Showing 27 results for Healthcare
Hamid Mohammadi, Shahram Tofighi, Mostafa Rajabi, Hamidreza Izadbakhsh, Bahar Hafezi,
Volume 21, Issue 1 (5-2022)
Abstract
Background: The use of simulation models can help elucidate the intuitive behavior of complex health care problems. Today, the complexity of problems goes far beyond our capacity to solve them manually. System simulation is considered as a wise option by approaching structural problems and understanding the complex interactions within the problems and their changes. The purpose of this study is to review the most advanced applications of system dynamics in healthcare.
Materials and methods: This study is a systematic selection of articles that explored the applications of system dynamics in health care in 11 databases between 1999 and 2019. The focus of this research was on articles with the keywords including system dynamics in health care, dynamic health care analysis, continuous health care simulation or dynamic health care simulation.
Results: 79 articles related to system dynamics applications in healthcare were identified in databases. Eighty-five percent of the articles focused on finance, politics, government, regulation, public health, and health care planning. Among the articles, the patient's treatment path, obesity and demand for healthcare workforce were examined.
Conclusion: The tendency to use continuous simulation in healthcare has increased. However, the power of hybrid simulation can take advantage of the inherent strength of the system dynamics overview perspective, and in a hybrid model it can utilize a holistic perspective for managing health care systems. Potential areas with the application of systems dynamics in future research include planning and policy-making in public health decision-making, purchasing quality management, care and risk.
Noushin Kohan, Fatemeh Keshmiri, Roohollah Askari,
Volume 21, Issue 3 (12-2022)
Abstract
Background: It is expected that graduates of healthcare management have the necessary skills to perform various managerial and administrative positions. This study was carried out with the aim of designing and compiling an evaluation framework for students based on educational standards in the internship period.
Materials &Methods: The current study was conducted in four phases: In the first phase, in order to identify the problem and assess the needs, the existing curriculum and topics were examined, as well as the studies conducted in this field. In the second phase, the perspective of the stakeholders was used to complete and modify the initial framework. In the third phase, worksheets for registering internship learning activities were prepared for students and a checklist of educational and learning objectives, personal and management skills, and skills for developing professional qualifications was compiled. Finally, a specialized panel was used to determine the type of formative and final exams.
Results: The problems and challenges of internships can be investigated in 4 areas: inappropriate planning of the course, faculty, group - professors and hospital. In designing the evaluation tool, 9 criteria were taken into consideration. Also, tests designed in a compilation framework were used as formative tests and reasoning tests were used as final tests.
Conclusion: The compiled framework can be used as a valid and comprehensive tool to evaluate the practical competence and capabilities of healthcare management students during the internship period.
Behrooz Rahimi, Seyed Mahdi Jalali, Hamed Nazarpour Kashani,
Volume 22, Issue 2 (9-2023)
Abstract
Introduction: Equitable geographical distribution of healthcare system initiatives, aimed at increasing quality and economic efficiency, is a crucial aspect of ensuring access to healthcare services. This study seeks to elucidate the contextual, procedural, and outcome factors of health marketing in Iran, with a focus on enhancing and improving health services.
Methods: This research was conducted using a qualitative approach. The sampling method employed was purposive, resulting in the participation of 51 experts. The study data were analyzed using content analysis.
Findings: The findings of this study have been categorized into conceptual subgroups, including causal conditions, foundational components, strategies, contextual factors, intervening factors, and consequences of implementation.
Conclusion: Adopting an effective health marketing model can create opportunities for service providers to generate sufficient income, thereby motivating them to deliver high-quality services. Attracting ample income, in addition to ensuring service quality for recipients, will also lead to their satisfaction with the healthcare system and contribute to the continuous provision of desirable services.
