Showing 335 results for Type of Study: Original Article
J.s Tabrizi , K Gholipour , R Alipour , M Farahbakhsh , M Asghari-Jafarabadi, M Haghaei ,
Volume 12, Issue 4 (3-2014)
Abstract
Objective: This study was aimed to assess Service Quality (SQ) of maternity care from the perception of pregnant women.
Methods and materials: A cross-sectional study was conducted using a sample of 185 pregnant women at the 9th month of pregnancy were selected randomly from 40 health posts and urban health centers in Tabriz, Iran. Service Quality was calculated using: SQ = 10 – (Importance × Performance) based on importance and performance of non-health aspects from the customer’ perspective. Data collection used a researcher-developed questionnaire whose validity and reliability was reviewed and confirmed. Data analyzed using SPSS-17 software. Independent sample T-test and ANOVA were used to investigate relationship between service quality dimensions and categorical variables.
Results: From the customers’ perspective the average service quality score was 7.59 of 10. Service quality aspects of “confidentiality” achieved scores at the level of good quality (≥9) and “support group” (3.48) reached low service quality scores. Also, result indicate housewife assess SQ better than worker (p=0.047) and mother who's have planned pregnancy has had greater SQ score (p=0.022). Although, in the linear regression analysis, job status and planned pregnancy were significantly and independently related to SQ score.
Conclusion: Findings revealed a significant room for quality improvement in most aspects of provided care, particularly support group and safety from the perception of people who received maternity care.
M Mahdavi, M Arab , M Mahmoudi , A Fayazbakhsh , F Akbari ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: This study is aimed to compare organizational commitment and intention to leave among employees in Teheran`s hospitals.
Materials and Methods: In this survey 3 hospitals with different ownership`s type were examined included: A public hospital, a hospital owned by Social Security Organization, and a private hospital. The data were collected by distributing 450, questionnaires among 450 employees, which were randomly chosen.
Results: Among all studied subjects few employees allocated high score of organizational commitment to themselves .This average rate is nearly 20%. Committed employees were impressively low in the Social Security hospitals compared to others. Comparing intention to leave indicate revealed the Public hospital`s employees have lowest scores among all subjects. There is a statistical significant correlation between commitment`s components and intention to leave.
Conclusion: Generally the majority of employees have average and low organizational commitment. Employees with high level of commitment and high level of intention to leave make a small proportion of all hospital employees. Social security hospitals must be taken into consideration due to the levels of commitment and intention to leave.
M Panahi , A Pourreza , F Akbari , A Rahimi , Z Khalili ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: In the hospital setting, the potential for conflict is considerably high, because of the frequent and complicated interactions among nurses, physicians and other medical team staff and also the variety of their roles. With regards to the destructive conflict between physician and nurse which can negatively impact on the quality of health care delivery, this study aimed to investigate sources of conflict between physicians and nurses.
Materials & Methods: The study population involved a total of physicians and nursing cadre employed in 4 hospitals affiliated to Ardebil University of Medical Sciences. 260 subjects were selected by both census and Simple random sampling methods. Data collection process was accomplished through questionnaire that its reliability and validity were confirmed. Data analysis was done using the Descriptive statistics and Mann-Whitney, Kruskal-Wallis tests.
Results: Inequality in the social status between physicians and nurses from the perspective of patients and their attendants and also inequality in distribution of immaterial benefits between two forementioned groups (mean=3.23) were the most leading factors in arising conflict. The Social economic system (p<0.001), the health system (p=0.013), the hospital system (p<0.001) and interpersonal relations (p<0.001) variables had a significant relationship with the organizational position.
Conclusion: creating appropriate social and cultural contexts in order to promote the social status of nursing profession as well as improving the organization and its management could be effective to prevent or at least mitigate conflict between physicians and nurses.
R Baradaran Kazemzadeh , M Sepehri , F Firouzi Jahantigh ,
Volume 12, Issue 4 (3-2014)
Abstract
Background and purpose: Hospital is the largest and most important executive unit of healthcare system therefore, full consideration of how to assess its quality is of particular importance. A question is always raised as how to evaluate the quality of the services. The current study seeks to provide a fuzzy model for assessing the service quality in this healthcare sector.
