Multi-stage random sampling was done. In this study, first, the questionnaire was translated into Farsi; then, face validity and construct validity were done through exploratory factor analysis, and concurrent criterion validity was also examined. Moreover, the reliability was assessed through internal consistency and stability methods. Results The results of the exploratory factor analysis showed that the MHLC-C scale consisted of four subscales, i.e. Chance, Internal, Other People, and Doctors, which accounted for 51.18% of variance. The results of the reliability analysis showed an acceptable internal consistency for the scale (Cronbach's alpha coefficient for subscales from 0.62 to 0.90). Also, the test-retest results showed good stability for all subscales other than Doctors (P<0.05). The concurrent validity of Forms B and C of MHLC scale showed a positive and significant correlation between subscales. Conclusion The results of this study showed that the MHLC-C scale had acceptable validity and reliability in pregnant women and is suggested as an applicable criterion for assessing individuals control beliefs with any medical or health-related condition in Iran.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Promotion, School of Health; Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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13
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Moshki M, Khajavi A, Sadeghi-Ghyassi F, Sadeghi-Bazargani H, Pour-Doulati S. Measurement properties of self-report pedestrians' road crossing behavior questionnaires constructed based on the theory of planned behavior: protocol for a systematic review. Syst Rev 2019; 8:192. [PMID: 31376831 PMCID: PMC6679428 DOI: 10.1186/s13643-019-1121-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pedestrians' unsafe crossing behavior exposes them at risk of trauma and death and puts a tremendous burden on the health care system. The theory of planned behavior (TPB) is one of the leading theoretical models used to develop pedestrians' road crossing behavior questionnaires, yet the quality of measurement properties of them has not been evaluated. The aim of the proposed systematic review is to evaluate the quality of measurement properties of the questionnaires constructed based on the TPB to predict pedestrians' road crossing behavior. METHODS We will include studies validating or evaluating one or more psychometric properties of the self-reported questionnaire employing the TPB for predicting pedestrians' road crossing behavior. A comprehensive search strategy will be formulated based on the components of review aim. The databases of MEDLINE, Embase, PubMed, Cochrane Library, PsycINFO, PsycARTICLES, and ProQuest, also grey literature and the reference lists of the included studies, will be searched. A hand search for the relevant journals and Google Scholar will be conducted. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist will be used to evaluate the measurement properties of the included questionnaires. First, we will assess standards for the methodological quality of each study. Then, each scale or subscale of a questionnaire will be rated using the updated criteria for good measurement property. We will quantitatively pool or qualitatively summarize the results and will evaluate them against the criteria for good measurement properties. Finally, we will grade the pooled or summarized evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach and provide recommendations for the most appropriate instrument. DISCUSSION The proposed systematic review will evaluate the measurement properties of self-report pedestrians' road crossing behavior questionnaires constructed based on the TPB. The findings will help researchers in selecting the appropriate TPB-based instrument for pedestrians' road crossing behavior. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017047793.
