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Showing 93 results for Health

Dr Roghieh Bayrami, Dr Hossein Ebrahimipour, Alireza Rezazadeh,
Volume 16, Issue 2 (7-2017)
Abstract

Background: Pre hospital emergency medical service (EMS) as the first line of emergency care and treatment in the out- of -hospital has a considerable importance in the health care system. Planning on finding about strengths and weaknesses and improve the quality of EMS by exploring the problems of this section has considerable important.This study aimed to explore the challenges of pre hospital emergency medical service in Mashhad.

Materials and methods: A qualitative study was done with 14 personnel working in EMS sites in Mashhad using purposeful sampling. Data was collected by semi structured interview and analyzed using conventional content analysis approach according to Graneheim and Lund man 2004 with ATLAS.ti  software.

Results: Three general themes were identified including 1) "challenges in Human resources"( Individual characteristics of human resources and personnel's dissatisfaction 2) "challenges in organization" (Structural challenges, lake of equipment and human resource limitation 3) "socio-cultural challenges"(Environmental-social challenges and cultural challenges) were determined.

Conclusion: personnel's dissatisfaction, structural challenges, human resource limitation, lake of equipment   and Environmental-social challenges were the most important challenges in pre-hospital emergency system. Organizational independence , create organizational rows, regulation of laws and administrative regulations reform in relation to the range of services offered by emergency personnel, attention to the facilities and cooperation And the participation of other organizations, such as media and traffic to enhance pre-hospital emergency services at the community level can be effective in reducing the challenges in hospital emergency system.


Yeganeh Hayati , Dr Hojjat Rahmani , Dr Mohammad Arab,
Volume 16, Issue 3 (11-2017)
Abstract

Background: Health of hospital staff has a determinant role in increased productivity and since the main mission of hospitals is community health promotion, in order to achieve this important issue, monitoring, maintaining and improving general health is essential; this study developed to assess general health of staff affiliated to Tehran University of Medical Sciences and identify its related factors.
Materials and Methods: This Cross-Sectional, Descriptive-analytical study was conducted among 320 staff members of the Tehran University of Medical Sciences who selected using random sampling. In order to data collection, the General Health questionnaire was used. Collected data were analyzed using SPSS software through t-test and ANOVA tests.
Results: Study findings revealed that 47.5% of participants had psychological disorders suspiciously; prevalence of physical symptoms, anxiety, social dysfunction and depression were 53.9%, 49.3%, 79.5% and 14.6% respectively. There was a significant relation between general health and demographic features such as gender, marital status, major, job department, housing situation and type of employment (p<0.05).  Also, the personal characteristics of managers influenced on the general health staff.
Conclusion: General Health of staff in hospitals Tehran University of Medical Sciences in comparison with similar studies at inside and abroad is not in good condition, therefore, it is recommended that policy makers and managers concerned the programs and solutions towards priorities in order to promote health personnel.


Dr Rahim Heydari Chianeh , Hojjat Mohamadi Torkamani , Musa Vaezi ,
Volume 16, Issue 3 (11-2017)
Abstract

Background:  Equitable and suitable access of all citizens to the urban public service is one of the primary principles of urban planning, which with the rise of the justice-centered approaches in recent decades has been double care. In the meantime, access to health services as one of the vital public service has greater sensitivity. This research has been performed with aim of identify enjoyed and non-enjoyed regions regarding health care and its distribution assessment applications in Tabriz city.
Materials and Methods: For the access analysis ARC GIS software, specially Network Analysis tool and Williamson and entropy index and has been utilized. Also, considering respective per capita, Tabriz city population needs and the existing deficiencies have been specified.
Results: The study results indicate that %76 of Tabriz city population have optimal access to healthcare facilities. In contrast, in the analysis of access to hospitals %36 of population have optimal access to theme and %64 have Undesirable access. Also, in urban zones analyses unit, based on Williamson index analysis, the index was calculated 0.67 to Tabriz city, which indicates an imbalance in the distribution of health care Facilities in the Tabriz city.
Conclusion: In general, zone 2 has the most balanced distribution of health care facilities and zone 9 is suffering from imbalanced distribution of health care facilities. It is suggested that in order to reduce the inequalities in the enjoyment of health care facilities, proper assessment about to existing facilities and future planning, in terms of Threshold, capacity and access should be conducted.


