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Kourosh Abbasiyan, Mohammad Alimoradnori, Mohammad Bagher Karami,
Volume 18, Issue 2 (5-2024)
Volume 18, Issue 2 (5-2024)
Abstract
Background and Aim: Managers, as the main decision-makers in facing various internal and external organizational problems, play a significant and determining role in the success or even failure of an organization. If competent and experienced managers are positioned at the top of organizations, the success of these organizations in achieving their goals will be guaranteed and an organization can achieve maximum efficiency with minimal resources. The aim of this study was to design a model of managerial competencies for hospital managers.
Materials and Methods: This qualitative research was conducted from year 2020 to 2022. After reviewing studies related to the topic, the extracted competencies were given to 19 experts consisted of relevant academic faculty members and managers with experience in the healthcare system and hospitals. Eventually, a managerial competency model was formulated through the use of the Delphi method and expert panel discussions. Collected data were analyzed in Excel software.
Results: The developed model in this research for the concept of hospital managers’ competencies includes 33 managerial competencies of hospital managers in four main management functions (planning, organizing, leadership and control) and managerial roles, which starts from literature review and performing two Delphi steps and implementing two expert panel plans. In the competency of hospital managers model, the planning dimension consists 4 components, organizing consists 4 components, leadership consists 12 components, control consists 4 components, and managerial roles consists 9 components. Strategic thinking, which is a subset of planning, has the highest weight (0.495) and highest rank among other components, and continuous improvement, which is a subset of managerial roles, has the lowest weight (0.033) and lowest rank among other components.
Conclusion: This study proposes an exclusive and comprehensive model, utilizing practical techniques as a suitable solution for evaluating the managerial competencies of hospital managers. The proposed framework in this study can serve as a standard performance assessment tool for evaluating managers.
Materials and Methods: This qualitative research was conducted from year 2020 to 2022. After reviewing studies related to the topic, the extracted competencies were given to 19 experts consisted of relevant academic faculty members and managers with experience in the healthcare system and hospitals. Eventually, a managerial competency model was formulated through the use of the Delphi method and expert panel discussions. Collected data were analyzed in Excel software.
Results: The developed model in this research for the concept of hospital managers’ competencies includes 33 managerial competencies of hospital managers in four main management functions (planning, organizing, leadership and control) and managerial roles, which starts from literature review and performing two Delphi steps and implementing two expert panel plans. In the competency of hospital managers model, the planning dimension consists 4 components, organizing consists 4 components, leadership consists 12 components, control consists 4 components, and managerial roles consists 9 components. Strategic thinking, which is a subset of planning, has the highest weight (0.495) and highest rank among other components, and continuous improvement, which is a subset of managerial roles, has the lowest weight (0.033) and lowest rank among other components.
Conclusion: This study proposes an exclusive and comprehensive model, utilizing practical techniques as a suitable solution for evaluating the managerial competencies of hospital managers. The proposed framework in this study can serve as a standard performance assessment tool for evaluating managers.
Fatemeh Soofiabadi, Alireza Shahraki, Mohebali Rahdar,
Volume 18, Issue 3 (7-2024)
Volume 18, Issue 3 (7-2024)
Abstract
Background and Aim: Given the high sensitivity of the medical field, a mistake can cause irreparable damage to human society. For this reason, finding the symptoms of the disease and the relationships between them to facilitate the improvement of diseases is inevitable. Therefore, the aim of the present study was to first identify the symptoms of neurofibromatosis type 1 by specialists, then determine the relationship between the symptoms and the degree of their impact on each other in order to determine the most important criterion in improving the disease.
Materials and Methods: The present study is of a developmental-applied type in terms of its purpose and of a descriptive-survey type in terms of its data collection method. The case study of the present study is spinal disorders, of which neurofibromatosis type 1 has been diagnosed as one of them based on the opinion of experts. Neurofibromatosis type 1 is a genetic disorder that causes tumors in the nervous tissue. Accordingly, in the present study, the criteria, which are the symptoms of the disease, were first determined using the opinion of a group of experts and the implementation of the fuzzy Delphi method. In the next step, a model for the causal relationships between the symptoms of the disease is presented. For this purpose, a fuzzy cognitive map is drawn using MATLAB, FCMapper and Pajek software, then backward and forward scenarios are presented for neurofibromatosis type 1 and the disease improvement scenario is determined.
Results: The results showed that hormonal changes, flat brown spots on the skin, freckles in the armpit and groin area, soft bumps on the face or under the skin, high blood pressure, respiratory problems, bumps on the iris of the eye (Lish nodules), tumor in the optic nerve-ocular glioma, short stature, bone deformity, learning disabilities-attention deficit hyperactivity disorder (ADHD) and larger than average head size are ranked first to twelfth, respectively. The causal relationships between the symptoms showed that the criterion of hormonal changes has the greatest impact on the criterion of freckles in the armpit or groin area; Therefore, if the hormonal changes criterion improves, neurofibromatosis type 1 will also improve.
Conclusion: The findings of this study have helped the medical community to have a better understanding of the symptoms of the disease so that doctors can improve their prevention and care recommendations based on the severity of the symptoms of the diseases.
Materials and Methods: The present study is of a developmental-applied type in terms of its purpose and of a descriptive-survey type in terms of its data collection method. The case study of the present study is spinal disorders, of which neurofibromatosis type 1 has been diagnosed as one of them based on the opinion of experts. Neurofibromatosis type 1 is a genetic disorder that causes tumors in the nervous tissue. Accordingly, in the present study, the criteria, which are the symptoms of the disease, were first determined using the opinion of a group of experts and the implementation of the fuzzy Delphi method. In the next step, a model for the causal relationships between the symptoms of the disease is presented. For this purpose, a fuzzy cognitive map is drawn using MATLAB, FCMapper and Pajek software, then backward and forward scenarios are presented for neurofibromatosis type 1 and the disease improvement scenario is determined.