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Affiliation(s)
- Mahdi Moshki
- Health Education and Health Promotion Department, School of Health; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Community Medicine Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Sadeghi-Ghyassi
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Saeid Pour-Doulati
- Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
- Center for Non-Communicable Diseases Control and Prevention, East Azerbaijan Province Health Center, Tabriz, 5143814998 Iran
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Moshki M, Khajavi A, Sadeghi-Bazargani H, Vahedi S, Pour Doulati S. Developing Pedestrians’ Red-light Violation Behavior Questionnaire (PRVBQ): Assessment of Content Validity and Reliability. J Inj Violence Res 2019; 11: Paper No. 20. [PMCID: PMC7187081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Pedestrians’ unsafe crossing behavior such as not waiting for pedestrians’ red-light expose them at risk of injury, disability, and death. The theory of planned behavior (TPB) is a widely used model used to understand individuals' unsafe behavior for setting interventional goals to prevent injuries. Purpose: The purpose of this study is to develop a self-completion pedestrians’ red-light violation behavior questionnaire (PRVBQ) based on the TPB and assess the content validity and reliability for this instrument. Methods: This study was conducted in three phases: 1) PRVBQ development study consists of belief elicitation for item generation and draft instrument construction; 2) Content validity study including face validity of the instrument; and 3) Reliability assessment including internal consistency and test re-test reliability over a 2-week interval. The directed content analysis method used for the analysis of the belief elicitation. The item impact score was calculated as an indicator of quantitative face validity. Content validity index (CVI) in the item level and average scale level, and content validity ratio (CVR) were calculated for quantitative content validity. Intra-class Correlation Coefficient (ICC), and Cronbach’s alpha was calculated for test-retest reliability and internal consistency respectively. Results: By qualitative belief elicitation study between four to twenty sub-categories were generated, which were classified in the ten categories of the theory of planned behavior: advantages, disadvantages, positive feelings, negative feelings, approving referents, disapproving referents, behaving referents, not-behaving referents, facilitators, and barriers. A primary draft of PRVBQ comprised of 86 items was generated, from which 17 were eliminated due to low face and content validity, remaining 69 item in total. The PRVBQ was rated as having good content validity (individual items CVI ranged from 0.80 to 1, and overall PRVBQ CVI-Average= 0.95, p=0.05). Cronbach’s alpha for the direct measures (reflective indicators) showed that they have excellent internal consistency 0.90. All items showed excellent agreement, ICC= .88 (95% CI [.80, .93]). Conclusions: This study provided a valid and reliable questionnaire which can be used to predict and to determine their underlying beliefs regarding their red-light violation behavior. Keywords: Pedestrians, Unsafe road crossing, Validity, Reliability, Questionnaire
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Affiliation(s)
- Mahdi Moshki
- Health Education and Health Promotion Department, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Community Medicine Department, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Shahram Vahedi
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Saeid Pour Doulati
- PhD candidate of health promotion, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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Corresponding Author at:
Saeid Pour Doulati: PhD candidate of health promotion, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, (Pour Doulati S.)
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Moshki M, Khajavi A, Doshmangir L, Pour Doulati S. Red light violation and pedestrians' modal salient beliefs about unsafe road crossing behavior: a qualitative study. J Inj Violence Res 2019; 11:189-202. [PMID: 31203305 PMCID: PMC6646824 DOI: 10.5249/jivr.v11i2.1184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/29/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Pedestrians are amongst the most vulnerable road users and their unsafe behaviors have a major impact on traffic injuries. The aim of this study was to determine the underlying psychological factors behind red light violation in pedestrians’ crossing behavior based on the Theory of Planned Behavior (TPB) and to provide recommendations for preventive interventions. Methods: This qualitative study was conducted in Tabriz, one of the metropolitan cities of Iran. 30 pedestrians were individually interviewed using semi-structured, open-ended questions to elicit salient consequences, social referents, and circumstances regarding pedestrians’ red light crossing behavior. The transcribed interviews were analyzed using directed content analysis followed by frequency analysis in order to detect modal salient beliefs. Results: A total number of 115 sub-categories were identified which were then classified in the ten predetermined categories of the Theory of Planned Behavior: advantages, disadvantages, positive feelings, negative feelings, approving referents, disapproving referents, behaving referents, not-behaving referents, facilitators, and barriers. “Saving time” was elicited as the most important both the advantage and the positive feeling. “Getting injured” was identified as the most serious disadvantage. “Lowering the level of culture” was obtained as the main negative feeling. “Friends/Peers” comprise the most prominent group among both the approving and the behaving referents, whereas “Family members” constituted the most significant group both among the disapproving and the not-behaving referents. “Being in a hurry” was introduced as the most substantial facilitator and “The fear of accident” was identified as the most influential deterrent factor. Conclusions: Based on the major findings, reducing pedestrians’ red light violations needs to focus: on the perceived negative and positive consequences and feelings of this behavior like getting injured, and saving time respectively; on the approval role of friends/peers, and the disapproval role of family; and on the fear of accident as a barrier, and rushing as a facilitating factor. More precise quantitative research is needed to determine the predictive power of these factors in such risky behavior.
