Hospitals In Tabriz Research Articles

The Effect of a Modified World Health Organization Surgical Safety Checklist on Postoperative Complications in a Tertiary Hospital in Iran,2012

Objective:The aim of this study is to modify the World Health Organization (WHO) Surgical Safety Checklist in order to be compatible to a hospital in Iran and measure effect of implementing this checklist on postoperative complications.Methods:In a cross-sectional study the views of surgeons and anesthesiologists of the main teaching hospital in Tabriz -Imam Reza Hospital- were taken by a form attached to the main checklist. The participants in this study asked to write their opinions on each item of checklist based on the environment of the hospital. Then, we performed before-after study to determine effect of a modified checklist implementing on postoperative complications.Results:Surgeons and anesthesiologists had consensus on 15 of 19 items of checklist to remain the same and just 4 items recommended to be changed. In pre intervention period of study, 100 patients (51 males and 49 females) were enrolled with the mean age of 48.5±13.5 years. The number of patients in the post intervention period was the same, but 49 males and 51 females, the mean age was 47.5 ±14.6 years. The incidence of any complications in pre intervention period was 30%, but this rate in post intervention period was 12% and the difference between 2 periods of study was statistically significant (p=0.002).Conclusion:World Health Organization Surgical Safety Checklist is better to modify based on the local needs and facilities in each hospital. After implementing of a modified surgical safety checklist, complications decreased by 58%.

Levels of Conscience and Related Factors among Iranian Oncology Nurses.

Having a conscience is one of the main pre-requisite of providing nursing care. The knowledge regarding levels of conscience among nurses in eastern countries is limited. So, the purpose of this study was to examine the level of conscience and its related factors among Iranian oncology nurses. This descriptive-correlational study was conducted in 3 hospitals in Tabriz, Iran. Overall, 68 nurses were selected using a non-probability sampling method. The perceptions of conscience questionnaire was used to identify the levels of conscience among nurses. The data were analyzed using SPSS version 13.0. The mean nurses' level of conscience scores was 72.7. In the authority and asset sub-scales nurses acquired higher scores. The mean of nurses' scores in burden and depending on culture sub-scales were the least. Also, there were no statistical relationship between some demographic characteristics of participants and their total score on the perceptions of conscience questionnaire. According to study findings Iranian nurses had high levels of conscience. However, understanding all the factors that affect nurses' perception of conscience requires further studies.

Risk factors for late presentation of chronic glaucoma in an Iranian population

Purpose:To identify risk factors for late presentation in chronic glaucoma.Materials and Methods:In a hospital-based case–control study, 312 newly diagnosed consecutive patients with chronic glaucoma were recruited to study in Nikookari Hospital in Tabriz – Iran. Cases were defined as patients presenting with absolute field loss within 5° of fixation or a cup to disc ratio >0.8 in one or both eyes (188 patients). Controls were patients with no absolute field loss within 20° in either eye but otherwise glaucomatous field loss and a cup to disc ratio >0.5 or a difference of 0.2 or greater between the discs (124 patents).Results:In logistic regression model, there was a significant association between late presentation and male gender, lower education status, pseudoexfoliative glaucoma, high intraocular pressure (IOP) in the first presentation and no eye exam in last 2 years. Patients with pseudoexfoliative glaucoma had 1.5 times more odd for late presentation (1.52 confidence interval [CI]: 1.14–2.24 P = 0.004). Patients that visited by an ophthalmologist in the last 2 years had 0.5 less likely to present with advanced glaucoma (0.54 CI: 0.32–0.92 P = 0.025). Higher IOP in initial examination was associated with advanced glaucoma. We estimated 1.08 increase in odd (CI: 1.03-1.04 P = 0.001) per increase in 1 mmHg in IOPs above 25 mmHg.Conclusion:Our study shows that several risk factors present for late presentation in chronic glaucoma. Our results suggest planning screening programs in high-risk individuals for early detection of glaucoma and prevention of blindness.