Results: The results showed that hormonal changes, flat brown spots on the skin, freckles in the armpit and groin area, soft bumps on the face or under the skin, high blood pressure, respiratory problems, bumps on the iris of the eye (Lish nodules), tumor in the optic nerve-ocular glioma, short stature, bone deformity, learning disabilities-attention deficit hyperactivity disorder (ADHD) and larger than average head size are ranked first to twelfth, respectively. The causal relationships between the symptoms showed that the criterion of hormonal changes has the greatest impact on the criterion of freckles in the armpit or groin area; Therefore, if the hormonal changes criterion improves, neurofibromatosis type 1 will also improve.
Conclusion: The findings of this study have helped the medical community to have a better understanding of the symptoms of the disease so that doctors can improve their prevention and care recommendations based on the severity of the symptoms of the diseases.
Fateme Hami Kargar, Narges Nikkhah Ghamsari, Mohammad Ganji,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: Breast cancer treatment is associated with changes in women’s bodies. Changes that are related to their femininity in addition to the appearance aspect and can face challenges in the part of women’s identity that is related to their body. This research deals with the process of changes in women’s physical identity in the context of culture and society
Materials and Methods: A qualitative method was used for the research, and in this regard, in-depth and semi-structured interviews were conducted with 15 women from Tehran who had undergone treatment for breast cancer, along with 5 companions who were alongside the patients during their illness, and 3 surgical doctors. The interviews focused on the experiences, emotions, and actions of the women in response to bodily changes. Sampling was conducted through purposive and snowball sampling methods. The thematic analysis technique developed by Braun and Clarke was employed for analyzing the interviews.
Results: The participating women were aged 27 to 65 years, with 8 holding bachelor’s degrees or higher. Seven women were housewives, 8 were employed, and 13 had undergone mastectomies. The main themes identified include changes in the female body, societal challenges, disruption of body image, support and companionship, economic constraints, and the redefinition of body image. These themes explain the process of women’s coping with bodily changes. Following bodily changes, women face challenges from society. Society judges women’s bodies after these changes and views them negatively. Furthermore, women experience dissatisfaction with their bodies, perceiving them as inadequate for fulfilling feminine roles and responsibilities as wives and mothers. However, over time, through acceptance of the changes and body management, women strive to reconstruct their body image. In addition, the women’s economic situation and the support and companionship of those around them—manifesting as acceptance of the bodily changes and emotional support—can facilitate the acceptance of these changes.
Conclusion: Given the importance of the body in defining femininity, women, after experiencing breast cancer, face not only the suffering of the disease but also identity challenges. Therefore, breast cancer treatment, alongside clinical interventions, requires societal awareness of how to interact with affected women.
Materials and Methods: A qualitative method was used for the research, and in this regard, in-depth and semi-structured interviews were conducted with 15 women from Tehran who had undergone treatment for breast cancer, along with 5 companions who were alongside the patients during their illness, and 3 surgical doctors. The interviews focused on the experiences, emotions, and actions of the women in response to bodily changes. Sampling was conducted through purposive and snowball sampling methods. The thematic analysis technique developed by Braun and Clarke was employed for analyzing the interviews.
Results: The participating women were aged 27 to 65 years, with 8 holding bachelor’s degrees or higher. Seven women were housewives, 8 were employed, and 13 had undergone mastectomies. The main themes identified include changes in the female body, societal challenges, disruption of body image, support and companionship, economic constraints, and the redefinition of body image. These themes explain the process of women’s coping with bodily changes. Following bodily changes, women face challenges from society. Society judges women’s bodies after these changes and views them negatively. Furthermore, women experience dissatisfaction with their bodies, perceiving them as inadequate for fulfilling feminine roles and responsibilities as wives and mothers. However, over time, through acceptance of the changes and body management, women strive to reconstruct their body image. In addition, the women’s economic situation and the support and companionship of those around them—manifesting as acceptance of the bodily changes and emotional support—can facilitate the acceptance of these changes.
Conclusion: Given the importance of the body in defining femininity, women, after experiencing breast cancer, face not only the suffering of the disease but also identity challenges. Therefore, breast cancer treatment, alongside clinical interventions, requires societal awareness of how to interact with affected women.
Hojjat Rahmani, Sadegh Moradi, Nayeb Fadaei Dehcheshmeh,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The fundamental right and most valuable asset for all strata of society is the enjoyment of health. Individuals residing in nomadic settings face geographical, social, cultural, and linguistic barriers when seeking access to essential services. The provision of healthcare services to nomads has become a complex issue due to the nature of the lifestyle. The aim of this study was to assess the challenges in the provision of healthcare services among the nomads in the Khuzestan province.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.
Mohammadreza Asghariyan, Farzad Firouzi Jahantigh,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The emergency department of the hospital is considered one of its main entrances; which has provided health care and treatment for critical and non-critical patients and faces various health and treatment restrictions, but the main emphasis is always on resource limitations. Many simulation projects were implemented in hospitals and first in emergency departments with the aim of increasing productivity. The present research is a general description of the patient’s movement flow and length of stay in the emergency department of a selected specialized hospital in Zahedan city. The aim of the current research is to prevent care complications, reduce waiting time and patient stay in the emergency department, present a simulation model and improve it based on discrete-event simulation.
Materials and Methods: Using the data bank of the emergency department system based on the required data and also through the in-person observation of the data related to the duration of the patient’s stay in the emergency department, including the arrival time, waiting time, The type of services provided to the patient, the time of service and the time of departure were collected and checked and confirmed by experts related to this field so that it has the highest level of reliability with the facts. The data were designed in Excel software, and then data analysis and simulation model creation were done using Aren V14 software, and according to the results, the effect of the proposed solutions was evaluated.
