Journal of Education and Health Promotion

Prevalence of self‑medication among the elderly: A systematic review and meta‑analysis

. Shideh Rafati; . Tayebeh Baniasadi; . Neda Dastyar; . Ghazal Zoghi; . Sudabeh Ahmadidarrehsima; . Nasibeh Salari; . Foozieh Rafati

Volume 13, Issue 2 , February 2023, , Pages 1-10

Abstract

  BACKGROUND: Self‑medication is the use of unprescribed drugs to treat a disease. Elderlyself‑medication can be more dangerous compared to other age groups because of changes in ...  Read More BACKGROUND: Self‑medication is the use of unprescribed drugs to treat a disease. Elderlyself‑medication can be more dangerous compared to other age groups because of changes in organfunctions that occur due to senescence. This study aimed to estimate the prevalence of self‑medicationin the elderly, its related factors, and common drugs used in this regard.MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, and Web of Sciencewere searched between January 2016 and June 2021. The search strategy was built on two coreconcepts: “self‑medication” and “aged”. The search was limited to original articles in the Englishlanguage. A random effect model was used to estimate the pooled prevalence of self‑medication.Heterogeneity among studies was assessed using both the I2 statistic and the χ2 test. Also, ameta‑regression model was used to investigate the potential sources of heterogeneity of the studies.RESULTS: Out of 520 non‑duplicate studies, 38 were included in the meta‑analysis. Self‑medicationin the elderly ranged from 0.3% to 82%. The pooled proportion of self‑medication was 36% (95%CI: 27%–45%). The result of the χ2 test and the I2 index (P < 0.001, I2 = 99.90%) revealed notableheterogeneity among the included studies in the meta‑analysis. The meta‑regression showed asignificant association between the sample size (adjusted β = −0.01; P = 0.043) and the pooledproportion of self‑medication.CONCLUSION: The prevalence of self‑medication in the elderly is high. Education through massmedia to raise awareness about the dangers of self‑medication can help solve this problem.

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Impact of relaxation therapy on premenstrual symptoms: A systematic review

. Ancy Jose; . Sabitha Nayak; . Aparna Rajesh; . Neetha Kamath; . Nalini M

Volume 12, Issue 11 , December 2022, , Pages 1-11

Abstract

  Relaxation therapy (RT) is considered to be helpful in the management of symptoms of premenstrualsyndrome (PMS). This systematic review (SR) was conducted to find the impact of RT on ...  Read More Relaxation therapy (RT) is considered to be helpful in the management of symptoms of premenstrualsyndrome (PMS). This systematic review (SR) was conducted to find the impact of RT on PMSmanagement, which could be utilized in clinical and community populations. Five major databaseslike Google Scholar, PubMed, ResearchGate, Scopus, and Web of Science were used as searchengines. The Joanna Briggs Institute checklist is used to analyze the quality of articles selectedfor this review. Only 35 different studies among 71 relevant articles which focused on the topicwere selected for this SR. All of the 35 different trials reported that the selected RTs, namely LauraMitchell, Jacobson, Benson, relaxation unnamed, yoga, aerobic exercise, and massage, significantlydecreased PMS. The outcome of this SR suggests that the selected seven RTs effectively relievePMS and ensure a productive life for all reproductive women.

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Psychometric properties of clinical competency assessment instruments for psychiatric nurses: A systematic review of literature

. Effat Sheikhbahaeddinzadeh; . Tahereh Ashktorab; . Abbas Ebadi

Volume 12, Issue 11 , December 2022, , Pages 1-9

Abstract

  BACKGROUND: Facilitating the healing process of patients with psychiatric disorders depends onhigh‑quality mental health care and expert psychiatric nurses. A valid tool is required ...  Read More BACKGROUND: Facilitating the healing process of patients with psychiatric disorders depends onhigh‑quality mental health care and expert psychiatric nurses. A valid tool is required to objectivelyevaluate the quality of performance and competency of psychiatric nurses. This systematic reviewaimed to investigate and critique the psychometric properties of some psychiatric nursing clinicalcompetency assessment instruments with Consensus‑based standards for the selection of healthstatus measurement instruments (COSMIN) checklist and according to Preferred Reporting Itemsfor Systematic Reviews and Meta‑analyses (PRISMA).MATERIALS AND METHODS: To retrieve published articles using Persian and English keywords“psychiatric nursing,” “competence,” “competency,” “tool,” “checklist,” “scale,” “questionnaire,”“psychiatric mental health nurse,” were searched in databases without time limitation. Then,psychometric properties of selected instruments were evaluated using the COSMIN checklist andreported according to the PRISMA statement.RESULTS: Most of these tools did not entirely and desirably report psychometric properties. It is notdesigned as a special tool for postgraduate psychiatric nursing.CONCLUSION: The methodology of existing instruments does not meet the COSMIN checklist criteria;therefore it needs to develop. To assess the competency of psychiatric nursing postgraduate, a tooltailored to the cultural and social context and with acceptable psychometric properties is necessary.

