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Assessment Of Validity And Reliability Of Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) In Iran
Minoo Najafi , Fatemeh Keshmiri , Maryam Najafi , Mandana Shirazi ,
Volume 7, Issue 5 (1-2014)
Abstract

Background and Aim: Collaboration within and between healthcare teams facilitates effective healthcare provision. Fundamental strategies in effective healthcare services focus on collaboration and teamwork. This study was an attempt to assess reliability and validity of Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) in Iranian context.

Materials and Methods: This cross-sectional survey was conducted in Iran in 2012. Delphi method was applied and the questionnaire was submitted to 11 experts in 2 rounds to determine its face and content validity. Besides, it was translated and back translated to determine external validity. To estimate the reliability of the instrument, test-retest method was used. A sample of 67 medical and nursing senior students was stratified from Tehran University of Medical Sciences (TUMS). T-TAQ is a questionnaire having 30 questions in 5 themes. The obtained data were analyzed by SPSS13.

Results: The content, face and external validity of the tool were approved by Iranian experts. Meanwhile, applying Cronbach's alpha, total reliability was estimated to be 0.80 moreover, the ICC turned out to be 0.8.

Conclusion : Since the validity and reliability of this instrument are confirmed in an Iranian context, it can be used to measure attitude regarding teamwork in this context.


Psychometric Properties of Organizational Cultural Competence Instrument in Tehran University of Medical Sciences
Najmeh Abbasi , Minoo Najafi, Nazila Zarghi , Maryam Karbasi Motlagh, Fourouzan Khatami Doost , Mandana Shirazi ,
Volume 11, Issue 6 (3-2018)
Abstract
Background and Aim: World Health Organization (WHO) has prioritized cultural competence to provide high-quality healthcare and patient-centered services. Therefore, it is necessary to develop them for all organizational levels. The present study aimed to determine the validity and reliability of the Persian version of OHCC (Ontario Healthy Communities Coalition) organizational cultural competence (2005) instrument in Tehran University of Medical Sciences (TUMS).
Material and Methods: In order to confirm reliability, 143 staff members (nurses and physicians) in different administrative positions working in Imam Khomeini educational Hospital, completed the questionnaire. Modified HSR toolkit for translating and adapting instrument, was used for contextualizing the questionnaire: first, two medical education experts who were proficient in English translated it. Then, the content validity of Persian version was confirmed using Lawshe method (CVR and CVI = 0.79); its internal consistency was calculated by Cronbach's alpha coefficient (0.91). It was backward translated to compare with the original copy and was sent to experts for their approval. Construct validity was calculated by LISREL software and the result showed that the questions were fit to the domains. The KMO, calculated for this instrument, was 0.75 and α was less than 0.05.
Results: Content validity was confirmed by deleting two items from the original 22-item questionnaire. Cronbach's alpha was calculated as 0.95 following the removal of two items.
Conclusion: The organizational cultural competence instrument was confirmed to be valid and reliable with 20 items in Iranian context.

Development of a Balanced Scorecard Suitable for Health Care Centers Based on DANP Hybrid Multi-Criteria Decision Making
Mahdi Hadi, Ali Jahan, Lila Najafi, Mohamad Ali Shariat,
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques. 
Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives. 
Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values.
Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.

Factors Related to Infection and Hospitalization of Covid-19, Results of the Participants of the Ravansar Non-Communicable Diseases Cohort Study in Kermanshah Province
Maryam Aghajarinezhad, Yahya Salimi, Shahab Rezaeian, Ghobad Moradi, Mehdi Moradinazar, Fatemeh Khosravi Shadmani, Roya Safari_ Faramani, Mitra Darbandi, Farid Najafi,
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: All people living in a society are not equally at risk of COVID-19 infection and hospitalization. The current study is aimed to determine the factors related to COVID-19 infection and hospitalization among participants of Ravansar Non-Communicable Disease (RaNCD) cohort study. 
Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively. 
Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.     
Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination. 

Solutions for Preventing Patient Falls in Hospitals: A Scoping Review
Marziyeh Najafi, Roya Rajaee, Hojjat Rahmani, Behrooz Pouragha, Nazanin Sheikh Mohammadi, Ghasem Rajabi Vasokolaei,
Volume 18, Issue 1 (3-2024)
Abstract
Background and Aim: Patient falls are common in hospitals, leading to financial loss and potential harm to patients, staff, and the organization. They can often be prevented with proper planning. This study aims to identify strategies to prevent patient falls and provide evidence to develop safety initiatives.
Materials and Methods: Our review used the Arksey and O’Malley scoping review model to identify strategies for preventing patient falls. We conducted searches with relevant keywords in the PubMed and Web of Science databases until May 25, 2024. In the final stage, we consulted with 18 experts using the Delphi method to gather their opinions. The data were analyzed using the thematic analysis method.
Results: Out of the 4202 studies initially found, 19 articles were chosen. The solutions to prevent patient falls can be grouped into six general categories: planning (which includes quality improvement programs, establishment of patient safety culture, patient fall prevention guidelines and programs), physical space (involving patient room design and the location of treatment staff), equipment (such as monitoring and alarms, pressure sensors, and standard beds), human resources (including communication networks between nurses and other treatment staff, as well as factors like self-efficacy and responsiveness of nurses, and their motivation and job satisfaction), training (covering education and patient participation, training of nurses and treatment staff, and electronic training), and control of executive processes (involving evaluation of risk factors and process control). The highest level of agreement among the members was on the equipment dimension (9.76), and the lowest was on the human resources dimension (8.65).
Conclusion: Patient falls are a common safety concern in hospitals and can be prevented with proper planning. Each hospital should use a combination of prevention methods tailored to its specific conditions.

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