1
|
Abdipour Mehrian SR, Uddin S, Ghahramani Z, Moshfeghinia R, Shahabi S, Haghdoost A, Mesbahi G, Khodadost M, Hashempur MH, Heydari M, Mojahedi M, Nimrouzi M, Pasalar M, Vardanjani HM, Lankarani KB. Evidence-based practice in traditional persian medicine (TPM): a stakeholder and social network analysis. BMC Complement Med Ther 2024; 24:253. [PMID: 38961415 PMCID: PMC11223371 DOI: 10.1186/s12906-024-04564-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The utilization of complementary and alternative medicine (CAM) is experiencing a global surge, accompanied by the adoption of national CAM policies in numerous countries. Traditional Persian medicine (TPM) is highly used as CAM in Iran, and the ongoing scientific evaluation of its interventions and the implementation of evidence-based medicine (EBM) encounters various barriers. Therefore, comprehending the characteristics and interactions of stakeholders is pivotal in advancing EBM within TPM policies. In this study, we utilized both classical stakeholder analysis and social network analysis to identify key stakeholders and potential communication patterns, thereby promoting EBM in TPM policy-making. METHODS A cross-sectional nationwide stakeholder analysis was conducted in 2023 using snowball sampling. The interviews were carried out using a customized version of the six building blocks of health. Data were collected through semi-structured interviews. Stakeholders were assessed based on five factors (power, interest, influence, position, and competency). The connections and structure of the network were analyzed using degree, betweenness, closeness centrality, and modularity index to detect clusters of smaller networks. RESULTS Among twenty-three identified stakeholders, the Ministry of Health and Medical Education (MOHME) and the Public were the most powerful and influential. The Iranian Academy of Medical Sciences was the most competent stakeholder. Social network analysis revealed a low density of connections among stakeholders. Pharmaceutical companies were identified as key connectors in the network, while the Public, supreme governmental bodies, and guilds acted as gatekeepers or brokers. The MOHME and Maraji were found to be high-ranking stakeholders based on four different centrality measures. CONCLUSION This study identifies powerful stakeholders in the network and emphasizes the need to engage uninterested yet significant stakeholders. Recommendations include improving competence through education, strengthening international relations, and fostering stronger relationships. Engaging key connectors and gatekeepers is essential for bridging gaps in the network.
Collapse
Affiliation(s)
| | - Shahadat Uddin
- Complex Systems Research Group, Faculty of Engineering & IT, The University of Sydney, Darlington, Australia
| | - Zahra Ghahramani
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aliakbar Haghdoost
- Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Golsa Mesbahi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmoud Khodadost
- Beheshti Shahid University of Medical Sciences, Medicine Traditional Iranian of Department, Tehran, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Mojahedi
- Traditional Medicine and History of Medical Sciences Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Majid Nimrouzi
- Essence of Parsiyan Wisdom Institute, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
- MD-MPH Program, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Luo C, Zhang MX, Yang YP, Tung TH. Self-perceived knowledge, attitude, and practice of evidence-based medicine before and after training among healthcare workers in Taizhou, China. BMC MEDICAL EDUCATION 2024; 24:700. [PMID: 38937713 PMCID: PMC11212180 DOI: 10.1186/s12909-024-05678-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Evidence-based medicine (EBM) is the combination of the best research evidence with our clinical expertise, specific situations, and the unique values of our patients. It is essential to evaluate the effectiveness of EBM training for healthcare workers (HCWs). OBJECTIVES This study aims to assess the impact of EBM training on HCWs' knowledge, attitude, and practice (KAP) related to EBM. METHODS A self-reported online survey was carried out to investigate KAP related to EBM among HCWs at a tertiary hospital in Taizhou, China. HCWs participated in EBM training on 9 and 10 September 2023. The questionnaire survey was conducted to understand KAP related to EBM before and after the training, and to compare and analyze the results before and after the training. The R software (version 4.1.0) was used to analyze data. RESULTS Sixty-four HCWs completed the survey with a response rate of 52.5% (64/122). The overall average scores of KAP related to EBM before training were 55.3, 63.0, and 34.5, respectively, and 56.9, 66.5, and 34.7 were the scores of KAP after training. HCWs' scores of knowledge (P = 0.033) and attitude (P < 0.001) related to EBM improved significantly after the training. CONCLUSION This study implied that EBM training may improve the knowledge and attitude of HCWs, and its teaching effect is considerable.