Saeede Afshari, Shaghayegh Vahdat, Iravan Masoudi Asl, Somayeh Hesam,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: In today’s competitive organizational landscape, the significance of recruiting and developing competent human resources has become paramount. Organizations not only aim to select and attract capable and efficient personnel but also seek to enhance and expand their capabilities. Consequently, the concept of meritocracy has become a key concern for modern organizations. This study aims to investigate the factors influencing succession planning in the leadership of healthcare organizations in Iran.
Methods: This qualitative study was conducted using content analysis in 2020. The statistical population comprised key decision-makers and policymakers in successful and prominent Iranian organizations known for effective succession planning, such as the Islamic Revolutionary Guard Corps (IRGC) and the public banking system. A total of 15 experts were selected through purposive and snowball sampling, with data collection continuing until theoretical saturation was achieved. Data were gathered through structured interviews, and the analysis and coding were performed using MAXQDA 11 software.
Results: The study identified five main themes: alignment of strategic goals and needs analysis, strategic communication and organizational structure, talent identification and empowerment, development and excellence of qualified individuals, and monitoring of succession planning programs. These were further divided into 13 sub-themes.
Conclusion: Organizations and managers should provide comprehensive support and demonstrate commitment to the effective implementation of succession planning programs. This will lead to improved organizational decisions and policies, ensuring that competent and qualified individuals are placed in key positions. Additionally, this approach will enhance work quality, boost employee motivation, reduce resource wastage, and improve career advancement opportunities for staff.
Mehran Lak, Farnaz Vosough, Kianoush Saberi, Shahnaz Sharifi, Hadi Pashapour,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Infections related to inadequate healthcare practices can have adverse effects on healthcare systems. This study aims to identify the gap between the current handwashing practices and standard levels by determining the frequency of handwashing among staff at Shahid Modares Hospital in Tehran.
Methods: This descriptive cross-sectional study was conducted in the wards of Shahid Modares Hospital between 2018 and 2019. The tool comprised two parts: job information and hand hygiene practices at different times and specific actions. Observers directly monitored all staff in each shift using a headcount method. Each column represented the hand hygiene compliance score of a specific professional group, allowing simultaneous performance evaluation.
Results: Out of 640 observed instances, 202 involved the use of disinfectants, 255 involved handwashing, 111 involved glove use, and in 71 instances, hand hygiene was not observed. The highest compliance occurred when staff intended to contact the patient's body, while the lowest compliance was observed after performing surgery on the patient.
Conclusion: Given the significant role of nurses in therapeutic interventions, multifaceted training interventions, the drafting of hand hygiene policies, and increasing awareness among department officials should prioritize this group of employees. These measures aim to bring practices closer to desired standards and prevent unwanted consequences.
Asgar Aghaei Hashjin, Ali Nemati, Seyed Mohammad Tabatabaee Jabali, Pouria Farrokhi,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: Iran is ranked among the top ten nations in the world for hosting a large number of migrants and refugees. During the COVID-19 outbreak, refugees and migrants were among the most vulnerable groups. This study aimed to investigate the extent of healthcare service utilization by refugees and migrants during the COVID-19 pandemic in healthcare centers affiliated with Iran University of Medical Sciences
Methods: This quasi-experimental study was conducted in 2021 in Tehran. The research environment included all healthcare networks and general and specialized hospitals. Data were collected through document review and registered information in the Sina system. All provided services were categorized into four groups: primary care, outpatient, emergency, and inpatient services. Data analysis was performed using the Chow test and Interrupted Time Series model with the Wats and Sctest software packages in R version 4.3.0.
Results: The decrease in utilization of outpatient, emergency, and inpatient services by refugees and migrants was significant (P-value < 0.001), whereas the decrease in primary care services was not significant. Additionally, after the onset of COVID-19, only the utilization of inpatient services showed a significant increasing trend (P-value < 0.013).
Conclusion: During the COVID-19 pandemic, the utilization of all healthcare services by refugees and migrants, including primary, outpatient, emergency, and inpatient care, decreased. It is recommended to provide complete insurance coverage for refugees, offer free treatment for impoverished refugees, increase awareness among refugees to encourage greater use of health services, reduce existing social and economic barriers, and facilitate interaction between healthcare providers and refugees.