Results: The findings of the present research showed that the longest queue created in the emergency department of the selected specialized hospital in Zahedan city is related to medical examination and additional tests. By implementing the simulation model and testing different solutions, solution 3, which means adding one nurse to nursing consultation and one person to radiology, has the most optimizing effect on the performance of the system at different levels of the patient admission process. and the cost of its implementation is more than solutions 1 and 2. This solution created a 14% decrease in the average length of stay and a 28% decrease in the average duration of additional tests.
Conclusion: The use of queuing models and simulation techniques improve the performance of the system and their implementation has significant effects on reducing the waiting time and length of stay of patients in the emergency department, increasing the quality level of the process of monitoring patients. It leads to optimal management of resources and increased productivity.
Mazyar Karamali, Azadeh Soleimaninejad, Peirhossein Kolivand, Reza Dehkhodaei,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The Iranian Red Crescent Society (IRCS) is recognized as one of the ten most powerful national societies among the Red Cross and Red Crescent societies globally in responding to disasters and emergencies. The purpose of this study is to outline the research topics of the Iranian Red Crescent Society by analyzing its scientific outputs over the past years.
Materials and Methods: The research is of an applied type with a scientometric approach and bibliometric analysis, which uses event network visualization techniques and synonym analysis. The statistical population of the study included all research conducted by the Iranian Red Crescent Society and articles indexed in the Scopus database since the 1990s. The synonym analysis of research titles conducted in the organization and article abstract information and data visualization techniques were used with VOSviewer, NVIVO, WordCloud and iThoughts software.
Results: The trend of publishing research outputs has been upward. Analysis of outputs showed that Shiraz University of Medical Sciences had the highest output and the Gastroenterology and Liver Research Center and Isfahan University of Medical Sciences had the lowest output among the 10 most active institutions. Also, the Iranian Red Crescent Medical Journal had the highest output, and among the topics related to outputs, the field of medicine was ranked first and the field of Multidisciplinary was ranked lowest. Among the frequently used words, “human” was ranked first. Identifying and drawing a map of research issues for this organization showed that the problem-oriented research topics of the Red Crescent Society were categorized into nine main areas, among which relief and rescue was ranked first with 21.4% and technology and innovation was ranked lowest with 4.6%.
Conclusion: The study of the scientific and research outputs of the Iranian Red Crescent indicates the breadth and diversity of research issues in the subject areas raised. The status of research conducted in the map of Iranian Red Crescent issues by comparing the keywords showed that the research performance of this organization is higher in the fields of health services, relief and rescue, and education. Given the breadth of issues commensurate with its missions, it needs balanced growth in research and knowledge production in other areas.
Materials and Methods: The research is of an applied type with a scientometric approach and bibliometric analysis, which uses event network visualization techniques and synonym analysis. The statistical population of the study included all research conducted by the Iranian Red Crescent Society and articles indexed in the Scopus database since the 1990s. The synonym analysis of research titles conducted in the organization and article abstract information and data visualization techniques were used with VOSviewer, NVIVO, WordCloud and iThoughts software.
Results: The trend of publishing research outputs has been upward. Analysis of outputs showed that Shiraz University of Medical Sciences had the highest output and the Gastroenterology and Liver Research Center and Isfahan University of Medical Sciences had the lowest output among the 10 most active institutions. Also, the Iranian Red Crescent Medical Journal had the highest output, and among the topics related to outputs, the field of medicine was ranked first and the field of Multidisciplinary was ranked lowest. Among the frequently used words, “human” was ranked first. Identifying and drawing a map of research issues for this organization showed that the problem-oriented research topics of the Red Crescent Society were categorized into nine main areas, among which relief and rescue was ranked first with 21.4% and technology and innovation was ranked lowest with 4.6%.
Conclusion: The study of the scientific and research outputs of the Iranian Red Crescent indicates the breadth and diversity of research issues in the subject areas raised. The status of research conducted in the map of Iranian Red Crescent issues by comparing the keywords showed that the research performance of this organization is higher in the fields of health services, relief and rescue, and education. Given the breadth of issues commensurate with its missions, it needs balanced growth in research and knowledge production in other areas.
Mahboubeh Fatemi, Mohammad Reza Yaghoobi-Ershadi, Yavar Rassi, Mohammad Mehdi Sedaghat, Hassan Vatandoost, Mahboubeh Bayat, Mehrdad Zarabi, Fatemeh Nikpoor, Amir Ahmad Akhavan,
Volume 18, Issue 5 (11-2024)
Volume 18, Issue 5 (11-2024)
Abstract
Background and Aim: Training and proper distribution of human resources are essential for maintaining and promoting society’s health. The first step in any health-related planning is to assess the current situation to draw a clear picture of the future to balance demand and supply. This research was conducted to assess the current situation of medical entomology and vector control/biology and vector control of the diseases in the country and determine the required human resources till 2025.
Materials and Methods: In this study, a “modified and combination model” was used, including the Hall model, which is location-based, and the Australian health workforce estimation model, which is a needs-based approach. The research was carried out in multiple stages, which included collecting the required data (number of faculty members, students, and graduates), the number of private companies providing spraying, and pest control services in all cities of the country and finally holding meetings with the board members of Biology and vector control of diseases and experts to estimate the human resources required in this field.
Results: Based on the data collected and face-to-face interviews conducted during six sessions with the experts in this field, it has been estimated that a total of 985 graduates have been trained in this discipline to date, while there is a requirement for 1,338 graduates in this area. Consequently, it is essential to train an additional 353 individuals in this field by the year 1404. In light of the country’s sixth five-year development plan, which allocates 30 percent of the total student population to postgraduate studies, it is imperative to prepare 35 individuals at the doctoral level, 71 at the master’s level, and 247 at the undergraduate level.
