Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post...Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.展开更多
Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the la...Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.Methods:This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran.The data collection form included the age,sex,injury location(cervical,thoracic,and lumbar),cause of injury(traffic accidents,falls,and assaults),length of hospital stay,injured segment of spine injury,severity of injury,and outcome.Statistical analyzes were performed using SPSS software version 24.Results:Totally 776 cases of spine injury were identified.The spine injury rate was 17.0%,and the mortality rate was 15.5%.Cervical spine injury(20.4%)more often occulted in motorcycle accident,and thoracic spine injury(20.1%)occulted in falls.The highest and lowest rates of spine injurys were related to lumbar spine injury(30.2%)and cervical spine injury(21.5%),respectively.There was a statistically significant relationship between the mechanism of injury and the location of spine injury(p<0.001).And patients with lumbar spine injury had the highest mortality rate(16.7%).Injury severity score(OR=1.041,p<0.001)and length of stay(OR=1.018,p<0.001)were strong predictors of mortality in trauma patients with spine injury.Conclusion:The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0%in southern of Iran.Road traffic injury and falls are the common mechanism of injury to spine.It is important to improve the safety of roads,and passengers,as well as work envi-ronment,and improve the quality of cars.Also,paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.展开更多
Objective:The objective of the present study is to explore the effects of personality traits on job burnout among hospital nurses.Materials and Methods:This cross-sectional research was done during 2019-2020 at Kashan...Objective:The objective of the present study is to explore the effects of personality traits on job burnout among hospital nurses.Materials and Methods:This cross-sectional research was done during 2019-2020 at Kashan Shahid Beheshti Hospital.The data analysis procedures included descriptive statistics and the partial least squares-based structural equation modeling.The participants were 150 nursing professionals.A questionnaire indicating information on demographics,burnout(measured using the Maslach Burnout Inventory with three dimensions of depersonalization,emotional exhaustion,and personal accomplishment),and personality profile(measured employing the neuroticism extraversion openness five-factor inventory including extroversion,conscientiousness,agreeableness,neuroticism,and openness to experience dimensions)was used to gather the required data.Results:The results of the study showed that the validity and reliability of the measurement model were desirable(factor load higher than 0.5,the Cronbach’s alpha value and the composite reliability are>0.7).Structural model showed statistically drastic,negative relationship between the nurses’burnout levels and neuroticism(β=0.722)and openness to experience(β=0.437).However,the relationship was significantly positive between the nurses’burnout levels and conscientiousness(β=0.672),agreement(β=0.594),and extraversion(β=0.559)(P<0.03).Conclusions:The present study helped the recognition of burnout among nurses working in hospitals and approved the effects of personality features on the burnout experience.展开更多
Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-...Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods:An observational prospective study was conducted from April 11,2021 to April 22,2022 in 8 centers enrolled in NSCIR-IR,respectively Arak,Rasht,Urmia,Shahroud,Yazd,Kashan,Tabriz,and Tehran.Patients were classified into 3 groups based on their need for care resources,respectively:(1)non-spinal cord injury(SCI)patients without surgery(group 1),(2)non-SCI patients with surgery(group 2),and(3)SCI patients(group 3).The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases:pre-hospital,in-hospital,and post-hospital.The data from the first 2 phases were collected through the registry.The post-hospital data were collected by conducting follow-up assessments.Telephone follow-ups were conducted for groups 1 and 2(non-SCI patients),while group 3(SCI patients)had a face-to-face visit.This study took place during the COVID-19 pandemic.Data on age and time interval from injury to follow-up were expressed as mean±standard deviation(SD)and response rate and follow-up loss as a percentage.Results:Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR.Of