Mehrak Pourmotahari, Soad Mahfoozpour, Shahram Tofighi, Shaghayegh Vahdat, Irvan Masoudi Asl,
Volume 22, Issue 4 (1-2024)
Abstract
Background and purpose: As health resources face increasing constraints, the use of medical imaging services has risen significantly. On average, diagnostic services account for approximately 10% of total healthcare expenditures, and this figure is steadily increasing. This study aims to identify the causes of irrational utilization of medical imaging services and propose corrective measures.
Methods: This descriptive-survey research was conducted in two phases. In the first phase, a comprehensive literature review was performed using both international and national databases, covering the period from 1990 to November 2021. Relevant studies were identified using specific keywords. In the second phase, a semi-structured questionnaire was developed, and a series of in-depth interviews with experts and professionals were conducted. Data were analyzed using the six-step thematic approach by Braun and Clarke, utilizing MAXQDA software.
Results: A total of 605 studies were initially identified, of which seven met the inclusion criteria after rigorous screening. In the second phase, 12 in-depth interviews were conducted, yielding 65 codes, which were organized into 12 themes. The identified themes included legal issues, conflict of interest, monitoring challenges, poor governance and stewardship, inappropriate policymaking and planning, financial incentives, inadequate service provision infrastructure, health culture, education and continuous training systems, financing and purchasing services, political factors, and inadequate insurance systems. Various strategies for controlling the inappropriate use of diagnostic and therapeutic services were proposed, including policy interventions, monitoring and evaluation, and training.
Conclusion: The irrational use of healthcare services is a significant challenge in many countries. Key contributing factors include incomplete insurance coverage, out-of-pocket payments by patients, defensive medical practices, and gaps in knowledge. Addressing these issues requires targeted interventions and reforms.
Mohammad Amin Zar Foroush, Zeinab Partovi Shayan, Ghasem Rajabi Vasakolaei,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The laundry unit is one of the most critical support services in a hospital. Optimizing processes and implementing effective management strategies in this unit can significantly impact cost management. This study aims to examine various aspects of hospital laundry units.
Methods: This research was conducted across the teaching hospitals affiliated with Tehran University of Medical Sciences. The study employed a multi-step approach. First, the most crucial performance criteria for laundry units were identified through a fuzzy Delphi technique, consulting 20 experts in the field. These criteria were then weighted using the Step-wise Weight Assessment Ratio Analysis (SWARA) method. Finally, hospitals were ranked using the VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method.
Results: The analysis of main criteria in the laundry unit revealed the following significance levels: "performance criteria" (56%), "equipment and facilities" (28%), and "cost management" (16%). Among the sub-criteria, "process" emerged as the top priority with a weight of 0.285, followed by "general laundry section regulations" (0.155), "safety and health" (0.139), and "general" (0.081).
Conclusion: The findings highlight the paramount importance of the "process" sub-criterion in hospital laundries. Consequently, we recommend updating guidelines for linen collection, washing, maintenance, and distribution. Furthermore, given that "general laundry section regulations" ranked as the second priority, we suggest implementing clear separation of dirty and clean pathways within the laundry unit and establishing a system for continuous recording and weighing of received garments. These measures can significantly enhance overall process management and cost efficiency.
Asra Khalili, Ali Mohammad Mosadegh Rad, Shahram Ghafary, Ebrahim Jaafaripooyan,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Effective management of human resources is crucial for improving healthcare services, as personnel are an organization's most valuable asset. This study aims to identify challenges in human resource management and propose solutions to enhance service quality in hospital settings.
Methods: This qualitative study employed semi-structured interviews with 53 managers and key decision-makers from Social Security hospitals in Tehran, using purposive and snowball sampling techniques. Thematic analysis was utilized to analyze the data. The validity and reliability of the qualitative findings were ensured through participant and expert review methods.
