Social Determinants of Health

What is believes, spiritual, subcultural, religious, traditional, and family structure of Perpetrators of  domestic violence? A question for further studies

Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs). Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.

Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002). Also, changes in symptom score from 34.5 to 23.7 (P=0.01) and functional score from 65.6 to 77.2 (P=0.01) in the two-month follow up were found to be statistically significant.

Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients.

among about 10% of hospitalized patients. HAIs increase mortality and morbidity and prolonged hospital stay not to mention considerable costs they impose on the health care system. The present study was conducted in order to evaluate the prevalence of HAIs based on National Nosocomial Infection Surveillance System in hospitals of Mashhad, Iran.

  Methods: The current prevalence study of HAI was carried out in 26 hospitals using a protocol updated yearly in Mashhad, Iran. The Centers for Disease Control and Prevention–National Nosocomial Infections Surveillance were used to define four HAIs. All patients admitted to the hospitals during a one-year period (March 1, 2015-February 30, 2016) were recruited in the study. Data was extracted using Iranian nosocomial infection surveillance software.

  Results: The overall prevalence rate of HAI in our study was 0.8% among the hospitals with the most frequent HAIs found to be pneumonia (25%), followed by urinary tract infections (20%), and blood stream infections (19%). The highest prevalence rate was observed in 15- to 65-year old patients with more than 50% related to surgical site infection. Also, the most frequently isolated micro-organism was acinetobacter. In addition, the highest seasonal prevalence was seen in winter with pneumonia as the most frequent infection. A total of 4988 pathogens were isolated with 30.33% of clinical confirmation and 69.66% of positive culture.

  Conclusion: These findings emphasize the need for appropriate measures for prevention, screening, labeling, and isolation precautions for infected patients.

  Background: Different factors affect the health care workers’ health and quality of life which lead to reduced performance, quality, and safety of services provided. The present study aimed to evaluate health-related quality of life (HRQoL) and its related factors among members of family medicine teams (FMTs).

  Methods: A cross-sectional descriptive study was carried out in the winter of 2015. Using SF36 questionnaire, HRQoL of all FMTs (physicians, midwives, and health technicians) at Kerman University of Medical Sciences was evaluated. Data were analyzed using Independent T test, ANOVA, Pearson Correlation coefficient, and multiple linear regression in IBM SPSS Statistics for Windows, Version 22.0.

  Results: Mean (SD) of total HRQoL score in FMTs was 71.6 (12.3) (out of 100). The Means (SD) of Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were 75.1(14.3) and 68.0 (14.2), respectively. Also, there was a positive correlation (r=0.49) between the PCS and MCS (P<0.001). Multivariate linear regression analysis showed that work experience was a predictor for total HRQoL (P<0.001) and PCS (P<0.001), while marital status was a predictor variable for MCS (P=0.04).

  Conclusion: The results of the current study revealed that HRQoL, particularly the MCS, is not at an appropriate level among FMTs. Therefore, it is necessary to design and implement interventions in order to increase their quality of life, especially with focus on mental aspect.

  Background: Responsiveness along with health promotion and financial risk protection plays a pivotal role in health systems. The present study aimed to examine responsiveness in hospitals affiliated to Bushehr University of Medical Sciences, in the south-west of Iran.

  Methods: In a cross-sectional study, the statistical population consisted of the patients referring to two university hospitals in Bushehr, namely Persian Gulf Hospital and Bushehr Heart Center. In total, 402 patients were selected using the stratified random sampling method. Data was collected using a demographic questionnaire and the validated Persian version of the standard World Health Organization questionnaire on health system responsiveness to assess responsiveness level during 2015.  

  Results: Responsiveness level was statistically different between the two hospitals (2.3±0.58 and 2.7±0.50, respectively). In general, “access to social support” (3±0.93) and “choice of health provider” (1.7±0.93) obtained the highest and lowest scores. Apart from “confidentiality” and “access to social support,” a statistically significant difference was observed in other domains (dignity”, “autonomy”, “communication”, “quality of basic amenities”, “choice of health care provider”, and “prompt attention” (between the two hospitals.

Background: The Vaginal Delivery Promotion Package was a part of the National Health System Reform Plan in Iran, which was implemented to reduce the rate of cesarean sections. The aim of the present study was to examine the views of the beneficiaries on the implementation of the promotion of natural vaginal delivery in the hospitals affiliated to Tehran University of Medical Sciences.

  Methods: A qualitative study conducted in 2016 using semi-structured interviews for data collection. The sampling method was purposeful with maximum variation of the beneficiaries. After doing 35 interviews, the data reached a saturation point. Data analysis was done through content analysis method using MAXQDA 10 software.

  Results: The package beneficiaries believed that it was successful in achieving its goal to reduce cesarean sections. Their perspectives were classified into two categories (strengths and weaknesses), eight themes (package design, achieving the goals, education and persuasion, package comprehensiveness, monitoring, infrastructures, plan implementation, and service quality), and 24 sub-themes. The most important weaknesses of this package were the payments and supervisions.

  Background: Nowadays, improving the quality of life for individuals with physical disabilities is a goal of rehabilitation. Among these, one of the most common and important physical disability groups is the Visual Impairment (VI). The aim of the present study was to compare the VI in athlete and non-athlete women in terms of self-concept and hope.

  Methods: In the present case-control study, 120 blind athlete and non-athlete women, resident of Tehran (60 participants in each group), were selected using simple random sampling method, according to the list provided by Goal Ball and Track-and-Field teams of the Blind and Visually Impaired Federation (60 blind athlete women) and Association of the Blind, Visually Impaired, and White Cane (60 blind non-athlete women) from March 2015 to August 2016. Both groups responded to Rogers' self-concept and Snyder's hope scales. Data were analyzed using t-test for independent measures.

  Results: The results showed that there was a significant difference between two VI groups of athletes and non-athletes in terms of real self-concept (t=6.02, P<0.001), ideal self-concept (t=3.6, P=0.005), and hope (t=4.4, P<0.001). Therefore, the VI athlete women had better self-concept and higher hope compared with the non-athletes.

  Conclusion: According to the findings, it seems that the exercise and physical activity, as a facilitating and health-promoting factor, plays a significant role in two variables of self-concept and hope in blind women. Hence, the inclusion of sport activities in programs for disabled people, especially for the VIs, can significantly be helpful to improve their psychological state.

  Background: Health literacy is an important issue in public health and defined as the cognitive and social skills of an individual that determine his/her ability to obtain, access, understand, and apply health information. As the area of social determinant of health and structure content of the questionnaires, such as the perception of health and the health status of people, were neglected in the previous reviews, the present study was conducted to review and compare Health literacy questionnaires, which have domains in these areas, in English and Persian languages.

  Methods: We reviewed the most famous health literacy questionnaires designed and validated in English and Persian languages published in PubMed, Google Scholar, Ovid, Scientific Information Database, and Barakat Knowledge Network System. After removing repetitive articles, the remaining articles were studied and the questionnaires were qualitatively analyzed.

  Results: More than 31 well-known English and Persian questionnaires and articles were included in the present review. Among these tools, 17 questionnaires had a section on understanding and comprehension and 14 had calculation and analysis in addition to comprehension. Among the 31 questionnaires, three questionnaires had some items about social determinants of health and 12 had some items about perception of health. According to our study, the questionnaire that covers all areas of health literacy as well as social determinants of health is the HLS-EU-Q, which has been translated into different languages.

  Conclusion: Since health literacy levels are related to many social determinants of health, the HLS-EU-Q can be used for health literacy evaluation as a strong predictor of a person’s health status.