Material and method: The present cross-sectional study was conducted in two hospitals in Zahedan 2012.Via reviewing the related literature, the dimensions and components of service quality assessment were identified. The SERVQUAL questionnaire for hierarchical analyses was designed and the fuzzy AHP (Analytical Hierarchy Process) model was presented. SPSS v 10.0 and Fuzzy TOPSIS Solver 2013 software were used to analyze data.
Results: The findings indicated that the most important dimension for estimating the quality of healthcare services was empathy. Responsiveness, assurance, and tangible assets were the last important factors. The hospitals were compared using fuzzy AHP. According to the calculations, the ranking of the hospitals based on their performance was as follows: Imam Ali hospital with 31% compared to Social Security hospital with 29% had a better performance in service quality.
Conclusion: The results revealed that hospitals needed to focus more on empathy, expertise and reliability than providing high quality and satisfactory services. By considering their weaknesses, each of these hospitals can enhance service quality and consequently, provide a better service for patients.
M Yousefi , A Assari Arani , B Sahabi , A Kazemnejad ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Today, the lack of financial protection against the health costs is recognized as a major flaw in the health systems. It seems that the first step towards solving this problem is exact identification of household health expenditure`s components which will result in better selection of prevention policies and appropriate procedures to solve the problem.
Materials and Methods: This study is a qualitative research conducted in two stages. The first stage consisted of interview with a sample formed by households from eight provinces of the country to identify the different components of household health expenditure. After that, a panel of experts categorized the identified components to direct and indirect costs.
Results: In The first stage, 93 kinds of households’ health expenditure were identified. In the next stage, 61 cases of these were categorized as direct costs and the other 32 cases were categorized as indirect costs.
Conclusion: The exact identification of the components of health expenditure of households and dividing them into two categories of direct and indirect costs can be useful for a more accurate calculation of the household health expenditure in future studies.
Zh Dadgarpanah , M Dadgarpanah ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Increaseing efficiency and effectiveness is the ultimate goal of staff training. Determining and being aware of staff training`s results efficiency is the necessity of learning transfer process and environmental identification which can complete the training cycle and leads to more effective plans and training activities. This study is aimed to predict the relationship between the aspects of learning environment and transmission of learning in Milad Hospital from clinical staff`s viewpoints.
Materials & Methods: In this study, 306 people from different hospital's wards were selected by random sampling. The data were collected using Bartram et al learning questionnaire and researcher-made questionnaire of training transmission.The data were analyzed using Pearson correlation test and regression analysis.
Results: There is a significant relationship between learning environment and learning transmission with correlation coefficient of 0.604 and coefficient of determination of. 0.604 with positive direction. About 0.60% of training transfer can be clarified by learning environment.
Conclusion: Identifying the elements of learning environment is essential to enhance learning transfer to workplace. Learning transfer can lead to the development of organizational learning
and sharing skills in order to optimize quality of services provided for clients and patients.
M.a Afshar Kazemi , N Bigdeli , J Manoochehri , Y Jenab ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Emergency department (ED) is the first place for providing diagnostic and therapeutic services to emergency patients. Due to importance of speed and accuracy in providing services the proper allocation of resources, the department must consider this matter in a particular way. Planning Emergency resources implements regardless of patient overcrowding which occurs at different times. In conclusion the emergency department may faces lack of resources and it results in delay of providing services, a whole mess in functions and decreasing in quality of services. This study is aimed to overcome these problems by suggesting a model for predicting the number of arrival patients at ED.
Materials and Methods: The number of arrival patients is predicted based on the data colleted by counting arrival patients and using the data mining technique and neural network model (Multi-layer Perceptron).
