bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trust in healthcare: methodological and conceptual insights from mixed-method research in Lao People’s Democratic Republic
Authors: Haenssgen Marco J , Elliott Elizabeth M , Phommachanh Sysavanh , Phomkong Sylivanh , Kounnavong Sengchanh , Kubota Shogo 
Published: May 2024

BackgroundGlobal health foregrounds trust as a key requirement for the achievement of international health initiatives, but it remains an elusive concept that is often mobilised without consideration of its dimensions, drivers and downstream behavioural consequences. This paper aims to contribute to the conceptual development and measurement of ‘patient trust in primary healthcare’ from the lower middle-income country perspective of rural Lao PDR.MethodsA two-phase mixed-method research design was implemented between January 2021 and April 2023. Phase 1 involved exploratory qualitative research to understand the local expressions and dimensions of patient trust in primary healthcare, with 25 semistructured interviews and 17 focus group discussions (120 participants) in eight villages in Bokeo Province. Phase 2 involved explanatory research to assess patterns of trust systematically at scale in 14 villages across four provinces, wherein 26 cognitive interviews, 17 expert interviews and non-participant community observations informed a community census survey with 1838 participants. We analysed qualitative data through content-oriented thematic analysis and developed an 8-item trust scale on that basis. Quantitative data analysis used descriptive statistical and regression analysis.ResultsWe found that trust in primary healthcare is readily understood and intrinsically valuable in rural Lao PDR. Key dimensions included communication, respectful care, relationship, fairness, integrity, reputation, assurance of treatment and competence. The survey highlighted that reputation, competence, integrity and respectful care had the lowest trust scores. Health centre operations predicted the local expressions of trust. The behavioural consequences of trust were limited to a positive statistical association with antenatal care uptake among pregnant women but outweighed by alternative measures that also captured the availability of healthcare facilities.ConclusionsOverall, the development of our quantitative trust scale offers a process model for future researchers. We conclude that interpersonal, institutional and service-related trust require more explicit recognition in health system development and integration into health policy.
126: THE EFFECT OF ESTABLISHING RAPID RESPONSE NURSING TEAM IN OUTCOME OF PATIENTS CARE IN EMERGENCY WARD
Authors: Yeke-Fallah Leili , Eskandari Zahra , Shahrokhi Akram , Javadi Amir 
Published: May 2024

Background and aims:Rapid response nursing team evaluates the patients in the early stages of clinical exacerbation and prevents unexpected cardiopulmonary arrest. The present study aimed to determine the effect of rapid response nursing team in outcome of patients care in the emergency ward.Methods:This clinical trial was conducted on 714 patients in the emergency ward in selected hospitals affiliated to Alborz University of Medical Sciences in 2013. The patients were randomly divided into a control and an intervention group. Rapid response nursing team comprised an intensive care nurse and an anesthesia technician who were in the emergency on a 24/7 basis. If the patient's clinical conditions exacerbated, they immediately attended him, evaluated his clinical condition precisely, and took necessary nursing measures for the patients in the case group, but those in the control group received the conventional treatment in the emergency ward. Patients' conditions and the measures taken for them were precisely recorded for both groups and the data were analyzed in SPSS 16.Results:The results of the study showed that there is a significant relationship between establishing rapid response nursing team and outcome of patient care (p=0.028), reduced transfer to special care units (p=0.014) and reduced level of care in the first 24 hours of admission (p=0.001).Conclusion:Given the results, rapid response nursing team was effective in preventing unexpected cardiovascular arrests, increased successful cardiopulmonary resuscitation, and reduced transfer of patients to special care units and higher levels of care.
132: THE EFFECT OF TRAINING INTERVENTION ON STUDENTS' EVIDENCE-BASED MEDICINE LITERATURE SEARCHING SKILLS, IN TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Authors: Abdekhoda Mohammadhiwa , Salehi Narges , Dehnad Afsaneh 
Published: May 2024

Background and aims:Evidence-Based Medicine (EBM) is an important issue requiring skills in locating, evaluating and applying the best evidence in a clinical setting. This study evaluated the effect of training intervention on students' skills in EBM literature Search.Methods:This was a cross sectional study in which 90 post graduate students in Tabriz University of Medical Sciences were selected randomly. Participants take part in 12 Sessions, in which EBM literature search skills were presented by highly qualified Teachers (HQT). Pre- and post-questionnaires and skills tests were developed to measure student' skills concerning EBM literature search. Data were then analyzed by SPSS using T-Test.Results:Statistically, significant improvement in students' ability in designing search strategies and formulating a clinical question based on PICO were found. Also, students' familiarity with EBM resources and databases significantly improved. The data showed a statistically significant increase in students' competency score concerning finding the best clinical evidence and critical appraisal of articles, after intervention versus took place.Conclusion:The findings of this study suggest that intervention is an effective method for developing search skills when finding and applying EBM literature is considered. This should be considered in curriculums by educational managers and policy makers.
136: THE ESTABLISHMENT AND CONTINUITY OF HAEMOVIGILANCE SYSTEM ACCORDING TO STAFF TRAINING IN THE USE OF BLOOD AND COMPONENTS IN ALZAHRA HOSPITAL IN TABRIZ IN 2013
Authors: Bahramzadeh Behzad , Shams Masoumeh Samadi 
Published: May 2024