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The roles and functions of future hospitals in health promotion: A systematic review in Iran

. Mona Rouhifard; . Abbas Vosoogh‑Moghaddam; . Esmaeil Moshiri

Volume 12, Issue 8 , September 2022, , Pages 1-6

Abstract

  As a main pillar of the health and social welfare system, hospitals affect the public health status in twoways: (1) Prevention, treatment, and rehabilitation services and (2) external ...  Read More As a main pillar of the health and social welfare system, hospitals affect the public health status in twoways: (1) Prevention, treatment, and rehabilitation services and (2) external effects on society andthe environment. The present study aimed to identify the roles and functions of future hospitals in theworld. The present study was a systematic review in which all studies about the roles and functionsof future hospitals in different countries with a time limit of 2000 to August 2021 were extracted fromforeign databases, including PubMed, Cochrane, Scopus, and Web of Science, and search engine,Google Scholar, as well as Persian databases, including Magiran, SID, and Iran Medex. We utilizedthe STROBE checklists for quantitative studies and SRQR checklists for qualitative studies tocritique and evaluate the quality of qualitative studies. We then extracted their results and classifiedthe content according to the main and subtopics. A total of 16 articles met the inclusion criteria ofthe present study. Hospitals can play four roles: stand‑alone, dominant, collaborative, and partner.Findings were classified into six general groups: the role and mission of future hospitals, the wayof providing care, funding, staff and patients, technology and information of future hospitals, andthe challenges and barriers of current hospitals. Health service policy‑makers need to pay specialattention to technological innovations and advances as well as changes in the roles and functionsof hospitals and seek to turn the threats arising from external changes into opportunities for betterhospital performances.

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Systematic review of health policy and behavioral economics: A neglected point in health promotion

. Zahra Zamani; . Zahra Ghalichi-Zave; . Sadegh Ahmadi Mazhin; . Maliheh Eshaghzadeh; . Mahsa Hami; . Telma Zahirian Moghadam

Volume 12, Issue 8 , September 2022, , Pages 1-7

Abstract

  BACKGROUND: Health policymakers use a variety of policy tools. These policies are either basedon external factors or are based on paternal considerations; people may need to have help ...  Read More BACKGROUND: Health policymakers use a variety of policy tools. These policies are either basedon external factors or are based on paternal considerations; people may need to have help in theselection of items that may be regretted about them in the future. However, recent research onbehavioral economics shows that major decision‑making mistakes are not only limited to vulnerablegroups but also are ubiquitous and systematic. The purpose of this study was on health policy makingwith a behavioral economics approach in health promotion.MATERIALS AND METHODS: The eligible studies were obtained from Medline (PubMed), Web ofScience, and Scopus databases. The search strategy uses a combination of keywords in the titles. Thekeywords of behavioral economics along with the keyword of health have been used to find related articles.RESULTS: After deleting duplicate articles, a total of 38 articles were identified. After reviewingthe title and abstract, 13 studies were omitted because they did not meet the inclusion criteria. Tenarticles were removed from the found articles due to the unavailability of the full text and four articleswere excluded because their method was quantitative. Finally, a total of 11 articles were eligible forincluding this review study.CONCLUSION: Recent research on behavioral economics shows that decision‑making errors are notlimited to vulnerable groups but are ubiquitous and systematic. Forgotten income or negligible incomeis very high and is reasonably explained by transaction costs. Educational interventions often havelittle effect and do not benefit from basic cost‑benefit tests. In addition, the seemingly insignificantaspects of choice‑frameworks and assumptions‑often have a profound effect on behavior.

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Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion: A systematic review

. Saeed Husseini Barghazan; . Mohamad Hadian; . Aziz Rezapour; . Setare Nassiri

Volume 12, Issue 5 , June 2022, , Pages 1-10

Abstract

  Pregnancy termination and abortion‑related complications are well‑established problems amongwomen at reproductive age and resulted in significant morbidity and mortality. Accordingly, ...  Read More Pregnancy termination and abortion‑related complications are well‑established problems amongwomen at reproductive age and resulted in significant morbidity and mortality. Accordingly, asystematic study was performed to investigate the economic evaluation studies results on costsand benefits of medical and surgical abortion methods. PubMed, Web of Science, Scopus, Embase,Cochrane library, ProQuest, and ScienceDirect databases as well as Google scholar were searchedthrough June 2021. Original full‑text English language studies that performed an economic evaluationanalysis comparing medical and surgical methods of pregnancy termination were included in thisreview. A critical quality assessment was conducted utilizing the Consolidated Health EconomicEvaluation Standards checklist. The latest web‑based tool adjusted the estimates of costs expressedin one specific currency and price year into a specific target currency (the year 2020 $US). Overall,538 records were retrieved, and 20 studies were deemed eligible for qualitative synthesis. Amongthe reviewed studies, three studies investigated cost‑minimization analysis, three studies investigatedcost‑utility analysis, and 14 studies investigated cost‑effectiveness analysis. The directly comparisonof medical with surgical abortion was most frequently studied. Medical abortion saved US$ 6 to US$2373 per patient’s costs. Medical abortion was cost‑effective and cost‑saving option in compare tothe surgical abortion across all perspectives (the incremental cost effectiveness ratio ranged fromUS$ 419 to US$ 4,044). Quality scores of included studies ranged from 54% to 100%, and 70% ofstudies received a score of above 85% and had “excellent” quality. According to the results, based onvarious economic and clinical effectiveness decision‑making criteria used in different studies of healtheconomic evaluation, the majority of research provided evidence on the advantage of pharmaceuticalmethods compared to surgical methods, as well as the advantages of using combinations therapycompared to single therapeutic interventions.