Dr Ehsan Zarei, Dr Behrooz Pouragha, Dr Soheila Khodakarim, Alireza Moosazadeh Nasrabadi,
Volume 16, Issue 3 (11-2017)
Abstract

Background: One of the main goals of health sector evolution plan is reducing the amount of out of pocket payment by patients receiving hospital services in public sectors. This study aimed to assess the amount of out of pocket payment by inpatients in public hospitals affiliated to Shahid Beheshti University of Medical Science in Tehran city in 2015.
 
Materials and Methods: In this cross-sectional study, 405 discharged patients from four public and teaching hospitals were selected using convenient sampling method. Data were collected using a researcher made checklist and investigating the hospital bills. In order to data analysis, descriptive statistics and regression analysis were utilized through SPSS Software version16.
 
Results:  The amount of out of pocket payment was 10.2 percent included 9.9 percent formal payment, 0.2 percent bought & brought goods and 0.1 percent informal payment. The most portion of the hospital costs was related to medical supplies and pharmaceuticals, surgeries services and hosteling with 32.6, 20.6 and 17.36, respectively. Type of hospital, having surgery, average length of stay, family size and gender had significant effect on the out of pocket payment amount (p ≤ 0.05).
 
Conclusion: The amount of out of pocket payment by inpatient in public hospitals was in accordance with goal of the health sector evolution plan, which reveals the appropriate government support. It is recommended to tailor and implement enormous plans regarding outpatients and private sector in national level to attain sustained reduction in out of pocket payment.


Somayeh Nouri, Dr Leila Riahi, Dr Kamran Hajinabi, Dr Katayuon Jahangiri ,
Volume 16, Issue 4 (2-2018)
Abstract

Background: Priority setting and resource allocation are assumed to be the most important issues of health-sector and fairness thereof requires considering various criteria. This study was performed to identify the criteria used for priority setting and resource allocation in the world health systems through comprehensive review.
 
Materials and Methods: Cochrane, PubMed and SCOPUS database were searched systematically from Jan.1,2005 to Oct.10,2016. The English articles with codified and specified qualitative and quantitative criteria in the resource allocation context in health sector were included in the study. The obtained data were synthetized thematically.
 
Results: Overall, 9162 papers were extracted. At the beginning of review of the included articles, 9089 papers were removed due to duplication and also based on the title. The abstracts of the remained papers were reviewed and 17 papers were removed. Full text of 59 remained papers were reviewed and based on matching with the inclusion criteria, 34 other papers were removed, too, and ultimately 25 papers were included in the final phase of the study. Extracted criteria were categorized into four dimentions based on economic, management, structural and contextual, out of which the most frequent ones were related to cost, health system goals, local capacity and disease status, respectively.
 

Conclusion: In this study, the most important criteria used by policy makers and decision makers of health system in the world were extracted for priority setting and resource allocation. The results indicated that in the world, priority setting and resource allocation in the health system is made mainly based on criteria such as cost-effectiveness, disease status, equity/equality and the need. 


Dr Ahmad Sadeghi, Dr Hossein Rohani, Sareh Davarzani, Zahra Davarzani,
Volume 17, Issue 2 (9-2018)
Abstract

Background: Patient complaints from the healthcare system can be helpful to respond patients’ needs using identifying the weaknesses. In this study, the complaints trend of patients has been investigated before and after healthcare system reform progress in a public hospital.
 
Materials and Methods: This descriptive-analytic study was carried out to assess trend of patient's complaints in two period of time in a northeast governmental hospital before and after healthcare system reform implementation (2012-2016). In order to collect data, the checklist designed by the ministry of Health was used. Data entered to SPSS version 21 and analyzed using descriptive statistics and analytical tests such as Chi-square.
 
Results: The study results revealed that the number of complaints were 29 and 198 before and after implementation of healthcare system reform, respectively. Most complaints were related to the emergency sector (31%) and about 40% of the complaints were from physicians. Most of the registered complaints were related to the quality of provided services (33.5%) and personnel exposure (30%), respectively. Accordance to study results, there was a significant difference between the number of complaints before and after implementation of the health system reform with the type of complainant (P <0.05).
 