Collapse
Affiliation(s)
- Chengwen Luo
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Mei-Xian Zhang
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
- Taizhou Institute of Medicine, Health and New Drug Clinical Research, Taizhou, China.
| |
Collapse
|
3
|
Iezadi S, Gholipour K, Sherbafi J, Behpaie S, Soltani N, Pasha M, Farahishahgoli J. Service quality: perspective of people with type 2 diabetes mellitus and hypertension in rural and urban public primary healthcare centers in Iran. BMC Health Serv Res 2024; 24:517. [PMID: 38658925 PMCID: PMC11044473 DOI: 10.1186/s12913-024-10854-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/12/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE This study aimed to assess the service quality (SQ) for Type 2 diabetes mellitus (T2DM) and hypertension in primary healthcare settings from the perspective of service users in Iran. METHODS The Cross-sectional study was conducted from January to March 2020 in urban and rural public health centers in the East Azerbaijan province of Iran. A total of 561 individuals aged 18 or above with either or both conditions of T2DM and hypertension were eligible to participate in the study. The study employed a two-step stratified sampling method in East Azerbaijan province, Iran. A validated questionnaire assessed SQ. Data were analyzed using One-way ANOVA and multiple linear regression statistical models in STATA-17. RESULTS Among the 561 individuals who participated in the study 176 (31.3%) were individuals with hypertension, 165 (29.4%) with T2DM, and 220 (39.2%) with both hypertension and T2DM mutually. The participants' anthropometric indicators and biochemical characteristics showed that the mean Fasting Blood Glucose (FBG) in individuals with T2DM was 174.4 (Standard deviation (SD) = 73.57) in patients with T2DM without hypertension and 159.4 (SD = 65.46) in patients with both T2DM and hypertension. The total SQ scores were 82.37 (SD = 12.19), 82.48 (SD = 12.45), and 81.69 (SD = 11.75) for hypertension, T2DM, and both conditions, respectively. Among people with hypertension and without diabetes, those who had specific service providers had higher SQ scores (b = 7.03; p = 0.001) compared to their peers who did not have specific service providers. Those who resided in rural areas had lower SQ scores (b = -6.07; p = 0.020) compared to their counterparts in urban areas. In the group of patients with T2DM and without hypertension, those who were living in non-metropolitan cities reported greater SQ scores compared to patients in metropolitan areas (b = 5.09; p = 0.038). Additionally, a one-point increase in self-management total score was related with a 0.13-point decrease in SQ score (P = 0.018). In the group of people with both hypertension and T2DM, those who had specific service providers had higher SQ scores (b = 8.32; p < 0.001) compared to the group without specific service providers. CONCLUSION Study reveals gaps in T2DM and hypertension care quality despite routine check-ups. Higher SQ correlates with better self-care. Improving service quality in primary healthcare settings necessitates a comprehensive approach that prioritizes patient empowerment, continuity of care, and equitable access to services, particularly for vulnerable populations in rural areas.