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Identifying the themes of medical tourism business in Iran: A systematic review

. Nafiseh Karimi Badrabadi; . Sogand Tourani; . Asef Karimi

Volume 12, Issue 4 , April 2022, , Pages 1-12

Abstract

  BACKGROUND: Nowadays, medical tourism reports impressive growth in terms of number of persons, income, and number of countries involved in cross‑border flows. It refers to people ...  Read More BACKGROUND: Nowadays, medical tourism reports impressive growth in terms of number of persons, income, and number of countries involved in cross‑border flows. It refers to people traveling abroad (from home to a target country) to obtain medical treatment. The present study aimed to identify the themes and codes of the medical tourism business in Iran.MATERIALS AND METHODS: We searched international databases (such as PubMed, Scopus, Embase, and Web of Science) and Iranian bibliography thesaurus and repositories (namely, Scientific Information Database and Magiran) using keywords such as medical tourism, international medical travel, and medical tourism business in the English and Persian literature, published between January 2000 and December 2019, identified with no restriction on the type of the studies. The data were analyzed based on the content analysis method.RESULTS: Out of 1054 articles, 14 were finally selected. In the end, eight themes of the medical tourism business including competitive pricing, safety and security, information and communication technology, labor market and human resources, structure management, leading the way in medical tourism, infrastructure, and exchange with the international world were identified which on the whole contain 45 codes. Most of the articles were quantitative. Four of the themes (competitive price, labor market and human resources, structure management, and infrastructure) were most frequent and of the highest importance.CONCLUSION: The themes and codes identified in this study helps companies and individuals who want to work in the field of medical tourism. According to this study, all 8 themes and 45 codes are of high value, but still, some themes are of higher value than others and special attention should be paid to them.

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Effectiveness of breastfeeding education compared to standard hospital information on exclusive breastfeeding among mothers: A systematic review

. Athirarani Muraleedharan Rohini; . Sujitha Elavally; . Geetha Saradakutty

Volume 12, Issue 4 , April 2022, , Pages 1-9

Abstract

  Breastfeeding is the single intervention with the largest impact on the health of a new‑born baby. Evidence has to be generated to convince the mother as well as policy‑makers ...  Read More Breastfeeding is the single intervention with the largest impact on the health of a new‑born baby. Evidence has to be generated to convince the mother as well as policy‑makers for the promotion of exclusive breastfeeding (EBF) for 6 months. This study aimed to assess the evidence for the effectiveness of breastfeeding education compared with standard hospital information among mothers on the rate of EBF. The study design is systematic review. Trials which are randomized or cluster randomized which studied the effect of educational interventions for mothers on EBF were searched for. Two databases were searched, namely PubMed and Cochrane. Manual search of reference lists of all included studies in Google scholar and Clinical Trial Registry was done. Two reviewers independently assessed the quality of the included studies. Data were extracted using a table format set by the reviewers referring the previously reported high‑quality systematic reviews. Out of the 12 comparisons of nine studies included for review, eight studies report that breastfeeding education has added advantage on increasing the rate of EBF. We conclude that there is evidence to support breastfeeding education versus standard hospital information across diverse settings.

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Clinical competence of Iranian nurses: A systematic review and meta‑analysis

. Amir Emami Zeydi; . Mohammad Javad Ghazanfari; . Ehsan Azizi; . Hadi Darvishi‑Khezri; . Hamed Mortazavi; . Joseph Osuji; . Samad Karkhah

Volume 12, Issue 3 , March 2022, , Pages 1-12

Abstract

  BACKGROUND: One of the most important steps in increasing the nurses’ professional competence and consequently improving the quality of nursing care is to evaluate nurses’ ...  Read More BACKGROUND: One of the most important steps in increasing the nurses’ professional competence and consequently improving the quality of nursing care is to evaluate nurses’ clinical competency and then take effective actions to enhance it. This study aimed at exploring the clinical competence of Iranian nurses and factors related to it.MATERIALS AND METHODS: In this systematic review and meta‑analysis, PubMed, Scopus, Web of Science, Scientific Information Database, and Iranmedex databases and Google Scholar search engine were searched to February 14, 2020.RESULTS: After screening, a total of 25 articles were included. In general, the level of clinical competence of Iranian nurses was at a desirable level. After meta‑analysis of the mean score of nurses’ clinical competence, the combined mean was 161.13 (95% confidence interval [CI]: 137.78–184.48;P < 0.001; I2 = 99.8%; P value for heterogeneity = P < 0.001) by the Competency Inventory for Registered Nurses (CIRN) questionnaire. The summarized mean of clinical competency measured by the Nurse Competence Scale (NCS) questionnaire was 70.75 (95% CI: 60.80–80.70; P < 0.001; I2 = 99.9%; P value for heterogeneity = P < 0.001). Factors affecting nurses’ clinical competence were age ≥33 years, nursing work experience ≥9 years, and a master’s degree in nursing. However, the clinical competence of nurses had a significant negative relationship with job stress.CONCLUSION: The level of clinical competence of Iranian nurses was desirable. Studies that used the CIRN, reported the highest and lowest clinical competence in clinical care and professional development dimensions, respectively. Studies that used the NCS, reported the highest and lowest clinical competence in dimensions of work role and ensuring quality, respectively.