Conclusion: Implementation of healthcare reform plan has led to systematic registration and special attention to complaints in assessed hospital. Most of registered complaints were related to the emergency department which requires managers and hospital officials to pay special attention to this sector and take effective steps to improve quality of services.
Dr Alimohammad Mosadeghrad, Mahnaz Afshari, Rahman Nasrolahi, Sareh Daneshgar, Rasoul Corani Bahador ,
Volume 17, Issue 2 (9-2018)
Abstract

Background: Insurance companies sometimes do not reimburse hospitals completely. Reducing the amount of deduction of bills increases hospital’s income and efficiency. This study compares the deductions imposed by social insurance organization on Imam Khomeini hospital’s bills before and after the implementation of health transformation plan.
 
Material and Methods: Data of this descriptive-descriptive study calculated from the deductions applied to the hospital of outpatient and inpatient bills of social insurance organization in second six months of 2013 (before implementation of health transformation plan) and the same time of 2014 (after implementation of of health transformation plan). This quasi experimental study was conducted using the data. Data was analyzed by SPSS software using paired t test.
 
Results: The bill deductions in the second six months of 2013 compare to the same time in 2014 were 2.9 and 11.1 percent, respectively. Hospital bill deductions increased 282.8 percent after the health transformation plan implementation. The deductions on inpatients and outpatients records increased 6 and 12 times, respectively. Most deduction was imposed on surgical and laboratory bills in 2013 and on radiotherapy, chemotherapy and hoteling bills in 2014.
 
Conclusion: Deductions of hospital bills extremely increased from social insurance organization after implementation of health transformation plan. In order to identify deductions causes, providing related education to staff and physicians and relative process improvement are necessary.


Fariba Asadi, Seyyedeh Sara Afrazandeh, Maryam Ebrahimi,
Volume 17, Issue 3 (11-2018)
Abstract

Background: One of the hospitals’ goals is providing high quality of health for patients and patient satisfaction is one of the indicators of quality of health care in hospitals in all countries. The present study aimed to evaluate patients’ satisfaction about performance of health transformation plan in teaching hospitals affiliated to southern Khorasan province in 2016.
 
Materials and Methods: This study was a cross-sectional, descriptive-analytic one which 410 patients admitted to seven public hospitals of south Khorasan province were evaluated using a standard questionnaire on patient satisfaction during one month. Data analysis was performed by SPSS22 software using descriptive and inferential statistics.
 
Results: level of 51.5% patients ‘satisfaction was assessed high, 37.1% in a good, 9.9% moderate and 1.6 low level. Regression analysis revealed that average score of satisfaction with education level and economic situation had a significant association (p <0.05) which patients with higher education level and better economic status had less satisfaction. There was no significant relationship between other demographic variables and satisfaction level.
 
Conclusion: According to study results, it can be concluded that the health transformation plan can achieve its goals and success regarding patients’ satisfaction and patient costs reduction due to patients' perspective. In order to increase patients’ satisfaction, paying more attention to welfare and nutrition and evaluating satisfaction in other groups (nurses, physicians and personnel) recommended.
 
Minoo Afshani, Dr Hojat Vahdati, Dr Mohammad Hakak, Dr Sayed Najomdin Moosavi ,
Volume 17, Issue 3 (11-2018)
Abstract

Background: Whistleblowing as a control tool should be encouraged in organizations to deter organizational illegal and immoral wrongdoings that finally are harmful to the society. Personality traits of people are influential factors on their intention to disclose the wrongdoings. This study aimed to assess the relationship between four personality traits (internal locus of control, ethical identity, extroversion and responsibility) and employees' intention to whistleblowing among the employees of central department of Mashhad University of Medical Sciences.
Materials and Methods: This cross-sectional study is a descriptive-analytic one. This research conducted on 251 employees of the central department of Mashhad University of Medical Sciences. A researcher-made questionnaire based on previous literature used to collect the data. Analysis of the data processed using the Partial Least Square (PLS) with Smart PLS software.
 Results: Since, the amount of standardized coefficients between independent variables (locus of control, ethical identity, extroversion and responsibility) and whistleblowing intention were statistically significant (P<0.005), all of these independent variables have positive and significant influence on the employees' whistleblowing intention.
Conclusion: Given that individuals with internal locus of control, ethical identity, responsibility and extroversion characteristics cannot be able to ignore the organizational wrongdoings, it is better organizations use employees with these characteristics at more sensitive or critical places, where the possibility of organizational wrongdoing is high, in order to prevent potential harm to the organization and society as a result of wrongdoings.
 