Collapse
Affiliation(s)
- Shabnam Iezadi
- Tabriz Health Services Management Research Center, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Gholipour
- Tabriz Health Services Management Research Center, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Jabraeil Sherbafi
- East Azerbaijan Provincial Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sama Behpaie
- Student Research Committee, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazli Soltani
- East Azerbaijan Provincial Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Pasha
- East Azerbaijan Provincial Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Farahishahgoli
- East Azerbaijan Provincial Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
4
|
Danaei Z, Madadizadeh F, Sheikhshoaei F, Dehdarirad H. Translation and cross-cultural adaptation of Persian version of Evidence Based Medicine Questionnaire (EBMQ) in postgraduate medical students in Iran. PLoS One 2024; 19:e0301831. [PMID: 38626040 PMCID: PMC11020528 DOI: 10.1371/journal.pone.0301831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/21/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Evidence Based Medicine Questionnaire (EBMQ) was developed to assess the knowledge, practice and barriers towards the implementation of Evidence-Based Medicine (EBM). This study aimed to translate, cross-culturally adapt and psychometrically validate the Persian version of EBMQ. METHODS This was an analytical cross sectional study. The EBMQ underwent translation and cross-cultural adaptation following best practices. Face validity was assessed by a panel of five experts. The content validity index (CVI) and content validity ratio (CVR) were evaluated by 15 experts who were familiar with EBM. The tool's internal consistency and test-retest reliability over a 2-week period were evaluated using Cronbach's α and intra-class correlation (ICC), respectively. To assess construct validity, the questionnaire was completed by 400 medical students. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity assessment. All analyses were carried out using IBM SPSS v.24 and AMOS v.24. A significance level of 5% was considered. RESULTS The CVR for 40 items was higher than 0.62, and their CVI score was 1.0, indicating good content validity. The scale demonstrated acceptable internal consistency and test-retest reliability (n = 30) with an ICC of 0.909 (95% CI: 0.866 to 0.941), and an overall alpha coefficient of 0.957. The structural validity was established through exploratory factor analysis (Bartlett's test p<0.001; the Kaiser-Meyer-Olkin index = 0.862), and it was further confirmed by confirmatory factor analysis. A three-factor solution with 40 items, explaining 51.610% of the variance, exhibited the best fit indices Chi-square statistics/df = 4.23; RMSEA = 0.08; CFI = 0.95; NFI = 0.93; TLI = 0.92). CONCLUSION The Persian version of the EBMQ was a reliable and valid tool that could be utilized to assess the knowledge, practice and barriers of EBM for physicians in Persian language countries.
Collapse
Affiliation(s)
- Ziba Danaei
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzan Madadizadeh
- Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Sheikhshoaei
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Dehdarirad
- Department of Medical Library and Information Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Hassan N, Mohammad Ali Alomari A, Singh K, Kunjavara J, Joy GV, Mannethodi K, Al Lenjawi B. The nurses perceived educational values and experience of journal club activities - A cross-sectional study in Qatar. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:431. [PMID: 38464662 PMCID: PMC10920683 DOI: 10.4103/jehp.jehp_456_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/08/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Journal club (JC) is widely used as an educational method to support nurses in up-to-date clinical practices, acquire critical appraisal skills, and promote evidence-based nursing practice. Traditionally, JC activities were conducted as face-to-face sessions. However, after the emergence of the pandemic, many educational activities including JC turn to the online platform. This study aims to assess the perceived educational value of JC and the experience of virtual journal club (VJC) among nurses. MATERIALS AND METHODS A cross-sectional research design was used to gather the information from the nurses using the Nursing journal club perception scale. A purposive sampling method was used to enroll 450 participants from the JC attendees of various facilities between May andAugust 2022. The data were analyzed using the Mann-Whitney U test and the Kruskal-Wallis test. RESULTS The data from 450 participants were analyzed with a response rate of 40.1%. The majority of the participants were females (82.4%) and belonged to the 35-44 years' age group (39.6%). Mostly, the subjects were registered nurses or midwives (78%) and had more than 5 years of clinical experience (45.8%). The mean perceived educational value of JC and VJC was 62.9 ± 8.3 and 56.3 ± 8.9, respectively. The nurse educators are holding higher educational value of JC as compared to other participants including clinical nurses, charge nurses, head nurses, and director of nurses (P = 0.03). Additionally, 90% of participants strongly agreed that the nursing journal club helps them to disseminate and reinforce evidence-based practice, update their clinical knowledge, and was very informative. Furthermore, 80% of participants agreed that educational standards, social networking, and time allocation of the VJC are enhancing the chance of attending more sessions. CONCLUSION The JC has a vital role in preparing nurses for promoting research culture and practicing evidence-based nursing care. The national health strategies are focused on improving research capabilities and enhancing research within the national context. The implementation of evidence-based practice in healthcare involves enhancing formal research opportunities, promoting continuing education in research, developing skills in addressing research gaps, and enhancing research-oriented cultures in healthcare facilities. The nursing leadership can play a key role to support the initiatives to develop and conduct nursing JC in their facilities to improve the nurse's research skills and evidence-based nursing practice.