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Quality of life in health Iranian elderly population approach in health promotion: A systematic review

. Mohsen Poursadeqiyan; . Maryam Feiz Arefi; . Amin Babaei Pouya; . Mojtaba Jafari

Volume 11, Issue 11 , December 2021, , Pages 1-9

Abstract

  BACKGROUND: The quality of life (QOL) is essential in all different stages of life; however, It ismore important for older people as it can be effective in promoting their health. Therefore, ...  Read More BACKGROUND: The quality of life (QOL) is essential in all different stages of life; however, It ismore important for older people as it can be effective in promoting their health. Therefore, the presentstudy aimed to review the literature on the QOL in the Iranian elderly population.MATERIALS AND METHODS: The study was carried out as a systematic review. For this purpose,all databases were searched in March 2021. The keywords used for the search were “quality of life,elderly, older adults, aging, seniors, and Iran” along with the Persian equivalents. PRISMA protocolwas used to screen articles. After removing duplicate and irrelevant items, two evaluators appraisedthe articles separately based on a researcher‑made checklist derived from the SBEM and STROBEStatement standard checklists.RESULTS: The initial search yielded 3734 studies on the QOL in the Iranian elderly population. Afterscreening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained inthe study. Most of the studies (cross‑sectional) were conducted in Tehran using a 36‑item Short‑FormHealth Survey to assess the QOL. The studies investigated sociodemographic determinants, physicaland health‑related behaviors, and spirituality and psychological determinants of the QOL. Thesociodemographic determinants were the most common factors under study. The results showedthat the role of gender and socioeconomic status was the strongest among the sociodemographiccharacteristics. A significant association was found between the QOL in the Iranian elderly populationand factors such as depression and religious confrontation.CONCLUSION: In addition to chronic diseases, diseases of the oral and dental, as well as anunhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social,physical, and psychological variables that affect the QOL of older people.

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Effect of sense of coherence on oral health behavior and status: A systematic review and meta‑analysis

. Roksana Poursalehi; . Arash Najimi; . Bahareh Tahani

Volume 11, Issue 8 , September 2021, , Pages 1-17

Abstract

  The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOCare better at dealing with stressful situations, psychological stress, and problems ...  Read More The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOCare better at dealing with stressful situations, psychological stress, and problems and are more ableto manage them, leading to better general health. The purpose of this study was to evaluate the effectof SOC on the oral health status of people in different age groups. A systematic search up to May2019 was carried out in PubMed,Scopus, Psycho info, and Persian sources. Studies were includedif they evaluated the relationship between SOC and oral health behaviors (OHBs) or oral healthstatus including dental caries. The Newcastle‑Ottawa checklist was used to appraise the selectedarticles and meta‑analysis of included studies were performed using Comprehensive Meta‑Analysissoftware. Value of P < 0.05 was considered to be statistically significant. Odds ratio (OR) was usedto measure effect size with 95% confidence interval (CI). The random‑effects model was chosenin the presence of heterogenicity. I2 index and Q index were used to measure the heterogeneitypresent between the studies. Fifteen articles received the minimum score of criticism. In general,SOC could significantly affect the oral health and OHBs of adults independently of the underlyingfactors. There was a significant relationship between SOC and tooth decay in adolescents, but thisassociation was poor after adjusting for the underlying factors. In children, only one article revealedan association with OHBs. Meta‑analysis revealed that SOC was significantly associated with thecaries rate (OR = 0.78, CI 95% = 0.9–0.67, P = 0.001) and tooth brushing frequency (OR = 1.22,CI 95% = 1.1–1.31 and P < 0.001). Sense of coherence appears to be one of the effective factorsin predicting oral health behaviors and ultimately oral health, especially in adults. The number ofarticles available for children and adolescents was not sufficient in this regard.

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Establishing clinical governance model in primary health care: A systematic review

. Leila Hosseini Ghavamabad; . Abbas Vosoogh‑Moghaddam; . Rouhollah Zaboli; . Mohsen Aarabi

Volume 11, Issue 8 , September 2021, , Pages 1-7

Abstract

  Clinical governance is a systematic approach to enhancing the quality of primary health care andensuring high clinical standards, responsiveness to performance, and continuous improvementin ...  Read More Clinical governance is a systematic approach to enhancing the quality of primary health care andensuring high clinical standards, responsiveness to performance, and continuous improvementin service quality. The objective of the current study was to investigate the global experiencesof clinical governance in primary health care. In the present systematic review, relevant articlesfrom different countries were searched in various databases such as MD PubMed from Medlineportal, Emerald Springer link, ProQuest, Cochrane, Scopus, Web of Science, and Consult untilApril 2019. The searched articles were checked through CASP and PRISMA checklists, and theirresults were extracted. Of the 17 selected studies, 16 belonged to developed countries, includingEngland (13), Australia, Italy, and New Zealand, and one was from Turkey. The findings were dividedinto three general categories: (1) principles of effectiveness and risk management, (2) deploymentrequirements such as structural and organizational needs, resource and communication, andinformation management, and (3) barriers of clinical governance toward providing primary healthcare. it is recommended that a suitable framework or model be developed and designed adaptedto the local culture and taking into account all effective dimensions for a proper establishment andimplementation of clinical governance in primary health care.