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Affiliation(s)
| | | | | | - Saeid Pour Doulati
- Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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16
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Moshki M, Khajavi A, Hashemizadeh H, Vakilian F, Minaee S, Martin SS. Dark or Bright Half of the Moon: A Qualitative Study Exploring the Experience of Iranian Heart Failure Patients Regarding their Quality of Life. Open Access Maced J Med Sci 2019; 7:824-830. [PMID: 30962847 PMCID: PMC6447335 DOI: 10.3889/oamjms.2019.189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Heart failure (HF) is a major public health problem in different societies and has numerous impacts on quality of life (QOL). AIM The present study was carried out with the aim to explore the experience of HF patients regarding the negative effects of the disease on their QOL. METHODS In this qualitative exploratory study data collection was performed through face-to-face, semi-structured, in-depth interviews with 19 patients with HF, who were selected through purposive sampling method from April to September 2017. Data analysis was carried out based on the framework analysis method. RESULTS The negative consequences of HF on QOL emerged in the form of 6 main themes including symptoms, disease complications, cognitive impairment, psychological distress, functional limitations and economic problems. Most of the participants (14 out of 19) assessed their QOL as well or very well. CONCLUSION The majority of the patients in this study, despite the many negative impacts of HF, had a high QOL that could indicate their satisfaction and effective coping with HF by creating a positive outlook and the perceived positive effects of the disease.
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Affiliation(s)
- Mahdi Moshki
- Department of Health Education and Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Haydeh Hashemizadeh
- PhD Candidate of Health Promotion, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Farveh Vakilian
- Department of Cardiology, Fellowship in Heart Failure and Transplantation, Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Minaee
- Fellowship in Heart Failure and Transplantation, Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran
| | - Shadi S Martin
- Hartford Foundation Scholar, University of Nevada, School of Social Work
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17
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Moshki M, Hashemizadeh H, Khajavi A, Minaee S, Vakilian F. Content Comparison of Health-Related Quality of Life Measures in Heart Failure Based on the International Classification of Functioning, Disability, and Health: A Systematic Review Protocol. J Tehran Heart Cent 2018. [DOI: 10.18502/jthc.v13i3.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Unraveling the relationship between health-related quality of life (HRQOL) instruments and the International Classification of Functioning, Disability, and Health (ICF) seems essential due to the increasing importance of quality of life evaluations in patients with heart failure (HF) and the use of the ICF for comparative purposes. The aim of this study is to identify and compare the content of HRQOL instruments for HF using the ICF coding system. Methods: In a 2-stage design, first we will identify all measures used to assess HRQOL for patients with HF and second we will compare the content of those measures using the ICF coding system. Systematic search will be performed in in MEDLINE, CINAHL, and Scopus databases using a combination of free texts and MeSH terms between January 1960 and January 2017. All instruments will be linked to the ICF separately by 2 reviewers according to 10 linking rules developed for this purpose. The degree of agreement between the reviewers will be calculated via the kappa statistic. Discussion: The results of this study may help clinicians and researchers to select the most appropriate outcome measure according to the ICF-based content validity. ROSPERO Registration number: CRD42015025380.
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Moshki M, Hashemizadeh H, Khajavi A, Minaee S, Vakilian F. Content Comparison of Health-Related Quality of Life Measures in Heart Failure Based on the International Classification of Functioning, Disability, and Health: A Systematic Review Protocol. J Tehran Heart Cent 2018; 13:144-152. [PMID: 30745929 PMCID: PMC6368918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background: Unraveling the relationship between health-related quality of life (HRQOL) instruments and the International Classification of Functioning, Disability, and Health (ICF) seems essential due to the increasing importance of quality of life evaluations in patients with heart failure (HF) and the use of the ICF for comparative purposes. The aim of this study is to identify and compare the content of HRQOL instruments for HF using the ICF coding system. Methods : In a 2-stage design, first we will identify all measures used to assess HRQOL for patients with HF and second we will compare the content of those measures using the ICF coding system. Systematic search will be performed in in MEDLINE, CINAHL, and Scopus databases using a combination of free texts and MeSH terms between January 1960 and January 2017. All instruments will be linked to the ICF separately by 2 reviewers according to 10 linking rules developed for this purpose. The degree of agreement between the reviewers will be calculated via the kappa statistic. Discussion: The results of this study may help clinicians and researchers to select the most appropriate outcome measure according to the ICF-based content validity.