Collapse
Affiliation(s)
- Nesiya Hassan
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Jibin Kunjavara
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - George V. Joy
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Badriya Al Lenjawi
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
6
|
Khoddam H, Modanloo M, Mehrdad N, Heydari F, Talebi R. Nurses' experience of integrating evidence-based changes into their practice: A qualitative study. Nurs Open 2023; 10:6465-6478. [PMID: 37322829 PMCID: PMC10416062 DOI: 10.1002/nop2.1898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023] Open
Abstract
AIM To explore the experiences of neonatal and NICU nurses on participating in evidence-based changes in their neonatal pain management practice. DESIGN It is a qualitative conventional content analysis. METHODS A purposive sample with nurses working in neonatal and NICUs was used. The data were collected through 11 semi-structured in-depth individual interviews, five focused group discussions, and observations and analyzed using the conventional content analysis method based on the Elo and Kyngäs model. The COREQ checklist was used for writing the report. RESULTS Analysis of gathered data led to the emergence of four themes, including 'being in a supportive and encouraging atmosphere', 'a journey from resistance to adherence', 'achieving multi-dimensional improvements', and 'facing obstructive challenges'.
Collapse
Affiliation(s)
- Homeira Khoddam
- School of Nursing and Midwifery, Nursing Research CenterGolestan University of Medical SciencesGorganIran
| | - Mahnaz Modanloo
- School of Nursing and Midwifery, Nursing Research CenterGolestan University of Medical SciencesGorganIran
| | - Neda Mehrdad
- Endocrinology and Metabolism Research CenterClinical Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical SciencesTehranIran
| | - Fatemeh Heydari
- Children and Neonatal Health Research CenterGolestan University of Medical SciencesGorganIran
| | - Razieh Talebi
- School of Nursing and Midwifery, Nursing Research CenterGolestan University of Medical SciencesGorganIran
| |
Collapse
|
7
|
Mohammadpour M, Delavari S, Kavosi Z, Peyravi M, Izadi R, Bastani P. The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system. Front Public Health 2023; 11:1041123. [PMID: 36761138 PMCID: PMC9902771 DOI: 10.3389/fpubh.2023.1041123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
Background COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era. Method This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software. Result Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects." Conclusion To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.
Collapse
Affiliation(s)
- Mohammadtaghi Mohammadpour
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmoudreza Peyravi
- Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reyhane Izadi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
8
|
Alabdullah MN, Alabdullah H, Kamel S. Knowledge, attitude, and practice of evidence-based medicine among resident physicians in hospitals of Syria: a cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:785. [PMID: 36376824 PMCID: PMC9661745 DOI: 10.1186/s12909-022-03840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is to integrate the best research evidence with our clinical expertise, circumstances, and unique values of our patient. However, there are no studies about using EBM in clinical practice among resident doctors in Syria. In this study, we aimed to evaluate the self-reported knowledge, attitude and practice (KAP) of EBM by resident doctors throughout different teaching hospitals in Syria. METHODS The study is a cross-sectional. A self-reported online questionnaire was used to collect data about KAP of EBM from 214 resident physicians working in secondary and tertiary teaching hospitals. The study was conducted between September 2021 and February 2022. All data were analyzed using SPSS, and non-parametric statistical tests were used to identify the correlation between different variables and make the necessary comparisons. RESULTS Two hundred and fourteen physicians responded to the questionnaire with a response rate of 85.6%. The overall mean scores of KAP of EBM were 59.2, 74.3 and 53.9%, respectively. The participants displayed a low level of awareness of resources and statistical terms used in EBM. The most well-known resources for residents were Up To Date and PubMed. Among the participants, pediatric residents achieved the highest score in practicing EBM, while family medicine residents scored the lowest score. CONCLUSION The overall impression about the KAP of EBM among Syrian residents was as following: weak awareness, neutral attitude and poor practice of EBM. Training workshops should be set up to teach residents the skills needed to move from opinion-based practice to evidence-based practice.
