Payavard Salamat

The Relationship Between Nursing Managers' Self-Reliance And Patients' Satisfaction In Hospitals Affiliated To Tehran University Of Medical Sciences(TUMS)

Fereshteh Farzianpour

Background and Aim: Self-reliance is a psychological belief that is formed in an individual during growth and is not changed easily and quickly.
The present study aims to evaluate the relationship between nursing managers' self-reliance and patients' satisfaction in hospitals affiliated to Tehran University of Medical Sciences(TUMS).

Materials and Methods: In this cross-sectional study, 400 individuals(200 nursing managers and 200 patients) were interviewed in various clinical wards of TUMS hospitals. Nursing managers' self-reliance and patients' satisfaction were evaluated using a structured questionnaire.
The data were entered into Stata 11 software and analyzed with non-parametric ANOVA and Spearman's correlation coefficient tests. The significance level was determined to be p<0.05.

Results: Of the nursing managers, 58(29%) were male and 142(71%) were female. The mean and SD of their self-reliance were 134.9 and 19.8, respectively. The patients, however, comprised 81(40.5%) males and 118(59.5%) females. The mean and the standard deviation of patients' satisfaction were 57 and 18.2, respectively the only individual factors affecting their level of satisfaction were educational level(p<0.005) and insurance status(p<0.0001). Besides, a multivariate analysis showed that there was a significant negative association between managers' self-esteem and patients' satisfaction(P=0.04).

Conclusion: The findings revealed that female managers had less self-esteem than male managers. Moreover, it showed that managers' higher self-esteem would cause patients' lower satisfaction. Furthermore, patients with higher education and/or with health insurance were more satisfied than others.

Evaluation Methods Of Theoretical And Practical Courses Of Paramedical Faculty Laboratory Sciences Undergraduate Students At Tehran University Of Medical Sciences In The Academic Year 2009-2010

Sakineh Abbasi

Background and Aim: Achievement-based evaluation is an important part of the educational planning process, in which learners are screened besides, it helps teachers in their self-evaluation. The purpose of present study is to survey the methods through which laboratory sciences students were evaluated by their professors at Tehran University of Medical Sciences(TUMS) in the academic year 2009-2010.

Materials and Methods: In this cross-sectional study, the population consisted of the faculty members who teach laboratory sciences courses. Data collection instrument was a researcher-made questionnaire. The collected data were analyzed to describe all evaluation methods using tables and necessary distribution frequencies. Then, the results were compared with those of Medical Planning Council resolutions.

Results: The results show that mid-term exams were used for the evaluation of students in 35% of all theoretical and practical courses. Besides, of the evaluation methods used, multiple-choice questions occupied the first rank(70%) among the methods normally employed.

Conclusion: According to the results, routine evaluation of undergraduate students of laboratory sciences at the Paramedical Faculty of Tehran University of Medical sciences not only conformed to the ratifications of the Supreme Council of Medical Planning, but also was done more extensively and with a higher degree of consistency in the academic year 2009-2010.

Survey Of Blinding Methods, Type Of Intervention And Subject Areas In Randomized Controlled Clinical Trials

Alireza Amanollahi

Background and Aim: Randomized controlled clinical trial is the most valid type of epidemiological studies for the treatment of diseases. The aim of the present article is to determine the subject area, type of intervention, and blinding methods used in this type of study design.

Materials and Methods: This is a cross-sectional descriptive study in which all the articles based on randomized controlled clinical trial were studied. The articles were all affiliated to Tehran University of Medical Sciences(TUMS) and indexed in PubMed by the end of the year 2010.

Results: Among the subject areas, most randomized controlled clinical trials(44 cases or 14%) were conducted in the field of Obstetrics and Gynecology. In terms of intervention type, the majority of the studied trials(214 cases or 68.2%) used drug intervention. And regarding the type of blinding, double-blinding was employed more than other blinding techniques(152 cases or 48.4%). On the whole, 125 cases(39.8%) of randomized controlled clinical trials were conducted through drug intervention simultaneous with double-blinding technique.

Conclusion: In different subject areas, the application of blinding techniques and type of intervention are somewhat related to research methodology and medical ethics. It seems that intervention type depends on subject area, and blinding technique is determined by the selected type of intervention.

Performance Evaluation In Hospitals Of Lorestan University Of Medical Sciences Using Pabon-Lasso Model

Sahar Goodarzi

Background and Aim: Assessment of hospital performance increases responsiveness and efficiency of limited resources. One of the most useful models of hospital performance assessment is Pabon-Lasso, a graphical model that determines the relative performance of hospitals using three indicators: Bed Occupancy Rate Bed Turnover and Average Length of Stay. The present study aims to compare the performance of Lorestan University of Medical Sciences (LUMS) hospitals using the above-mentioned tools.

Materials and Methods: In this descriptive cross-sectional study, fourteen LUMS hospitals were selected through census. The data-gathering instrument was the standard data form verified by the Ministry of Health and Medical Education. Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Rate were calculated and Pabon-Lasso graph was drawn using SPSS 15.

Results: The average length of stay, bed occupancy, and bed turnover rates turned out to be 3/21 days, 53/07% and 95/54, respectively. Five hospitals were in Zone III, indicating a satisfactory level of efficiency. Four hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. Three hospitals were placed n Zone II. And two hospitals were in Zone IV.

