IntroductionThe World Health Organization (WHO) Responsiveness model showing the ability of health systems in fulfilling people’s expectations in connection with nonclinical aspects is an appropriate pattern to assess healthcare. The purpose of this study was to determine the status of pregnancy care provisions based on the responsiveness model.MethodsThis was a cross-sectional study conducted by randomly sampling 130 women visiting selected hospitals in Tehran in 2015. A researcher-made questionnaire based on the responsiveness model of WHO was used to collect data. We determined the face validity and content validity of the questionnaire, and its reliability was confirmed by Cronbach’s alpha coefficient (0.94) and test-retest analysis (0.96). The obtained data were analyzed by SPSS version 20 descriptive statistics, t-test, one-way ANOVA, Pearson product-moment correlation coefficient, and Spearman correlation.ResultsTotal responsiveness from the perspective of service recipients was 69.46±14.65 from 100. The obtained scores showed that, in the range of 0 to 100, 73.02 were about basic amenities (the most score), 72.93 about dignity, 70.91 about communication, 70.76 about confidentiality, 66.30 about provision social needs, 65.96 about choice of provider, 65.92 about autonomy, and 52.65 about prompt attention (the lowest score), which are representing the average level of service quality. There were significant relationships between participating in preparation class of labor and dignity (p<0.001), autonomy (p=0.01), provision social needs (p=0.01), and overall responsiveness (p=0.03). It was obtained that there is a significant linear relationship between scores given to hospitals and dimensions of responsiveness (p=0.05). Findings indicated a significant relationship between insurance type and dimensions of choice of provider (p=0.03) and communication (p=0.03).ConclusionThe mean score of service quality in the present investigation illustrated that nonclinical dimensions have been disregarded and it has potential to be better. So some grand plans are needed.
Vitiligo is a commonly acquired autoimmune pigmentary disorder. Some patients are resistant to conventional treatments, leading to the search for combination therapies. This study aimed to compare the efficacy of 308-nm excimer laser monotherapy versus combined treatment with topical bimatoprost 0.03% in patients with vitiligo on the face. This study was conducted on patients with facial vitiligo referred to a hospital in Tehran, Iran. The study included 38 patients who were randomly allocated to either the intervention group (18 patients) or the control group (20 patients). Both groups received treatment with a 308-nm excimer laser twice a week for 15 weeks. In addition, the intervention group received treatment with bimatoprost 0.03% solution once daily for 15 weeks. The patients were visited at the end of every 5 weeks and after the 15th week. The efficacy of the treatments using the scale for assessment of improvement, visual analog scale satisfaction (VASS), and visual analog scale improvement (VASI) were evaluated. The study also evaluated the side effects of treatment. The average scores for the measures over time indicated that VASI scores after the 30th treatment session (P = 0.04), VASS scores after the 20th session (P = 0.04) and 30th session (P = 0.03), and SAI scores after the 30th session (P = 0.03) were significantly higher in the intervention group than in the control group. The addition of bimatoprost 0.03% to the treatment regimen may improve the outcomes of patients with facial vitiligo who are resistant to conventional treatments.
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