Diagnostic value of anti-smooth muscle antibodies and liver enzymes in differentiation of extrahepatic biliary atresia and idiopathic neonatal hepatitis.

Background:We aimed to evaluate the diagnostic value of anti-smooth muscle antibodies (ASMA) and two liver markers (gamma-glutamyl transpeptidase [GGT] and alkaline phosphatase [ALP]) for differentiating between patients with extrahepatic biliary atresia (EHBA) and idiopathic neonatal hepatitis (INH).Materials and Methods:During April 2010–2011, all infants at 2 weeks of age who were diagnosed with cholestasis and admitted to Children's Hospital of Tabriz were enrolled. Based on the results of physical examination, laboratory, imaging and pathological studies, neonates were divided into two groups (EHBA and INH). Receiver operating characteristics analysis was used to define sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for ASMA, GGT and ALP.Results:Thirty neonates with cholestasis (18 with EHBA and 12 with INH) and mean age of 54.66 ± 25.86 days were enrolled. Total and direct bilirubin, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase and ASMA titres were highly not significant (P > 0.05) in patients with INH. GGT (P = 0.008) and ALP (P = 0.01) had statistically significant differences that were higher in patients with EHBA. The sensitivity, specificity, PPV and NPV, accuracy, LR+ and LR− of SMA in differentiating cases with BA were 66.7%, 75%, 80% 60%, 70%, 2.68 and 0.44, respectively. For GGT, the values were 88.9%, 66.7%, 80%, 80%, 79.1%, 3.08 and 0.31, respectively. Finally, for ALP, the values were 77.8%, 75%, 82.4%, 69.2%, 80%, 2.66 and 0.24, respectively.Conclusion:Our study showed that ASMA may be a useful biomarker for differentiation of EHBA from INH. Further studies with larger samples are recommended for confirming the results of this study.

Efficacy of proton pump inhibitors and H2 blocker in the treatment of symptomatic gastroesophageal reflux disease in infants.

PurposeGastroesophageal reflux disease (GERD) occurs in pediatric patients when reflux of gastric contents presents with troublesome symptoms. The present study compared the effects of omeprazole and ranitidine for the treatment of symptomatic GERD in infants of 2-12 months.MethodsThis study was a clinical randomized double-blind trial and parallel-group comparison of omeprazole and ranitidine performed at Children Training Hospital in Tabriz, Iran. Patients received a standard treatment for 2 weeks. After 2 weeks, the patients with persistent symptoms were enrolled in this randomized study.ResultsWe enrolled 76 patients in the present study and excluded 16 patients. Thirty patients each were included in group A (ranitidine) and in group B (omeprazole). GERD symptom score for groups A and B was 47.17±5.62 and 51.93±5.42, respectively, with a P value of 0.54, before the treatment and 2.47±0.58 and 2.43±1.15, respectively, after the treatment (P=0.98). No statistically significant differences were found between ranitidine and omeprazole in their efficacy for the treatment of GERD.ConclusionThe safety and efficacy of ranitidine and omeprazole have been demonstrated in infants. Both groups of infants showed a statistically significant decrease in the score of clinical variables after the treatment.

Atypical Location of Osteoid Osteoma in Patients Referred to Orthopedic Hospital in Tabriz

Background: Osteoid osteoma is a painful bone tumor that usually affects long bones. The unusual location of osteoid osteoma is rare and may be misleading and misinterpreting the diagnosis. Objective: The objective of current study was to determine and explain the unusual cases of Osteoid osteoma found in atypical location (the coccyx, iliac bone, toe, vertebral body and scapula) of patients that were referred to our institution. Patients and Methods: We examined the imaging features: Plain Film, CT Scan, MRI, Scan isotope that could alert the radiologists toward a correct diagnosis. For reviewing the literature in the field, we extracted all publications indexed as a MeSH Major Topic of “osteoma, osteoid” in MEDLINE database via PubMed search engine throughout 2006-2015. We restricted our search to case reports. Results: We determined 5 patients with atypical location of osteoid osteoma in patients referred to our hospital during years 2014-2015. The literature review of osteoid osteoma in MEDLINE showed that, there have been only 134 rare case reports about osteoid osteoma which were published and indexed in MEDLINE during the last decade (2006-2015). The rarest of rare case reports for osteoid osteoma was in Maxilla, Nasal, Ribs, and Sarcrum. Conclusion: Analysis of our study concluded that the physicians should bear in mind, the probability of osteoid osteoma, when they are considering the chronic pain in the atypical areas of patients’ body.