Background and aims:Haemovigilance is defined as the surveillance of adverse reactions occurring in donors and in recipients of blood components. A surveillance system for transfusion-related adverse reactions was started in 2010 in Iran. From 863 hospitals in Iran, 542 center runs (63 percent).The ultimate purpose of haemovigilance is to prevent the repetition of adverse events and reactions.Methods:According to national haemovigilance guideline, the training course for the target group was held. First, pretest from the target group was taken and after theoretical and practical training, posttest was taken. After the Six months of training, test was performed again and using statistical methods, the test results were analyzed.Results:From all of the target groups, the educational haemovigilance system was implemented to 75 percent and the average of pre-test in nine different sections was 15.2 and after training, the mean was 18.96 which represent an increase 18.8 percent in training course. The results show that the haemovigilance system is effective in hospitals.Conclusion:Haemovigilance is an effective tool for identifying adverse effects of blood components. Increased knowledge of haemovigilance among physicians and nurses can lead to improved transfusion safety. Efforts to identify and eliminate the complications associated with blood transfusions and improve them, to reduce the death rate, infection and reduce the amount of disability, health promotion and ultimately the patients' satisfaction enhancement. The most important factor in the success of haemovigilance system is cooperation and coordination between hospitals and blood centers.
137: THE EVALUATION OF A DRUG USE PREVENTION PROGRAM AMONG ADOLESCENCES BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS PROGRAM (MAPP) – ISFAHAN: 1392
Authors: Dastgerdi Zohreh Fathian , Eslami Ahmadali 
Published: May 2024

The propagation of teen drug use cessation programs internationally are increased in recent decade. Use of evidence-based teen drug use prevention program might help more decrease the prevalence of drug use among teens. Mobilizing for Action through Planning and Partnerships (MAPP) is a community-wide strategic planning tool Facilitated by public health leadership to help communities prioritize public health issues and identify resources for addressing them. In 2007–2010, twelves departments received grant awards to implement their intervention strategies according to Mapp approaches in prevention of substance use.Method:A semi experimental study was conducted in 6 phases according to planning model MAPP in 720 adolescents from 14 to 18 years old in Isfahan. The cognitive–behavioral program including knowledge, self-efficacy, social skills, outcome expectancies and perceived social support was planned by speech, discussion, Visit the exhibition, role playing, parent education methods in 4 month.Results:The results of intervention showed significant differences between control and intervention group in knowledge, outcome expectancies, social skills and self- efficacy but did not significantly increase in perceived social support toward substance use.Conclusion:The final results showed that educational interventions with MAPP approach had an expected effect to increase skills related to substance use behavior in adolescents and could be used as a planning model in drug use prevention programs.
14: ANIMAL BITE EPIDEMIOLOGY AND SURVEILLANCE FOR RABIES POST EXPOSURE PROPHYLAXIS, IRAN
Authors: kasseri Hamid , Lotfi Masoud , Shahkarami Babak 
Published: May 2024

Background and aims:Animal bites are a significant threat to human health because of fatality of subsequent infections such as rabies. The aim of this study was to determine the epidemiology of animal bites during a five-year period in Shush County.Methods:In a descriptive cross sectional study, all cases of animal bites referred to the health centers in Shush County were investigated during 2004–2008. The necessary data were recorded on the special questionnaire that contains questions about bite animal, age, sex, occupation, treatment, the bite site on the body and so forth.Results:Out of a total of 2283 cases, 1771 people (77.6%) were male. Most cases were related to age groups 10–20 (33.4%). The average incidence rate of animal bite during these years was determined as 2.82 cases per 1000 people. Almost 86.5% and 13.5% of the cases occurred in rural areas and urban areas, respectively. Nearly 30% and 20.4% of cases were students and farmers, respectively. A total of 2155 (94.4%) and 86 (3.8%) bites occurred by the dog and cat, respectively. The greatest bite place on the body was in the feet (81.4%). During the study period, 2162 cases (94.7%) were treated with an incomplete regimen, and 120 cases (5.3%) were treated with a complete regimen.Conclusion:Because the cost of prevention after biting for the health system is high, so, preventive programs must be concentrated on public health instruction, particularly in villagers, students, farmers and the owners of the domestic animals.
140: THE IMPACT OF E-LEARNING ON ASPECTS OF HEALTH-PROMOTING LIFESTYLE NURSES
Authors: Darkhor Shokofe , Estebsari Fatemeh , Charati Jamshid Yazdani 
Published: May 2024