Results: The study identified numerous human resource challenges, categorized into five main groups and 20 subgroups. Key issues included flawed recruitment and hiring processes, unfavorable working conditions, weak human resource organization, inadequate staff training, and ambiguity in employment laws and regulations. Proposed solutions, classified into five main groups and 29 subgroups, encompassed: enhancing recruitment and hiring processes, fostering a dynamic organizational culture, improving human resource productivity and efficiency, transforming hospitals into learning organizations, providing comprehensive and effective training, and increasing transparency in rules and regulations, particularly in job descriptions.
Conclusion: Regular identification of human resource management challenges and implementation of evidence-based, scientific, and operational solutions can significantly improve human resource management and, consequently, hospital performance in Social Security hospitals.
Seyed Mohammad Mahdi Heydari Baghdadabad, Alireza Maetoofi, Ali Farhadi Mahalli , Mojtaba Tabari,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Hospitals play a critical role in promoting public health and well-being in social contexts. This necessitates codified standards aimed at maintaining treatment quality and enhancing social satisfaction. Hospital accreditation policy evaluation is considered a systematic process that can have significant social and functional implications for hospitals. This study aims to present an evaluation model of hospital accreditation policy based on the process of paradigmatic phenomenology.
Methods: Using Husserl's (1970) phenomenological approach, this study developed a paradigmatic evaluation model in five analytical steps. First, through interviews with experts and open coding, propositional themes related to the phenomenon under study were identified. A focus group was then formed to discuss and analyze these propositions. Each proposition was scored using the Q-method checklist, with scores ranging from +6 to -6, to identify paradigmatic clusters.
Results: During the qualitative analysis, 16 interviews resulted in 138 open codes. After eliminating redundancies and overlapping codes, 50 propositional themes were finalized. These themes were organized into conceptual clusters within the framework of paradigmatic phenomenology, following Husserl's methodological steps.
Conclusion: The study's findings underscore the formation of a hospital accreditation policy evaluation model structured around causal, intervening, contextual conditions, strategies, and outcomes. This model has the potential to enhance the effectiveness of healthcare service delivery and improve the overall quality of treatment in society.
Ali Ghaffarian, Azam Cheraghi, Masoud Ferdosi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Accreditation is one of the most widely recognized and reliable methods for evaluating the quality of hospital services. However, its implementation is often accompanied by various challenges for hospitals. This study aimed to identify the challenges associated with accreditation in small and single-specialty hospitals from the perspective of those involved in the process.
Methods: This qualitative descriptive study was conducted with the participation of 30 individuals, including hospital staff, national accreditation evaluators, and experts from the Ministry of Health's Monitoring and Accreditation Office. Data were collected through semi-structured interviews and individual sessions. Content analysis was used to process the data, which was analyzed using Max-QDA software (version 20).
Results: The accreditation challenges of small hospitals were categorized into four main themes: "accreditation process," "human resources," "structural issues," and "financial constraints." For single-specialty hospitals, challenges were grouped into three themes: "accreditation process," "human resources," and "uniformity of accreditation standards." Common challenges for both hospital types included low staff motivation, insufficient training in accreditation procedures, and issues related to evaluators.
Conclusion: In addition to general accreditation challenges, small and single-specialty hospitals face unique obstacles due to their specific conditions and inherent differences from other hospitals. To ensure the successful implementation of accreditation programs in Iran, policymakers should thoroughly examine the identified challenges and incorporate these insights into national hospital accreditation planning and implementation strategies.
Shadi Khalilolahi, Nasrin Kazemi, Saeid Besharati, Atefe Abedini, Mohammad Varharam,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The globalization of medical tourism has intensified competition among destinations, making it crucial to identify key success factors. While research emphasizes the role of host communities in tourism development, non-medical aspects of medical tourism remain underexplored. This study examines healthcare staff perspectives to identify the drivers and barriers affecting medical tourism in public hospitals.