Assessment of the ratio of cross-matched to transfused blood amounts in pregnant patients in Alzahra Hospital in Tabriz before and after the implementation of the health reform program in 2013-2015

Background: Postpartum hemorrhage is the most common cause of mortality in women with vaginal or cesarean delivery. WHO statistics shows that about 500 thousands women have died of complications related to pregnancy or during childbirth in 2013. haemorrhage probability is the main reason to order blood requests in delivery and cesarean units. The purpose of this study is to evaluate the ratio of cross-matched to transfused blood in pregnant women during one year before and after the implementation of health reform program. Materials and Methods: In this retrospective descriptive study, the requests of blood reserves for pregnant patients with the gravid of 34±7 weeks and the age of 30±16 years old in two periods, before and after the implementation of health reform program were being collected and compared. Blood group antiserums and anti-human globulins with bovine albumins were purchased from LORN company and Baharafshan Company respectively. Results: The total number of requests for reserved cross-matched blood during the year before the health reform program were 2837 units which 277 of them had been transfused and a year later the total number of requests was for 3029 units, which 270 of them had been transfused. This study showed 6.76 percent increase in requests and 2.53 percent decrease in transfusion in comparison with its past year. Conclusion: The implementation of health reform program have accompanied by relative reduction of cesarean but considerable increase in vaginal delivery, and to prevent blood loss complications, the requests for reserved cross-matched blood have been increased without noticeable change in the proportion of necessarily transfused amount of them.

Results of a Hospital Waste Survey in Tabriz Hospitals

Results of a Hospital Waste Survey in Tabriz Hospitals

The effects of flexed (fetal tucking) and extended (free body) postures on the daily sleep quantity of hospitalized premature infants: A randomized clinical trial.

Background:Proper sleep is essential for the development of premature infants. Infants, during hospitalization, might suffer from inappropriate postures and insufficient sleep hours. To compare the daily sleep quantities of premature infants in flexed (facilitated fetal tucking) posture and extended (free body) posture. This study is a randomized clinical trial which was conducted in neonatal ward of Al-Zahra Teaching Hospital of Tabriz, Iran, 2015. Thirty-two premature infants with the age range of 33–36 weeks were selected for the study.Materials and Methods:Every infant was studied for 4 days in a sequential format. Every infant was studied for 4 days and in a 12-h period every day (8 a.m–8 p.m). Each day, an infant was randomly put in one of the four statuses, namely, free body posture in the supine position, free body posture in the lateral position, facilitated fetal tucking in the supine position and facilitated fetal tucking in the lateral position. Films were recorded in the 12-h period (8 a.m–8 p.m). SPSS Software (version 13) was used for data analysis.Results:The results showed that about the main effect of posture on sleep variable, there was a statistically significant difference (P = 0.003). In addition, about the main effect of position on sleep variable; there was a statistically significant difference (P = 0.002). Meanwhile, there was no significant interaction effect between the posture and position for the daily sleep duration (P = 0.746). Daily sleep duration of the infants in flexed (facilitated fetal tucking) posture and lateral position is longer than that of the infants in extended (free body) posture and supine position.Conclusion:Daily sleep duration in the infants experiencing flexed posture and lateral position at rest is longer. Moreover, it decreases wakefulness time of the premature infants.

Effect of prophylaxis of magnesium sulfate for reduction of postcardiac surgery arrhythmia: Randomized clinical trial.