Background and aims:One of the most important measures of health promoting behaviors as determinants of health are the underlying cause of many diseases, not having known and Health promotion and disease prevention are related directly to these behaviors . Six important part of promoting healthy lifestyles, including relationships between individual responsibility for health, spiritual development, stress management, nutrition and physical activity Aim of this study is the effect of empowerment on nurses' health-promoting lifestyle.Methods:This is a quasi-experimental study with pre-test and post-test. 100 nurses sampling and divided into intervention and control groups randomly. Nurses are randomly selected. Educational content prepared based on pre-test results and Training was conducted via text message and creates a channel in the telegram as a healthy lifestyle for two weeks for the intervention group. Data were collected by demographic and health-promoting lifestyle questionnaire, knowledge, attitudes, self-efficacy, self-esteem and self-control takes place. The tests were analyzed after 6 weeks.Results:The e-learning intervention had the effect of significantly increasing nurses' post intervention Health-Promoting Lifestyle Profile total scores. No significant changes were observed in the post intervention scores of the control group subjects.Conclusion:Tailored e-learning is an effective and accessible intervention for enhancing health-promoting behavior among nurses.
149: TRAINING EFFECTIVE SEARCH SKILLS IN EVIDENCE-BASED MEDICINE IN THE CLINIC IN BUSHEHR`S PERSIAN GULF MARTYRS HOSPITAL IN 2016: A DESCRIPTIVE STUDY
Authors: zareivenovel Mojgan , khosravi Abdolrasoul 
Published: May 2024

Background and aims:Effective information search and access to the right information at the right time, has become one of the ideals medical purposes for physicians. If for any reason physicians do not get an immediate response and appropriate to their clinical questions, a big problem and serious fault in various processes including diagnosis and treatment in health care happen. Medical librarian or Information professionals are expert in the acquisition, integration, and implementation of updated and reliable information and can help to solve this problem. Thus, the present study investigates a fundamental solution in this context to solve the problem by using and enjoyment of the medical librarian in teaching expertise.Methods:This was a descriptive study. Training how to do effective search to access information in the frame of workshop to fourth-year medical students in the Persian Gulf hospitals set a timetable (one month), 8 sessions and per section took an hour and a half meeting held. In order to assess the training, the students were taken pre-test and post-test. The sample size of 57which included the entering medical students of 2013 who had recently entered to clinical stage of treatment. Students randomly assigned to the Intervention group included 29 and control group 28. Information gathered through the Self-administered questionnaire and its validity and reliability have been highlighted by 10 professors of library and information field. Data analysis was performed using statistical software SPSS16.Results:The results were determined by using chi-square test shown the student satisfaction after attending a workshop and 90 percent of the physician evaluated medical librarians useful to provide updated information on evidence-based medicine.Conclusion:Training students who have recently entered to the clinical stage, for doing effective search on evidence-based medical information in order to meet the needs of the medical community and reduce medical errors that occur in clinical practice, is necessary.
157: ASSESSING THE METHODOLOGICAL QUALITY OF DECISION SUPPORT SYSTEM (DSS) SYSTEMATIC REVIEWS BY AMSTAR CHECKLIST
Authors: Sadeghi-Ghyassi Fatemeh , Fathifar Zahra , Hasankandi Hossein Saeedi 
Published: May 2024