Conclusion: It seems that by accepting an average of 9 people at the Ph.D. level, 18 people at the master’s level, and 62 people at the bachelor’s level, in addition to matching the amount of demand and supply, there will be no problem for the employment of the graduates of this field.
Materials and Methods: In this study, a “modified and combination model” was used, including the Hall model, which is location-based, and the Australian health workforce estimation model, which is a needs-based approach. The research was carried out in multiple stages, which included collecting the required data (number of faculty members, students, and graduates), the number of private companies providing spraying, and pest control services in all cities of the country and finally holding meetings with the board members of Biology and vector control of diseases and experts to estimate the human resources required in this field.
Results: Based on the data collected and face-to-face interviews conducted during six sessions with the experts in this field, it has been estimated that a total of 985 graduates have been trained in this discipline to date, while there is a requirement for 1,338 graduates in this area. Consequently, it is essential to train an additional 353 individuals in this field by the year 1404. In light of the country’s sixth five-year development plan, which allocates 30 percent of the total student population to postgraduate studies, it is imperative to prepare 35 individuals at the doctoral level, 71 at the master’s level, and 247 at the undergraduate level.
Conclusion: It seems that by accepting an average of 9 people at the Ph.D. level, 18 people at the master’s level, and 62 people at the bachelor’s level, in addition to matching the amount of demand and supply, there will be no problem for the employment of the graduates of this field.
Shabnam Ghasemyani, Kobra Movalled, Shafi Habibi, Rahim Khodayari Zarnaq,
Volume 18, Issue 5 (11-2024)
Volume 18, Issue 5 (11-2024)
Abstract
Background and Aim: In recent years, active patient participation in healthcare has been increasingly recognized as a vital component in health policies aimed at achieving optimal health outcomes. This study aims to identify the contexts and areas in which patients engage in safety-related measures within healthcare settings.
Materials and Methods: A scoping review of the English-language literature published from 2000 to 2021 was performed. The search strategy involved relevant keywords, including MeSH modifications, as well as common terms associated with the topic, such as patient collaboration, patient participation, patient engagement, patient involvement, patient education, and patient safety. Literature was sourced from the Scopus, PubMed, Web of Science, and ProQuest databases. The research design adhered to the framework proposed by Arksey and O’Malley, and data analysis was conducted using a content analysis approach.
Results: The search strategy yielded a total of 2,951 articles, of which 38 articles met the inclusion criteria. The majority of studies originated from the United States (14), the United Kingdom (8), and Australia (6). The publication years with the highest output were 2015 (5 articles) and 2017 (4 articles). Five key areas of patient participation were identified: fall prevention, prevention of drug interactions, medical error prevention and awareness, participation in infection control and staff hand hygiene, and educational initiatives. The articles identified focused on various areas, including participation in fall prevention (26.3%), education and awareness promotion, participation in infection control and hand hygiene (23.6%), prevention and awareness of medical errors (18.4%), and prevention of drug interactions (7.9%).The main findings of the reviewed studies were categorized into four areas: patient participation, methods of patient participation, examples and outcomes of patient participation, and challenges associated with patient participation in safety-related measures.
Conclusion: Promoting patient involvement in safety-related practices within healthcare is essential for bolstering patient safety. Such participation is contingent upon empowering patients by improving their health literacy and knowledge while simultaneously fostering a shift in the attitudes of healthcare providers. The involvement of policymakers, particularly at the levels of the Ministry of Health and Medical Education, is critical in advancing patient and family participation in national hospital accreditation standards and facilitating broader initiatives aimed at transitioning the health system towards a model of participatory care.
Materials and Methods: A scoping review of the English-language literature published from 2000 to 2021 was performed. The search strategy involved relevant keywords, including MeSH modifications, as well as common terms associated with the topic, such as patient collaboration, patient participation, patient engagement, patient involvement, patient education, and patient safety. Literature was sourced from the Scopus, PubMed, Web of Science, and ProQuest databases. The research design adhered to the framework proposed by Arksey and O’Malley, and data analysis was conducted using a content analysis approach.
Results: The search strategy yielded a total of 2,951 articles, of which 38 articles met the inclusion criteria. The majority of studies originated from the United States (14), the United Kingdom (8), and Australia (6). The publication years with the highest output were 2015 (5 articles) and 2017 (4 articles). Five key areas of patient participation were identified: fall prevention, prevention of drug interactions, medical error prevention and awareness, participation in infection control and staff hand hygiene, and educational initiatives. The articles identified focused on various areas, including participation in fall prevention (26.3%), education and awareness promotion, participation in infection control and hand hygiene (23.6%), prevention and awareness of medical errors (18.4%), and prevention of drug interactions (7.9%).The main findings of the reviewed studies were categorized into four areas: patient participation, methods of patient participation, examples and outcomes of patient participation, and challenges associated with patient participation in safety-related measures.
Conclusion: Promoting patient involvement in safety-related practices within healthcare is essential for bolstering patient safety. Such participation is contingent upon empowering patients by improving their health literacy and knowledge while simultaneously fostering a shift in the attitudes of healthcare providers. The involvement of policymakers, particularly at the levels of the Ministry of Health and Medical Education, is critical in advancing patient and family participation in national hospital accreditation standards and facilitating broader initiatives aimed at transitioning the health system towards a model of participatory care.
