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۶۲

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توسعه سلامت در جامعه، در راستای برقراری امنیت روانی، تنها به متولیان حوزه بهداشت محدود نیست و مشارکت اجتماعی همه اقشار جامعه، نقشی سازنده در این زمینه دارد. در همین راستا، پژوهش حاضر با هدف طراحی و اعتبارسنجی الگویی برای افزایش مشارکت اجتماعی در جهت کنترل پاندمی، با تأکید بر امنیت روانی جامعه، در دو مرحله کیفی و کمّی انجام شده است. این پژوهش ازلحاظ هدف، اکتشافی و ازلحاظ نوع، توصیفی است. جامعه آماری پژوهش در مرحله اول، 20 نفر از پزشکان با سابقه در بیمارستان های استان اردبیل بودند که به شیوه هدفمند و با روش ارجاع زنجیره ای (روش گلوله برفی) انتخاب و در مرحله دوم نیز، 302 نفر از کارکنان شاغل در دانشگاه علوم پزشکی به صورت تصادفی طبقه ای تعیین شدند. برای تجزیه و تحلیل اطلاعات از روش تحلیل مضمون در 6 مرحله، در نرم افزار Atlas-ti و همچنین از تحلیل عاملی تأییدی در نرم افزار Smart PLS استفاده شد. براساس یافته های پژوهش، 9 مضمون اصلی و 62 مضمون فرعی به عنوان ابعاد الگوی افزایش مشارکت اجتماعی در جهت کنترل پاندمی ارائه شد. براساس نتایج پژوهش، عوامل مدیریت، رسانه، سازمان های مردم نهاد، اقدامات، ویژگی های بیماری های واگیر، مشارکت برون سازمانی، تکنولوژی، مشارکت مردم و تدوین برنامه جامع، به عنوان مضامین اصلی الگوی مشارکت اجتماعی شناسایی شدند.

Designing and Validating a Model to Increase Social Participation and Control the Pandemic with an Emphasis on Psychological Security of the Society through a Mixed Approach

Introduction The development of health in the society for establishing mental security is not limited only to the guardians of the health sector, while social participation of all sectors of the society has a constructive role in this field. On the other hand, taking into account the development of the society in different dimensions of social, economic, political, and cultural life, goal-setting and planning for achieving predetermined goals, and reaching the desired states of its various dimensions, it is necessary that the tools and consequences of achieving such an all-round development be recognized and accepted. In this regard, all the potential, natural, and human resources and facilities should be used effectively and efficiently. In many cases, with the occurrence of a pandemic and non-participation of the members of the society in complying with health standards, psychological insecurity is created in the society and the people’ social life of is severely disrupted. Accordingly, different countries of the world have turned to the discussion of community participation in the management and prevention of pandemics due to aggravation of the problem of widespread diseases. Health care systems must have a proper interaction with the private sector, universities, civil society, and people, implement pandemic prevention and control models in the society with a community-oriented approach, and consider relevant experiences and challenges (Shabani and Taheri-Kharameh, 2021: 358). One of the social issues that the society is still involved in after a few years is the spread of the Corona pandemic, which progressed beyond international borders and affected many people in the world. Governments adopted a series of measures, including restricting entry into cities, closing schools and universities, and quarantining people at home, to control the epidemic and prevent its further spread. Although these measures reduced the duration of the conflict with the corona virus and its incidence and spread, the people's social activities were limited by these measures. In addition to concerns about the physical dangers of the pandemic, its effects on mental health had to be considered as well. Epidemic diseases lead to some psychological disorders, including stress, anxiety and symptoms of depression, insomnia, anger, fear, and significant disorders (Esdalahei and Rafezi, 2021: 122). In general, it can be said that the health sector, with all its facilities and resources, cannot overcome the problems alone until it gets the people’s conscious support. By laying the foundation for increasing public participation, we can do better in preventing the spread of diseases, including Covid-19 (Rezabigi Davarani et al., 2020: 113). Therefore, in this research, a model was designed to increase social participation in pandemic control by using the mixed approach of effective factors and components with an emphasis on psychological security.     Material & Methods The current research was conducted in the two qualitative (thematic analysis) and quantitative stages. It was exploratory in terms of purpose and descriptive in terms of type, thus being carried out in the field (Ardabil University of Medical Sciences) in the period of February 2022 to July 2022. The statistical population included 20 doctors with more than 20 years of experience in Ardabil Province in the first stage. In the second stage, the size of the statistical population under study was 1392 people based on the Statistics and Information Office of Ardabil University of Medical Sciences, 2022. According to Morgan Table for estimating sample size, 302 employees working at the University of Medical Sciences and Health Services of Ardabil Province were selected for the study. The sampling method in the first stage was a purposeful method (theoretical sampling) associated with the chain reference method (snowball method). The stratified random sampling method was used in the second stage, while the studied community units were grouped in classes that were more homogeneous in terms of attributes. This way, changes within the groups were minimized. For this purpose, the studied sample was classified into administrative (29 people), service (42 people), operational (25 people), nursing (145 people), educational (31 people), financial (21 people), and directorate or presidency (9 people) areas. Also, in the first stage, the data were collected through in-depth and semi-structured interviews. The tool for collecting information in the second stage was a researcher-made questionnaire with closed answers (Likert scale) based on management indicators to increase social participation in controlling communicable diseases with an emphasis on psychological security of the society. The data extracted in the first step were then adjusted. Finally, ATLAS .ti software and Smart PLS and SPSS software were used to analyze the the data collected in the first stage through the theme analysis method and the second stage via confirmatory factor analysis, respectively.   Discussion of Results & Conclusion The results of coding showed that the factors affecting the presentation of this model could be generally placed in the 9 main themes of characteristics of communicable diseases, extra-organizational participation, non-governmental organizations, media, people's participation, management, measures, technology, development of a comprehensive program and 62 sub-themes. Based on the results, the factor of "management" had the greatest effect on increasing social participation in controlling communicable diseases with an emphasis on psychological safety of the community. Among the indicators of this factor, the indicator of "clarifying the employees’ roles and duties" had the highest impact in the designed model. The factor of "media" was the second most influential factor. Among the indicators of this factor, the index of "role of mass media" was the most effective one. The third influential factor for increasing social participation in controlling communicable diseases was the factor of "non-governmental organizations". Among the indicators of this factor, the index of "role of fertilizers in people's education" had a high coefficient of importance. The factors of "actions", "characteristics of communicable diseases", "extra-organizational participation", "Technology", "people's participation", and "development of a comprehensive program" were identified as the most influential factors in the presented model.  

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