Methods: This qualitative study employed structured interviews with 16 healthcare staff at Masih Daneshvari Hospital, selected through purposive sampling. Interviews were conducted in person during the summer of 2024 until data saturation was reached. Data analysis followed an inductive content analysis approach using MAXQDA software for coding, grouping, and categorization of themes into drivers and barriers.
Results: Key drivers of medical tourism development include skilled human resources, strong medical potential, affordable healthcare and associated costs, and the presence of complementary attractions. Conversely, major barriers include inadequate welfare services for medical tourists, managerial and institutional inefficiencies, hospital infrastructure deficiencies, and political and cultural challenges.
Conclusion: Developing a successful medical tourism sector requires a holistic approach. Identifying, prioritizing, and implementing strategic plans to strengthen facilitators and address obstacles are essential steps toward sustainable growth in this field.
Fatemeh Sadat Vahabzadeh Moghadam, Ahmad Vedadi, Karam Allah Daneshfard,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: A fearless organization fosters psychological safety, ensuring that every member feels secure to express concerns, ask questions, or share mistakes without fear of humiliation, ridicule, or punishment. This research aims to introduce the Fearless Organization Model in Iran's healthcare sector, with a focus on the Ta’amin Ejtemaie hospitals.
Methods: This research employs a mixed-methods approach. In the qualitative phase, methods such as meta-synthesis, expert Delphi, and Shannon’s entropy were used to identify the components of a fearless organization. The quantitative phase involved structural equation modeling (using surveys distributed among the staff of Ta’amin Ejtemaie hospitals in Tehran) to validate the research model.
Results: The Fearless Organization Model consists of two main dimensions: “Behavioral” and “Structural.” The behavioral dimension includes "managers' behavioral components" and "employees' behavioral components." The structural dimension includes "organizational components," "human resource components," and "environmental components." Key characteristics of a fearless organization include: creating psychological security, openness, transparency, accountability, humble listening, quick employee feedback, learning from mistakes, encouraging knowledge sharing, avoiding silence, and promoting open communication. Effective response systems and coherent organizational structures for extracting ideas and concerns, as well as fostering a supportive culture, are essential.
Conclusion: The findings of this study emphasize the importance of addressing both behavioral and structural dimensions in creating a fearless organization. However, the behavioral dimension plays a more significant role than the structural one. Within the behavioral dimensions, "employee behavior" is the most crucial factor. Managers should focus on cultivating behaviors that promote security and openness within the organization. This research can serve as a foundation for further studies on the drivers and barriers to establishing fearless organizations in different contexts.
Amirhossein Abdolalipour, Masoumeh Mikailiy, Khadijeh Alizadeh,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: This study proposes an integrated model to explore the mediating role of financial performance in the relationship between quality indicators, learning and growth, and the overall performance of hospital facility management services.
Methods: The statistical population included hospital managers across West Azerbaijan Province, Iran. Based on Cochran’s formula, 147 participants were selected using a simple random sampling method. Data were analyzed using Structural Equation Modeling (SEM) via SmartPLS software. Standardized factor loadings were used to assess model fit, and the Z-test was applied to evaluate the statistical significance of the relationships. Predictive power was assessed using the adjusted R² and Stone-Geisser Q² criteria.
Results: The indirect effects of quality indicators (t = 2.41), learning and growth indicators (t = 2.20), and internal process indicators (t = 2.39) on hospital service performance—mediated by financial performance—were all statistically significant (t > 1.96). Standardized path coefficients of 0.201, 0.344, 0.359, and 0.805 further confirmed the model's empirical robustness and goodness of fit.
Conclusion :The findings suggest that improvements in internal processes, service quality, and organizational learning and growth significantly enhance financial performance, which in turn improves the effectiveness of hospital facility management services. These enhancements contribute to increased patient satisfaction, strengthened hospital reputation, reduced operational costs, and ultimately improved revenue and financial efficiency.