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Affiliation(s)
- Mahdi Moshki
- SocialDevelopment and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
| | - Haydeh Hashemizadeh
- SocialDevelopment and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.,Corresponding Author: Haydeh Hashemizadeh, PhD Candidate of Health Promotion, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Imam Khomeini Street, Gonabad, Iran. 9691793718. Tel: +98 51 57229025. Fax: +98 51 37658820. E-mail: .
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
| | - Shima Minaee
- Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran.
| | - Farveh Vakilian
- Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ameli M, Ahmadzadeh M, Khajavi A, Nabizadeh M. Evaluation of the success rate and complications of conventional varicocelectomy: Do we need microscopic surgery really? Urologia 2018; 86:23-26. [DOI: 10.1177/0391560318758938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: Varicocele is the most commonly curable cause of infertility in men. Varicocele is found in 15% of the total male population, 35% of men with primary infertility, and 75%–81% of men with secondary infertility. Generally, patients seek microscopic surgery via surfing the Internet, which is not an available option in all medical centers. The purpose of this study was to determine the success rate and complications of conventional varicocelectomy and to compare it with that of the microscopic method. Methods: In this descriptive cross-sectional study, 88 patients with varicocele who underwent non-microscopic varicocele surgery in the 15th Khordad Hospital during 2013–2015 were evaluated by the census method. Results: The mean age of patients with varicocele was 27.30 years; 52 patients underwent bilateral varicocelectomy and 36 left varicocelectomy. Surgical complications of non-microscopic varicocelectomy in the studied patients included bleeding and hydrocele formation both in 0.7% and recurrence in 2.8%. Testicular atrophy was not observed in any case. Conclusion: The incidence of recurrence, hydrocele formation, atrophy, and bleeding in non-microscopic varicocelectomy, if done in accordance with its principles, is not more than the microscopic approach and therefore it could be recommended as a safe surgical treatment in centers where microscopic surgery is not available.
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Affiliation(s)
- Mojtaba Ameli
- Gonabad University of Medical Sciences, Gonabad, Iran
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Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, Kamalinejad M, Esmaeeli H, Asadpour AA, Khajavi A. Effects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Trial. J Evid Based Complementary Altern Med 2015; 20:283-6. [PMID: 25948674 DOI: 10.1177/2156587215583756] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/28/2015] [Indexed: 11/15/2022] Open
Abstract
Erectile dysfunction is a man's persistent or recurrent inability to achieve and maintain erection for a satisfactory sexual relationship. As diabetes is a major risk factor for erectile dysfunction, the prevalence of erectile dysfunction among diabetic men has been reported as 35% to 90%. This randomized, parallel-group, double-blind, placebo-controlled trial investigated the effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetic men. Patients were randomly allocated to 2 equal groups (with 25 patients each). The intervention group was treated with topical saffron, and the control received a similar treatment with placebo. The 2 groups were assessed using the International Index of Erectile Function Questionnaire before the intervention and 1 month after the intervention. Compared to placebo, the prepared saffron gel could significantly improve erectile dysfunction in diabetic patients (P < .001). This preliminary evidence suggests that saffron can be considered as a treatment option for diabetic men with erectile dysfunction.
