Investigation the success rate of hospital information system (HIS): Development of a questionnaire and case study

INTRODUCTION AND OBJECTIVES

The implantation of hospital information systems (HISs) has grown dramatically in recent years. Understanding the success rate of HIS is key in health organizations. In this study, a validated questionnaire for HISs evaluation based on the Information System Success Model (ISSM) has been provided. In addition, the HIS success rate was determined.

MATERIALS AND METHODS

The current study was conducted at one of the largest teaching hospitals in eastern Iran. The 44-items questionnaire was developed for data gathering. The questionnaire covered ISSM dimensions, which include analysis of quality system, quality of information, quality service, system use, usefulness, satisfaction, and net benefits. Content validity, constructs validity, and reliability of the ISSM questionnaire was measured. HIS success rate has been determined and categorized based on users' perspective as follows: appropriate (75%≤HIS success rate), moderate (50%≤HIS success rate<75%), low coverage (25%≤HIS success rate<50%), and poor (coverage rate<25%).

RESULTS

In total, 253 users participated in the study. The ISSM questionnaire was validated by an expert panel with CVI: 85.12% and CVR: 88.22%. The overall Cronbach's alpha value of the instrument was determined as 92.2%. Nine factors with eigenvalues greater than 1.00 were identified, jointly accounting for 66.91% of the total variance. The value of KMO was.866 showed that the sample size was adequate for factor analysis. The highly significant Bartlett's test (p<0.000) indicated that variables were correlated and the factor analysis was appropriate. Our results demonstrated that the total mean of HIS success was "moderate" base on the users' point of view.

CONCLUSIONS

The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country.

Distribution of intraocular pressure, central corneal thickness and vertical cup-to-disc ratio in a healthy Iranian population: the Yazd Eye Study

PURPOSE

To determine the distribution of intraocular pressure (IOP), central corneal thickness (CCT) and vertical cup-to-disc ratio (VCDR) in the healthy Iranian population.

METHODS

This population-based, epidemiologic study evaluated Iranian aged 40-80 years, residing in Yazd, Iran, in 2010-2011. Eligible subjects were selected by cluster random sampling. Each participant underwent an interview and ophthalmologic examination including slit lamp examination, Goldmann applanation tonometry, binocular optic disc evaluation, stereoscopic fundus photography, ultrasonic pachymetry and visual field testing.

RESULTS

Of 2320 eligible individuals, 2098 subjects (response rate of 90.4%) participated in the study. One eye from 1159 subjects (total of 2262 normal eyes) were randomly selected for the purpose of the study. Mean age was 53.1 ± 9.6 years. Mean IOP, CCT and VCDR were 14.2 ± 2.5 mmHg, 543 ± 37 μm and 0.32 ± 0.14, respectively. Multiple regression analysis showed a significant correlation between IOP and age (regression coefficient = 0.02 per year, p = 0.015), CCT (regression coefficient = 0.02 per micron, p < 0.001), Spherical equivalent (regression coefficient = -0.15 per dioptre, p = 0.0.024) and smoking (regression coefficient = 0.89 higher for smokers, p = 0.009); it also showed a significant correlation between CCT with spherical equivalent (regression coefficient = 3.6 per dioptre, p = 0.002) and IOP (regression coefficient = 3.6 per mmHG, p < 0.001). There was no significant correlation with VCDR.

CONCLUSIONS

Mean IOP, CCT and VCDR were 14.2 ± 2.5 mmHg, 543 ± 35 μm and 0.32 ± 0.14, respectively, in healthy Iranians that is different from other ethnicities. It seems advisable to pay attention to ethnicity for interpretation of each person's variables.

Comparing Zonisamide With Sodium Valproate in the Management of Migraine Headaches: Double-Blind Randomized Clinical Trial of Efficacy and Safety

Background

Migraine is one of the most debilitating medical conditions and has a high socioeconomic burden. As conventional therapeutic methods do not entirely alleviate the symptoms, new alternatives are being considered.

Objectives

This study evaluates the efficacy and safety of zonisamide compared with sodium valproate in the management of migraine headaches.

Patients and Methods

In the current double-blind, parallel, randomized, controlled trial, 96 patients with a migraine diagnosis based on the international headache society (HIS) criteria were selected. They were divided randomly into two groups; the case group was given zonisamide, and sodium valproate was given to a control group. In addition to the side effects of the drugs, the severity, duration, and frequency of migraine attacks were evaluated at baseline and at three months.