Dr Abdolreza Shaghaghi, Hassan Mahmoodi, Hossein Shahriari,
Volume 17, Issue 3 (11-2018)
Abstract

Background: The Health Promoting Hospitals (HPH) initiative emphasizes on changes in traditional hospitals’ approach in care provision. This study aimed to provide scientific evidence required for successful planning and implementation of the HPH in the country’s educational hospitals.
 
Materials and Methods: In this descriptive-analytical study, opinions of 300 frontline health professionals working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences were examined using validated tools in 2016. Descriptive data analysis procedures and logistic regression analysis (using Enter method) were applied by SPSS software version 22. The level of significance was considered less than 0.05.
 
Results: The mean scores and SD for applicability of the HPH standards were 66.06±17.51. Gender (OR=3.19 95%CI: 1.33- 8.40), occupation type (OR= 1.50 95% CI: 0.65- 0.70), hospital type (general vs. specialized) (OR= 1.59 95%CI: 1.10- 1.25), number of active beds (OR=3.84 95% CI: 1.56-9.42) and having prior knowledge about the HPH program (OR=2.81 95% CI: 1.31-4.80) were identified as significant predictors of the HPH standards’ feasibility in the studied hospitals.
 
Conclusion: Given that study findings, at least the baseline subjective inclination to adapt the HPH standards in the educational hospitals do not exist through the Iranian health care providers’ points of view. As the first step in progress towards preparation for implementing the HPH standards, planning of tailor-made educational programs for hospitals’ staff in Iran is recommended.
 
Dr Mohamad Hakkak, Seyed Ali Hozni, Neda Shahsiyah, Tahereh Akhlaghi,
Volume 17, Issue 3 (11-2018)
Abstract

Background: Hospitals are the most important and largest institution in each country's health system which health care services are carried out on a large scale. One of the most important processes to improve the quality of health services is accreditation in the country. This study aimed to identify challenges, obstacles and providing solutions in hospital accreditation.
Materials and Methods: This research is a qualitative one which conducted using content analysis approach in the north of the country in 2017.  Twenty-five people consisted of two heads of hospitals, three hospital managers, three matrons, four supervisors, ten nurses, three people responsible for accreditation selected as contributors to the study using a targeted sampling approach. After the interview with Maxqda software, coding was performed and necessary analysis was carried out. In order to obtain data validity, two methods of reviewing the participants and reviewing experts were used.
Results: Analyzed data was categorized in the 98 initial codes, 16 concepts and 5 main categories. The main issues included resource challenges, organizational challenges, technical challenges, negative consequences and solutions.
Conclusion: Pathology helps the organization to focus on problems and by collecting and analyzing data and identifying risky spots, managers and planners will find methods to develop and solve the problem. Particularly, the correct implementation of the accreditation process can lead to comprehensive clinical excellence.
 
Mahdiyeh Heydari, Dr Leila Doshmangir,
Volume 17, Issue 4 (2-2019)
Abstract

Background:  Need to assess the health system performance, various models and frameworks have been developed by different groups and organizations. This study explores health system performance assessment frameworks using the comparative-analytical study.
 
Materials and Methods: This is a comparative-descriptive study conducted using descriptive-prescriptive method based on comprehensive comparative analysis. The scope of research includes health system frameworks. The study results compared and interpreted based on identified factors in comparative tables.
 
Results:  Overall, 11 frameworks out of 16 ones described, analyzed and compared to each other. Some of the frameworks in addition to providing insight about the health system have focus on assessment of health system performance. Each framework follows especial goals which focus on importance the health systems assessment.
 