Results: The number of arrival patients during whole days of a week and 24 hours a day were calculated by sorting out 1, 2 and 3 priorities . The highest number of arrival patients counted was for Saturdays and the lowest for Fridays. Holidays and non-holidays` number of arrival patients differ . The number of arrival patients on formal holidays was similar to Fridays. The highest number of arrivals was between 9 am and 11 and also between 20 pm and 23 pm and the lowest arrivals was between 2 am and 7 am.
Conclusion: prediction the number of ED arrival patients can be used for estimating required sources and distributing them appropriately and improving quality of services.
R Shahrabadi , B Moeini , Gh Roshanai , S Dashti , V Kafami , M Haghighi ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Health care providers`culture about the patient safety means accepting and considering patient safety as the first priority and organizational core value or health center`s staffs beliefs, perceptions and trends of on patient safetywhich is reflected in their behavior. This study is aimed to assess nurses perceptions of patient safety culture`s dimensions which is working in hamadan`s hospital.
Materials & Methods:The method of this study is descriptive- analytical type and statistical society includes 215 nurses of 3 hospitals of Hamadan which had been selected by random sampling. Stanford patient safety culture questionnaire was used to assess dimensions of patient safety culture.The data were analyzed by SPSS 15 software and descriptive tests.
Results: The result indicated that all dimensions of patient safety culture through nurses` perception are weak . Among these dimensions, the " Unit Leadership for Safety " with 25.21 percentage and "Learning and Feedback " with 41.82 percentage were the lowest and highest positive rating in all three hospitals respictively .
Conclusion: According to weak rate of all patient safety culture`s dimensions in studied hospitals, performing training programs by head nurses is suggested in order to improve cultural concepts such as establishing “supportive mechanisms for patients families” and "culture of discussion of errors among nurses" .
E Zeraatkar , H Rahmani , M Ghazi Asgar , J Saeid Pour , S Azami , A Aryankhesal , M Pakdaman ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: Hospital waste is one of the environmental problems .Ignoring the proper management of these wastes can lead to outbreak of diseases and epidemics which threat the public health and rise high costs as a result. This study is aimed to assess the level of staff awareness and hospital performance concerning waste management in selected hospitals of Tehran University of Medical Sciences in 2010.
Materials & Methods: This is a descriptive-analytical study. The data were collected by distributing a multipartite Likert scale questionnaire among 351 individuals which had been used to measure hospital awareness and performance. The collected data were analyzed by SPSS software. Among Descriptive tests Chi-Square test was used to determine the correlation of qualitative variables and Pearson correlation coefficient was used for quantitative variables. The significance level was considered at 0.05.
Results: Significant differences had been seen among different professions` level of awareness .There were no significant difference among different hospitals ` average awareness level although there were significant statistical differences among each hospital`s performance level (p ≤ 0.001).
Conclusion: Due to relatively poor status of hospital`s waste management and hospital staff `s performance , better planning for proper management and wastes `excretion is needed to achieve sustainable development, public health protection and the environmental preservation. Staff Training and their performance monitoring and improving is one of the most important factors of hospital waste management plan success.
M Mehrolhasani , V Yazdi Feyzabadi , T Barfeh Shahrbabak ,
Volume 12, Issue 4 (3-2014)
Abstract
Background: A method of performance assessment is required to improve Productivity and reduce hospital costs . Pabon Lasso diagram is known as a tool for performance assessment. The current study is aimed to assess and compare Kerman province`s hospitals performance by using Pabon Lasso diagram.
Materials & Methods: This descriptive and cross-sectional study was conducted retrospectively between 2008 and 2010. All hospitals of Kerman province in three groups of public, social security and private were selected by census method (N=23). The data were gathered from statistics unit and entered into SPSS 18.0. Three indicators include bed occupancy rate, bed turnover and average of length of stay were calculated and then hospitals` performance were analyzed by Pabon Lasso diagram.
Results: In first two years, seven and eight hospitals out of twenty-three and in third year nine hospitals out of twenty-two located in third zone of the model (desired productivity) respectively. Among all hospitals, regarding number and ownership type, social security hospitals had better performance in 2008. Additionally Public hospitals had better performance than others in 2009 and 2010,.