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Affiliation(s)
- Hossein Mohammadzadeh-Moghadam
- Department of Iranian Traditional Medicine, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Nazari
- Department of Iranian Traditional Medicine, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Shamsa
- Department of Urology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Kamalinejad
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habibollah Esmaeeli
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Abbas Asadpour
- Department of Urology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdoljavad Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Boroumand H, Moshki M, Khajavi A, Hashemizadeh H. Mothers' Satisfaction Rate from Hospital Cares in Hematology- Oncology Ward. Iran J Ped Hematol Oncol 2015; 5:138-44. [PMID: 26705452 PMCID: PMC4688597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 04/04/2015] [Indexed: 10/29/2022]
Abstract
BACKGROUND Satisfaction evaluation is a good way to assess hospital conditions. In Health Care System, parentscan be also as children's main supporters, thus they may act as patient's viewpoints' representatives.This study aimed to evaluate mother's satisfaction of hospital care in hematology - oncology ward in Dr Sheikh hospital. MATERIALS AND METHODS A Cross-sectional descriptive analytic study was conducted using Pediatric Family Satisfaction (PFS) questionnaire and interviewing with 164 mothers duringMarchto February2013. The obtained data were analyzed using SPSS -16 software and descriptive statistics. RESULTS The mean age of mothers and children was31.2±5.8, and 7.95 4/66 years.The children were 64 % male and 36 % femael. A large number of mothers (%56 (describedtheir satisfaction about medical care as moderate,(%70.7) reported their satisfaction about nursing care at very high level and(36.5 %) reported satisfaction about welfare services at high level(59%)and describe overall satisfaction at very high level . The totals mean of mothers' satisfaction ratewas 121.8 ± 10.8. The mean of medical care, nursing care, welfare services was 2.9±34.1,4.6±50 and4.8± 32.9 respectively. CONCLUSION Overall satisfaction with medical, nursing and welfare staff was acceptable. For more satisfaction, it is widely recommended to improve veinipuncture by nurses, Physicians should inform parents about the tests results, and finally disturbance in ward with noise should be controled.
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Affiliation(s)
- H Boroumand
- Dr Sheikh hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - M Moshki
- Associate Professor, Department of public Health, School of Health; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - A Khajavi
- Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
| | - H Hashemizadeh
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.,Department of nursing, Quchan Branch, Islamic Azad University, Quchan, Iran.,Corresponding Author Hashemizadeh H PhD, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran,
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Heyrani A, Maleki M, Marnani AB, Ravaghi H, Sedaghat M, Jabbari M, Farsi D, Khajavi A, Abdi Z. Clinical governance implementation in a selected teaching emergency department: a systems approach. Implement Sci 2012; 7:84. [PMID: 22963589 PMCID: PMC3457909 DOI: 10.1186/1748-5908-7-84] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 08/24/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Clinical governance (CG) is among the different frameworks proposed to improve the quality of healthcare. Iran, like many other countries, has put healthcare quality improvement in its top health policy priorities. In November 2009, implementation of CG became a task for all hospitals across the country. However, it has been a challenge to clarify the notion of CG and the way to implement it in Iran. The purpose of this action research study is to understand how CG can be defined and implemented in a selected teaching emergency department (ED). METHODS/DESIGN We will use Soft Systems Methodology for both designing the study and inquiring into its content. As we considered a complex problem situation regarding the quality of care in the selected ED, we initially conceptualized CG as a cyclic set of purposeful activities designed to explore the situation and find relevant changes to improve the quality of care. Then, implementation of CG will conceptually be to carry out that set of purposeful activities. The activities will be about: understanding the situation and finding out relevant issues concerning the quality of care; exploring different stakeholders' views and ideas about the situation and how it can be improved; and defining actions to improve the quality of care through structured debates and development of accommodations among stakeholders. We will flexibly use qualitative methods of data collection and analysis in the course of the study. To ensure the study rigor, we will use different strategies. DISCUSSION Successful implementation of CG, like other quality improvement frameworks, requires special consideration of underlying complexities. We believe that addressing the complex situation and reflections on involvement in this action research will make it possible to understand the concept of CG and its implementation in the selected setting. By describing the context and executed flexible methods of implementation, the results of this study would contribute to the development of implementation science and be employed by boards and executives governing other clinical settings to facilitate CG implementation.