Maryam Katebi, Masoud Bahreini, Razieh Bagherzadeh, Shahnaz Pouladi,
Volume 18, Issue 6 (2-2025)
Volume 18, Issue 6 (2-2025)
Abstract
Background and Aim: Nurse managers leverage managerial intelligence to mitigate decision-making challenges and systemic issues. Emotional intelligence, a crucial aspect of managerial intelligence, is vital for job performance and leadership. This skill enables managers to comprehend their emotions and those of others and establish more effective communication. Also, managers in complex environments, such as hospitals, need systemic thinking. Systemic thinking enables managers to solve problems comprehensively, enhancing decision-making accuracy and efficiency. This study was conducted to determine the relationship between emotional intelligence and systemic thinking in nurse managers of affiliated hospitals of Bushehr University of Medical Sciences.
Materials and Methods: The present study is a descriptive-analytical correlational study. One hundred and forty-five nurse managers working in Bushehr University of Medical Sciences-affiliated hospitals were included in the study based on the inclusion criteria. The sampling was done as a full census. Data were collected using the demographic information form, Bradbury and Graves’ emotional intelligence questionnaire, and Amini et al.’s systemic thinking questionnaire. Data were analyzed using SPSS software, descriptive statistics (frequency, mean, and standard deviation), and analytical statistics (Pearson correlation coefficient). A significance level of less than 0.05 was considered in all cases.
Results: This study involved 145 nurse managers, 88.3% female, 84.8% married, and 87.6% holding a Bachelor of Science in Nursing (BSN). The mean age and average tenure in managerial positions were 41.93±6.37 and 8.68±6.52 years, respectively. The mean score for emotional intelligence (EI) among nurse managers was 130.81±11.84 (range: 28-168), while the mean score for systems thinking (ST) was 43.30±5.90 (range: 8-56). A positive correlation was found between emotional intelligence and systems thinking (r=0.365, P<0.001); however, EI was not a significant predictor of ST (β=0.131, P=0.146).
Conclusion: Considering the positive correlation between emotional intelligence and systemic thinking as essential management competencies, it is suggested that training these skills should be considered in continuing education programs for nurses and nurse managers. This will help managers strengthen their emotional intelligence and apply systemic strategies in nursing management.
Materials and Methods: The present study is a descriptive-analytical correlational study. One hundred and forty-five nurse managers working in Bushehr University of Medical Sciences-affiliated hospitals were included in the study based on the inclusion criteria. The sampling was done as a full census. Data were collected using the demographic information form, Bradbury and Graves’ emotional intelligence questionnaire, and Amini et al.’s systemic thinking questionnaire. Data were analyzed using SPSS software, descriptive statistics (frequency, mean, and standard deviation), and analytical statistics (Pearson correlation coefficient). A significance level of less than 0.05 was considered in all cases.
Results: This study involved 145 nurse managers, 88.3% female, 84.8% married, and 87.6% holding a Bachelor of Science in Nursing (BSN). The mean age and average tenure in managerial positions were 41.93±6.37 and 8.68±6.52 years, respectively. The mean score for emotional intelligence (EI) among nurse managers was 130.81±11.84 (range: 28-168), while the mean score for systems thinking (ST) was 43.30±5.90 (range: 8-56). A positive correlation was found between emotional intelligence and systems thinking (r=0.365, P<0.001); however, EI was not a significant predictor of ST (β=0.131, P=0.146).
Conclusion: Considering the positive correlation between emotional intelligence and systemic thinking as essential management competencies, it is suggested that training these skills should be considered in continuing education programs for nurses and nurse managers. This will help managers strengthen their emotional intelligence and apply systemic strategies in nursing management.
Samira Sadat Pourhosseini, Nozar Nakhaee, Vahid Yazdi-Feyzabadi, Reyhane Saljooghinejad,
Volume 18, Issue 6 (2-2025)
Volume 18, Issue 6 (2-2025)
Abstract
Background and Aim: Social emergency is intervention programs aimed at preventing social problems by managing social crises. Public awareness of this program plays a crucial role in mitigating such problems. This study aimed to assess the level of public awareness and practice regarding social emergency services.
Materials and Methods: This cross-sectional survey was conducted in 2023 using an online questionnaire and convenience sampling. A total of 706 urban residents of Kerman participated. The data collection tool comprised four sections: demographic information, awareness of social emergency services, awareness of examples of social problems, and practice when encountering social problems.
Results: The mean age of respondents was 36 years, and the majority (70.3%) were women. Regarding awareness, 71% of participants had poor knowledge of social emergency, and 86.7% demonstrated poor awareness of examples of social problems. Additionally, 44.2% exhibited inadequate practice when encountering social problems. The logistic regression analysis revealed a significant association between awareness of social emergency services and both performance and higher education. Individuals with adequate awareness exhibited, on average, 2.28 times better performance than those with inadequate awareness. Similarly, individuals with higher education had, on average, 3.68 times better awareness as compared to those with less than a high school diploma. A significant relationship was also found between awareness of social problems indicators and marital status. Married individuals demonstrated, on average, 0.56 times lower awareness as compared to single individuals. Furthermore, gender and education level were significantly associated with performance. Men’s performance levels were, on average, 1.42 times better than women’s. Additionally, individuals with university and high school education exhibited, on average, 4.22 and 3.47 times better performance, respectively, than those with less than a high school diploma.
Conclusion: Given the poor public awareness of social emergency, there is an urgent need for programs aimed at raising awareness about social problems and the role of social emergency in supporting victims.
Materials and Methods: This cross-sectional survey was conducted in 2023 using an online questionnaire and convenience sampling. A total of 706 urban residents of Kerman participated. The data collection tool comprised four sections: demographic information, awareness of social emergency services, awareness of examples of social problems, and practice when encountering social problems.