Conclusion: Public hospitals had better performance.Although studied hospitals` performance experienced growing trend, only one third of the them had desired performance. It can be caused by changing the provided services type from inpatient to outpatient services.It seems that Considering type of ownership and assessing past trend of 3 studied indicators concurrently is necessary for Planning for development of a broader range of inpatient services and diversified medical services based on province`s need.
A Hajihasani, M Mohammadzadeh, H Zeraati, M Rahbar, M Alavimoghaddam, M Sabzi, S Ghoorchian, A Ramezani, M Soltandallal, M Douraghi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Non-fermentative, gram-negative bacilli (NFGNB) have emerged as a factor of
nosocomial infections and mortal epidemics . Hospital environment is one of the most important
sources of NFGNB`s colonization and diffusion. This study is aimed to assess the frequency of
NFGNB in various wards of selected hospitals of Tehran.
Materials & Methods: 469 samples were randomly selected from various wards from two hospitals
during a period of 11 weeks. All isolations had been identified using standard microbiological,
biochemical and phenotypic tests. The data were analyzed by SPSS software (version 11.5).
Results: Fifty three specimens were positive for NFGNB. Stenotrophomonas maltophilia and
Burkholderia cepacia complex were found as predominant bacteria in hospital I(28%) and II
(28.6%).The highest rate of NFGNB isolated from surfaces was 60.3% .The pediatric ward was
identified as the most contaminated ward (50%).
Conclusion: Several genus of NFGNB are found in hospitals. Therefore, identifying other NFGNB`s
genus and training health care staff are of prime importance. NFGNB`s distribution depends on type of
ward, surface, and equipment. Periodic sampling of hospital environment can be effective against
spreading infection.
S Rezaei, T Miraki, N Jahanmehr, F Gharibi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: the using of economic tools such as production function is one of the ways to improving performance and efficient use of hospital resources. The aim of this study was the estimation of production function in educational hospitals of Kurdistan University of Medical Sciences during 2007- 2011.
Material & Methods: the number of inpatient as dependent variable and the numbers of active beds, nurses, doctors and other staffs as explanatory variables was considered. These data For 12 of hospitals since 2007 to 2011 was collected by production form. Also with Eviews software version 6 and panel data, the production function of hospitals was estimated.
Results: the elasticity and marginal of production for all variables explanatory was positive. The marginal of production for bed active, physician, nurse and other staff was 16.7, 54, 23.6 and 40.9 respectively. The total of input coefficient was equal 1.08 and the return to scale was increasing.
Conclusion: according to the positive marginal of production for all variables explanatory, for improving of productivity and efficient use of hospital resources is suggested that the managers of hospitals in exposure to regular and irregular demand can be used elasticity of production.
M Keshavarz, A Akbari Sari, A Rahimi Foroshani, M Arab,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Accreditation is a program that is designed for evaluation of health care organizations and measured processes and structures according to predetermined standards. The purpose of this study is to survey the safety situation and quality of care in selected hospitals of Tehran University of medical sciences based on the Joint Commission International (JCI) standards and determination of their strengths and weaknesses.
Materials and Method: This descriptive, analytical and cross-sectional study was carried out in 5 hospitals. Translated Joint Commission International (JCI) questionnaire checklist with 14 standards was used as the study tool. Data entry and statistical analysis were performed using the SPSS.13 and K Independent Samples tests were used to compare hospitals.
Results: Highest quality and safety of care score belonged to the hospital B (84%) and then to hospitals C (83%), A (72.75%), E (72%) and D (70.5%). Central indices like patient and family rights, quality improvement and patient safety, infection prevention and control standards in the studied hospitals are completely different according to the statistical results.
Conclusion: Study results show that the status of hospitals in terms of safety and quality of care are almost appropriate but in some cases there is a large distance between JCI standards and their current status and the studied hospitals have to make appropriate and related policies in order to plan and implement proper programs to improve their situation in quality and safety of care.