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Affiliation(s)
- Ali Heyrani
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Barati Marnani
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Ravaghi
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Sedaghat
- Community Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mosadegh Jabbari
- Internal Medicine (Nephrology) Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Farsi
- Emergency Medicine Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdoljavad Khajavi
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhaleh Abdi
- Department of Health Services Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Moladoust H, Mokhtari-Dizaji M, Ojaghi-Haghighi Z, Noohi F, Khajavi A. Frame rate requirement for tissue Doppler imaging in different phases of cardiac cycle: radial and longitudinal functions. Int J Cardiovasc Imaging 2007; 24:377-87. [PMID: 17926142 DOI: 10.1007/s10554-007-9271-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2007] [Accepted: 09/14/2007] [Indexed: 11/24/2022]
Abstract
Tissue Doppler imaging (TDI) has been suggested for quantitative analysis of regional myocardial function. Myocardial movement included different mechanical phases with different duration and tissue velocity profiles need to high sampling rate in the acquisition of tissue velocity imaging for phases with shorter duration. The aim of this study is determining of frame rate requirement for myocardial tissue velocity imaging for longitudinal and radial functions separately. Tissue velocity imaging recorded from 29 healthy volunteers by use of the apical and para-sternal views. Off-line analysis performed for extracting tissue velocity profiles of the myocardial longitudinal and radial functions. The frequency and subsequently the frame rate calculated separately for all LV segments during two consequent cardiac cycles. Segmental distribution of the time intervals measured in all cardiac phases and the minimum frame rate requirement calculated for each segment. We found significant differences between radial and longitudinal functions (P < 0.001) except early diastolic phases. The presented normal frame rate values for LV segments may useful for accurate studies of myocardial longitudinal and radial functions in different cardiac phases. We conclude that data sampling at a rate of at least 105 and 118 frames per second need for longitudinal and radial functions respectively.
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Affiliation(s)
- H Moladoust
- Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
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Moladoust H, Mokhtari-Dizaji M, Ojaghi-Haghighi Z, D'hooge J, Noohi F, Khaledifar A, Khajavi A. Radial strain assessment of the interventricular septum wall by a new technique in healthy subjects. Med Biol Eng Comput 2007; 45:855-62. [PMID: 17657520 DOI: 10.1007/s11517-007-0222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Accepted: 07/01/2007] [Indexed: 10/23/2022]
Abstract
The aim of this study was to design a new approach for the acquisition of regional radial strain from the middle portion of the interventricular septum. We designed and wrote a program in Matlab (computer-assisted method) for use on a personal computer so that the septum thickness throughout the cardiac cycle could be measured instantaneously. Computer-assisted and conventional manual methods were used on the same 2D echocardiography image frames. Then, real-time 2D color Doppler myocardial imaging and conventional 2D imaging of the septum walls of 12 healthy participants at rest using apical four-chamber view were acquired. Wall thickness was measured using both the computerized program and velocity data used for tracking the segment and intensity line profile modification automatically. Then, the radial strain was estimated. Bland-Altman statistical analysis shows good agreement between the computer-assisted method and conventional manual method. The average of the peak and mean radial strains from the mid-septum of 12 healthy participants were 63.5 +/- 10.7 and 31.7 +/- 7.5%, respectively. We introduced a simple approach that is capable of radial strain estimation of the septum wall, which cannot be measured by current Doppler based methods in echocardiography systems.
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Affiliation(s)
- H Moladoust
- Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
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Lachman R, Zonana J, Khajavi A, Rimoin D. [The spondylometaphyseal dysplasias. Clinical, radiologic and pathologic correlation]. Ann Radiol (Paris) 1979; 22:125-35. [PMID: 485064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Tehranzadeh J, Khajavi A, Kozlowski K. Complex spondylo-epi-metaphyseal dysplasia with severe platyspondyly in two brothers. Australas Radiol 1978; 22:173-7. [PMID: 106833 DOI: 10.1111/j.1440-1673.1978.tb02610.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Khajavi A, Lachman R, Rimoin D, Schimke RN, Dorst J, Handmaker S, Ebbin A, Perreault G. Heterogeneity in the campomelic syndromes. Long-and short-bone varieties. Radiology 1976; 120:641-7. [PMID: 948600 DOI: 10.1148/120.3.641] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Analysis of 9 cases of bilateral bent limbs (campomelia) and dwarfism, as well as a review of the literature, indicate that campomelic syndrome appears to be a well-defined distinct disorder which the authors call long-limbed campomelic syndrome. Other neonates with congenital bent-limbed dwarfism can be classified as having short-limbed campomelic syndrome, and among these at least two distinct forms have been delineated--the craniosynostotic and the normocephalic form. Congenital bent bones also occur in a variety of generalized disorders of ossification that must be distinguished from these well-defined types of campomelic dwarfism.
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