Journal of

Background and Aim: Information Technologies (ITs) has become a significant resource for dissemination of information and resulted to an increase of health knowledge in communities. With attention to patient - centered approach this study was done to determine knowledge of inpatients about ITs.

Materials and Methods: A descriptive - cross-sectional study was done on 461 inpatient in Kashan University of Medical Sciences hospital's with a reliable (spearman Brown, r =0.83) and valid (face and content) questionnaire in two section, demographic information and study objects. Data gathering was done with interview then analyzed by SPSS and descriptive analysis.

Results: %42.1 and %26.7 of participants had knowledge about computer and the Internet relatively. %41.9 of them had the Internet access. 86.3% and 88.3% relatively would be interested to access and get medical records and their information. They intended to get test (%85.7), refill her/his prescription (79%), get appointment (%76.4), consult with physicians (%80), and get information about diets (80%) through ITs.

Discussion  and Conclusion: It seems ITs attitude in inpatients is relatively good. Providing their information needs especially about prescription order and diets from CD or the Internet by hospital sites and introducing good medical sites to patient were recommended.

Background and Aim: The provision of high-quality services is considered as a prerequisite to the success of responsible organizations. Using SERVQUAL model, the present article seeks to delve into the quality of services provided in outpatient clinics as judged by patients in case-study hospitals throughout Tehran.

Materials and Methods: This is a cross-sectional descriptive research in which 242 subjects were studied at the outpatient clinics under investigation throughout Tehran using a standardized questionnaire named SERVQUAL (1988).

Results: The results of a t-test revealed a meaningful difference between the patients' perception and their expectation about 5 factors (tangible elements, reliability, assurance, accountability and collaboration) affecting the quality of services in clinics. The patients rated ‘assurance' as the most important factor (4.41) and ‘accountability' as the least important of the 5 factors (2.21).

Conclusion: The results indicate that the application of SERVQUAL model enables hospital managers to evaluate the quality of services as evaluated by patients as their most important clients and enhance the quality of such services through proper planning and removal of deficiencies.

Background and Aim: Quality of printed papers in 4 four medical journals affiliated to one of the universities of medical sciences in Iran was assessed based on methodological and statistical methods.

Materials and Methods: In this cross sectional study conducted in 2010, out of all articles published between the years 2002 to 2008 in one of the universities of medical sciences for affiliated journals that were equal to 1568, a sample of 162 articles were selected with Multi-stage stratified sampling method . For data collection, standard questionnaire was used to develop an information form. One sample t-test and Kruskal-Wallis test were used to compare scores from different parts of article.

Results: Cross sectional studies with 61.7% (100 papers) formed most of studies. Median of authors and number of references for each article were 3 and 19, respectively and 10% of articles had more than 35 references. Material and methods with 3.53 points from 4 points (88.2%) earned the mighest score which was of high quality and conclusion achieved the lowest score. Also p-value has been reported correctly in 102 articles (81.6%). In 95 articles (58.6%) results were not compare with the similar internal articles whereas only in 21 articles (13%) comparison was not made with similar external researches.

Conclusion: The present study showed that the overall quality of the medical articles is not desirable. Hence, employing experts in research methods and statistics in various medical studies can improve the quality of articles in this branch of science.

Background and Aim: The present case study aims to investigate the impact of service quality on patients' loyalty to the services rendered in outpatient clinics of the studied hospitals throughout Tehran.

Materials and Methods: This is a descriptive-analytical survey in which 242 outpatients referring to the studied hospital clinics in Tehran. For data collection purposes, the standardized SERVQUAL questionnaire(1988) and for the measurement of loyalty for service quality, the standard questionnaire for customer's behavioral tendencies(Zitamel and Berry, 1996) were used. Regarding the validity of the questionnaire, its content validity was confirmed and its reliability was approved through test-retest method and Cronbach's alpha coefficient. For data analysis, Pearson correlation test was employed.

Results: The results revealed that there was a positive and meaningful relationship between the quality of services and the patients' loyalty in Tehran clinics. The most important aspect of loyalty was complaining behavior.