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Factors affecting development of air ambulance base: A systematic review and thematic analysis

. Zahra Eskandari; . Zohreh Ghomian; . Sanaz Sohrabizadeh; . Ahmad Alibabaei; . Hojjat Ahmadinejad

Volume 11, Issue 7 , August 2021, , Pages 1-11

Abstract

  Nowadays, air ambulances have been developed as part of advanced emergency medicine serviceswith many countries employing these services for transferring patients in usual and emergencyconditions. ...  Read More Nowadays, air ambulances have been developed as part of advanced emergency medicine serviceswith many countries employing these services for transferring patients in usual and emergencyconditions. However, there are challenges concerning the optimal development of air ambulancebase. The present research aimed to identify factors affecting the development of air ambulancebases to provide the opportunity of planning to improve the quality of emergency medical services.In this systematic literature review, the peer-reviewed papers in fiv electronic databases, includingMedline through PubMed, Scopus, Web of Science, ScienceDirect, and ProQuest, as well asavailable gray literature, were searched and selected. Two combinations of groups were used askeywords: the Health Planning and development factor, air ambulance base. The focus was onthe PRISMA checklist, with no time limitations until from 1990 to January 2020. Finally, through5156 related citations, 20 articles were included. Descriptive and thematic content analyses wereevaluated. The factors affecting the development of the air ambulance base were classified in fivcategories and 14 subcategories as follows: navigation criteria, process indications and standards,sociopolitical factors, and current situation of the area. There are few studies on factors affecting thedevelopment of air ambulance bases. It is necessary to apply multidimensional models to considervarious factors for development. The development of high populated cities, events and ceremonieswith a crowd of participants, and increase of human-made disasters are making these servicesincreasingly indispensable.

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Countries’ experiences in reforming hospital administration structure based on the Parker and Harding model: A systematic review study

. Jafar Sadegh Tabrizi; . Saber Azami Aghdash; . Mahdi Nouri

Volume 11, Issue 7 , August 2021, , Pages 1-11

Abstract

  In recent years, many reforms have been made on the structure of hospital administration, mostof which are proposed by Parker–Harding models. Therefore, the purpose of this study ...  Read More In recent years, many reforms have been made on the structure of hospital administration, mostof which are proposed by Parker–Harding models. Therefore, the purpose of this study is tosystematically review global relevant experiences in reforming the hospital governance structurewith emphasis on the Parker–Harding model. Required information was collected using keywordsautonomization, corporatization, privatization, decentralization, reform, hospital autonomy, governancemodel, and structural reform in databases such as EMBASE, PubMed, Scopus, SID, MagIran, andother resources. Information on the subjects under study was collected from 1990 to 2020. Thecontent extraction method was used for data extraction and data analysis. Thirty‑nine sources wereincluded in the study. Results of searching for relevant evidence on a variety of hospital governancemodels (government, board, corporate, and private) based on the Parker–Harding model in fourcategories including strengths (31), weaknesses (30), outcomes (26), and interventions (21) areoutlined. In this study, strengths, weaknesses, outcomes, and corrective interventions were presentedfor different models of hospital administration that could be used by healthcare policymakers. Also,According to the results of this study, governmental model less recommended.

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The effects of teaching methods on academic motivation in nursing students: A systematic review

. Maryam Saeedi; . Raziyeh Ghafouri; . Fereshteh Javaheri Tehrani; . Zahra Abedini

Volume 11, Issue 6 , July 2021, , Pages 1-8

Abstract

  Motivation is one of the key factors in educational achievement. Like any other field of study, motivationin nursing is highly critical. The instructor’s knowledge about the teaching ...  Read More Motivation is one of the key factors in educational achievement. Like any other field of study, motivationin nursing is highly critical. The instructor’s knowledge about the teaching methods that are effectivein academic motivation of students enables them to adopt proper measures to improve the teachingefficiency. The present paper is a systemic review of the efficiency of instructional interventions inimprovement of academic motivation in nursing students. The published papers related to the studyfrom 2000 to February 2020 were searched at different databases such as PubMed, Scopus, Webof Science, PsycInfo, and ERIC. To examine the quality of the articles, critical appraisal instrumentfor reports of educational interventions was used. Totally, 18 articles entered the study for structuredreview. The majority of the articles reported that educational interventions improved academicmotivation in nursing students. The effective teaching methods described in the reviewed articlesthat led to an improvement in academic motivation were simulation, case‑based learning, cooperativelearning, learning contract, peer assessment, and self‑assessment using video typing. As the findingsshowed, implementation of applied and participatory methods in teaching process improved theacademic motivation of nursing students. Therefore, using such methods, nursing instructors canimprove the academic motivation of their students.