the total calls,918(71.05%)were related to successful follow-ups,but 38 cases died and thus were excluded from data analysis.In the end,post-hospital data from 880 patients alive were gathered.The success rate of follow-ups by telephone for groups 1 and 2 was 73.38%and 67.05%respectively,compared to 66.67%by face-to-face visits for group 3,which was very hard during the COVID-19 pandemic.The data completion rate after discharge ranged from 48%-100%,22%-100%and 29%-100%for groups 1-3.Conclusions:To improve patient accessibility,NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information.Regarding the loss to follow-ups of SCI patients,NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through,for example,providing transportation facilities or financial support.展开更多
Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patien...Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion: This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.展开更多
Purpose: Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and pat...Purpose: Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes, as well as reducing mortality rates. Methods:【n this retrospective cohort study, systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months (February 2017-July 2017);the *patients case files were evaluated in terms of demographic information, pre- and post-accident conditions, clinical conditions at the time of admission and finally, accident outcomes. A logistic regression model was used to analyze the role of factors affecting mortality among subjects. Results: Among subjects, 60.4% were in the age-group of 15-39 years. There was a 10.4% mortality rate among patients and motor-vehicle accide nts were the most comm on mecha nism of injury (66.7%). Aging led to in creased risk of fatality in this study. For each urHt increase in Glasgow coma scale (GCS), risk of death decreased by about 40%(odds ratio (OR)= 0.63, 95% confidence interval (C/): 0.59—0.67). For each unit increase in injury severe score (ISS), risk of death increased by 10%(OR = 1.11%, 95% Cl: 1.08-1.14) and for each unit in crease in trauma revised injury severity score (TRISS), there was 18% decrease in the risk of fatality (OR = 0.82, 95% CI: 0.71-0.88). Conclusion: The most common cause of trauma and the most common cause of death from trauma was traffic accidents. It was also found that an increase in the ISS index increases the risk of death in trauma patients, but the increase in GCS, revised trauma score (RTS) and TRISS indices reduces the risk of death in trauma patients. The TRISS indicator is better predictor of traumatic death than other indicators.展开更多
文摘Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.
基金the Research Vice-Chancellor of Shiraz University of Medical Sciences for inancially supporting the research(Grant No.25125).
文摘Purpose:Spine injury is one of the leading causes of death and mortality worldwide.The objective of this study was to determine the incidence,pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years.Methods:This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran.The data collection form included the age,sex,injury location(cervical,thoracic,and lumbar),cause of injury(traffic accidents,falls,and assaults),length of hospital stay,injured segment of spine injury,severity of injury,and outcome.Statistical analyzes were performed using SPSS software version 24.Results:Totally 776 cases of spine injury were identified.The spine injury rate was 17.0%,and the mortality rate was 15.5%.Cervical spine injury(20.4%)more often occulted in motorcycle accident,and thoracic spine injury(20.1%)occulted in falls.The highest and lowest rates of spine injurys were related to lumbar spine injury(30.2%)and cervical spine injury(21.5%),respectively.There was a statistically significant relationship between the mechanism of injury and the location of spine injury(p<0.001).And patients with lumbar spine injury had the highest mortality rate(16.7%).Injury severity score(OR=1.041,p<0.001)and length of stay(OR=1.018,p<0.001)were strong predictors of mortality in trauma patients with spine injury.Conclusion:The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0%in southern of Iran.Road traffic injury and falls are the common mechanism of injury to spine.It is important to improve the safety of roads,and passengers,as well as work envi-ronment,and improve the quality of cars.Also,paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.
基金the Vice Chancellor of Research and Technology Kashan University of Medical Sciences for providing financial support to conduct this work(Approval code:94070).
