Journal of

Backgrounds and Aim: Self-care behaviors are an important aspect of Heart Failure (HF), management, Educating self-care behaviors to HF patients have to be a part of routine management of HF in hospitals and health care Centers. The aim of this study was to determine the impact of an educational intervention on self-care behaviors and its perceived benefits and barriers in patients with HF in Tehran.

Materials and Methods: This is was an interventional study. A Simple sampling was conducted on 180 outpatients (90 intervention group and 90 control group) with HF referring to Shaheed Rajaee Heart Hospital in Tehran to participate in this study. Before and 2 months after implementing the educational program through group discussion, face to face interview, educational movies and pamphlets, a self-prepared questionnaire was completed by the participants. Validity and reliability of the scales were approved. SPSS software was used for the purpose of data entry, manipulation, and analysis.

Results: After implementing the educational program, patients' self-care (74.5%) and perceived benefits (19.35%) were significantly increased (P<0.0001) and their perceived barriers (27.76%) were significantly decreased (P<0.0001). After intervention there was no significant difference in these variables in control group.

Discussion and Conclusion: In order to design effective educational programs, healthcare professionals and nurses should better understand self-care behaviors in HF patients and their determinants and develop educational interventions. Promoting perceived benefits and barriers of these behaviors are priorities of the program. Healthcare professionals and nurses applying such educational programs can have a more effective role in promoting self-care behaviors and consequently quality of life of HF patients.

Background and Aim: Over the past decade, the number of private centers providing health care services in Iran has had a continuous growth and the highly competitive market in private hospitals industry has caused increasing pressure on them to provide services with a higher quality. The purpose of this study was to assess the quality of services being provided in private hospitals of Tehran as judged by patients.

Materials and Methods: This cross-sectional study was conducted in 2010 in Tehran. The study sample comprised 983 patients, randomly selected from 8 private hospitals. The survey instrument was the standard SERVQUAL questionnaire. Wilcoxon, t-test, and Kruskal-Wallis tests were used for statistical analyses.

Results: The total mean scores of patients' expectation and perception were 4.92 and 4.02, respectively. The highest figures were related to the tangible factors dimension and the lowest ones to the empathy dimension. The differences between the perception and expectation for all the 22 items and the 5 dimensions were found to be statistically significant(p< 0.001).

Conclusion: SERVQUAL is valid and reliable in hospital settings as a standard tool for the assessment of quality. The results of the present study have revealed the areas that need to be improved as far as the patients are concerned. Measuring the opinion of patients can help facilitate the provision of hospital services, and improve the quality of such services and patients' satisfaction.

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: The risk of breast cancer increases directly in line with breast density. Therefore, it is important to pay more attention to denser breasts in order to detect abnormalities. The aim of this paper was to design and suggest a quantitative method to categorize breast density in digital mammogram images using fuzzy logic.

 Materials and Methods: This was a crosectional study which resulted in developing a new system. The research population was including patients who undergo mammography in National Cancer Society of Malaysia during 2010 to 2011. Sample included 220 mammogram images which was selected randomly. Data analysis was done using SPSS with Kappa statistics.

 Results: Accuracy level of 92.8% was obtained based on evaluation of the system and there was a strong correlation between the system output and radiologists’ estimation (K=0.87, p=0.0001).

 Conclusion : Results obtained from the suggested system had higher performance than similar systems. Therefore, it could be concluded that the fuzzy logic may be used in this area. In addition, such systems could be helpful for physicians.