Roohollah Askari, Hassan Jafari, Arefeh Dehghani Tafti, Neda Futuhi Tafti,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: Nurses, as the closest healthcare providers to patients, hold significant popularity and trust. Strengthening their competence in spiritual care is critical in ensuring holistic healthcare delivery. This study aimed to evaluate the spiritual care competence of nurses working in selected teaching hospitals of Shahid Sadoughi University of Medical Sciences in Yazd in 2023.
Methods: This cross-sectional study was conducted on 262 nurses employed in three selected teaching hospitals (Shahid Sadoughi, Shahid Rahnamoun, and Afshar hospitals). Data were collected using the Standard Spiritual Care Competence Questionnaire (SCCS) and analyzed through ANOVA, Mann-Whitney, Kruskal-Wallis tests, and Spearman's correlation coefficient using SPSS version 21 software.
Results: The overall mean score and standard deviation of spiritual care competence among nurses were 83.9±18.2, indicating an optimal level of competence. Among the dimensions of spiritual care competence, the "personal support and consultation with the patient" dimension scored the highest (18.8±5.2), while the "communication" dimension scored the lowest (7.3±1.6). The highest overall competence score was observed at Shahid Rahnamoun Hospital (88.5±17.7)
Conclusion: While the overall competence in spiritual care among the nurses studied was favorable, the low score in the communication dimension highlights the need for workshops focused on effective nurse-patient communication. Developing these skills can significantly enhance nurses' roles in improving patient health outcomes.
Mahshid Zare, Zahra Kavosi, Sedighe Sadat Tabatabaei Far,
Volume 23, Issue 1 (5-2024)
Abstract
Background and purpose: The COVID-19 pandemic has brought a significant shock to healthcare systems worldwide, including Iran. The mental health of nurses, who have been at the forefront of the fight against the virus, has been profoundly impacted. This study aims to examine the mental health status of Iranian nurses during the pandemic.
Methods: This rapid review was conducted by searching keywords such as "Mental Health," "Nurse," and "COVID-19" in databases including Google Scholar, PubMed, ScienceDirect, ProQuest, Mag Iran, and Civilica. Articles were selected based on their titles, abstracts, and full texts in alignment with the study’s research objectives.
Results: The reviewed studies revealed a range of mental health disorders among nurses working in COVID-19 wards, with stress, anxiety, and depression being the most common. Several factors, such as demographic variables and the specific departments where nurses served, were identified as influencing their mental health. Given that the mental health of nurses affects the quality of care, resilience, and job satisfaction, various strategies have been proposed to improve their mental health.
Conclusion: The findings suggest that the mental health status of nurses is not at an optimal level, and neglecting this issue could lead to long-term harm to the healthcare system and its economic stability. It is recommended that healthcare managers and policymakers implement appropriate measures to address this critical concern.
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.
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.
Milad Mehri, Mohammad Efatpanah, Ebrahim Jaafaripooyan, Mohammad Arab,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: Abuse within health insurance systems represents a significant challenge for health systems globally, leading to substantial negative repercussions. This study investigates instances of abuse in the Iranian Health Insurance Organization and proposes strategies to mitigate such abuses within its primary insurance processes.
Methods: This applied study employs a qualitative methodology, with data collected via semi-structured interviews. Experts from the Iranian Health Insurance Organization were interviewed to gather their insights. Data analysis was performed using conventional content analysis, and MAXQDA 20 software was used for coding and categorizing the findings.
Results: Instances of abuse within Iran’s health insurance system were classified into two main categories: "providers" and "service recipients," which were further divided into 18 subcategories. The underlying causes of these abuses were analyzed on two levels: macro-level factors (economic, cultural-social, legal, and technological) and micro-level factors (implementation processes, oversight, and service delivery). Based on these findings, strategies for reducing abuse were proposed in three primary areas: "planning," "execution," and "control." These strategies included revising and amending relevant laws and regulations, enhancing technological infrastructure, and improving information systems in the planning phase; verifying the identities of service recipients and providers during service delivery; and strengthening oversight personnel, alongside continuous inspections, in the control phase.