Results

The 96 selected patients were divided randomly into two treatment groups (zonisamide n = 48, sodium valproate n = 48). Seven patients were excluded from analysis because of early dropout, leaving 89 (n = 45; n = 44) patients for analysis. While using zonisamide, six (13%) patients complained of fatigue, and two (4%) patients encountered noticeable appetite and weight loss. In the control group, five (11%) patients reported dizziness, and four (9%) patients faced obvious appetite and weight gain. Both drugs were considerably efficient in reducing further attacks. There was no statistically significant correlation between frequency or severity of migraine attacks and the drug used for treatment in three months of follow-up.

Conclusions

Both medications are effective in reducing migraine attacks. It will be important to consider the drugs’ adverse effects and availability and patients’ medical and socioeconomic condition to select the appropriate treatment.

Evaluation of Quality Of Life after Cardiac Surgery in High-Risk Patients

<p><b>Background:</b> Conventionally, there is controversy over subjecting high-risk patients to cardiac operations, due to major postoperative complications. Higher survival rates and less morbidity as well as better quality of life can be good predictors of the outcome of surgery. This study evaluates the quality of life before and 12 months after cardiac operations on high-risk patients.</p><p><b>Methods:</b> In this study, the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was used to separate high-risk patients from others. The quality of life was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) before surgery and one year afterward. Based on SF-36, the score for each of the eight different dimensions of the quality of life was quantified; and, their differences between pre-surgery and post-follow up period were analyzed.</p><p><b>Results:</b> 126 high-risk patients were included in this study. The mean age of the patients was 64.29 � 12.35 years. The median of EuroSCORE II score in these cases was 6.83 (6.04-25.98). The results reveal that the majority of the quality of life dimensions, except mental health, improved significantly after the follow-up period.</p><p><b>Conclusion:</b> Cardiac surgery on high-risk patients can noticeably promote the different aspects of their quality of life; although, such improvements should be considered against surgical complications.</p>

The Effectiveness of self management program on quality of life in patients with sickle cell disease

BACKGROUND

Sickle cell patients suffer from many physical, psychological, and social problems that can affect their quality of life. To deal with this chronic condition and manage their disease and prevent complications associated with the disease, they must learn skills and behaviours. The aim of this study was to determine the effectiveness of self-management programs on quality of life in these patients.

MATERIAL AND METHODS

Samples of this quasi-experimental study, which included 69 patients with sickle cell disease referring to the Thalassemia Clinic of Shafa Hospital, were entered into the study by census method. Patients received a self-management program using the 5A model for 12 weeks, while their quality of life before the intervention were assessed at the twelfth week and thirty-sixth week using SF-36 questionnaire. Data were analyzed by descriptive statistics, paired t-test, Wilcoxon test, Hotelling's T2, and repeated measures test.

RESULTS

The eight dimensions and the total QoL score after intervention were significantly increased compared to those before the intervention (P<0.001). Repeated measures test showed that the mean score of eight QoL dimensions and the total QoL score decreased in the thirty-sixth week, compared to twelfth week. However, it was significantly enhanced in comparison with the intervention baseline (P<0.05).

CONCLUSIONS

Current study revealed the efficacy of self-management interventions on the quality of life in patients with sickle cell disease. Therefore, application of this supportive method could be useful to empower the patients and help them to manage the disease.

The role of biodegradable engineered scaffolds seeded with Schwann cells for spinal cord regeneration

Spinal cord injury is very complicated, as there are factors in the body that inhibit its repair. Although regeneration of the mammalian central nervous system (CNS) was once thought to be impossible, studies over the past two decades have shown that axonal growth after spinal cord injury can occur when provided with the correct substratum. Traditionally, tissue transplantation or peripheral nerve grafting are used to repair damaged or diseased regions of the CNS, but donor shortage and immunological problems associated with infectious disease are often encountered. Fortunately, recent advances in neuroscience, cell culture, and biomaterials provide optimistic future using new treatments for nerve injuries. Biomaterial scaffold creates substrate within which cells are instructed to form a tissue or an organ in a highly controlled way. The principal function of a scaffold is to direct cell behavior such as migration, proliferation, differentiation, maintenance of phenotype, and apoptosis by facilitating sensing and responding to the environment via cell-matrix and cell-cell communications. Therefore, having such abilities provides scaffolds seeded with a special type of cell as an important part of tissue engineering and regenerative medicine which spinal cord regeneration is an example of. Nevertheless, the vast number of biodegradable synthetic and natural biopolymers makes choosing the right one very difficult. In this review article, it was tried to provide an inclusive survey of biopolymers seeded with Schwann cells (SCs) to be used for axonal regeneration in the nervous system.