Conclusion: During the time, health system frameworks have changed and developed according to the health systems changes. Developed Frameworks in recent years are more comprehensive than others which have been presented at first. Utilizing these frameworks in order to identify health system goals, assess based on responsibility (organizational actions or outside the organizations) and ways to reach them can be effective. Using the developed frameworks based on their domains and objectives can be considered in health system performance.
 
Dr Sodabeh Vatankhah, Ghasem Rajabi Vasokolaei, Dr Sogand Tourani, Samira Raoofi, Susan Rahimi,
Volume 17, Issue 4 (2-2019)
Abstract

Background:  Development of the tourism sector and health tourism specifically can improve the Non-Oil GDP. In this regard, in accordance with the policies of the Ministry of Health and Medical Education, international patient department establishment has been facilitatated health tourism development in the affiliated hospitals. This study aimed to evaluate the performance of international patient department  and its effect on the attraction of medical tourists among hospitals affiliated to Medical Sciences Universities in Tehran City.
Matrials and Methods: This analytical cross-sectional study was designed and conducted in 2017. Study population consisted of all hospitals affilliated to  Tehran University of Medical Sciences (TUMS), Iran University of Medical Sciences (IUMS) and Shahid Beheshti University of Medical Sciences (SBMU). In this study,  hospital entrance criteria was certified by the Health Tourism Department of MOHME. Data was collected using the health tourism assessment checklist which approved by the MOHME. SPSS version 24 utilized to data analysis using descriptive and Inferential statistics.
Results: The study results revealed that  the overall performance of international patient department was evaluated at a desirable level (87.5 score) in hospitals of Tehran city.  Hospitals had the highest rank of hoteling indices (95/100), in compliance with the regulations and functional indicators gained 87.03 and 82.2 score, respectively.  Also, data analysis highlighted that there was no significant difference between hospitals of TUMS, IUMS and SBMU. The establishment of international patient department had no effect on health tourists attraction.
Conclusion: Considering the purpose and mission of international patient department to facilitate the provision of quality and satisfactory services in health tourists, management and oversight mechanisms for the standards implementation such as patient admission, follow up in the origin country and development of hospital marketing policies in order to attract international patients and increase hospital incomes are recommended.
Dr Msoomeh Erfani Khanghahi, Soodabeh Tayeri,
Volume 17, Issue 4 (2-2019)
Abstract

Background: Women's health has a broad concept that various biological, social, political, economic and environmental factors affect it. This study aimed to prioritize the factors affecting women's health promotion, provide a model for decision making and choose the best option for decision makers and health system planners to achieve the goal of promoting women's health.
 
Materials and Methods: In this descriptive-analytical study, the factors affecting women's health were extracted based on theoretical background and Farmehr's conceptual model. Then, the points of view of five women's health experts on the criteria and options of the model were collected and analyzed using paired comparison tables and Likert measure, and analyzed according to the hierarchical decision-making process. After analyzing the experts 'opinion individually, two methods of computing the geometric meanings and the experts' opinions were combined and the priorities were determined based on group views. The Excel software was utilized to perform the calculations.
 
Results: Among the four main factors, priorities included the individual factors (subcategory of lifestyle), family factors (family relationships) and underlying factors (attitudes and beliefs). In the first level of decision making related to intervention methods in women's health promotion, the multidisciplinary approach was determined; and in the second level of decision-making related to health management, the partnership of governmental and nongovernmental organizations established in the first priority.
 
Conclusion: Based on study results, designing and planning interventions with the prioritization of individual, family and infrastructure factors using multi-disciplinary approach and participation of governmental and nongovernmental organizations for promoting women's health are recommended.
Dr Sima Rafiei, Mohammad Zakaria Kiaiei, Pejman Sadeghi, Zahra Rahmati,
Volume 18, Issue 1 (5-2019)
Abstract