Background:Arrhythmia is a common complication after heart surgery and is a major source of morbidity and mortality.Aims:This study aimed to study the effect of magnesium sulfate (MgSO4) for reduction of postcardiac surgery arrhythmia.Setting and Design:This study is performed in the cardiac operating room and Intensive Care Unit (ICU) of Shahid Madani Hospital of Tabriz (Iran) between January 1, 2014, and September 30, 2014. This study is a double-blind, randomized controlled trial.Materials and Methods:In Group 1 (group magnesium [Mg]), eighty patients received 30 mg/kg MgSO4 in 500 cc normal saline and in Group 2 (group control), eighty patients received 500 cc normal saline alone.Statistical Analysis:The occurrence of arrhythmia was compared between groups by Chi-square and Fisher's exact test. In addition, surgical time, length of ICU stay, and length of hospital stay were compared by independent t-test. P < 0.05 was considered as significant.Results:There was a significant difference in the incidence of arrhythmia between two groups (P = 0.037). The length of ICU stay was 3.4 ± 1.4 and 3.73 ± 1.77 days in group MgSO4 and control group, respectively, and there was no statistically significant difference between two groups (P = 0.2).Conclusion:Mg significantly decreases the incidence of all type of postcardiac surgery arrhythmia and hospital length of stay at patients undergo cardiac surgery. We offer prophylactic administration of Mg at patients undergo cardiac surgery.

Comparison of end-tidal carbon dioxide and arterial blood bicarbonate levels in patients with metabolic acidosis referred to emergency medicine.

Introduction: The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated. Results: Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15 and 12.78 ± 3.83, respectively. In all patients, the significant direct linear relationship was found between ETco2 with Hco3 (r = 0.553, P < 0.001). We had 4 groups of patients with metabolic acidosis, also there is a significant direct linear relationship between the ETCo2 and the Hco3 level of arterial blood in patients with renal failure (P < 0.001 and r = 0.551), sepsis (P < 0.001 and r = 0.431), drug toxicity (P < 0.001 and r = 0.856), and ketoacidosis (DKA) (P < 0.001 and r = 0.559). Conclusion: According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment.

The Association Between Survivin -31G/C Promoter Polymorphism and Breast Cancer in Eastern Azerbaijan, Iran

Background: Because survivin has a significant role as an inhibitor in breast cancer (BC) advancement and development and its pro- ductivity and interactions may well be under the eects of polymorphisms in the gene promoter we investigated a common polymor- phism (-31G/C) that has been reported to be influential on the survivin expression in dierent forms of cancer. But the observations did not show any correlation between this SNP (single nucleotide polymorphism) and breast cancer disease at least in our study population (east Azerbaijan, Iran). The (-31G/C polymorphism is the cause of over expression of survivin once it de-represses the cell cycle-dependent transcription of survivin gene. Objectives: In this paper, the aim has been to study the role of -31G/C in breast cancer in the hospitals of the province of east Azerbaijan, Iran. Patients and Methods: In this case-control study, 5 mL of peripheral blood samples of 82 healthy subjects and 94 breast cancer patients with pathologically confirmed were gathered. We analyzed -31G/C single nucleotide polymorphisms of survivin promoter with using of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and gene sequencing. The required samples were acquired from two of the general hospitals in Tabriz. Results: Statistical analysis revealed that genotype frequencies and allele distribution of the survivin promoter -31G/C for both controls and cases were similar. There has been no statistically noteworthy association between breast cancer and the variant genotypes (CC and CG). Conclusions: Seemingly, there has been no statistically association between -31G/C polymorphism with BC and clinicopathological characteristics in the population being investigated in this paper.

The Technical Quality of Delivered Care for People with Inflammatory Bowel Disease in Tabriz Gastroenterology Clinics.

