INTRODUCTION:Fatigue is one of the common symptoms of sarcoidosis, which occurs in about 50-70% of patients.AIM:Considering that there are no valid Iranian questionnaires for evaluating fatigue in sarcoidosis, in the present study, for the first time, we translated Fatigue Questionnaire into Persean and evaluated its validity and reliability among Iranian patients with sarcoidosis.MATERIAL AND METHODS:In methodological research, English version of Fatigue assessment scale (FAS) 10 items questionnaire which is designed to assess physical or mental fatigue in chronic disease patients, was translated into Persian and back-translated into English. Its validity and reliability were studied on the one hundred and thirteen confirmed sarcoidosis patients are referring to respiratory referral hospital of Iran. Reliability analysis was performed by estimation of Cronbach`s alpha test.RESULTS:According to the cut-off point of 22.84 (74%) of the studied patients were suffering from fatigue. The internal consistency calculation revealed that the alpha value of the physical fatigue and mental fatigue was 0.945 and 0.896, respectively.CONCLUSION:We concluded that the existence of questions number 4 and 10 in the questionnaire reduces the continuity of the questions, and therefore we suggest applying the FAS questionnaire without the two questions 4 and 10. This study showed that FAS questionnaire was very practical and can routinely be applied to assess the fatigue scale in sarcoidosis patients.

Background: While chemotherapy is an effective modality for the treatment of patients with cancer, it is a complex, multidisciplinary, and error-prone process. Paper-based protocols are commonly applied in chemotherapy; however, they fail to eliminate the complexity of this process. Therefore, a new guideline-based workflow software (GWS) system is needed to improve the workflow and quality of chemotherapy process. Methods: Planning was initiated 11 months before the system implementation and it involved a multidisciplinary group to analyze the current chemotherapy workflow and protocols for identifying the workflow components, analyzing paper-based protocols, developing computer-based protocols, and designing of systems based on an object-oriented analysis. To implement the GWS, we applied a system based on Python programming language and SQL language. Results: The conceptual model was developed based on need assessments and chemotherapy steps. A minimum dataset was developed for the electronic health records. We established examination forms for the patient management system (PMS), as well as specific standard forms for chemotherapy ordering, prescription verification and administration templates. Finally, developed GWS system consisted of a PMS, computerized provider order entry (CPOE), prescription verification system (PVS), and nursing administration system (NAS). Conclusions: A PMS, a PVS, a NAS, and a protocol-based clinical decision support system were integrated into the CPOE system to improve the chemotherapy process. Elimination of iterations and unnecessary steps in old chemotherapy workflow, increase of patient safety, improvement of communication and coordination between healthcare providers, and use of updated evidence-based medicine in direct chemotherapy orders justify the integration of GWS in the cancer care settings.

BACKGROUND: Chemotherapy is a complex, multi-disciplinary, and error-prone process. Information technology is being increasingly used in different health care settings with complex work procedures such as cancer care to enhance the quality and safety of care. In this study, we aimed to develop a computerized physician order entry (CPOE) for chemotherapy prescribing in patients with gastric cancer and to evaluate the impact of CPOE on medication errors and order problems. MATERIALS AND METHODS: A multi-disciplinary team consisting of a chemotherapy council group and system design and implementation team was formed for chemotherapy process evaluation, requirement analysis, developing computer-based protocols, and implementation of CPOE. A before and after study was conducted to evaluate the impact of CPOE on the chemotherapy process and medication errors and problem orders. To evaluate the level of end-user satisfaction, an ISO Norm 9241/110 usability questionnaire was chosen for the evaluation. RESULTS: Before the implementation of the CPOE system, 37 medication errors (46.25%) and 53 problem orders (66.25%) were recorded for 80 paper-based chemotherapy prescriptions. After implementation of the CPOE system, 7 (8.7%) medication errors and 6 (7.5%) problem orders were recorded for 80 CPOE prescriptions. The implementation of CPOE reduced the medication error by 37.55% and the problematic order by 58.75%. The results for usability evaluation indicate that the CPOE was within the first class of the ISONORM level rating; this shows that a CPOE is with very high satisfaction and a very high functionality rate. CONCLUSION: Developing a CPOE system significantly improved safety and quality of the chemotherapy process in cancer care settings by reducing the medication error, deleting unnecessary steps, improving communication and coordination between providers, and use of updated evidence-based medicine in direct chemotherapy orders. However, the CPOE system does not prevent all medication errors and may cause new errors. These errors can be human-related factors or associated with the design and implementation of the systems.