Collapse
Affiliation(s)
- Muhammad Nour Alabdullah
- Otorhinolaryngology Department, Al-Mowassat University Hospital, Damascus University, Damascus, Syrian Arab Republic
| | - Hadi Alabdullah
- Faculty of Medicine, Hama University, Hama, Syrian Arab Republic
| | - Sondos Kamel
- Faculty of Civil Engineering, Hama University, Hama, Syrian Arab Republic
| |
Collapse
|
9
|
Rezapour R, Khosravi A, Farahbakhsh M, Ahmadnezhad E, Azami-Aghdash S, Tabrizi JS. Developing Iranian sub-national Primary Health Care Measurement Framework: a study protocol. Prim Health Care Res Dev 2022; 23:e62. [PMID: 36217764 PMCID: PMC9641646 DOI: 10.1017/s1463423622000469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 07/05/2022] [Accepted: 08/13/2022] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Developing an effective system for measurement and improvement of primary health care (PHC) based on the conditions and characteristics of the countries' health systems is one of the World Health Organization (WHO) recommendations. AIMS This study will aim to develop a framework to assess the Iranian sub-national PHC system performance using the WHO measurement framework for PHC. METHODS/DESIGNS This is a mix-method study with a triangulation design. The Iranian sub-national PHC Measurement Framework (PHCMF) will be developed through a review of the WHO's PHC measurement conceptual framework (for selecting key performance indicators (KPIs)), literature review (academic database), PHC-related national documents, consultations with national experts, and the Delphi technique for finalizing the framework. The required data for calculating selected KPIs is expected to encompass qualitative and quantitative data. Discussion: Iranian PHC system performance is not measured based on the holistic and scientific framework and international standards. The information obtained from this project will guide managers and policymakers to be aware of the current situation and the success rate of the PHC system in achieving the desired goals, as well as identify strengths and weaknesses of the PHC system and provide the solution to better policy formulation.
Collapse
Affiliation(s)
- Ramin Rezapour
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ardeshir Khosravi
- Center for Primary Health Care Management, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Ahmadnezhad
- National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Dawes N, Topp SM. A qualitative study of senior management perspectives on the leadership skills required in regional and rural Australian residential aged care facilities. BMC Health Serv Res 2022; 22:667. [PMID: 35585599 PMCID: PMC9115967 DOI: 10.1186/s12913-022-08049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With increasing recognition of the quality and safety issues in residential aged care, there is an urgent need to better understand what skills senior managers require to deliver on the spectrum of leadership functions in residential aged care facilities. This qualitative study sought to explore the leadership skills that positively influence the quality of care within Australian residential aged care facilities and better understand the professional development needs of senior managers to positively influence care within these complex environments. METHODS We conducted semi-structured interviews with 19 senior managers purposively recruited from 14 high-performing non-government residential aged care facilities of varying geographical remoteness in northern Queensland, Australia. Participants held a range of professional roles, including Chief Executive Officer, Director of Nursing and Facility Manager, and had various professional qualifications. We used inductive thematic analysis to identify and categorise senior managers' perspectives on the leadership skills and related strategies to promote quality of care. RESULTS Senior managers reported leadership skills in five major domains: i) communication and relationship management, ii) stewardship, iii) professional development, iv) health care knowledge and v) information technology and finance. Most participants highlighted communication and relationship management skills and responding to regulatory change as influential to residential aged care quality performance. Participants with different professional backgrounds often emphasised different skills. CONCLUSIONS Participants identified a broad range of skills and strategies required by senior managers in Australian residential aged care facilities. Identifying different skills by differently trained individuals suggests more work is needed to understand and develop sector-specific professional development approaches to better prepare individuals to lead in this complex service environment.