Results: The mean age of respondents was 36 years, and the majority (70.3%) were women. Regarding awareness, 71% of participants had poor knowledge of social emergency, and 86.7% demonstrated poor awareness of examples of social problems. Additionally, 44.2% exhibited inadequate practice when encountering social problems. The logistic regression analysis revealed a significant association between awareness of social emergency services and both performance and higher education. Individuals with adequate awareness exhibited, on average, 2.28 times better performance than those with inadequate awareness. Similarly, individuals with higher education had, on average, 3.68 times better awareness as compared to those with less than a high school diploma. A significant relationship was also found between awareness of social problems indicators and marital status. Married individuals demonstrated, on average, 0.56 times lower awareness as compared to single individuals. Furthermore, gender and education level were significantly associated with performance. Men’s performance levels were, on average, 1.42 times better than women’s. Additionally, individuals with university and high school education exhibited, on average, 4.22 and 3.47 times better performance, respectively, than those with less than a high school diploma.
Conclusion: Given the poor public awareness of social emergency, there is an urgent need for programs aimed at raising awareness about social problems and the role of social emergency in supporting victims.
Akram Hemmatipour, Fatemh Karimi, Azam Jahangirimehr, Elham Abdolahi Shahvali, Mehdi Makvand,
Volume 18, Issue 6 (2-2025)
Volume 18, Issue 6 (2-2025)
Abstract
Background and Aim: One of the most important medical problems in the whole world is chronic pain, which affects millions of people every year and they are not provided with proper treatment. Research shows that one of the consequences of chronic pain is emotional reactions such as anxiety, depression, and stress that occur due to the long-term effects of pain. Therefore, the aim of the present study is to determine the effectiveness of cognitive-behavioral therapy on the mental health and pain intensity level of patients with chronic pain.
Materials and Methods: In this semi-experimental study, 126 patients with chronic musculoskeletal pain and having entry and exit criteria from physiotherapy centers under the supervision of Shoushtar Medical Sciences Faculty were randomly divided into two groups of 63 intervention and control. The intervention group received the intervention based on cognitive behavioral therapy for three months and 12 educational sessions. The patients of both groups completed the data collection tool, which included the numerical pain questionnaire (VAS) and the stress, anxiety and depression level questionnaire DASS21, before the intervention and one week after the completion of the educational intervention. To analyze the data, descriptive and parametric tests (paired t and independent t), Pearson correlation and covariance analysis were used using SPSS software.
Results: The average age of the participants was (46.12±27.16) years. The effectiveness of cognitive-behavioral therapy was associated with a significant reduction in stress, anxiety, and depression levels (P<0.001) only in the intervention group, and this reduction was seen in the levels of stress (P=0.032), anxiety (P=0.030), and depression (P=0.015) compared to the control group. A significant reduction in pain intensity was observed in both groups (P<0.001). However, this reduction in the intervention group was not statistically different from the control group (P>0.05). Also, there was no significant correlation between the levels of stress, anxiety, and depression and pain disability (P<0.05).
Conclusion: The findings of the present study emphasize the importance of using cognitive behavioral therapy in a group setting to treat stress, anxiety, depression, and pain intensity in patients with chronic musculoskeletal pain.
Materials and Methods: In this semi-experimental study, 126 patients with chronic musculoskeletal pain and having entry and exit criteria from physiotherapy centers under the supervision of Shoushtar Medical Sciences Faculty were randomly divided into two groups of 63 intervention and control. The intervention group received the intervention based on cognitive behavioral therapy for three months and 12 educational sessions. The patients of both groups completed the data collection tool, which included the numerical pain questionnaire (VAS) and the stress, anxiety and depression level questionnaire DASS21, before the intervention and one week after the completion of the educational intervention. To analyze the data, descriptive and parametric tests (paired t and independent t), Pearson correlation and covariance analysis were used using SPSS software.
Results: The average age of the participants was (46.12±27.16) years. The effectiveness of cognitive-behavioral therapy was associated with a significant reduction in stress, anxiety, and depression levels (P<0.001) only in the intervention group, and this reduction was seen in the levels of stress (P=0.032), anxiety (P=0.030), and depression (P=0.015) compared to the control group. A significant reduction in pain intensity was observed in both groups (P<0.001). However, this reduction in the intervention group was not statistically different from the control group (P>0.05). Also, there was no significant correlation between the levels of stress, anxiety, and depression and pain disability (P<0.05).
Conclusion: The findings of the present study emphasize the importance of using cognitive behavioral therapy in a group setting to treat stress, anxiety, depression, and pain intensity in patients with chronic musculoskeletal pain.
Masoud Mohammadi, Ali Mousavizadeh, Maysam Behnampour, Seyed Hassan Faqihi,
Volume 19, Issue 1 (4-2025)
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: The COVID-19 pandemic has confronted the world with various problems in the economic, social and political dimensions of health. The present study aimed to investigate control and preventive measures in controlling COVID-19, to investigate the epidemiology and cumulative incidence of COVID-19, as well as management activities, empowerment of personnel, and capacity estimation in Kohgiluyeh and Boyer Ahmad provinces; an attempt was also made to use GIS geographic information to guide policymakers.
Materials and Methods: The present study is a cross-sectional study that was conducted using a review of reliable information within a period of 41 months after the identification of the first case of the disease in the province. The collected information, including sampling cases, hospitalizations, deaths, and COVID-19 vaccination statistics, was collected from the portal of the Center for Infectious Disease Management of the Ministry of Health, the Integrated Health System (SIB), and the Health System Information Observatory of the Ministry of Health, Treatment and Medical Education.
