Journal of

---

Background: Current paper aims at investigating factors affecting physicians'knowledge-sharing intention in teaching hospitals affiliated to Tehran University-Medical Sciences in which one of the most authentic model of behavior prediction namely planned behavior has been used as the theoretical framework of study.
Materials and Methods: The method of current study is descriptive/survey correlational type and statistical society includes physicians employed in hospitals affiliated to Tehran University-Medical Sciences.Date was collected by questionnaires and analyzed using Lisrel&SPSS software.Confirmatory factor analysis was employed to evaluate consistency,Cronbach's alpha was used to assess reliability and structural equation modeling was used to fit the model and test hypotheses.
Results: Prediction power of model for knowledge-sharing intention of physicians is(R2=0.66)The results suggested that impact of attitude on the knowledge-sharing intention is positive and significant with factor loading of(=0.87)However,influence of subjective norms and perceived behavioral control on the knowledge-sharing intention was not confirmed.Influence of subjective norms on attitude were evaluated positive and significant with factor loading of(=0.55)As a result, subjective norms affect knowledge-sharing intention through indirect mediation of attitude.All tests were significant at the level of(P0.01).
Conclusion: According to findings of this research on improvement of knowledge-sharing behavior of physicians, health authorities need to take corrective measures to enhance the attitude and subjective norms of physician.

---

Background and Objective: The operating room is one of the main units in hospital, where the most important phase of patient treatment is performed. This study aimed to investigate the safety attitude among the staff of operating room in selected hospitals of Tehran University of Medical Sciences.

Methods: In this descriptive - analytical study, 230 staff of operating room of hospitals affiliated to Tehran University of medical sciences were selected by Random cluster sampling. Research tool was a safety attitude questionnaire (Cronbach’s alpha 0.854) that classified in 3 categories: demographic questions (11questions), quality of communications (14questions) and safety attitude questions (58 questions). All data collected were analyzed using SPSS18. T-test, Spearman correlation, analysis of variance (ANOVA) and Chi-square have been used for data analyzing.

Results: The results indicated that 90.9% of staffs had moderate safety attitude and the average of the safety attitude score was 188.52(± 22.4). As the results showed, there was a positive and significant relationship between the safety attitude score and age, total work experience and work experience at hospital (p 046/0=, r =±0.141). There were significant differences between: average of the safety attitude score among men and women (P=0.047) average of the safety attitude score among staffs who have been trained and untrained safety (P=0.004).

Conclusion: The safety attitude score among the staff. It is therefore necessary to implement the effective interventions to improve safety attitude among operating room staff in understudy hospitals. 

Keywords: Safety attitude, Operating Room, Hospital, Staff

---

Background: Clinical Governance (CG) is a framework which obligates heath care system to responsiveness regarding maintaining and improving health care services' quality. Purpose of this study was to exists challenges in Clinical Governance establishment evaluation based on national assessors' aspect.

Materials and Methods: This qualitative study was conducted with national assessors' participation of Clinical Governance plan in 2014.Data collection was carried out using face to face interviews with assessors  and analyzed  based on content analysis.

Results: Three main themes were categorized including problems related to clinical governance standards, Existing challenges in assessment process and recommendations to improve quality assessment process.

From the assessors' aspects, the main existing challenges were lack of knowledge and adequate skills in some assessors towards CG, lack of sufficient accordance among assessors team, resistance of some universities and health care systems, lack of existing comprehensive guidelines with the purpose of responsiveness in related ambiguity in assessment and direction process among assessors.

Conclusion: Reinforcement of quality improvement culture in hospitals and increasing susceptibility in plan continuation, correct assessors election and ensuring about knowledge in responsibilities, updating assessors' training and putting to use equal indices in improving clinical governance assessment can be a considerable assist to improve assessment process and resolve related problems. 

---

Background: This study was conducted to validate the "staff attitude toward the use of coercion in the treatment of mentally ill patients" questionnaire and assessed their attitude in selected public psychiatric hospitals in Tehran city.
Materials and Methods: This is a descriptive and analytical study which was carried out on three hospitals of Tehran University of Medical Sciences, Iran University of Medical Sciences and social welfare and Rehabilitation University in 2015. The questionnaires were distributed to the participants and finally 273 questionnaires were used.  Data were analyzed using confirmatory factor analysis test. Moreover, ANOVA and independent t-test were applied to evaluate the participants' attitude on using coercion for treatment of mentally ill patients.
Results: Study findings revealed that 61% of participants were nurse and 11% were physicians. According to the study results, three final obtained factors explained 61.93% of the total variance; this variance reflects the proper and appropriate selection of the questions.  In addition, there were statistically significant differences between marital status and offending attitude domain; between job and education and offending attitude; and security and treatment domains.
Conclusion: The current questionnaire has a high validity and reliability and is also appropriate for the context of Iran.  The attitude of the studied participants was a bit towards using coercion in treatment of mentally ill patients. Therefore, it is recommended that authorities take some steps toward changing health services providers' attitude of using coercion. 

---

 
Background: One of the main principles in comprehensive care giving in nursing is spirituality and spiritual care which has been addressed to have a crucial role in providing more effective treatment in patients. This study aimed to assess nurses’ attitude toward spirituality and spiritual care in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016.
 
Materials and Methods: This descriptive, cross-sectional study was conducted among 133 nurses employed in three selected teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016. Data collection was performed through a two- section standard SSCRS questionnaire (The Spirituality and Spiritual Care Rating Scale) including spirituality (n=15 items) and spirituality care (n=8 items). To data analyze SPSS software version 22 was utilized. Significance level was set less than 0.05.
 
Results: The mean score of attitude toward spirituality and spiritual care were calculated relatively 31.15±7.89 and 21.05±5.5, respectively. Furthermore, there was a significant statistical association between nurses’ attitude with gender (p=0.01) and job category (p=0.03). given that, there was no significant association between age, educational level, employment and marital status.
 
Conclusion: Based on study findings, attitude toward spirituality were more desirable compare to spiritual care among nurses. Thus, more training and awareness can have affecting effects on clinical care and treatment quality potentially in spite of positive attitude toward spirituality.