Journal of Health Research in Community

11-22

Authors: Ayat Rahmani; Taleb Askaripoor; Hamed Aghaei; Mohammad Ebrahim Ghaffari; Mahdi Mohammadian Mastanabad; Mohammad Ali Jalilvand; Hasan Irvani; Elahe Kazemi;Amir Abedin Darkoush

Introduction and purpose: Students’ perceptions of the learning environment play a vital role in the process of education, buoyancy, and academic performance. This study aimed to investigate the capability of explaining the academic buoyancy and academic performance of health students of Semnan University of Medical Sciences, Semnan, Iran, based on their perception of learning environment. Methods: The statistical population of this descriptive-correlational study consisted of all health students who were studying at Semnan University of Medical Sciences, Semnan, Iran, in the academic year 2018-19. A total number of 138 students were selected through systematic random sampling. The data were collected using a Dundee Ready Educational Environment Measure (DREEM), academic buoyancy questionnaires, and grade point average. Moreover, simple and multiple regressions were used for data analysis. Results: The results showed that 16.1% (R=0.408, R2=0.167, Adjusted R2=0.161, F=27.212, P<0.01) of the variance of academic buoyancy can be explained by the overall score of students’ perception of the learning environment. Furthermore, according to the regression coefficients, the subscale of students’ perception of educational climate had a significant role in explaining academic buoyancy. According to the findings of the study, 13.3% (R=0.373, R2=0.139, Adjusted R2=0.133, F=21.971, P<0.01) of the variance in academic performance could be explained by the overall score of students’ perception of the learning environment. In addition, the subscales of students’ perceptions of learning and social conditions of education had a significant role in explaining academic performance. Conclusion: Given the positive role of perception of the learning environment in explaining academic buoyancy and academic performance based on the study findings, it is very important to conduct comprehensive assessments, identify strengths and weaknesses, and perform educational interventions to enhance students’ perception of the learning environment.

33-44

Authors: Maryam Haghighi;Ehteramsadat Ilali; Jamshid Yazdani; Zohreh Taraghi

Introduction and purpose: Poor medication adherence may result in adverse outcomes, such as a higher rate of hospitalization and increased costs of healthcare. In this regard, the present study was designed to determine the relationship between cognitive status and medication adherence among elderly patients with hypertension. Methods: In this cross-sectional study, 180 elderly patients with hypertension were selected from Imam Reza Hospital in Amol, Iran, (2018) using convenience sampling. Cognitive impairment and medication adherence were assessed using the Cognitive State Test and Morisky Medication Adherence Scale, respectively. The data were analyzed by SPSS software (version 16) using the independent t-test, Chi-square test, and logistic regression. Results: Out of 180 participants, 66.1% (n=119) of them were female. The mean age of the patients was 72.877.63± years. The mean values of medication adherence and cognition score were reported as 5.212.29± and 26.033.21±, respectively. There was no significant relationship between medication adherence and total cognition score (P=0.322). Medication adherence was two times higher among those who were reported with no anxiety, compared to those who suffered from anxiety (β=-0.67; odds=0.51; P=0.008). The obtained results also showed medication adherence increased twelve times with one unit increase of verbal fluency. Moreover, medication adherence enhanced eight times with one unit increase of abstract thinking and judgment. Conclusion: The subdomains of cognition, such as verbal fluency, as well as abstract thinking and judgment, had a significant relationship with medication adherence in elderly patients with hypertension. In this regard, it is suggested to assess cognitive status among elderly patients with hypertension and design appropriate interventions.

57-67

Authors: Hamid Jani Darmian; Tayebeh Khazaei;GholamhoseinYaghoubi;Gholamreza Sharifzadeh; Ayoub Akbari

Introduction and purpose: Diabetic retinopathy is the most common cause of blindness in adult diabetic patients. Therefore, it is necessary to provide patients with appropriate training programs, such as multimedia education as a new and effective method to enhance their understanding of self-care. This study aimed to evaluate the effect of multimedia education on disease perception and eye care performance in type 2 diabetic patients referring to Birjand Diabetes Clinic in 2019. Methods: This controlled clinical trial included 70 patients who were divided into two groups according to the inclusion criteria.The intervention group received 4 multimedia educational sessions (one session per week). The relevant parameters were measured before and after the intervention . Moreover, the data were analyzed in SPSS software (vesrion18). Results: The results of this study showed a significant difference before and after the intervention in the case group in terms of the mean score of eye care performance (P=0.005). Moreover, a significant difference was observed before and after the study regarding the mean diastolic pressure in the case group (P=0.05). However, there was no significant difference between the two groups before and after the intervention in terms of the mean score of perception of disease (P=0.35), blood glucose changes (P=0.13), hemoglobin A1c (P=0.86), and systolic blood pressure (P=0.89). Conclusion: In this study, the implementation of multimedia method improved the performance of eye care in diabetic patients. Therefore, it is recommended to use this educational method to improve self-care in type 2 diabetic patients.

82-98

Authors: Jamshid Bahmaei; Peivand Bastani; Ali Keshtkaran;Mohammadtaghi Mohammadpour; Yaser Sarikhani

Introduction and purpose: Accreditation is a method used for the improvement of the quality of hospital services. It refers to the systematic evaluation of the health centers based on specific standards. The present study aimed to critically review the implementation of accreditation standards in hospitals. Methods: This critical review investigated all the articles that were published during 1993-2019. In order to find the sources, the authors referred to various databases, namely ISC, DOAJ, PubMed, ProQuest, Embase, Science Direct, Scopus, and Web of Science. The keywords used for the search included Mesh terms and common keywords related to the subject of the study, including challenges, barriers, hospital management, accreditation, hospital, or accreditation hospital. Finally, the full texts of 16 articles were reviewed for the purposes of the study. Results: According to the results, various issues, such as the accreditation organization independence, staff and physician participation, number, structure, and content of standards, structural and contextual problems, importance of human resources, financial and capital resources, organizational and management issues, other plans, role of evaluators and their evaluation methods, role of stakeholders, and impact of accreditation on the patients and teaching atmosphere of the hospital were executive challenges of hospital accreditation. Conclusion: In order to increase the impact of accredition and significantly address its challenges, there should be emphasis on performance indicators, preparation by training and raising awareness of the personnel, budget allocation, and development of plans on accreditation