Knowledge, attitude, and practice of Iranian adults toward Persian Medicine: a national survey

BACKGROUND

Previous researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time.

METHODS

A total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants' residences.

RESULTS

Approximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded "I don't know" to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime.

CONCLUSION

This study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice).

Epidemiology of mental health disorders in the citizens of Tehran: a report from Tehran Cohort Study

BACKGROUND

Mental health disorders (MHD) impose a considerable burden on public health systems. With an increasing worldwide trend in urbanization, urban mental health stressors are affecting a larger population. In this study, we evaluated the epidemiology of mental health disorders in the citizens of Tehran using the Tehran Cohort Study (TeCS) data.

METHODS

We utilized data from the TeCS recruitment phase. A total of 10,247 permanent residents of Tehran metropolitan (aged 15 years and older) were enrolled in the study from March 2016 to 2019 via systematic random sampling from all 22 districts of Tehran. The participant's demographic, socioeconomic, and medical characteristics were evaluated by conducting comprehensive interviews. The standardized Persian version of the General Health Questionnaire version 28 was utilized to assess the mental status of the patients according to four central mental health disorders.

RESULTS

Almost 37.1% of Tehran residents suffered mental health problems (45.0% of women and 28.0% of men). The greatest incidence of MHDs was seen in the 25-34 and over 75 age groups. The most common mental health disorders were depression (43%) and anxiety (40%), followed by somatization (30%) and social dysfunction (8.1%). Mental health disorders were more frequent in the southeast regions of the city.

CONCLUSIONS

Tehran residents have a significantly higher rate of mental health disorders compared to nationwide studies, with an estimated 2.7 million citizens requiring mental health care services. Awareness of mental health disorders and identifying vulnerable groups are crucial in developing mental health care programs by public health authorities.

Comparing the Diagnostic Value of Four Dementia Tests in the Amnestic and Healthy Elderly

Introduction

This study aimed to compare the diagnostic value of four questionnaires for the diagnosis of neurocognitive disorders (NCDs) in the elderly.

Methods

In this project, people older than 60 years who lived in Tehran were investigated. A total of 99 literate cases were enrolled in the study, and four questionnaires, including functional assessment staging tool (FAST), abbreviated mental test score (AMTS), mini-mental state examination (MMSE), and modified Persian test of elderly for assessment of cognition and executive function (PEACE) were completed for them. They were then referred to a neuropsychiatrist, and the status of their cognition and neurobehavior was determined. The specialists were blinded to the results of the tests.

Results

Of the 99 participants studied, 39 cases were healthy, eight cases had mild Alzheimer's disease, 38 had amnesic MCI, five cases had secondary dementia, and nine cases had mixed vascular dementia and Alzheimer's disease. The area under the ROC curve for distinguishing the healthy group from the rest of the population was 0.692, 0.629, 0.734, and 0.751 for the FAST, AMTS, MMSE, and NBCSS questionnaires, respectively.

Conclusion

MMSE and NBCSS tests had better diagnostic power than the other two tests to distinguish the healthy group from the rest of the population.

The influence of shift work on the psychomotor capabilities of emergency medicine residents

OBJECTIVE

Shift work affects health status of healthcare providers and patients. We assessed the effect of shift work on psychomotor activities of emergency medicine residents of 3 university hospitals.

METHODS

The participants were enrolled to perform selected psychomotor tests via the Vienna test system (VTS) after written consent. They passed 4 episodes of test performance before and after 2 consecutive day and night clinical shifts of 12 hours. The status of general health, circadian rhythm, sleepiness, smoking habits, and the scores of the cognition test (COG), the determination test (DT), and the visual pursuit test of emergency medicine residents were compared before and after morning and night shifts.

RESULTS

Overall, 23 residents (34.8% were male) performed tests. The mean (SD) age was 35.7 + 8.5 years. The mean general health and circadian scores before and after day/night shifts were not different. The Stanford sleepiness scale showed higher scores after night shifts. In the cognition test, the sum of correct rejections was higher after day shifts. Moreover, in the DT results, correct responses were more prevalent, the omitted responses were fewer accompanied by better median reaction time after day shifts. The sum of correct rejections of the COG test showed difference in terms of improved results in night tests compared to day-shift tests. The mean reaction time of the DT showed significant difference with shorter reaction time in night-shift tests. The visual pursuit test results were not different between day and night shifts.