Background: The Inflammatory Bowel Disease (IBD) is considered as one of the chronic diseasesre-quiring complicated treatment. This study aimed to assess technical quality of providing care for pa-tients with IBD. Methods: This cross-sectional study was conducted on 94 people with IBD using interviews and simple random sampling methods in Gastroenterology, Endoscopy and clinic of Imam Reza Hospital and Golgasht Clinic in Tabriz in 2012. The data collection tool was a researcher-designed questionnaire whose validity and reliability had been confirmed. In order to investigate the statistical relationship between the background variables and compliance with the standards the Chi-square test was applied using SPSS 17 Software. Results: "visit by the physician" and "diet advice by the dietitian" have had the highest and the lowest levels of compliance with the standard respectively, and "the care related to the disease exacerbation" and "the care provided by the other physicians" were not compatible with the standards in 80% of the cases. Data analyses also showed that there was a significant relationship between participant’s age, job, education and the smoking status and compliance of some care with the relevant standards (P<0.05). Conclusion: The results indicate a substantial gap between provided care for the people with IBD and the relevant standards. This indicates the areas that need of improvement and requires the serious attention of the authorities.

Patient satisfaction in the emergency department: a case of Sina hospital in Tabriz

Objective: Patient satisfaction is one of the most important indicators for measuring the quality of emergency services and health care. The purpose of this study was to evaluate the patients’ satisfaction in the emergency department (ED) of Sina hospital. Methods: This descriptive, cross-sectional study was performed during one month in Sina hospital in 2014. Data were collected by a questionnaire which its validity and reliability were confirmed in previous studies. The questionnaire consisted of 2 parts. Part 1 included the demographic characteristics and part 2 encompassed the scales of satisfactory. Data analysis was conducted by SPSS version 15. Results: Totally, 425 patients participated in this study. The mean age of patients was 41.6±17.6 years. The mean total score of patient satisfaction was 17.43±1.56. The maximum satisfaction was related to the knowledge of physicians and the minimum satisfaction was related to the remaining period in the ED. Additionally, there was a desirable satisfaction for nurses’ performances. In terms of satisfaction regarding the physical environment and the workflow of the ED, the results were moderate. There was a significant statistical difference regarding nurses and physicians behavior in the ED during different working shifts, vacation days, and workdays. Conclusion: Based on the results obtained, patients had good satisfaction for the received services in the ED. It is necessary to develop physical spaces and improve the workflow of patients in the ED.

SCCmec Typing of Methicillin-Resistant Staphylococcus aureus: An Eight Year Experience

Background: Methicillin resistant Staphylococcus aureus strains (MRSA) are important pathogens that cause serious diseases in humans. Throughout the recent years, the spread of these strains has increased in medical environments and society, and has become a serious challenge in health systems. Therefore, it is vital to investigate the various MRSA types to identify the origins of the infections and to control the spread of these infections in hospitals. Objectives: The current study aimed to evaluate the different SCCmec types in MRSA isolates from hospitals of Tabriz, by staphylococcal cassette chromosome mec (SCCmec) typing. Materials and Methods: The present descriptive and retrospective study was performed on 151 selected S. aureus isolates obtained from clinical specimens who were referred to Tabriz university of medical sciences educational-health care centers from April 2005 to September 2012. MRSA isolates were identified by agar disk diffusion and mecA PCR assays. Ultimately, they were typified according to the genetic diversity of the chromosome cassette of SCCmec and ccr regions. Results: Of the 151 isolates, 53 were recognized as MRSA. All of these 53 samples were sensitive to teicoplanin and vancomycin. Antibiotic resistance patterns were as follows: azithromycin 56.6%, ciprofloxacin 28.3%, imipenem 11.3%, meropenem 9.4%, ofloxacin 13.2%, ceftriaxone 66%, cotrimoxazole 49.1%, gentamicin 52.8%, linezolid 11.3%, penicillin 90.6%, and rifampicin 5.7%. The majority of MRSA isolates belonged to SCCmec III (69.8%) followed by SCCmec IVc (7.5%), SCCmec IVa (3.8%), and SCCmec I (1.9%). Other types of SCCmec were not observed in the present study. Moreover, from the 53 MRSA samples, 9 were recognized as non-typable. However, staphylococcal cassette chromosome recombinase (ccr ) genetic complex analysis revealed that among the 53 studied samples, 4 isolates had ccr type 1 pattern, and 11 and 32 isolates had ccr type 2 and ccr type 3 pattern, respectively. Furthermore, 6 isolates were considered as non-typable with ccr -typing. Conclusions: As about 70% of methicillin-resistant isolates belonged to SCCmec III, the present study can conclude that, over an 8-year period, only one dominant and stable clone of MRSA strain was found in Tabriz hospitals. This finding could be a result of incorrect medical orientations, inadequate infection controlling policies, and insufficient preventive approaches.