S Rafeiyee, A Pour Reza, A Rahimi,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Human resource management has a critical role in organizations and organization culture is an outcome of human resource management performance. One of the dimensions of the organizational culture is power distance. This study aims to investigate the attitude of employees of selected hospitals of Tehran University of medical sciences towards the power distance in the organization and its consequences.
Materials and Method: This is a cross sectional study with a descriptive research design conducted in a sample of 306 employees and managers from Tehran University of Medical Sciences hospitals located in Tehran, Iran. A distinctive questionnaire for each group was developed, distributed and collected as a main procedure to gather data. Data were analyzed using SPSS 16.
Results: Study results indicates that there is a positive and significant relationship between power distance and employee participation, organizational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities in the level of 95%(p value<0.05). The moderated multiple regression results also supported the hypothesis that managers’ attitude towards power distance had a significant relationship with their manner with the employees, noticing their qualifications and abilities, giving them independence and responsibility and supporting them in their role.
Conclusion: A limited power distance in an organization will result in more committed and satisfied employees with positive perception toward justice in the organizational interactions and ready to accept job responsibilities and movement toward the organization objectives.
Z Farahnaki, A Pournajaf, A Karami, A Abbasi, M Karchani,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Shift work can be associated with decreasing performance, changing eating habits, getting into conditions such as fatigue and insomnia, developing individual and social life disorders and health problems. This study is aimed to investigate the prevalence of shift work disorders among nurses working in Ilam’s teaching hospitals in order to provide solutions for dealing with these disorders.
Materials and Methods: This is a descriptive – analytical study in which 84 nurses of Ilam’s teaching hospitals had been chosen by simple random sampling. The data had been collected by “Survey of Shift Worker” (SOS) questionnaire and analyzed using SPSS (version 18) and descriptive statistics and Chi-2 test.
Results: Results indicated that shift work disorders are prevalence among nurses. Emotional and Mental problems (96.4%), Social Life (84.5%), digestive problems (81%) have the highest prevalence rate respectively. Nurses who volunteered to work shifts have more job satisfaction than the ones who were obliged to do that (P<0.05). In addition prevalence of problems was far less among nurses who get satisfaction from shift work than the others who do not.
Conclusion: Choosing shift work voluntarily results in more satisfaction with shift work which eventually decrease problems caused by shift work.
H Dargahi, F Forouzanfar, M Bakhtiari, Z Rajabnejad,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Nowadays Medical devices have an important role in diagnosis, treatment, rehabilitation of patients and also in medical education. However, in the recent years usage and maintenance of these devices have not been in a good situation in developing and even some developed countries. Therefore fundamental changes and reprocessing has begun among management and usability of medical devices in these countries. This research is aimed to determine the management situation with the approach of usability evaluation in order to change and reprocess the management system among Tehran University of Medical Sciences general teaching hospitals at 2012-2013.
Materials& Methods: This study was a descriptive and cross sectional research among eight general teaching hospitals of Tehran University of Medical Sciences in 1391. The research tool was a self-made check list consisting of 38 questions about medical devices management condition and Nielsen questionnaire about usability of these devices which were completed by head nurses of CCU, ICU and OR departments with the help of medical devices supervisor in 56 departments of these hospitals. Data were collected and analyzed by SPSS software.
Results: We found that medical device management and the usability of these devices were not in a good situation in these hospitals as well as usage of electronic information technology.
Conclusion: Regarding the results of this research specially in the usability of medical devices, we recommend that users and supervisors of medical devices should be trained about usability criteria and evaluation procedures of these criteria, and the relationship between management styles and applications of quality improvement and pay attention to reprocessing of medical devices management among hospitals administrators and healthcare policy makers to select and purchase the best devices.
J Beikzad, A Hoseinpour , M Hejazi Bavil ,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Responsibility and job satisfaction are important issues. This study is aimed to investigate the relationship between responsibility and job satisfaction of nurses working in teaching hospitals of Tabriz University of Medical Sciences.