Background: One of the main important principles of human health is spirituality which its promotion could lead to an effective control of work related stress; can be considered in nurses’ job performance and assurance of their physical and mental health as a crucial factor. This study aimed to explore the effect of spiritual health on job stress among nurses employed in a training hospital affiliated to Qazvin University of Medical Sciences in 2017.
Materials and Methods: This was a descriptive-cross sectional one conducted on 220 nurses at Velayat hospital in Qazvin city. Data gathering was performed using two standard questionnaires including spiritual health and nurses' job stress. Data analysis was carried out with SPSS22 using descriptive statistical methods, Pearson Correlation Coefficient and multivariate regression analysis at a significance level of P < 0.05.
Results: The mean score of spiritual health and job stress assessed at a moderate level 70.5±5.2 and77.5±2.3, respectively. Spiritual health in both religious and intrinsic dimensions, gender, job history and type of employment were statistically related to job stress (p<0.05). Furthermore, multiple regression analysis revealed these variables predict 25% of job stress variation.
Conclusion: Due to the important role of spiritual health on job stress among nurses, strengthen this dimension of health through acknowledging them about its potential effects on physical and mental health and ultimately on successful job performance recommended.
 
Ali Alizadeh Zoeram, Dr Alireza Pooya, Dr Zahra Naji Azimi, Dr Ali Vafaee Najar,
Volume 18, Issue 1 (5-2019)
Abstract

Background: In service organizations such as hospitals, human resources (HR) play a key role in the quality of service delivery. Lack of a systemic attitude in terms of system dynamics, HR planning have been somewhat distant from reality. In order to solve such a problem, this study aimed to modeling the dynamics of human resources capacity management system in healthcare services.
 
Materials and Methods: This case study is one of the cases at a clinic of Khatam -al-Anbia Eye Hospital of Mashhad which was used to simulate the system dynamics approach. In the implementation process, after modeling and formulating in Vensim software, the model was validated and appropriate policies were identified based on simulation results.
 
Results: The simulation results revealed a gap existence between service capacity and desired capacity led to a work pressure. Consequently, time per service relative to the standard time per service (0.333 hours equivalent to 20 minutes) as the core of service quality has been reduced (cutting corners of time).  To counteract such a situation, appropriate policies were identified during the time in a dynamic manner using sensitivity analysis based on changing patient acceptance rates and human resource changes.
 
Conclusion: The proposed model provides the status for hospital managers which allows them to manage appropriate human resources in the same conditions with a viewpoint of causal relationships with respect to system dynamics.
 
Ali Ebraze, Fahimeh Rabbanikhah, Amir Kazemi-Bolboloy, Reza Moradi, Amin Aghili,
Volume 18, Issue 1 (5-2019)
Abstract

Background: Organizational culture is one of the important predictor of organizational effectiveness, and a key factor success of the organization as a competitive advantage. Todays, a continuous assessment of organizational culture status is considered essential; therefore, this study aimed to identify and measure organizational culture of the Ministry of Health and Medical Education.
Materials and Methods: This descriptive-analytical study was conducted on the headquarters of the Ministry of Health and Medical Education in 2018. The study population consisted of all employees of the Ministry of Health and Medical Education (N=2200), 327 personals were selected through Cochran formula and stratified sampling method. The data collection instrument was a researcher-made questionnaire whose validity and reliability were confirmed (Cronbach's alpha =86.5%). In order to data analysis SPSS24 using descriptive and inferential statistics tests were utilized.
Results: The mean score of total organizational culture was 3.30 ± 0.70 from 5 which was higher than the theoretical average. Also, there was also a significant difference in partnership dimension in terms of employment type and in participation dimensions, accountability to the upstream institutions as well as total organizational culture score in terms of deputy. There was a direct statistical association between dimensions of organizational culture.
Conclusion: According to study results, strong organizational culture will lead to improved performance in the organization and alignment of individuals and activities. Given the importance of specific role of culture in each organization, plans success and change strategies, human resources managers should take appropriate actions to improve internal and external communication and increase teamwork and accountability. 
 