Nursing experiences of clinical governance implementation: a qualitative study

Purpose – Clinical governance (CG) was used as a driver to improve safety and quality of healthcare. CG implementing is a change in health system and all the stakeholders must be participating. The purpose of this paper is to study nurses’ experience about CG movement in Tabriz hospitals. Design/methodology/approach – A qualitative study using Focus Group Discussions (FGD) was done. Purposeful Sampling was used to select the objectives including 65 participants. Actually seven FGD’s were held. Content analysis was used to extract the meaningful themes. Findings – It is revealed that nurses are the focal point in CG implementation in hospitals. Low commitment of managers and lack of physicians’ contribution was experienced by nurses. However, personnel education and development and patient safety have got more attention. Blame culture and increased work stress was reported as challenges. Originality/value – CG as a change in healthcare system, especially in low- and middle-income countries, is faced by several challenges and its implementation would have different experiences. Nursing staff, the major group in hospitals, would be having interesting experiences through CG. Their practical opinions could guide the policy makers to employ proper plans to effectively implement CG. Considering the result of this study in practice would lead to improve CG implementation.

Provision of Iron and Folic Acid Supplementations for Pregnant Women in Public and Private Sectors of Tabriz, Iran

Background: This study aimed to investigate different methods used to provide necessary supplementations for pregnant women and obtain reliable data about the general status of health promotion during pregnancy. Methods: This descriptive, cross-sectional study was conducted on 401 pregnant women referring to different women’s hospitals of Tabriz, including Alzahra, Taleghani, 29-Bahman, Zakariya, Shafa, and Shams from March 2011 to September 2013. Subjects were selected using simple random sampling and had prior experience of childbirth. Results: In this study, prenatal care was provided for all the pregnant women at public (55.8%) and private sectors (44.2%). Iron supplementation used by the subjects included ferrous sulfate (150 mg) + folic acid (0.5 mg) (20.2%), regular-release ferrous sulfate (325 mg) (70.4%), folic acid (0.1 mg) + ferrous sulfate (200 mg) (6.5%), and vitamin B12 (15 mg) + ferrous fumarate (350 mg)+ vitamin C (150 mg) + folic acid (1 mg) (1.6%). Supplementations were provided before (56.7%) or after (43.3%) the onset of pregnancy. In total, 40.9% of the subjects received family planning care, 44.7% of whom referred to medical centers, 34.6% referred to health houses, 12.3% consulted gynecologists, 2.8% consulted midwives and 5% received traditional care. Conclusion: According to the results of this study, general status of iron and folic acid supplementation, their provision and average use of these substances were suboptimal. However, status, provision and use of iron were significantly more efficient than folic acid.

Comparison between primary closure and T-tube drainage after open choledocotomy

Background: Common Bile Duct (CBD) exploration for choledocolithiasis is usually closed after T-tube insertion. However, complications of T-tube insertion limit its use. In the present study, we wanted to compare outcomes between primary repair of choledocotomy and traditional T-tube insertion. Material and methods: Thirty patients with CBD stones disease admitted at Sina and Imam Reza hospitals of Tabriz, from April 2012 to February 2013, were included in this study. The patients were randomly divided into two groups: T-tube drainage group and primary closure group. Intraoperative findings and postoperative complications were recorded and analyzed. Results: There was no mortality and retained stones in both groups. Two of 15 patients in the T-tube group and four of 15 patients in primary closure group suffered from minor bile leakage. There was no major bile leakage in the T-tube group but one patient in the primary closure group had major bile leakage, which was treated conservatively without surgical or endoscopic intervention. Wound infection was seen in two patients in the T-tube group and one patient in the primary closure group. In follow up assessment, there was no intra-abdominal collection in both groups. Overall postoperative complications include biliary complications, wound infection and intra-abdominal collections, were seen in four patients in the T-tube group and six patients in primary closure group; that was not statically significant difference. Conclusion: primary closure of CBD after open choledocotomy is feasible and is as safe as T-tube insertion. In effect, primary closure avoids T-tube insertion and disadvantages associated with the use of T-tube. Primary closure can be recommended for selected patients with CBD stone disease. Key words: common bile duct stones; choledocotomy; T-tube drainage; primary closure