Results: The cumulative number of cases and deaths due to COVID-19 in the province is 130,129 and 1,137, respectively. The total number of doses of vaccine administered in the province, based on the coverage area, according to the Integrated Health System (IHS), was 1,363,703. Also, increasing the bed capacity of the intensive care unit in the province to 55 beds, setting up three CT scanners in the provincial hospitals, and setting up a cellular and molecular laboratory in the two cities of Boyer Ahmad and Kohgiluyeh, in addition to distributing COVID-19 vaccines to all health centers, health bases, and health and medical centers, and sending mobile teams to conduct COVID-19 vaccinations to administer the vaccine door-to-door and in offices and organizations, were among the management activities in the field of COVID-19 control in the province.
Conclusion: Increasing the capacity to sample suspected cases and identify patients in the shortest possible time, isolating them, taking intervention measures to encourage people to get vaccinated, and creating awareness about preventing this disease have reduced the burden caused by it and increased the response capacity of the provincial health system.
Materials and Methods: The present study is a cross-sectional study that was conducted using a review of reliable information within a period of 41 months after the identification of the first case of the disease in the province. The collected information, including sampling cases, hospitalizations, deaths, and COVID-19 vaccination statistics, was collected from the portal of the Center for Infectious Disease Management of the Ministry of Health, the Integrated Health System (SIB), and the Health System Information Observatory of the Ministry of Health, Treatment and Medical Education.
Results: The cumulative number of cases and deaths due to COVID-19 in the province is 130,129 and 1,137, respectively. The total number of doses of vaccine administered in the province, based on the coverage area, according to the Integrated Health System (IHS), was 1,363,703. Also, increasing the bed capacity of the intensive care unit in the province to 55 beds, setting up three CT scanners in the provincial hospitals, and setting up a cellular and molecular laboratory in the two cities of Boyer Ahmad and Kohgiluyeh, in addition to distributing COVID-19 vaccines to all health centers, health bases, and health and medical centers, and sending mobile teams to conduct COVID-19 vaccinations to administer the vaccine door-to-door and in offices and organizations, were among the management activities in the field of COVID-19 control in the province.
Conclusion: Increasing the capacity to sample suspected cases and identify patients in the shortest possible time, isolating them, taking intervention measures to encourage people to get vaccinated, and creating awareness about preventing this disease have reduced the burden caused by it and increased the response capacity of the provincial health system.
Seyed Hadi Hosseini, Saeed Shahsavari, Yasaman Poormoosa, Mitra Rahimzadeh,
Volume 19, Issue 2 (7-2025)
Volume 19, Issue 2 (7-2025)
Abstract
Background and Aim: Medical university-affiliated dental clinics, particularly those located in metropolitan areas, provide oral healthcare services to a wide range of patients with diverse demographic and socio-cultural backgrounds. The sustainability and continued effectiveness of these clinics largely depend on patients’ satisfaction and loyalty. Understanding the determinants of these two critical factors and exploring their interrelationship is essential for improving service delivery and enhancing patient retention. Therefore, the present study aimed to analyze patient satisfaction and loyalty in a university dental clinic using a structural equation modeling (SEM) approach.
Materials and Methods: This cross-sectional, descriptive-analytical study was conducted during 2023–2024 on a sample of 190 patients who visited the dental clinic of Alborz University of Medical Sciences. Participants were selected through convenience sampling. Data were collected using two standardized questionnaires: one assessing dental patient satisfaction and the other measuring patient loyalty. Structural equation modeling was employed using AMOS software, and model fit was evaluated using standard indices including the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA).
Results: The SEM analysis revealed a significant and positive relationship between patient satisfaction and loyalty (β=0.931, P<0.001). Among the dimensions of satisfaction, hygiene and physical conditions (β=0.939), responsiveness and service delivery (β=0.847), appointment scheduling and waiting time (β=0.761) had the most substantial impact on overall satisfaction (P<0.001). Additionally, attitudinal (β=0.996) and behavioral (β=0.859) components emerged as key dimensions of patient loyalty. Model fit indices demonstrated an acceptable level of fit with the data (CFI=0.893, RMSEA=0.077).
Conclusion: To enhance patient satisfaction and foster loyalty, university dental clinics should prioritize internal operational improvements, particularly in the areas of environmental hygiene, service responsiveness, and time management. Creating a positive mental impression through these factors can serve as a foundational step in cultivating long-term loyalty, ultimately contributing to the clinic’s credibility and sustainable performance within a competitive healthcare environment.
Materials and Methods: This cross-sectional, descriptive-analytical study was conducted during 2023–2024 on a sample of 190 patients who visited the dental clinic of Alborz University of Medical Sciences. Participants were selected through convenience sampling. Data were collected using two standardized questionnaires: one assessing dental patient satisfaction and the other measuring patient loyalty. Structural equation modeling was employed using AMOS software, and model fit was evaluated using standard indices including the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA).
Results: The SEM analysis revealed a significant and positive relationship between patient satisfaction and loyalty (β=0.931, P<0.001). Among the dimensions of satisfaction, hygiene and physical conditions (β=0.939), responsiveness and service delivery (β=0.847), appointment scheduling and waiting time (β=0.761) had the most substantial impact on overall satisfaction (P<0.001). Additionally, attitudinal (β=0.996) and behavioral (β=0.859) components emerged as key dimensions of patient loyalty. Model fit indices demonstrated an acceptable level of fit with the data (CFI=0.893, RMSEA=0.077).
Conclusion: To enhance patient satisfaction and foster loyalty, university dental clinics should prioritize internal operational improvements, particularly in the areas of environmental hygiene, service responsiveness, and time management. Creating a positive mental impression through these factors can serve as a foundational step in cultivating long-term loyalty, ultimately contributing to the clinic’s credibility and sustainable performance within a competitive healthcare environment.
Manizheh Mohammadi, Leila Nazarimanesh, Mozhgan Karimi,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Today, structural empowerment has been considered as one of the key factors in improving the performance of organizations, especially in the field of health and treatment. This study was conducted with the aim of investigating the relationship between structural empowerment and entrepreneurial organizational culture of employees in health and treatment centers of Shahr Salem Company.