文摘Objective:The objective of the present study is to explore the effects of personality traits on job burnout among hospital nurses.Materials and Methods:This cross-sectional research was done during 2019-2020 at Kashan Shahid Beheshti Hospital.The data analysis procedures included descriptive statistics and the partial least squares-based structural equation modeling.The participants were 150 nursing professionals.A questionnaire indicating information on demographics,burnout(measured using the Maslach Burnout Inventory with three dimensions of depersonalization,emotional exhaustion,and personal accomplishment),and personality profile(measured employing the neuroticism extraversion openness five-factor inventory including extroversion,conscientiousness,agreeableness,neuroticism,and openness to experience dimensions)was used to gather the required data.Results:The results of the study showed that the validity and reliability of the measurement model were desirable(factor load higher than 0.5,the Cronbach’s alpha value and the composite reliability are>0.7).Structural model showed statistically drastic,negative relationship between the nurses’burnout levels and neuroticism(β=0.722)and openness to experience(β=0.437).However,the relationship was significantly positive between the nurses’burnout levels and conscientiousness(β=0.672),agreement(β=0.594),and extraversion(β=0.559)(P<0.03).Conclusions:The present study helped the recognition of burnout among nurses working in hospitals and approved the effects of personality features on the burnout experience.
基金supported by Elite Researcher Grant Committee under award number 972056 from the National Institutes for Medical Research Development (NIMAD),Tehran,Iran,and by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences,Tehran,Iran grant number 97-02-38-39581.
文摘Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods:An observational prospective study was conducted from April 11,2021 to April 22,2022 in 8 centers enrolled in NSCIR-IR,respectively Arak,Rasht,Urmia,Shahroud,Yazd,Kashan,Tabriz,and Tehran.Patients were classified into 3 groups based on their need for care resources,respectively:(1)non-spinal cord injury(SCI)patients without surgery(group 1),(2)non-SCI patients with surgery(group 2),and(3)SCI patients(group 3).The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases:pre-hospital,in-hospital,and post-hospital.The data from the first 2 phases were collected through the registry.The post-hospital data were collected by conducting follow-up assessments.Telephone follow-ups were conducted for groups 1 and 2(non-SCI patients),while group 3(SCI patients)had a face-to-face visit.This study took place during the COVID-19 pandemic.Data on age and time interval from injury to follow-up were expressed as mean±standard deviation(SD)and response rate and follow-up loss as a percentage.Results:Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR.Of the total calls,918(71.05%)were related to successful follow-ups,but 38 cases died and thus were excluded from data analysis.In the end,post-hospital data from 880 patients alive were gathered.The success rate of follow-ups by telephone for groups 1 and 2 was 73.38%and 67.05%respectively,compared to 66.67%by face-to-face visits for group 3,which was very hard during the COVID-19 pandemic.The data completion rate after discharge ranged from 48%-100%,22%-100%and 29%-100%for groups 1-3.Conclusions:To improve patient accessibility,NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information.Regarding the loss to follow-ups of SCI patients,NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through,for example,providing transportation facilities or financial support.
基金This research was supported with grant number of 1396-01-38-16261 by Shiraz University of Medical Sciences in Shiraz,Iran.
文摘Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion: This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.
文摘Purpose: Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes, as well as reducing mortality rates. Methods:【n this retrospective cohort study, systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months (February 2017-July 2017);the *patients case files were evaluated in terms of demographic information, pre- and post-accident conditions, clinical conditions at the time of admission and finally, accident outcomes. A logistic regression model was used to analyze the role of factors affecting mortality among subjects. Results: Among subjects, 60.4% were in the age-group of 15-39 years. There was a 10.4% mortality rate among patients and motor-vehicle accide nts were the most comm on mecha nism of injury (66.7%). Aging led to in creased risk of fatality in this study. For each urHt increase in Glasgow coma scale (GCS), risk of death decreased by about 40%(odds ratio (OR)= 0.63, 95% confidence interval (C/): 0.59—0.67). For each unit increase in injury severe score (ISS), risk of death increased by 10%(OR = 1.11%, 95% Cl: 1.08-1.14) and for each unit in crease in trauma revised injury severity score (TRISS), there was 18% decrease in the risk of fatality (OR = 0.82, 95% CI: 0.71-0.88). Conclusion: The most common cause of trauma and the most common cause of death from trauma was traffic accidents. It was also found that an increase in the ISS index increases the risk of death in trauma patients, but the increase in GCS, revised trauma score (RTS) and TRISS indices reduces the risk of death in trauma patients. The TRISS indicator is better predictor of traumatic death than other indicators.