Collapse
Affiliation(s)
- Nathan Dawes
- Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, I Building 41 I Room 114, 1 James Cook Drive Townsville QLD, 4811, Douglas, Australia.
| | - Stephanie M Topp
- Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, I Building 41 I Room 114, 1 James Cook Drive Townsville QLD, 4811, Douglas, Australia
| |
Collapse
|
11
|
Shafaghat T, Zarchi MKR, Nasab MHI, Kavosi Z, Bahrami MA, Bastani P. Force field analysis of driving and restraining factors affecting the evidence-based decision-making in health systems; comparing two approaches. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:419. [PMID: 35071625 PMCID: PMC8719555 DOI: 10.4103/jehp.jehp_1142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND All policies and decisions need evidence examined by scientific methods. Moving toward evidence-based decision-making (EBDM) as a change in organizations, especially health systems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSs from two approaches and to score them. MATERIALS AND METHODS A mixed-method study was carried out using the force field analysis regarding the change toward EBDM in HS in 2020. This study included six steps to identify and score the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM in HS: first, finding forces from literature; second, selecting key DFs and RFs through focus group discussion; third, scoring the first group of DFs and RFs by the experts through electronic forms; fourth, determining key DFs and RFs from the managers' perspective using qualitative interviews; fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forces resulted from two approaches. RESULTS According to the literature and experts' opinions, "relevant, reliable, interpretable, and understandable evidence" and "interaction between researchers and decision-makers" were the strongest forces to change, and "lack of organizational commitment and support" and "lack of relevant/high-quality evidence" were the strongest forces against the change toward EBDM in HS. Further, based on managers' perspective and scores by the experts, "suitable supervision and control" and "reforming the planning and decision-making system" were the strongest forces to change, and "inadequate knowledge of the managers and staff about the principles and contents of EBDM" and "issues beyond the authorities of managers" were the strongest forces against the change toward EBDM in HS. CONCLUSIONS Based on the findings, HSs' managers can focus to reduce RFs and promote DFs for implementing EBDM strategies, so they can provide better services by making more efficient decisions.
Collapse
Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Department of Health Care Management, Health Policy and Management Research Center, School of Public Health, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Kavosi
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahammad Amin Bahrami
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
12
|
Goodarzi H, Teymourzadeh E, Rahimi S, Nasiri T. Efficacy of active and passive evidence-based practice training for postgraduate medical residents: a non-randomized controlled trial. BMC Res Notes 2021; 14:317. [PMID: 34412699 PMCID: PMC8374403 DOI: 10.1186/s13104-021-05732-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
Objective This study examined the effects of two evidence-based practice (EBP) educational programs for postgraduate medical residents on their attitude, behavior, knowledge, outcome, and competencies in EBP. Results Forty-five and thirty-five medical residents were recruited in the active and passive educational intervention groups, respectively. Among those, 39 and 30 participants were included in the final analysis. The participants of the active group received 12 h of EBP-structured presentation. The passive educational group received EBP education through their daily rounds, evidence-based journal clubs, and morning reports. Participants were evaluated with EBP-KABQ and ACE tools questionnaires. The active and passive intervention groups were not significantly different from each other at the baseline in the EBP-KABQ questionnaire and ACE tools score (p > 0.05). However, most questions in the EBP-KABQ questionnaire were significantly different from the pre-intervention measurement and the passive intervention group after the educational intervention. Educational intervention in both groups led to a significant difference in ACE tools score between groups (8.86 ± 2.62 vs. 7.31 ± 2.92, p = 0.029, in the active and passive groups, respectively). Paired t-test analysis revealed that our intervention led to a significant increase in ACE tool scores in both groups (p < 0.000, in both groups). Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05732-3.
Collapse
Affiliation(s)
- Hassan Goodarzi
- Emergency Department, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ehsan Teymourzadeh
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Siyavash Rahimi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Taha Nasiri
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. .,Department of Health Services Management, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| |
Collapse
|