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Investigating the challenges and barriers of palliative care delivery in Iran and the World: A systematic review study

. Mohammad Salimi Amroud; . Pouran Raeissi; . Seyed‑Masoud Hashemi; . Nahid Reisi; . Seyed‑Ahmad Ahmadi

Volume 11, Issue 6 , July 2021, , Pages 1-7

Abstract

  Palliative care and terminal patients care centers have an important role in improving the physicaland psychological state of the patient and their families and increasing their satisfaction ...  Read More Palliative care and terminal patients care centers have an important role in improving the physicaland psychological state of the patient and their families and increasing their satisfaction and careproviders. A literature search of online databases (PubMed, Scopus, Web of science, Cochranelibrary, and Google Scholar) was searched from January 1, 2000, to the end of April 2019, by usingthe appropriate English keywords. Furthermore, IranMedex, Barkat, and Magiran databases weresearched for the Persian articles. We used Standards for Reporting Qualitative Research checklistto evaluate the articles quality. From 1328 articles, 166 were reviewed in depth with 13 satisfyingour inclusion criteria. The findings of this study revealed a wide range of barriers and challenges topalliative care delivery. The identified barriers were: Cultural, social and organizational barriers, lackof resources, equipment and financing, attitudes and cultures, barriers related to the patient and thepatient’s family, related barriers providers, time and money, education, communication challenges,policies, insurance problems, safety, and crisis management. The results of the studies showed thatthere are various barriers and challenges such as economic, cultural, social, organizational, andcommunication related to palliative care. Given the identified barriers and challenges, it is suggestedthat to improve the delivery of palliative care, the health system policy‑makers and planners considera resource‑appropriate and culturally appropriate framework for palliative care delivery.

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Relation between stress, time management, and academic achievement in preclinical medical education: A systematic review and meta‑analysis

. Soleiman Ahmady; . Nasrin Khajeali; . Masomeh Kalantarion; . Farshad Sharifi; . Mehdi Yaseri

Volume 11, Issue 1 , January 2021, , Pages 1-6

Abstract

  Identifying the learners’ problems is important. Besides, many factors are associated with academicfailure, among which time management and stress are more important than any ...  Read More Identifying the learners’ problems is important. Besides, many factors are associated with academicfailure, among which time management and stress are more important than any others basedon evidence. By using a systematic review and meta‑analysis, this study aims to synthesize thefindings of studies about the correlation of time management and stress with academic failureto suggest a more in‑depth insight into the effect of these two factors on academic failure. Fourdatabases were searched from the inception of January 2018. Publication bias was evaluated visuallyusing funnel plots and sized up by Egger’s test. Ninety‑four articles were found to be qualified forinclusion after full‑text review and additional manual reference made. Of these, 8 were studies ofeducational interventions that were reviewed in this paper. Regarding the relation of stress andacademic performance, the Funnel plot (results not shown) and Egger’s test showed no publicationbias in the studies (P = 0.719). Based on this result, the estimated pooled correlation (reverted byhyperbolic tangent transformation) between stress and academic performance was found to be −0.32(95% confidence interval: −0.38–−0.25). In conclusion, the review recognized a series of potentiallymutable medium‑to‑large correlates of academic achievement, time management, and stress. Itwould be essential to have experimental data on how easily such self‑regulatory capacities can bealtered, and these interventions could help students enhance their potential, providing empirical testsfor offered process models of academic achievement.

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Blended learning and health professional education: Protocol for a mixed‑method systematic review

. Narasimman Swaminathan; . Latha Ravichandran; . Sivakumar Ramachandran; . Steve Milanese

Volume 10, Issue 2 , February 2020, , Pages 1-4

Abstract

  Blended learning (BL) refers to a systematic teaching method, which combines the aspects offace‑to‑face and online interactions using appropriate Information and Communication Technologies.This ...  Read More Blended learning (BL) refers to a systematic teaching method, which combines the aspects offace‑to‑face and online interactions using appropriate Information and Communication Technologies.This mixed‑method systematic review (SR) protocol is developed with the objective to determine theeffectiveness and appropriateness of BL in the health‑care professional education. Mixed‑methodSR protocol: For the purpose of this SR, PICO is defined as P‑entry level graduate students of healthsciences program; I‑BL; C‑traditional face‑to‑face training; and O‑achievement of learning outcomes,learner’s and teacher’s perception (primary). The search will be done through possible databaseusing predetermined search strategy. Eligible studies will be appraised independently by authors.Joanna Briggs Institute’s mixed‑method protocol will be used to assess and synthesis the data. Thisprotocol is registered with the International Register of Systematic Reviews (PROSPERO) with theregistration number CRD42018082699.