Conclusion: Hospital managers should enhance their understanding and awareness to maintain, and even improve, the patients' loyalty to their services and should do their best in this regard. Hospital employees should be aware of the patients' expectations and act beyond it. Finally, they should know that rendering services to patients is teamwork and that the key to providing patients with good services lies in their satisfaction with the quality of services they receive.

Background and Aim: Accountability is a process by which all service organizations including hospitals are required to legitimize their activities. This research aims to study the seven aspects of accountability in Iran's teaching hospitals.

Materials and Methods: This is a cross-sectional analytic study performed in the second half of 1390 in five major medical-educational hospitals in 5 points of the country. A research-made questionnaire with seven dimensions (ethical, cultural, financial, operational, legal, informational, and structural) was used. The collected data were analyzed using descriptive and inferential statistics.

Results: The total number of subjects was 454, of whom 45.6% were males and the rest were females (n = 247). They were mostly (40.1%) in the age group of 21- to 29-year-olds, and the least figure (6.8%) pertained to those older than 50 years of age. The average mean of structure turned out to be the highest (3.54 ± 0.97) and the informational dimension had the lowest (3.45 ± 0.97). The average accountability score was the highest in Rasht hospital (99.3 ± 0.61) and the lowest in Tehran hospital (3.02 ± 0.67). The correlations between all dimensions were confirmed. Moreover, accountability as evaluated in the studied educational hospitals was above average.

Conclusion: Patients' attitude towards accountability in Iran's teaching hospitals was assessed to be above average. The findings show that an office or a unit for accountability, validation, and continuous audit of its dimensions is essential to advance the high goals of the hospitals.

Background and Aim: Female pattern hair loss(female androgenic alopecia) is a common but puzzling condition in women which increases by aging. Female hair loss is strongly linked to hormones and hormonal imbalances. The aim of this study was to determine the serum level of hormones such as T4, TSH, free testosterone, Prolactin(PRL) and Alb, SHBG in women(15-50 years old) with hair loss versus those without hair loss.

Materials and Methods: In this cross-sectional case-control study, 71 women with hair loss and 70 normal women were selected from skin and hair care day clinics. The level of hormones and SHBG were measured by ELISA, and Alb was measured by spectrophotometery. Data were analyzed by independent t-test.

Results: After analyzing the data and determining the levels of TSH, T4, Prolactin, Alb, SHBG, no significant difference was found between the case and control groups. However, free Testosterone level was significantly different between patients and controls(P= 0.000), with a higher mean level in the case group(patients).

Conclusion : Since androgens have a major role in regulating the biological cycle of hair in women and since there was a significant difference between free testosterone in patient and control groups, we suggest that the serum level of free testosterone should be measured in women with androgenic alopecia .

 Background and Aim: Isoflurane is one of the selective and mostly-used respiratory anesthetic materials in the field of neurosurgery. Studies have shown that temporary rise in the level of liver enzymes may occur after anesthesia by halogenic ethers and hence cause liver lesions. The aim of this study was to investigate the effects of isoflurane on the activity of ALT-AST-ALP-GGT enzymes as an indicator of liver function.

 Materials and Methods: This study was performed on a sample of 40 patients who were under neurosurgery without any liver disease in Milad Hospital of Tehran. The patients' blood samples were collected before, 24, and 72 hours after anesthesia. The enzymes activities was assessed by spectrophotometric method.

 Results: Insignificant changes before and after anesthesia were seen in the activity of ALP, and AST enzymes. The level of ALT enzyme has a significant rise, 72 (P=0/022) and 24 (P=0/014) hours after anesthesia in comparison with before anesthesia. The level of GGT enzyme in comparison to its past has significant rise 72 hours after anesthesia (P=0/002). The level of this enzyme showed a significant difference 24, and 72 hours after anesthesia (P=0/041).

