Journal of

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In many countries, different methods and tools for improving the quality of health cares have been used. Among these methods, the NHS clinical governance provided by the NHS British government as a strategy to enhance the quality of clinical cares was introduced in 1998. Clinical governance both responsibilities for maintain the current level of cares and improving the quality of future care are emphasized. Materials & Methods: The aim of this study was to investigate the relationship between clinical governance and organizational performance of hospitals in Ardabil. The research is an applied one questionnaire is used to collecting data. The population comprises patients, doctors employees and hospitals managers of Ardabil 180 were selected as the sample. To investigate the hypothesis test, correlation and regression analysis were used. Results: According to data, there is a significant relationship between organizational performance and clinical governance. On the other hand, the results of F test showed meaningful level for the components of %99, so we can use linear regression. Furthermore, the coefficient of all the components of clinical governance has a positive and significant effect on performance. Among the components of clinical governance, clinical audit component has %163 of the minimum amount, and staff management component 908 percent has the most effect on hospital performance. Conclusion: According to the results, are considered essential patient’s engagement in treatment, the use of information and patients' family’s experiences to provide more services to patients, credit allocation for staff training and staff expertise in the field of employees training.

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Background: The organizational learning has been influenced in different theories and model based on theoretical and practical dimensions in organizations development and provides a favorable context for changing and development. Organizational learning capacity can play a main role in clinical governance implemention.
Materials and Methods: This study was a descriptive- analitical and cross-sectional one which performed during the first six months of 2014. Study population included staff of Ardabil Social Security hospital. One hundred and seventy participants selected using simple random sampling. A four dimensional standard questionnaire of Gumejeet et al  and a seven dimensional self administrated questionnaire were conducted to examine organizational learning capacity and clinical governance assessment, respectively. Data analysis was carried out using Pierson Correlation Coefficient and Mulivariate regression analysis. Data was analyzed by SPSS₁₈ software.

Results: Study results revealed that there was a positive and significant relation between organizational learning capacity and clinical governance implementation (R= 0.507). This correlation coefficient was 0.644 in management commitment, 0.498 in systematic approach, 0.446 in open climate and 0.261 in knowledge transfer.

Conclusion: According to the main role of organizational learning on implementing clinical governance, providing an essential background to enforce organizational learning capacity in four components especially management commitment and systematic approach to implement efficient clinical governance is recommended.

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Background: Nowadays, the medical tourism market is one of the most profitable and competitive industries in the world, and it is one of the new developed fields of tourism. Advertising is one of the methods of increasing tourist attraction and influencing tourists' decision-making to choose a destination. The present research aimed to simulate the effect of advertising on the attraction of medical tourists in the hospitals of Yazd city.
Materials and methods: The present research is applied in terms of research objective, and in terms of methodology, it is in descriptive-analytical research. The statistical community was formed by university professors and experts in the field of medical tourism, and managers of hospitals and medical centers in Yazd. The snowball method was used for sampling. Information was collected through text reviews, questionnaires and semi-structured interviews with experts. The integrated and innovative approach of factor-based modeling and Taguchi method was used for data analysis, and the software used was AnyLogic and MiniTab.
Results: The results of the scenario execution revealed that among the advertising tools, internet advertising is more effective, and television ads, specialized tourism magazines, and seminars and conferences are in the next ranks. As the final output of the research, the investigation of the main effects related to each advertising tool led to identification of the suitable level of each tools and the presentation of the most favorable scenario based on the advertising program of Yazd hospitals.
Conclusion: Based on the fact that among the advertising tools, internet advertising has the greatest effect on attracting medical tourists, hospital management should pay special attention to internet advertising to attract more tourists in the field of medicine. In this way, more information will be provided to tourists and the demand for medical tourism will increase.

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Background and objective: As a critical factor for hospital effectiveness, agility uncovers the way such organizations react to internal and external changes. From this perspective, the present study was to design an agent-based model to simulate organizational agility development in the hospitals of Ardabil Province, Iran, in view of the effective factors.
Materials & Methods: Utilizing an exploratory, mixed-methods research design, this study was performed in accordance with inductive-deductive reasoning. For this purpose, the samples included 10 theoretical and experimental experts, selected by purposive sampling of the non-probability type. As well, the data collection tools were interviews and questionnaires. During the qualitative phase, the main factors affecting organizational agility were initially isolated using thematic analysis. Afterward, the given factors were prioritized with the fuzzy Delphi method in the quantitative phase. Ultimately, the model for organizational agility development was simulated through the agent-based approach.
Results: With reference to the study results, 50 primary codes, 15 sub-themes, and 5 main themes were identified, and then “influence in management” was acknowledged as the most significant one shaping organizational agility. Besides, the simulation outputs demonstrated that the proposed model could provide the right estimate of the future of organizational agility development in the hospitals of Ardabil Province, Iran.
Conclusion: Along with the study results, hospital managers are suggested to reflect on the effective factors identified here to better fulfill organizational agility development.

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Background and purpose: Early Maladaptive Schemas (EMSs) are pervasive cognitive patterns that can detrimentally affect the well-being of individuals with chronic illnesses. This study aimed to investigate the structural relationship between EMSs and Health-Related Quality of Life (HRQoL) in cancer patients, with a specific focus on the mediating role of health literacy.
Methods: This descriptive-analytical study utilized a correlational design based on Structural Equation Modeling (SEM). The statistical population comprised all cancer patients aged 20 to 60 years referring to private oncology centers in [City Name] in 2025. A total of 665 participants were recruited using convenience sampling. Data were collected using the Young Schema Questionnaire (YSQ), the Health Literacy for Iranian Adults (HELIA) questionnaire, and the Health-Related Quality of Life questionnaire. Data analysis was performed using SPSS (v.25) and AMOS (v.24) software, with the significance level set at 0.05.
Results: The path analysis revealed that EMSs had a significant direct negative effect on both health literacy (β =-0.85, P< 0.001) and HRQoL (β= -0.56, P<0.001). Conversely, health literacy showed a significant positive effect on HRQoL (β=0.51, P<0.001). Furthermore, health literacy significantly mediated the relationship between EMSs and HRQoL (β=0.26,P<0.001). The goodness-of-fit indices confirmed the model's optimal fit (X²/Df = 3.94, GFI = 0.913, IFI = 0.903, CFI = 0.901, RMSEA = 0.067)
Conclusion: The findings suggest that Early Maladaptive Schemas significantly compromise the quality of life in cancer patients. However, health literacy acts as a protective buffer, mediating this negative impact. Therefore, interventions aimed at enhancing health literacy could be an effective strategy to mitigate the adverse effects of maladaptive schemas and improve the HRQoL of cancer patients.