Conclusion: This study indicates that revising laws and regulations within the insurance sector, upgrading technological infrastructures, providing continuous training for claims assessors, enhancing inter-organizational communication, and strengthening oversight of service providers are essential strategies for preventing abuse in the Iranian Health Insurance Organization.
Morteza Ghaderi Azarkhavarani, Mohammadreza Khajeh Aminian, Milad Ahmadi Marzaleh, Mohammad Hosein Yarmohammadian, Seyed Masood Mousavi, Hassan Nouri Sari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The Emergency Operations Center (EOC) is a centralized facility designed to coordinate disaster management activities across all phases of the disaster management cycle. EOCs play a vital role in facilitating efficient and effective responses by coordinating information and resources. This study aims to highlight the importance of establishing a standardized framework for EOCs in Iranian universities of medical sciences and to examine its key dimensions.
Methods: This study is a commentary article that compiles information from published literature on the framework of emergency operations centers. It focuses on two prominent global frameworks: the World Health Organization’s Public Health Emergency Operations Center Framework and the U.S. Federal Emergency Management Agency’s Emergency Operations Center Guidelines. The study emphasizes the necessity of creating a standardized framework for emergency operations centers in Iranian universities of medical sciences.
Results: EOCs across different countries vary in terms of their missions, authorities, and resources. Consequently, the frameworks used in these centers are not uniform, and are largely shaped by the governance and regulatory requirements specific to each country.
Conclusion: A standardized framework, tailored to the specific needs and conditions of Iran, is essential for EOCs at universities of medical sciences. Such a framework could enhance the operational capabilities of these centers during incidents and disasters, improving their responsiveness and effectiveness.
Shahrzad Rasekhi, Sedighe Sadat Tabatabaei Far, Abdosaleh Jafari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: The aim of this study was to investigate the waiting time of patients referred to the emergency department and the factors affecting it in the country.
Methods: A search was conducted in the scientific databases PubMed, Science Direct, ProQuest, Scopus, Web of Science, Mag Iran and Civilica with the keywords waiting time, duration, emergency, Iran, etc. The Search period was up to 2024/02/06. After applying the search strategy, 26 studies were included in the study.
Results: The findings of the present review study (rapid review) showed that the average time from patient arrival in the emergency department to the first doctor's visit ranged from about 2 minutes to about 32 minutes, the average time from patient arrival in the emergency department to the first treatment ranged from 3.7 minutes to 262 minutes, the average time from request to the first test result was from 20.17 to 629.2 minutes, the average time from request to the first radiology result was from 5.85 to 1080 minutes, and the average time from request to the first ECG result was from 3.7 to 32.3 minutes. Also, the most important factors affecting the waiting time of patients referred to the emergency department included individual factors related to the patient, reason for referral, factors related to the hospital and emergency department, and factors related to human resources in the emergency department.
Conclusion: This study showed that patients' waiting time in the emergency department depends on various factors. To reduce it, improvements in triage, workforce management, the use of smart technologies, infrastructure enhancement, and patient education are recommended.
Elham Haghshenas, Ali Ghangalikhan Hakemi, Samira Raoofi, Sara Akhavan Rezayat, Soheila Damiri, Saeed Nateghi, Maryam Radinmanesh,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: Given the interdisciplinary nature and multiple stakeholders involved in electronic prescribing systems, their implementation process encounters numerous complexities. This qualitative study aimed to explore and clarify the challenges associated with electronic prescribing and prescription dispensing systems.
Methods: A qualitative content analysis was conducted in 2021 (Iranian calendar: 1400). Data were collected through semi-structured interviews with 25 key informants from the treatment management sector and affiliated hospitals of Tehran University of Medical Sciences. The collected data were analyzed using conventional content analysis methodology facilitated by MAXQDA 10 software.
