Journal of

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Background: One of the necessities of hospital administrations is that the top and middle managers should be familiar with leadership styles and conflict management strategies completely and select a right managerial method. Through this, they can actively play a significant role in improving effectiveness and efficiency of hospital performance. The main objective of this research is surveying the relationship between Fidler's LPC score (as a sign for leadership style) and conflict management strategies (avoidance oriented, solution oriented, control oriented).

Materials and Methods: For surveying leadership styles Fiddler's Least Preferred Coworker questionnaire and for surveying conflict management strategies, another questionnaire was used. The reliability of these two was 0.90 and 0.88 respectively. The survey population was consisted of the high and middle managers of Kerman's educational hospitals (81), and a sample 67 individuals was selected for survey.

Results: The result showed that respondents mostly use communication oriented style and employed conflict management strategies are avoidance, solution and control respectively. Also it was observed that there is a positive and significant relation between LPC score and avoidance and solution strategies (r= 0.512 and 0.298 respectively). But there is a negative and significant relation between LPC score and control oriented strategy (r= -0.474).

Conclusion: According to the findings it is suggested that, the reasons of using avoidance strategy should be surveyed and try to encourage people to state their inconsistent ideas and converse freely. This could help organization to improve its performance. But communication oriented style is suitable and its maintenance should be taken into consideration.

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Abstract Background: EMS technicians are faced with numerous stressful situations during a working day. These mental tensions may significantly effect on delivered services quality actually. This situation can be considered as a threaten risk for people who use the EMS. This study aimed to determine the most common stressful factors influencing the EMS technicians in Kerman. Materials Methods: In this cross-sectional study 140 EMS technicians participated. Sampling method was census and data collection was done by using a valid and reliable nursing tension factors questionnaire. Data analyzing was performed by SPSS software version 19 using Pearson correlation coefficient, Spearman and regression tests. Results: The most and least common stressful factors were patient care (Mean=3.24) and environmental tension (Mean=2.64) respectively. Regression analysis revealed significant relation between age and environment tension factors (β = -0.155, p=0.034,) and managerial stressful factors had significant relation with gender (β= -2.955, p= 0.047) and educational level of EMS technicians (β= -0.23,p=0.05). Conclusion: Patient care and personal factors cause stressful situations among EMS technicians. Therefore, it is recommended emergency managers to provide strategies toward decreasing job stress in order to improve the quality of working life and organizational commitment to help EMS technicians.

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Background: Given that Tabriz Shohada hospital is the place of admitting emergency patients including accident victims, Nurses are exposed to double stress at hospital. This study conducted to predict nursing stress based on personality traits and job engagement among nurses in Shohada hospital of Tabriz.

Materials and Methods: The current study was a correlational one. Randomly selected 105 nurses from Tabriz Shohada hospital sections such as sixth general sections including Rehabilitation, ICU & Emergency Department participated. Contributors answered to Nursing Stress Scale, Eysenck Personality Questionnaire Revised (EPQ-R) and Job Engagement Scale. Data were analyzed using stepwise multiple regression analysis.

Results: The study results indicated that nursing stress was more strongly associated with the neuroticism; there were no relationships among nursing stress and extraversion or psychoticism. Also, nursing stress revealed a positive relationship with job engagement. Using the multivariate regression analysis showed that the neuroticism trait (p< 0.001, F=10.68) and job engagement (p= 0.004, F=10.12) were suitable predictors for nursing stress among three personality factors and job engagement.

Conclusions: Nursing stress influenced by internal factors more than demographic variables and two important predictive variables (neuroticism trait and job engagement) had more important roles in nursing stress prediction.

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Background: Employees’ empowerment is the best and efficient organizational strategy for improvement of human resources productivity. Therefore, the present study was aimed to investigate the relationship between empowerment training courses with human resources productivity among Tehran University of Medical Sciences employees.
Materials and Methods: This was a descriptive-analytical and cross-sectional study. The study population included 1452 employees of the university deputies. Research sample was calculated 304 according to Krejcie and Morgan table. The research tool consisted of Hersey's empowerment training courses effectiveness translated by Jafari “et al.” and Hersey-Goldsmith's human resources productivity questionnaires. The content and structural validity including convergent and divergent validity of questionnaires were determined, and their reliability was confirmed by Alpha Cronbach with 0.86 and 0.89 coefficient, respectively. Data were analyzed by SPSS version 23, and descriptive results were presented by absolute and relative frequency and analytical results by inferential statistical techniques and Structural Equation Modeling.
Results: The mean of empowerment training courses effectiveness of employees and human resources productivity was relatively desirable. Also, the relationship between empowerment courses effectiveness and human resources productively of employees was confirmed.
Conclusion: Using different procedures of employees’ empowerment in early period of employment including organizational socialization, on-the-job training courses by workshops, distance learning and in-person training for empowerment of self-esteem, compatibility, and innovation of employees’ for promotion of organizational and individual productivity is recommended.