 Conclusion: The significant changes seen in the levels of ALT, GGT enzymes in three different periods of time might be as a result of possible liver parenchymal and cholestatic damage caused by using Isoflurane or other drugs such as Midazolam which effects liver function. It seems the assessment of the levels of these enzymes can provide useful information for probable subsequent actions.

Background and Aim: Identifying obesity-related eating behavior predictors especially in women, who have a key role in their family's food basket, has a great importance in the prevention of obesity. The purpose of the present study is to determine the role of eating attitude on obesity-related eating behavior in overweight and obese women in Urmia.

Materials and Methods: The present descriptive-analytical study was performed on 100 overweight or obese women covered by Shahid Nikkhah and No. 13 Health Centers in Urmia. Sampling was conducted through c onvenience method and women with a BMI equal to or more than 25 (kg/m²) were selected. Following their informed consent, they completed the questionnaires about demographic characteristics , attitude, and food behavior checklist. Data analysis was conducted using SPSS software version 18 and descriptive and inferential statistics (Chi-square , analysis of variance and regression ) at 0.05 significance level .

Results: The result confirmed that there was a significant relationship between attitude and poor , average and good eating behavior groups of women (p=0.003).

  Regression analysis revealed a positive and significant relationship between eating behavior and attitude scores (p=0.004, r=0.285) . Also, prediction of observed distribution in eating behavior was confirmed by age , anthropometric indices and demographic factors in addition to eating attitude .

Conclusion: The study results confirmed the predictive role of eating attitude on obesity-related eating behavior. Therefore, it is recommended that correction of eating attitude be emphasized in the promotion of healthy eating behavior.

Background and Aim: The study of human resources flexibility impact on hospitals performance indicators can be effective on hospitals performance improvements. The main purpose of this research is to investigate the relationship between human resources flexibility and hospitals’ performance indicators of Islamic Azad University.

Materials and Methods: The present research was a descriptive-analytical research that has been induced cross-sectionally in 2013. The statistical sampling has been selected randomly, and class assignment among 108 nurses, and supportive employees in five hospitals of Islamic Azad University. Data collection tools was hospital’s performance indicator forms, and flexibility questionnaire based on Right and Esnel. The process of data analysis has been done using SPSS software and by descriptive statistical indicators and correlation tests.

Results: The studied employees had low flexibility. The total studied hospitals were in undesirable situation from the perspective view of bed occupying and bed rotation ratio. Finally, there were not any meaningful relationship between human resources flexibility and hospitals performance indicators.

Conclusion: According to low flexibility of human resources of Islamic Azad University hospitals, the policies should be made in order to coordinate human resources process  with human  resources  flexibility strategies. Furthermore, human resource for the purpose of creating flexibility and hospital subsidiaries of Islamic Azad University performance improvements could be clearly effective in such hospitals situation promotion.

Background and Aim: Inclusive implementation of Electronic Medical Records (EMR) is more serious because of physicians’ perception. This study was carried out to identify the effects of organizational contextual factors on physicians’ perception regarding EMR’s adoption in 2013 (The merger of Tehran University and Iran). 
Materials and Methods: This was a descriptive, analytical and cross- sectional study in which a sample of 270 physicians working in hospitals affiliated to Tehran University of Medical Sciences was selected. Physicians’ perception toward adoption of EMR has been assessed by Technology Acceptance Model or TAM questionnaire and organizational context variables. Collected data were analyzed by SPSS. The study model was tested by Structural Equation Modeling (SEM) and represented by AMOS. 
Results: The findings showed that perceived usefulness (PU), perceived ease of use (PEOU), management support, physicians’ involvement, physicians’ autonomy, and physician- patient relationship have direct and significant effect on physicians’ attitudes toward EMR adoption. However, training has no significant effect on TAM variables. Moreover, the results showed authorizing proposed conceptual path model explained about 56 percent of the variance of EMR adoption.
Conclusion: The present study revealed that organizational context factors had significant effect on physicians’ attitude toward EMRs’ adoption. The study clearly identified six relevant factors that affected physicians’ perception regarding EMR adoption. These factors should be considered when comprehensive implementation is pursued.