Mehdi Hosseini, Ahad Norouzzadeh, Fatemeh Hosseini,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: The integration of digital technologies—computer-based systems, devices, and methods—is transforming organizational activities within the healthcare sector. However, research on the adoption of these technologies in healthcare remains limited, with a predominant focus on structural rather than behavioral factors. As the successful implementation of technology ultimately depends on the workforce, behavioral aspects play a decisive role. Therefore, this study aims to identify the principal behavioral barriers to the adoption of digital technologies in the healthcare sector.
Methods: This applied research utilized a three-stage survey methodology. The stages included: (1) identifying the most significant behavioral barriers to digital technology adoption through a literature review and expert opinions; (2) developing a hierarchical model of these barriers using Interpretive Structural Modeling (ISM); and (3) testing the hypotheses derived from the model with a sample of 302 healthcare professionals.
Results: The ISM model identified a hierarchy of six key behavioral barriers: lack of digital literacy, low perceived value, high perceived risk, negative attitude, resistance to change, and ultimately, non-adoption of digital technology. Based on this model, six research hypotheses were formulated. Regression analysis was conducted to test these hypotheses, and the results indicated that all six were statistically supported.
Conclusion: The findings establish that a lack of digital literacy is the most fundamental barrier to digital technology adoption in the healthcare sector. To address this primary obstacle, the study recommends targeted interventions, such as conducting national assessments of digital literacy levels among healthcare staff and implementing tailored training programs to enhance their technological competencies.
Fateme Tavallaei, Fattah Sharifzade, Reza Vaezi, Seyed Jalalodin Faraji,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Non-communicable diseases (NCDs) account for 76% of mortality in Iran, where effective management hinges on community empowerment and integrated service delivery. Co-production, an innovative strategy involving shared power between service users and providers, is a promising approach for addressing the multifaceted needs of patients with chronic conditions. This study aimed to develop a context-sensitive framework for implementing and evaluating co-produced NCD management programs. We achieved this by integrating the core principles of co-production with a realist evaluation lens, drawing on the perspectives of senior healthcare managers.
Methods: Employing a qualitative methodology, this study conducted a thematic analysis of data derived from a comprehensive literature review and semi-structured interviews. A cohort of 17 senior healthcare managers, selected via purposive sampling in 2025, participated as key informants.
Results: The analysis yielded a hierarchical thematic structure comprising 71 basic themes, 20 organizing themes, and 6 overarching global themes. These global themes, which form the core of the proposed framework, are: (1) Developing Participatory Clinical Processes, (2) Establishing Equity-Oriented Support Services, (3) Recognizing Diverse User Groups, (4) Enhancing Provider Capabilities, (5) Understanding User Responses, and (6) Fostering Mutual Benefits among Stakeholders. The dynamic interplay of these themes is crucial for operationalizing effective NCD co-production.
Conclusion: By innovatively integrating co-production principles with a realist evaluation framework, this study offers a context-sensitive model that clarifies theoretical concepts for practical application in NCD management. A key implication is the necessity for monitoring systems that track both clinical and well-being outcomes, supported by multi-level incentive structures. This research provides a foundational model for policymakers to develop, implement, and evaluate more effective and equitable co-produced healthcare programs. Further longitudinal research is recommended to assess long-term outcomes and incorporate patient perspectives.
Karen Fatahi,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Nurse's thermal comfort in a clinical setting directly impacts their performance and the quality of patient care. This study investigates how two key environmental factors—ambient light intensity and Correlated Color Temperature (CCT)—influence this perception of thermal comfort.
Methods: This experimental study was conducted in a controlled laboratory setting with 60 healthy female nurses over four months (December 2024–March 2025). We assessed the effects of light intensity (at two levels: 300 and 750 lux) and CCT (at three levels: 2700 K, 4000 K, and 7800 K) on perceived thermal comfort. Data were analyzed using a two-way Analysis of Variance (ANOVA).