Materials &Methods: Statistical population includes, nurses in teaching hospitals of Tabriz University of Medical Sciences. 316 samples had been selected by stratified random sampling. The data had been collected through a questionnaire and analyzed by using SPSS software.
Results: There is a significant relationship between responsibility and two dimensions of job satisfaction (job satisfaction and promotion satisfaction) but there is not significant relationship between responsibility and other three job satisfaction dimensions (satisfaction of supervision and monitoring, satisfaction of colleagues, satisfaction of salaries and payments).
Conclusion: Responsibility is an accurate predictor of performance in wide range of occupations .It has a significant relationship with job satisfaction. The more a nurse feels responsible for her or his duties, the more efficient she or he is in delivering health services to patients .Therefor nurses feel more satisfied of their jobs.
J Saeidpour, M Ghazi Asgar, H Rahmani, M Khoshkho,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Educating patients and improving their self-care skills are main factors to achieve maintaining and improving health as health care organizations prime priorities all over the world. This study is aimed to assess nurses and doctors viewpoints on obstacles and facilitators of educating patients.
Materials and Methods :This quasi experimental research were undertaken in Kermanshah Razi hospital.85 nurses and doctors were selected by Simple Random Sampling method. The data were collected by a questionnaire based on Likert scale consisted 32 questions in 3 parts. Validity and reliability of the questionnaire were confirmed by Content validity and Test-Retest methods respectively.
Results : Shortage of nurses and lack of sufficient financial resources among inhibiting factors and holding seminars on teaching and learning strategies and also considering educating patients as a annual evaluation determinant among enhancing factors were the most important ones .
Conclusion: Providing efficient resources and facilities and running personnel`s training courses seems necessary to overcome current obstacles.
M Hosseini, M As’adi,
Volume 13, Issue 1 (6-2014)
Abstract
Abstract
Background: Conducting further research on medical tourism as a lucrative business is required. Very little research has been conducted into medical tourism barriers and a large amount of them just note structural barriers. This study is aimed to identify the most important communicational barriers of medical tourism and provide and examine a model of such barriers considering medical tourism`s intercultural nature.
Materials & Methods: This study is applied by purpose and survey by method. The three stages in completion of this study are : 1) Identifying the most important communicational barriers of medical tourism in Iran,2) designing a model of identified barriers by using interpretive structural modeling approach 3) examining the designed model in a sample of 300 individuals.
Results: Correlation test indicates a positive and significant relationship between variables in less than 0.01 significant level. Regression analysis confirms that all independent variables are significant predictor of the dependent variables .Therefore all hypotheses are confirmed.
Conclusion: This survey identified main medical tourism communicational barriers in Iran as: Lack of understanding, Perceived linguistic difference, Lack of trust, Perceived cultural difference, Prejudice, Stereotyping. Overcoming to Lack of understanding as the major obstacle has a dramatic effect on operating medical tourism.
Keywords: Communicational Barriers, Medical Tourism
M Hosseini, M As’adi,
Volume 13, Issue 1 (6-2014)
Abstract
Background: Conducting further research on medical tourism as a lucrative business is required. Very little research has been conducted into medical tourism barriers and a large amount of them just note structural barriers. This study is aimed to identify the most important communicational barriers of medical tourism and provide and examine a model of such barriers considering medical tourism`s intercultural nature.
Materials & Methods: This study is applied by purpose and survey by method. The three stages in completion of this study are : 1) Identifying the most important communicational barriers of medical tourism in Iran,2) designing a model of identified barriers by using interpretive structural modeling approach 3) examining the designed model in a sample of 300 individuals.
Results: Correlation test indicates a positive and significant relationship between variables in less than 0.01 significant level. Regression analysis confirms that all independent variables are significant predictor of the dependent variables .Therefore all hypotheses are confirmed.
Conclusion: This survey identified main medical tourism communicational barriers in Iran as: Lack of understanding, Perceived linguistic difference, Lack of trust, Perceived cultural difference, Prejudice, Stereotyping. Overcoming to Lack of understanding as the major obstacle has a dramatic effect on operating medical tourism.
