Homa Yousefie, Anahita Khodabakhshi-Koolaee, Mohammad Reza Falsafinejad,
Volume 22, Issue 6 (1-2020)
Abstract
Background and Aim: Currently, the prevalence of chronic kidney disease has increased for a variety of reasons. Renal diseases, followed by dialysis and kidney transplantation, can greatly affect the People's physical and mental health. Since most of previous studies have examined the physical and often preoperative problems of kidney transplant patients and many of them have used quantitative methods, the present study aimed to investigate the psychological challenges of renal disease patients after Kidney transplantation.
Methods & Materials: The study population consisted of kidney transplant patients referred to the Nephrology Clinic of Labafinejad Hospitalin Tehran, Iran in 2019 aged 35-50 years and 1-5 years had passed since their transplantation. A semi-structured in-depth interview was done for collecting information. A purposive sampling and continued until data saturation and until no themes were available. In the end, 15 patients were interviewed. Data analysis was performed by Colaizzi’s method.
Ethical Considerations: This study with a code of IR.IAU.SRE.1398.022 was approved by the Research Ethics Committee at Islamic Azad University, Science and Research Branch in Tehran, Iran.
Results: The primary themes were divided in to 3 main themes including: Concerns and psychologically disturbing feelings, emotional and spiritual support of the family, and uncertainty of receiving specialized, financial and welfare support.
Conclusion: Patients with kidney disease after transplantation surgery have psychological challenges in addition to physical problems that are of great importance to mental health professionals. Studying these challenges can provide a deeper understanding of their psychological problems and adaptation after surgery.
Nahid Chezani Sharahi, Seyed Mojtaba Hosseini, Khalil Alimohammadzadeh, Ali Hassan Shaban Khamseh, Mohammadkarim Bahadori,
Volume 28, Issue 6 (1-2026)
Abstract
Introduction: Health system planning, as a core function of health governance, plays a crucial role in resource allocation, performance improvement, and equity promotion. Despite recent reforms, evidence suggests that planning processes in Iran’s health system still face significant structural, managerial, and implementation challenges. This study aimed to identify and explain the key challenges of health system planning in Iran.
Methods: qualitative study was conducted using a thematic analysis approach. Seventeen participants—including senior and middle managers, faculty members, and health planning experts at national and university levels—were selected through purposive sampling with maximum variation. Data were collected via semi-structured interviews over eight months and analyzed using MAXQDA version 20. Credibility, transferability, dependability, and confirmability were ensured to strengthen the trustworthiness of the findings.
Results: Thematic analysis led to the identification of 160 initial codes, 36 organized themes, and 9 overarching themes. The main categories of challenges included: human resources, leadership and governance, processes and regulations, inter- and intra-sectoral coordination, budgeting and financing, physical infrastructure and equipment, health information and technology, service delivery, and sociopolitical–cultural–economic factors. Major issues were found in managerial transparency, cross-sectoral collaboration, financial constraints, and the lack of systematic monitoring and evaluation mechanisms.
Conclusions: The Iranian health planning system suffers from centralization, structural ambiguities, limited stakeholder participation, and weak information systems. Strengthening evidence-informed policymaking, enhancing transparency and accountability, and reforming governance structures are essential for improving the effectiveness and efficiency of health system planning.