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Evaluation of psychometric properties of scales measuring student academic satisfaction: A Systematic review

. Pardis Rahmatpour; . Hamid Sharif Nia; . Hamid Peyrovi

Volume 9, Issue 12 , December 2019, , Pages 1-11

Abstract

  BACKGROUND: Student satisfaction has an impact on student motivation, recruitment of newstudents, and retention of existing students. Hence, it is important for researchers and academicinstitutes ...  Read More BACKGROUND: Student satisfaction has an impact on student motivation, recruitment of newstudents, and retention of existing students. Hence, it is important for researchers and academicinstitutes to assess student academic satisfaction by valid and reliable scales. The aim of this studywas to rigorously assess methodological quality and psychometric properties of scales measuringstudent academic satisfaction.METHODS: In this systematic review, databases including Scopus, PubMed, ProQuest, ScienceDirect,and Web of Science, and two Persian databases were searched using relevant keywords such asacademic satisfaction, student satisfaction, university satisfaction, campus satisfaction, academiclife experience, validation, and psychometric and factor analysis from 1970 to December 2018.Considering eligibility criteria, studies were selected after titles and abstracts screening. Themethodological quality assessment was performed by the COnsensus‑based Standards for theselection of health Measurement INstruments (COSMIN) checklist and the Terwee quality criteria.RESULTS: Of 814 retrieved articles, 13 studies were included in the study. Based on the COSMINchecklist, structural validity (84%), content validity (53%), and hypothesis testing (53%) were themost reported properties. One study reported cross‑cultural validity, one for criterion validity, andnone reported measurement error.CONCLUSION: The results of our study showed that in spite of ≥48 years of development in studentsatisfaction scales; however, each scale has at least one “poor” psychometric property based onthe COSMIN checklist. Quality appraisal of scales is necessary after developing and performingpsychometric process.

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Hospitals’ efficiency in Iran: A systematic review and meta‑analysis

. Somayeh Mahdiyan; . Ali Dehghani; . Arefe Dehghani Tafti; . Mohsen Pakdaman; . Roohollah Askari

Volume 9, Issue 6 , June 2019, , Pages 1-8

Abstract

  BACKGROUND: Given that the need to pay attention to measuring efficiency is considered asone of the main pillars of improving the level of efficiency in hospitals, so this study was ...  Read More BACKGROUND: Given that the need to pay attention to measuring efficiency is considered asone of the main pillars of improving the level of efficiency in hospitals, so this study was carriedout aimed to determine the mean technical efficiency (The technical efficiency is bound by zeroand one and a score of less than one means that the theatre is inefficient as it could) score interms of type and activity of the hospital, input‑oriented and output‑oriented attitude, returns toscale (In economics, returns to scale and economies of scale are related but different conceptsthat describe what happens as the scale of production increases in the long run, when all inputlevels including physical capital usage are variable (chosen by the firm). The concept of returnsto scale arises in the context of a firm’s production function. It explains the behavior of the rateof increase) in hospitals of Iran using data envelopment analysis (DEA) (DEA is a nonparametricmethod in operations’ research and economics for the estimation of production frontiers. It isused to empirically measure productive efficiency of decision‑making units) and stochastic frontieranalysis (SFA) (SFA is a method of economic modeling. It has its starting point in the stochasticproduction frontier models simultaneously introduced by Aigner, Lovell and Schmidt[1977] andMeeusen and Van den Broeck[1977]MATERIALS AND METHODS: The present study was carried out with a systematic reviewof all studies conducted on measuring efficiency of hospitals in Iran from March 21, 2001 toDecember 21, 2017 using DEA and SFA. Eleven databases were searched using appropriatekeywords and 470 articles were found and evaluated using a checklist, and finally, 24 articleswere entered into the meta‑analysis process. Meta‑analysis was performed using random effectmodel and fixed‑effect model, and study heterogeneity was investigated using Q‑Cochrantest and I2 index. Furthermore, the main reasons of study heterogeneity were identified dueto meta‑regression.RESULTS: The average technical efficiency score of hospitals using DEA and SFA methodwas obtained equal to 0.885 and 0.809, respectively. Furthermore, with regard to the DEAmethod, 0.885, 0.891.0.952 and 0.913 was obtained for input‑oriented and output‑oriented,general and specialized care hospitals and constant returns respectively. With regard to SFAmethod, 0.733, 0.664, 0.641, 0.802, was obtained, and the inputs and outputs affect measuringthe efficiency.DISCUSSION: In contrast, the DEA method can investigate several input and output simultaneouslyand is used as an effective and flexible tool in order to measure the efficiency of the hospital. DEAcan be easily used for calculating efficiency scores based on the proper selection of input andoutput indicators. The data envelopment analysis method and different input and output variableshave been used in most studies conducted in Iran, and Stochastic Frontier Analysis has been lessconsidered. In the present study, the DEA method in governmental educational hospitals showed ahigher efficiency than SFA method in the hospitals under study. But in general, due to lack of optimalefficiency level in the hospital, it is suggested that policymakers determine the hospital efficiencyindices in order to evaluate their efficiency from different dimensions.  CONCLUSION: The average technical efficiency score of hospitals using DEA and SFA method was obtained equal to 0.885and 0.809, respectively. Also, the mean technical efficiency score in terms of input-oriented and output-oriented, general andspecialized care hospitals and constant returns to scale using the DEA method was obtained equal to 0.885, 0.891.0.952 and0.913 and using the SFA method, respectively, it was equal to 0.733, 0.664, 0.641, 0.802, and the inputs and outputs affectingmeasuring the efficiency. There is no significant difference between the mean efficiency score between the two methods, butthe data envelopment analysis method is used more. It is suggested that the hospitals efficiency indicators to be determined inorder to more accurately evaluate the hospitals efficiency.