CONCLUSIONS

Sleepiness was higher after night shifts. The results of selected psychomotor tests showed that the psychomotor function of the residents was not delayed or worse after night shifts in comparison to the day shifts.

A province-based surveillance system for the risk factors of non-communicable diseases: A prototype for integration of risk factor surveillance into primary healthcare systems of developing countries

OBJECTIVES

To establish a surveillance system for risk factors of non-communicable diseases, develop a valid tool and methodology for surveillance surveys, and build capacity in 41 provincial surveillance sites to design and conduct the surveys and provide provincially interpretable baseline data.

STUDY DESIGN

Population-based national study.

METHODS

The World Health Organization's STEPwise approach to non-communicable disease surveillance was adapted to design a national risk factor surveillance model. The first national population-based and cross-sectional study was conducted in 2005 in 41 universities of medical sciences in all 30 provinces of Iran. This involved multi-stage cluster sampling from 25-64 year-old Iranians and non-institutionalized populations. A national technical unit at the Ministry of Health and Medical Education supervised all study processes including data management and analysis.

RESULTS

From the national results, the survey estimated that the prevalence of daily current smoking was 17.9%. Of the target population, 5% consumed at least five combined servings of fruit and vegetables per day. The median daily time spent undertaking transport-related physical activity (43.8 min) was significantly higher than the median time spent on work-related physical activity (27.5 min) or recreational physical activity (28.6 min). Overall, 54.7% of the target population were overweight or obese, and waist circumference was greater among women than men. The prevalence of hypertension was 23.8%, with a higher prevalence among women than men. In addition, 6% of the target population had a high fasting blood glucose (> or =126 mg/dl), and 45.1% had a total cholesterol level of at least 200 mg/dl.

CONCLUSION

Integration of province-based surveillance activities into the Iranian primary healthcare system is feasible. Provincial reports could provide a baseline picture of the most important risk factors for non-communicable diseases. There are several important risks with a prominent burden that may cause a progressive epidemic of major non-communicable diseases in the future in the absence of quality interventions.

Obesity and associated lifestyle behaviours in Iran: findings from the First National Non-communicable Disease Risk Factor Surveillance Survey

OBJECTIVE

To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran.

DESIGN AND SETTINGS

This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to non-communicable diseases' risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires.

SUBJECTS

The study population comprised 89,532 subjects aged over 15 years living in the 28 provinces of Iran.

RESULTS

Overall, 50.4% (n = 45,113) of the participants were male and 64.6% (n = 57 866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) > or = 25 kg m-2 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45-64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI.

CONCLUSIONS

The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.

Applying a modified Prochaska's model of readiness to change for general practitioners on depressive disorders in CME programmes: validation of tool

OBJECTIVE

To assess the validity and reliability of an 11-item questionnaire for stages of readiness to change according to a modified Prochaska model (including attitude, intention and action stage) in the context of continuing medical education (CME) on depressive disorders for general practitioners (GPs) in Tehran, Iran.

METHODS

Three hundred and fifty GPs were recruited for filling in a questionnaire in order to assess content validity and modifying the questionnaire. Fifty-nine GPs were involved for testing reliability and 39 GPs for testing concurrent validity. Content validity of the questionnaire was assessed by expert consensus. Concurrent validity was assessed by correlating the results of a semi-structured interview with those of the self-assessment questionnaire. For testing reliability there was a test-retest approach with an interval of 3-7 days.

RESULTS

A panel of experts was held at four times and the final version of modified Prochaska questionnaire (MPQ) was compiled by the panel. Total kappa coefficient for concurrent validity of the whole questionnaire was 0.80. Only two of the questions had a kappa coefficient lower than 0.70. In the test-retest, 96% of participants reassigned to the same stage and the total kappa coefficient of reliability was 0.89 for the whole questionnaire.

CONCLUSION

The validity and reliability of the MPQ for assessing GPs' readiness to change in the field of depressive disorders were found to be high in the Iranian context. These findings support its application in tailoring and evaluating CME programmes for GPs in Iran.