Background and aims:It is all accepted that high-quality evidence is essential for clinical decision making. As Haynes “6S pyramid”, systems including decision support systems are at the top of this pyramid as the highest level of evidence. There are numerous systematic reviews which have assessed various aspects in this field. The aim of this study is evaluating the methodological quality of decision support system (DSS) systematic reviews.Methods:A comprehensive literature search using MEDLINE (via Ovid), Embase, PubMed and Cochrane Library was conducted until September August 2016. The search was limited to systematic reviews and with no language restriction. Meta- reviews were excluded. Only results of searching for “decision support systems” or “decision support system” keywords and limited to title of documents were included in this study. Two independent authors screened the results. Disagreement was resolved by discussion. The assessment of multiple systematic reviews (AMSTAR) checklist was used to assess methodological quality of selected studies. Data were extracted into Excel 2013.Results:A total of 47 systematic reviews (SRs) were enrolled which only 7 of them had meta-analysis. About 25.5% of studies were published in specialized publications. There was a dramatic increase in the number of SRs in recent decade and near to 66% of studies were published from 2011. The mean AMSTAR score of SRs was 6.78 (out of 9) and 9.71 (out of 11) for SRs with meta-analysis. Meanwhile 52.5% of SRs received a score between 7 and 8 while 70% of them scored more than 7. Near 83% of studies performed a reasonable comprehensive literature search, presented characteristics of the included studies and also stated conflict of interest. It was remarkable that 76.6% of studies had not a list of excluded studies. In more than 95% of SRs the scientific quality of the included studies was mentioned in conclusions.Conclusion:It seems that the quality of reporting in the field of DSS is acceptable. But although the score of literature search was good, lack of full presentation of search strategies was observed. Few meta-analyses in the included studies was notable and most of SRs stated heterogeneity as the reason. It seems that because of the overall view in AMSTAR scoring methods and its questions, it is hard to determine the specific bias and failures in the quality assessment of systematic reviews.
169: DEVELOPMENT OF A SCALE FOR MEASURING EVIDENCE-SEARCHING CAPABILITY: A MODIFIED DELPHI STUDY
Authors: Chi Ching-Chi , Tsai Yu-Shiun , Fang Tien-Pei 
Published: May 2024

Background and aims:The ability to acquire the best evidence efficiently is important for busy healthcare professionals who have to make decision within a limited time. However, the current available assessment tools in evidence-based medicine (EBM), e.g. Berlin questionnaire and Fresno test, were not designed for examining evidence-searching capability. The objective of this study was to develop a scale for measuring evidence-searching skills.Methods:We use 2-round modified Delphi technique and organised a workforce of 7 experts who provided comments on a draft 33-item scale and rated each item on a 5-point Likert-type scale. All items rated less than 3 by any expert were removed. The items were modified or merged after authors' discussion considering experts' comments. When all items were rated ≥3 by all experts with an interquartile range (IQR) of ≤1, a consensus was achieved. In a pilot test, the searching capability of two examinees was assessed by two raters and re-assessed two weeks later for reliability. In a further pilot test, the searching capability of another eight examinees was assessed by two raters and the reliability of the scale was examined.Results:All 7 experts completed the two rounds. In Round 1, 33 items were removed and 11 items were merged into 4 items, leaving 17 items remained in the scale. In Round 2, 17 items were removed. The final consensus scale consisted of 15 items, all rated 4 or 5 with a mean of 4.79 and an IQR of 1 or less. The full details of the scale will be presented. In the pilot tests, the inter-rater correlation was 0.911 (95% confidence interval 0.821–0.956), while the intra-rater correlation coefficient was 1. The Cronbach's alpha was 0.903.Conclusion:This study is the first to develop a scale for measuring evidence-searching skills. The scale fills in the gap in objective assessment of knowledge-acquiring ability, and may be used in improving the training of evidence-searching skills.
175: EVALUATING THE PRINCIPLES IN WHICH THE DECISIONS ABOUT PIVOTAL MATTERS IN IRANIAN HEALTH SYSTEM ARE MADE
Authors: Doshmangir Leila , Rashidian Arash 
Published: May 2024

Background and aims:This study aimed to evaluate the basis in which the decisions about pivotal matters in Iranian health system are made and how these decisions are in accordance with the best available evidence.Methods:To conduct this qualitative study, in the first step, four main issues with a high degree of importance, novelty and significant impact on health system were selected as follows: outsourcing clinical and Para-clinical services and health sectors to the private sector, global payment system to the hospitals and listing or delisting of pharmaceuticals from insurance coverage. In the next step, along with reviewing reports, documents and papers, semi-structured interviews were conducted with policymakers, experts and officials involved in the formulation and implementation of the selected issues. In the following step, a comprehensive search was carried out to find the research studies on the mentioned topics (fundamental evidence of policy-making). In the final stage, the results of the interviews and documentary analysis were compared with the best acquired evidence from the research studies. As a result, analytical model about decision making and interpretation method of evidence informed policy making in the health system were extracted.Results:In Iranian health system, evidence production is limited and the produced evidence is moderately applied in decision-making. Most decisions are made subconsciously, intuitively, fast, with low cognitive load and based on experiences. In recent years, due to the increasing number of researchers, awareness about modern methods of research and using evidence in decision-making is increasing gradually in the health system.Conclusion:Developing the importance and role of using evidence in making better decisions and policies for health managers and policy-makers and localizing global evidence are proper ways to enhance the use of evidence-informed decision-making approach in Iranian health system.