Results: Light intensity, CCT, and their interaction all had a statistically significant effect on nurses' perceived thermal comfort (p < .05). Optimal thermal comfort was reported at a CCT of 4000 K under both 300 and 750 lux intensities. At a warm CCT (2700 K), comfort was maintained at 300 lux but not at 750 lux. Conversely, at a cool CCT (7800 K), the 300 lux condition was perceived as uncomfortable, while the 750 lux condition was reported as comfortable.
Conclusion: This study demonstrates a significant interaction between light intensity and CCT in shaping thermal perception in a clinical context. The findings suggest that lighting design in healthcare facilities must consider both metrics simultaneously to optimize the work environment. A neutral CCT of 4000 K appears to be the most robust for maintaining thermal comfort across different light levels, highlighting its potential as a design standard for healthcare settings.
Ali Modabber, Habib Jalilian, Behnam Gholizadeh, Esmaeil Mousavi Asl, Farzad Faraji-Khiavi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Ensuring continuous access to healthcare services is critical for patients with hypertension, particularly during pandemics and public health crises. This study aimed to evaluate the resilience of service delivery by Primary Healthcare Centers (PHCs) to hypertensive patients during such emergencies.
Methods: This descriptive cross-sectional study was conducted in 2023 across 10 PHCs in Markazi Province, Iran. A total of 250 patients with hypertension were recruited using a systematic random sampling method. Data were collected using a researcher-designed questionnaire assessing four dimensions of resilience: quality, accessibility, continuity, and coordination. Data were analyzed using descriptive statistics and multiple linear regression in SPSS software (version 24).
Results: The overall service resilience score was 2.95 (±0.32), indicating a "relatively weak" level of resilience. The mean scores for the dimensions were: Accessibility 3.08 (±0.28), Coordination 3.03 (±0.76), Quality 2.93 (±0.41), and Continuity 2.88 (±0.35). Multiple regression analysis revealed that these four dimensions collectively explained 96.1% of the variance in service resilience. Accessibility (β = 0.478) was the strongest predictor, followed by Quality (β = 0.379), Continuity (β = 0.352), and Coordination (β = 0.178).
Conclusion: The resilience of services provided by PHCs to hypertensive patients during pandemics was assessed as suboptimal. These findings highlight an urgent need for strategic operational planning by health policymakers. Developing protocols to ensure service continuity and expanding infrastructure for remote care (telemedicine) are recommended as key priorities to enhance system resilience.
Yousef Hamidzadeh Arbabi, Mohammad Panahi Tosanloo, Rohqayeh Farrokhi, Amin Ahmadi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Workplace Violence (WPV) is a significant occupational hazard and is increasingly recognized as a critical crisis within the healthcare sector. Due to the inherent nature of their services, healthcare organizations are more susceptible to this phenomenon than other sectors. This study aimed to investigate the prevalence of workplace violence and its role in predicting the job satisfaction of healthcare workers in Ardabil.
Methods: This descriptive-analytical cross-sectional study was conducted in 2024. A total of 300 employees working under the auspices of the Ardabil Health Center were selected using stratified random sampling. Data collection utilized two standardized instruments: the Minnesota Satisfaction Questionnaire (MSQ) and the Workplace Violence in the Health Sector Questionnaire. Data were analyzed using SPSS software (version 20) via descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and linear regression analysis.
Results: The overall job satisfaction rate was calculated at 58.75%. In terms of prevalence, 63.8% of the participants reported experiencing workplace violence at least once during the past year. The mean score of experienced violence was 27.35%. Psychological violence was the most frequent form (51.5%), while physical violence was the least frequent (9.4%). Significant statistical relationships were observed between demographic characteristics, workplace violence, and job satisfaction (P<0.05). Linear regression analysis identified workplace violence (β = 0.181) as the third most influential predictor of job satisfaction, following the payment system (β = 0.482) and advancement opportunities (β = 0.312).
Conclusion: The findings suggest that healthcare workers may have normalized workplace violence as an inherent part of their professional environment. Consequently, their job satisfaction appears to be more heavily influenced by economic factors—specifically the compensation and payment system—than by the adverse effects of occupational violence.
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