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The economic consequences of practice style variation in providing medical interventions: A systematic review of the literature

. Mojtaba Nouhi; . Mohamad Hadian; . Reza Jahangiri; . Mostafa Hakimzadeh; . Serajaddin Gray; . Alireza Olyaeemanesh

Volume 9, Issue 6 , June 2019, , Pages 1-7

Abstract

  The practice style variation (PSV) incurs undesirable clinical and economic consequences for patientsand the healthcare system. This review aims to analyze the economic consequences ...  Read More The practice style variation (PSV) incurs undesirable clinical and economic consequences for patientsand the healthcare system. This review aims to analyze the economic consequences of PSV inmedical interventions. A comprehensive electronic search was conducted through PubMed, Web ofSciences, EBSCO, EMBASE, and Cochrane databases to retrieve studies on economic consequencesof PSV within 1975–2018. The studies were independently assessed by two reviewers. The qualityof studies was assessed by Strengthening the Reporting of Observational Studies in Epidemiologychecklist. No language restriction was applied. Only four studies met the eligibility criteria. Thesestudies have been conducted retrospectively in developed countries. Most of the included studiesused consumer demand theory to measure the economic consequences of PSV. Findings showed12%–74% of all variations in healthcare services are related to PSV, thereby incurring up to 23 milliondollars for the healthcare system. The PSV is related to the total expenditure, price elasticity, andcoefficient of variation of healthcare services. PSV associated with huge inefficiency and inequity inaccess to healthcare services. To mitigate the consequences of PSV, policymakers should considerPSV in both developing the medical education plans as well as cost management. Using multilevelanalysis to investigate the determinants of PSV would be beneficial.

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Psychological empowerment strategies in infertile women: A systematic review

. Mahboubeh Taebi; . Masoumeh Simbar; . Somayeh Abdolahian

Volume 8, Issue 5 , May 2018, , Pages 1-7

Abstract

  Infertility requires long‑term care and treatments which would influence different aspects of healthincluding the mental health of infertile women. The present study was conducted ...  Read More Infertility requires long‑term care and treatments which would influence different aspects of healthincluding the mental health of infertile women. The present study was conducted to determinestrategies for psychological empowerment of infertile women. This systematic review was performedon previously conducted clinical trials. To achieve the intended studies, databases of Magiran,Scientific Information Database, Google Scholar, Scopus, PubMed, ProQuest, ScienceDirect, andWeb of Science and also Iranian Registry of Clinical Trials website were searched using “infertilityand infertile women” as the keywords. The inclusion criteria were being an interventional studyand assessing the psychological status of infertile women. Performed studies in Iran with no timelimitations were evaluated. Based on the Jadad criteria, studies with a score of 3 or more wereenrolled in the systematic review. After assessing the quality of the studies, 21 studies were enrolledin the review for final evaluation. Reviewing the conducted studies showed that educational andcounseling interventions could be effective in improving the aspects of psychological well‑being ofinfertile women. Existing evidence revealed that applying coping strategies is effective in improvingthe quality of life in infertile women, which consequently lead to the improvement of psychologicalempowerment of infertile women.

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The efficacy of hepatitis B vaccine in Iranian population: A systematic review and meta‑analysis

. Mehdi Tazhibi; . Abdollah Hajivandi; . Arefeh Dehghani Tafti; . Hossein Fallahzadeh

Volume 4, Issue 3 , June 2014, , Pages 1-8

Abstract

  Introduction: Hepatitis B infection is an important health problem all over the world, andaccording to the studies, Iran is a country with intermediate prevalence, so vaccination is ...  Read More Introduction: Hepatitis B infection is an important health problem all over the world, andaccording to the studies, Iran is a country with intermediate prevalence, so vaccination is acost-benefit approach. In this study, evidence about the efficacy of hepatitis B vaccine wascollected by systematic review methods and its amount was estimated by a meta-analysis.Materials and Methods: In this study, documents and literature search were performedusing valid key words in Information Sciences Institute, PubMed, Scientific InformationData base, and Iranmedex databases from 1997 to 2010 in different regions of Iran. Allcross-sectional studies about the efficacy of hepatitis B vaccine in Iran which fulfilledthe inclusion criteria entered the study. Antibody titer (Anti-hemoglobins > 10 IU/L) wasconsidered as the desired efficacy. In order to present the results, prevalence and Forestplot were used and for evaluation of the inconsistency meta-regression model and I2 indexwere used. We used R.15.3.2 software for analysis. Results: Totally 64 studies (52 studiesin general population and 12 studies among specific populations) including 12,575 subjectswith age range from 8 months to 55 years entered the meta-analysis. The efficacy was86.3% (confidence interval [CI]: 83.9-88.7%) in the general population and 59.62% (CI:47.9-71.29%) in specific patient populations. Also the efficacy was significantly related to theyear of publication, age and gender (P < 0.05). Conclusion: Prevention is an important issuein general health. Hepatitis B vaccination is one of the methods used to prevent hepatitisB infection. According to this study, the efficacy of hepatitis B vaccination was more than80% in general population, so injection of full course of hepatitis B vaccinationis enoughand booster dose is not required.

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