Results: Approximately 350 initial codes were identified, which were categorized into four main themes with eight sub-themes: policy preparation (establishing a policy secretariat and achieving political consensus), policy formulation (developing policy content and advocacy), policy implementation (planning and executing policies), and policy evaluation (monitoring and evaluating policies).
Conclusion: Ensuring public health remains the ultimate goal of the healthcare system. Electronic transformation, particularly in establishing electronic health records, can significantly improve healthcare service quality. Integrated policymaking among the various institutions involved, enhancing technical and procedural infrastructure, human resource training, and societal cultural readiness are essential factors for the effective implementation of electronic prescription systems and the enhancement of healthcare quality.
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.
Newsha Poursaadat, Mohammad Ali Cheraghi, Maryam Esmaeili, Fatemeh Hajibabaee,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: A key aesthetic dimension of nursing leadership involves embedding aesthetic principles into the formulation of organizational documents and artifacts. These elements embody beauty in both visual design and semantic content within the healthcare environment, created by providers and perceived by all stakeholders. This study aimed to explore the role and manifestation of aesthetics in such organizational materials from the perspective of nursing leaders at Tehran University of Medical Sciences.
Methods: This qualitative study, conducted in 2023, utilized a conventional content analysis methodology guided by the Graneheim and Lundman approach. The participants were nursing managers and leaders from hospitals affiliated with Tehran University of Medical Sciences. A total of 28 participants were recruited via purposive and snowball sampling. Data were collected through in-depth, semi-structured interviews, supplemented by photovoice and field observations, to explore the guiding principles and prevailing atmosphere shaping organizational aesthetics.
Results: The analysis of the data yielded 191 initial codes, which were abstracted into six main themes: (1) Preservation and Maintenance, (2) Standardization, (3) Cleanliness and Beautification, (4) Order and Arrangement, (5) Organization, and (6) The Sublime.
Conclusion: The study concludes that the aesthetic vision championed by nursing leaders—as manifested in organizational documents and the workplace environment—is palpable to all stakeholders. This perceived aesthetic fosters a sense of grace and compassion in the thoughts, speech, and actions of both care providers and recipients. Ultimately, it facilitates a more holistic form of "aesthetic nursing care" and helps to create a comforting, home-like atmosphere for patients.
Beheshteh Jebelli, Mohammad Varahram, Fatemeh Keyvani Rad, Solmaz Zarrineh, Elham Ghazanchaei,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Hekmat (Wisdom) implies deep knowledge, understanding, and sagacity. Hospital services are uniquely dependent on human resources; therefore, beyond technical expertise, staff commitment is essential for maximizing efficiency and effectiveness. A "Hekmat-based hospital" is defined as an institution delivering care founded on three pillars: human dignity, medical knowledge/wisdom, and Islamic ethics. This study aims to identify the key factors influencing hospital accreditation through the lens of the Hekmat-based hospital approach.
Methods: This qualitative study employed conventional content analysis based on the Graneheim and Lundman approach. Data were collected through purposive sampling and semi-structured interviews with 62 participants (32 physicians and 30 patients) from various departments until data saturation was reached. Additionally, a comprehensive review of 20 upstream documents related to health, medicine, education, and culture within the Iranian health system (post-1979 Revolution) was conducted to supplement the field data.
Results: The analysis of interviews yielded 10 main categories representing the components of accreditation in a Hekmat-based context. These categories included: social, cultural, and religious issues; facilities, equipment, and human resources; communication skills; patients' financial and livelihood challenges; knowledge and education; tangible environmental factors; economic factors; cultural dynamics; patients' psychological resilience; and service reliability.
Conclusion: The findings suggest that mutual understanding of emotions and beliefs, patience, reciprocal respect, and effective knowledge exchange are core expectations shared by both physicians and patients. Addressing these primary and secondary needs is a prerequisite for achieving a standardized hospital model aligned with the vision of Hekmat-based medicine.