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Introduction: Socio-economic inequalities in the use of dental services are a major challenge to health policies in many countries. This cross-sectional study was conducted to investigate socio-economic inequalities in utilization of dental services in households of Lorestan province and comparing it with neighboring provinces.
Methods: Data required for the study were collected from the household expenditure and income survey (HIES). The study population included 5547 households in the western provinces of the country. Logistic regression method was used to determine the most important factors affecting the use of dental services, and the focus index was used to measure inequality between income groups. Data analysis was performed using Stata software version 14.
Results: The highest and lowest percentages of dental services among households were related to Hamedan (7.02%) and Lorestan (3.19%) provinces, respectively. The results of the focus index showed that the benefits and costs of dental services were concentrated among households with higher socio-economic status. In other words, inequality benefits the rich. Being a female head of household and increased size of the household leads to a decrease in the use of these services. The higher education level of the head of the household and the increase in the number of employed and literate household members showed a positive relationship with the utilization of dental services.
Conclusion: Benefiting from dental services was significantly higher among higher socio-economic groups. These inequalities can be avoided by introducing and implementing targeted policies. Low-income households, lower education levels, and the unemployed should be the focus of health policies to address unmet dental care needs.

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Background and purpose: Considering the dimensions of organizational bullying and the context of its creation in the emergency department of the hospital, the decrease in the quality of patient care and the increase in dissatisfaction with the services received and the limited research studies in this area, the research was conducted in the emergency department of a hospital of Yazd University of Medical Sciences.
Materials and methods: To carry out this descriptive-analytical research, the interpretive structural modeling method was used. The experts included 30 doctors, nurses, and nurses who were either working in the emergency department of a Yazd University of Medical Sciences hospital or had experience of service in this department. From the extraction of these factors, they were returned to them for scoring, and the effects of these factors were measured from their point of view, and the final analysis was done by MATLAB software.
Results: The results show that the greatest effect in reducing bullying is related to "adequate training for personnel to communicate" and "proper and courteous treatment in the face of clients" (with influence power of 5) and the least effect is related to "creating a suitable comfortable environment". and "Perform appropriate triage" (with penetration power of 1).
Conclusion: Considering the destructive effects of bullying, creating appropriate mechanisms to reduce this phenomenon shown in this research and using the factors identified by the people involved in bullying can prevent this phenomenon, which occurs frequently in the emergency room of the hospital. 

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Background: The development of the health system increases the health level of the society. The present study was carried out with the aim of development of "Health System Development Scale".
Methods: The study was qualitative-quantitative. For qualitative part, a semi-structured interview with 11 experts was conducted in a targeted manner with maximum diversity and the results were analyzed by open, central and selective coding method. For quantitative part, first the validity of the questionnaire was carried out through interviews with 10 experts. Finally, the construct validity was conducted according to the opinion of 220 experts by exploratory factor analysis (with the Kaiser-Meyer-Elkin scale) and confirmatory factor analysis (in the form of divergent, convergent validity and fit indices) using SPSS and Lisrel software. Reliability was also measured by calculating Cronbach's alpha coefficient and composite reliability.
Results: The scale was designed with 40 statements obtained from the findings of the qualitative study. In the quantitative part, the appearance and content validity ratio of the dimensions of the questionnaire was qualitatively confirmed (for all statements between 0.80 and 0.1). Construct validity was done by exploratory and confirmatory factor analysis and convergent validity was between 0.53 and 0.75 and divergent validity was between 0.54 and 1. The internal consistency of the tool was approved with Cronbach's alpha coefficient between 0.75 and 0.86 and composite reliability coefficient was between 0.72 and 0.80.
Conclusion: The validity and reliability of the scale was confirmed. It is suggested to use it to measure the level of development in the health system by experts in this field.