Journal of

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Background: Focusing on making opportunities to participate of patients in all levels of health care system is important in order to develop of system capability that could make improving of patients’ safety and quality of care services. The aim of this study was to determine inpatient perceptions in general hospitals of Tehran medical university regarding patient participate in treatment decisions and safety. Material and methods: This was a cross-sectional study in 1390. First, the list of eight general hospitals affiliated to Tehran University of medical sciences and all clinical wards were obtained through the university website. Then, stratified random sampling method applied to collect 300 patients as a sample size. Data were collected by using a structured questionnaire that validity and reliability were accepted. Descriptive statistical methods, linear regression and multivariate logistic regression were applied to analyze. Results: From total of 300 patients, 60% of them were female. The level of participating by patients in cure decision making were at high level (59.7%) and 27% in low level. The range of patients’ safety was at high (60%) and low (26%). The level of participate in decision making of cure process had high rate among young people and employed participants. The patients who were unmarried, educated, and employed had lower score in patients’ safety. The participants’ perception had no effect on the patients’ safety perceptions. Conclusion: The symptoms that might be interpreted as an abnormal could be interpreted in different ways by the others. These unusual results could come from dissimilarities in demographic features

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Abstract Background: Today there is still a shortage of postgraduates of medicine for multiple reasons. This study aims to determine factors related to Tehran, Shahid Beheshti and Iran Universities students' educational and career tendencies. Materials and Methods: This is a descriptive cross-sectional study. The study population consists of medical students of Tehran, Shahid Beheshti and Iran Universities of Medical Sciences. A sample of 510 individuals was selected using simple random sampling method proportional to the category size.Data were collected using a structured questionnaire of acceptable validity and reliability. Descriptive statistical methods were used for data analysis. Results: Medicine was selected due to its social dignity, motivation to serve the people and interest in medical sciences affect studying medicine as a major .Existence of Medical Universities, improving information and abilities and the need for medical services in different areas affect physician’s choice of working location .Simultaneous activity in both private and governmental sectors , disorganized in governmental sectors compared to well organized and well equipped private sector , affect physicians` choice of working sector . Realistic thinking instead of idealism, lack of adequate support from students and differences between the academic environment with student`s interest affect changing the students' educational and career tendency. Conclusion: Actions like regulating the capacity of medical students admission, improving the quality of studies, modification of human resources , better familiarity of students with medicine field while choosing the university field and financial support for young physicians could improve the situation.

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Introduction: Major consideration on hospital emergency services had been taken into account in recent years. This study is aimed to analyze contributory factors of clients' satisfaction in services provided in emergency unit of selected hospitals affiliated with Tehran and Shahid Beheshti University of  Medical Sciences.

Materials and Methods: This is a descriptive-analytical and cross-sectional study. 768 clients of emergency departments of selected hospitals had been chosen during last year as  samples . 3 general and 3 specialized hospitals had been chosen randomly among total hospitals affiliated with mentioned two universities . A questionnaire consisted of  54 questions in 2 sections had been used for data collection . Reliability and validity were confirmed by professors and 50-sample pilot study respectively. The alpha-cronbach was calculated at 0.87.Responsible rate had been determined at 97.66 % . The data had been analyzed by independent sample t-test, simple linear regression and linear multi-regression.

Results: The demographic characteristics of attendants were as follows: 57.3% women, 56.8%  over  45 years old , 63.1%  social insurance coverage, 92.7% urban residents , 56%  married, 58.7%  low education ( below high school level) and 68.4%  complementary insurance coverage. Clients had to pay more  for services provided by Shahid Beheshti University. Moreover, majority of the clients paid  their  expenditures by out-of-pocket and insurance. Clients were more satisfied with admission unit ,  gaurds, physicians, nursing cadre and environment provided by hospitals of Tehran university. On the other hand , in terms of management , clients were more satisfied with management approach provided by hospitals of Shahid Beheshti university . Totally , women , elderly people , urban residents , individuals who visited physicians out of referral system and also ones who came during physician presence felt more satisfaction .Generally , patients were more satisfied with services delivered by hospital affiliated  with Tehran university .   

Conclusion: Evaluating viewpoints of patients about quality of services result in promoting current trends of providing services.

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Background: Nowadays, managers should develop working conditions which attracts new nurses, retains current nurses and prevents their absenteeism. This study at aim at determining Effective Factor Analysis on Health Related Absence among Nurses of Clinical Wards in General Hospitals Affiliated to Tehran University of Medical Sciences

Materials and Methods: four hundred nurses of clinical wards selected as sample size to participate in this descriptive-analytical; cross-sectional study from general hospitals of Tehran University of Medical Sciences. The instrument was a questionnaire in 100 items and two sections including demographic characteristics (13 items) and effective factors of sickness absence (organizational-directorial factors in 49 questions, physical factors in 16 questions and mental factors in 22 questions). The validity of questionnaire confirmed by experts and reliability was calculated 0.79.Absenssism criterion was based on Rajbhandary and Basu' definition (2010); total numbers of days that they didn't present at ward/hospital due to sickness. Data gathered retrospectively from nurses' records. Data analyzed by SPSS using descriptive statistics tests, simple and multiple linear regressions.

Results: The mean age of participants was 44.97±5.910 and 73.8 of them were women. Explaining power of predicting factors was very well (F=71.121, P<0.01). Variables such as Marital Status (β=0.150, P<0.001), ward's type (β=-0.553, P<0.001), physical factors (β=0.101, P=0.001) and mental factors (β=0.226, P<0.001) explained 42% of the absence variance.

Conclusion: considering some aspects such as physical and mental factors and also health issues of nursing staff  based on wards' type  can be result in  absenteeism reduction.