Conclusion: Among 14 studied hospitals, just 5 were considered as efficient. Therefore, it is necessary that policy-makers develop solutions to improve the performance of other hospitals and distribute health resources appropriately.

Assessment Of The Internal Environment Of Gachsaran's Shahid Rajai Hospital Using Weisbord Organizational Diagnosis Model

Yusef Masoudian

Background and Aim: Hospital internal evaluation is considered as one of the most important steps in strategic planning. Therefore, besides the recognition of the weaknesses and limitations of the organization, especially affecting issues on the performance, the responsibility of the organization will be defined. This study was performed for the assessment of internal environment of the Gachsaran's Shahid Rajai Hospital based on Weisbord Organizational Diagnosis model.

Materials and Methods: In a cross-sectional study, 123 hospital staff were selected using random sampling formula. Data was collected using Weisbord Questionnaire which consisted of 35 questions in seven areas. Data analysis was conducted using SPSS statistical software and the t-test.

Results: Among six variables studied, variable communication with 3/15 ± 1/25 mean and standard deviation has the best situation and reward mechanism with the mean and standard deviation of 4/59 ± 1/32 was the worst. There was a meaningful difference among all variables except for the leadership variable.

Conclusion: Based on the findings of this study, Gachsaran's Shahid Rajai hospital has strength in the fields of goals, organizational structure, coordination, and internal organizational communication

Relationship Between Number Of Involved Coronary Artery With Some Risk Factors By Angiography

Ali Akbar Abdollahi

Background and Aim: Despite the information regarding CAD risk factors, there isn't agreement between the relation of this risk factors and coronary artery diseases. This study was done for determination of related factors with vessels involved in coronary artery angiography.

Materials and Methods: In this descriptive and analytical study, 2390 patients' .were selected via census sampling from Kosar Angiography center in the Golestan province. Data gathering form included data such as age, gender, body mass index (BMI), blood pressure, diabetes, smoking and opiates addiction history. Vessels involved were determined by angiography. Data analysis was done with one way ANOVAs and logistic regression using SPSS 16 soft ware.

Results: Mean and standard deviation of patient's age was 57.9±10. 58.2 percent of them were male. There were significant correlations between age, gender and BMI with numbers of vessels involved. Male gender(OR=1.329), hypertension (OR=1.25) and diabetes(OR=1.20) increased the probability of more than one vessels involvement. Regression analysis showed there were no significant correlations between age, BMI, smoking and opiates addiction history with more than one vessels involvement.

Conclusion: Our finding confirmed that male gender, hypertension and diabetes are the main risk factors in involvement of more than one vessel.

Prevalence Of Staphylococcus Aureus (SA) And Methicillin Resistant Staphylococcus Aureus (MRSA) In Personnel Of Operation Room Of Shahid Sadoughi Hospital, Yazd, Iran

Alireza Sazmand

Background and Aim: Staphylococcus aureus(SA) may cause infection in all body organs. Many personnel and patients in hospitals may become carriers of this species. The aim of this study was to investigate relative frequency of SA and its resistance to Methicillin.

Materials and Methods: A couple of swabs were taken from nose and nails of 151 personnels working in operation room of Shahid Sadoughi Hospital in Yazd. Samples were inoculated into Mannitol salt agar medium and S. aureus colonies were antibiogramed to determine the rate of resistance to methicillin. Statistical analyses were performed by chi-square and Fishers' exact test.

Results: Overall prevalence of SA was 35.09%(19.2% and 15.9% in noses and nails, respectively). Prevalence of methicillin-resistant SA(MRSA) was 11.92%(5.3% and 6.6% in noses and nails, respectively). Surgeons had the highest, and workers the lowest prevalence of nasal SA carrier rate. In contrast, the nails of servants had the highest, and surgeons the lowest SA carrier rate. No significant difference was found between carrier rate and age, sex and duration of employment. But a meaningful relation was found between type of job and MRSA in both noses and nails. All of the MRSA isolates were sensitive to vancomycin.

Conclusion: Since employees of operation room are continuously working with patients undergone operation, screening both the personnel and patients to determine the rate of carriage, preventing transfusions of fore mentioned bacterium is necessary and highly recommended.

Obesity Among Female Adolescents Of Tehran Schools

Masumeh Shakeri

Background and Aim: Obesity in childhood can cause obesity and its related complications in adulthood. This study was aimed to determine the correlateion between obesity among female adolescents and its related complications of Tehran schools in 2011.

Materials and Methods: In this cross-sectional study, 810 female adolescents, aged 12-16 years old, studying in schools of Tehran University of Medical Sciences were selected using multi-stage random sampling. Height and weight of the participants were measured and their BMI calculated. Data were collected using a questionnaire. Validity and reliability of the questionnaire was confirmed using content validity and test-retest. Using BMI, the participants were categorized into obese(BMI>95 percentile for age and gender) and overweight(BMI between 85 and 95 percentiles for age and gender) individuals. Data were analyzed using the Chi-squared test, Fisher's exact test, ANOVA, and multivariate logistic analysis.

Results: The prevalence of overweight and obesity in our study were 4.4%(95% CI 4/2-6/4) and 14/1%(95% CI 10/25-15/3), respectively. There was a statistically significant relationship between obesity and TV watching(p<0.001).

Conclusion: Based on our findings, further investigations are recommended to determine factors affecting overweight.