Relationship between Health Promoting Lifestyle and Perceived Stress in Pregnant Women with Preeclampsia

Lifestyle during pregnancy has long-term effects on health of mother and child. Having previous illness or unexpected maternal or fetal conditions such as preeclampsia can complicate pregnancy and interfere with health-promoting behaviors and cause stress might interfere with health-promoting behaviors. This study was carried out to examine the relationship between health-promoting lifestyles and perceived stress in women with preeclampsia. This study is a descriptive correlation design that was conducted on 182 pregnant women with preeclampsia attending in the high risk clinics of Al-Zahra and Talegani hospitals in Tabriz 2014. Data gathering tools were three: demographics, health-promoting lifestyle (HPLP-II), and perceived stress questionnaires. SPSS Ver. 13 was used for data analysis. The mean (SD) of health promoting lifestyle among pregnant women with preeclampsia was 2.4 (0.4). Among the dimensions of health promoting life style, the highest mean score was for sub domain of nutrition, i.e. 2.8 (0.5), and the lowest score was achieved by the sub-domains of physical activity, i.e. 1.5 (0.5).The mean (SD) score of perceived stress was 27.3 (7.1). There was reverse relationship between perceived stress and health -promoting behaviors. Based upon the results, health promoting behaviors were decreased by increment of perceived stress. Therefore, midwives can help women with preeclampsia by promoting health behaviors to reduce their stress and increase health-promoting behaviors.

The Association Between Management of the Board of Trustees and Its Effectiveness at Hospitals in Tabriz; 2011 to 2013.

Background:Reforming the structure and improving care and service system, particularly at hospitals, are the main priorities of the health system. The board of trustees of the hospitals is the main proposed strategy in this field. Hospitals with board of trustees were created with the aim of improving accountability to the community and guaranteeing efficient management and attracting public support in running the hospital.Objectives:The aim of this study was to investigate the association between hospital effectiveness and the board of trustee’s management method.Materials and Methods:This cross-sectional study was conducted in Tabriz City, Iran, during the years 2011 to 2013. To assess the effectiveness of board of trustees’ management, two hospitals in Tabriz City were compared. Hospitals selected through purposive typical case sampling method. Two hospitals had equal structure, same doctors, and both were gynecology hospitals of Tabriz City, but one of them was a gynecology hospital managed by the board of trustees and the other was managed by the chairman. The information about the five variables of hospital effectiveness was collected during the years 2011 to 2013 using standard lists and questionnaires, which were available in the hospitals; these variables included quality management, safety, medical equipment management, and patients and staff satisfaction. Then, each variable was weighted through the technique of hierarchical analysis and finally they were analyzed using SPSS 17 and Expert Choice 11.Results:Among the five variables related to the effectiveness, safety showed to have the highest weight and medical equipment management had the lowest weight. According to the statistical analyses, the score of the effectiveness of the hospital with the board of trustees was 33.08 (on the scale of 0 - 100) and the score of the hospital with the chairperson was 29.52. No significant association was found between the effectiveness of hospital and the board of trustees management (P = 0.81).Conclusions:Because there was no significant difference in the effectiveness between hospitals with and without board of trustees, decision-makers must monitor how the commands are carried out to make board of trustees for hospitals and make sure its success in achieving its objectives.