Abbas Jahangiri, Dr Hojjat Rahmani, Shiva Tolouei Rakhshan,
Volume 18, Issue 2 (8-2019)
Abstract

Background: Iranian health system transformation plan has been implemented since 2014 with the aim of financial protection of people, equity establishment in access to health services and quality improvement of hospital services. Hospital performance evaluation is essential in order to monitor the health system transformation plan. One of the tools for evaluating hospital performance is the dynamic multi-attribute decision-making method. The purpose of this study was to use the dynamic multi-attribute decision-making method to evaluate the performance of the hospital before and after the implementation of the health system transformation plan.
Materials and Methods: In this cross-sectional study, the performance of Shariati Hospital in Tehran was evaluated for 48 consecutive months (24 months before and 24 months after the Health System Transformation plan, 2012-2016). Each month was addressed as an option in the decision-making matrix and ,with considering six important health indicators, the hospital performance was dynamically assessed  using the weighted aggregated sum product assessment and through EXCEL software 2010. 
Results: Hospital performance scores had some fluctuations over time; however, in general, it had an increasing trend over forty-eight months. The highest and lowest values were for months 42 and 13 (0.4932 and 0.9408, respectively). In addition, in the first month of the solar year, the hospital performance score declined significantly for each year.
Conclusion: Changes in hospital performance scores during the study period show improvement in hospital performance. Nevertheless, this incremental process cannot be considered as a positive outcome of the health system transformation plan. Therefore, while improving the current process, continuing the hospital performance evaluation can lead to the hospital's performance promotion.
 
Mohssen Ghanavatinejad, Mahdieh Tavakoli, Dr Mohamadmehdi Sepehri,
Volume 18, Issue 3 (10-2019)
Abstract

Background: with increasing demand for treatment, patients are monitored with help of Internet of Things(IOT). Patient's monitoring devices and technologies include heart rate measurement, blood pressure measurement, blood glucose and other vital signs. The purpose of study is to provide a model of clustering patient physical monitoring gadgets and apps in Healthcare Internet of Things (HIOT) environment using data mining techniques, so based on the needs and characteristics of the user, the more appropriate results of choosing technologies acquired.
Materials and methods: This study is a review and functional since its result. The data includes 6 unique features of 60 selected technologies including function, price, connectivity route, power supply, location and type of use that has been extracted from R&D and advertising sites of technologies and also relevant articles. data analysis method is clustering technique and K-medoids algorithm. to identify the most effective features, random forest algorithm has been used.
Results: the proposed clustering model takes into account 6 as inputs and clusters gadgets and apps in accordance with selected characteristics as the model outputs. clustering problem data is clustered in 4 categories.  Silhouette index is 0.45, which indicates the validity of the model. The type of application and then the price had the greatest impact on clustering.
Conclusion: By this model, patients or users can find the most appropriate technology based on the type of disease and other effective features, such as price. So with accurate physical and momentary monitoring, disease progression decrease and prevention of disease will improve.

Dr Hosein Dargahi, Sajjad Alahdadi, Abbas Salarvand,
Volume 18, Issue 3 (10-2019)
Abstract

Background: Human resources form the basis of health care systems and nurses are a large part of this community; therefore, paying attention to factors affecting the performance of nurses is necessary. The aim of this study was to investigate the relationship between mental health dimensions with organizational commitment and work ethics among nurses working in general hospitals affiliated to Tehran University of Medical Sciences. The mental health status among nurses was also investigated.
Materials and Methods: This is a descriptive-correlation study and the study population included nurses from general hospitals affiliated to Tehran University of Medical Sciences. 242 nurses were selected from Vali-Asr, Imam-Khomeini, Baharlu, Sina, and Amir-Alam hospitals using stratified sampling and responded to self-monitoring questionnaires including GHQ-28, Allen & Meyer's organizational commitment (OCQ), and work ethics (Petty, 1995). Data were analyzed using SPSS-23 software as well as Pearson correlation coefficient, ANOVA, one sample t-test, and independent t-test.
Results: Dimensions of social impairment(r=-0/19, p<0/01) and depression(r=-0/33, p<0/01) correlated with work ethics. Dimension of hypochondriasis correlated with nurses organizational commitment (r=-0/15, p<0/05). The mean of dimensions of hypochondriasis (7.45±0.28), anxiety and insomnia (6.97±0.27) and social impairment (6.33±0.19) among female nurses was higher than the average.
Conclusion: The dimensions of mental health of nurses are related to their organizational commitment and work ethics. Also, the mental health status among nurses is undesirable. Therefore, it is essential to address the issues of nurses at high levels, such as the Ministry of Health and the Nursing Organization, and low levels such as hospitals nursing management.
 

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