Materials and Methods: This study is a descriptive-analytical study with an applied purpose, which is positivist in terms of research philosophy, with a deductive and quantitative approach, correlational in terms of research purpose, and cross-sectional in terms of time, and the data were collected using a survey method. The sample size was determined using the Cochran formula to be 263 people and was selected using a stratified, simple, and questioning random method. Standard Kanter structural empowerment questionnaires and Cornwall and Baron entrepreneurial organizational culture questionnaires were used to collect data. The data were analyzed with SPSS and Smart PLS 3 software.
Results: The findings showed that structural empowerment has a significant relationship with entrepreneurial organizational culture (rs=0.606 and P=0.000). Also, empowerment dimensions including opportunity (rs=0.505), information (rs=0.484), resources (rs=0.552) and support (rs=0.509) have a positive effect on entrepreneurial organizational culture. Statistical results showed that the greatest effect was related to the resource dimension. The opportunity dimension also plays a significant role in increasing employee motivation, which can pave the way for promoting entrepreneurial culture. In addition, in the first hypothesis, the relationship between entrepreneurial organizational culture and opportunity has been examined, which indicates the existence of a positive and significant relationship between these two variables. Also, P-value is 0.000, which is less than the significance level of 0.05, making this relationship statistically significant. In the second hypothesis, the relationship between information and entrepreneurial organizational culture has been confirmed with rs=0.484. The P-value less than 0.05, indicating the P-value is 0.009 which is significance of this relationship. the relationship between support and entrepreneurial organizational culture has been tested, indicating that this relationship is also positive and significant. The P-value is 0.008, which is less than 0.05, indicating the significance of this relationship. In the relationship between resources and entrepreneurial organizational culture, the P-value is 0.004, which is less than 0.05, this relationship is confirmed.
Conclusion: The findings of this study showed that structural empowerment, especially in the dimensions of access to resources, information, opportunities, and organizational support, has a positive and significant effect on strengthening the entrepreneurial organizational culture in health centers. Creating supportive infrastructures and providing opportunities for growth and improvement of employees’ skills can increase their motivation, creativity, and innovation. Making decision-making processes transparent and designing reward systems based on innovation promotes employee participation and responsibility. In addition, facilitating the free flow of information and knowledge, supporting innovative ideas, and developing creative skills pave the way for creating a sustainable entrepreneurial culture and improving the overall performance of the organization, and strengthening organizational capacities.
Materials and Methods: This study is a descriptive-analytical study with an applied purpose, which is positivist in terms of research philosophy, with a deductive and quantitative approach, correlational in terms of research purpose, and cross-sectional in terms of time, and the data were collected using a survey method. The sample size was determined using the Cochran formula to be 263 people and was selected using a stratified, simple, and questioning random method. Standard Kanter structural empowerment questionnaires and Cornwall and Baron entrepreneurial organizational culture questionnaires were used to collect data. The data were analyzed with SPSS and Smart PLS 3 software.
Results: The findings showed that structural empowerment has a significant relationship with entrepreneurial organizational culture (rs=0.606 and P=0.000). Also, empowerment dimensions including opportunity (rs=0.505), information (rs=0.484), resources (rs=0.552) and support (rs=0.509) have a positive effect on entrepreneurial organizational culture. Statistical results showed that the greatest effect was related to the resource dimension. The opportunity dimension also plays a significant role in increasing employee motivation, which can pave the way for promoting entrepreneurial culture. In addition, in the first hypothesis, the relationship between entrepreneurial organizational culture and opportunity has been examined, which indicates the existence of a positive and significant relationship between these two variables. Also, P-value is 0.000, which is less than the significance level of 0.05, making this relationship statistically significant. In the second hypothesis, the relationship between information and entrepreneurial organizational culture has been confirmed with rs=0.484. The P-value less than 0.05, indicating the P-value is 0.009 which is significance of this relationship. the relationship between support and entrepreneurial organizational culture has been tested, indicating that this relationship is also positive and significant. The P-value is 0.008, which is less than 0.05, indicating the significance of this relationship. In the relationship between resources and entrepreneurial organizational culture, the P-value is 0.004, which is less than 0.05, this relationship is confirmed.
Conclusion: The findings of this study showed that structural empowerment, especially in the dimensions of access to resources, information, opportunities, and organizational support, has a positive and significant effect on strengthening the entrepreneurial organizational culture in health centers. Creating supportive infrastructures and providing opportunities for growth and improvement of employees’ skills can increase their motivation, creativity, and innovation. Making decision-making processes transparent and designing reward systems based on innovation promotes employee participation and responsibility. In addition, facilitating the free flow of information and knowledge, supporting innovative ideas, and developing creative skills pave the way for creating a sustainable entrepreneurial culture and improving the overall performance of the organization, and strengthening organizational capacities.
Taraneh Mohajeri, Talaat Khadivzadeh, Fatemeh Hadizadeh-Talasaz, Zahra Hadizadeh-Talasaz, Negar Sangsefidi,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Lack of awareness and inadequate knowledge about pelvic floor dysfunction (PFD), its nature, complications, prevention, and available treatments leads to increased anxiety, exacerbation of disease symptoms, and decreased quality of life. Given the high prevalence of pelvic floor disorders, this study aimed to determine the knowledge of pelvic floor disorders in women referring to clinics of teaching hospitals of Mashhad University of Medical Sciences.
Materials and Methods: A descriptive-cross-sectional study was conducted in the women’s clinics of teaching hospitals of Mashhad University of Medical Sciences in the period from July and December 2024. 205 people were included in the study using a convenience sampling method with inclusion criteria. Eligibility criteria included Iranian women over 18 years who spoke Persian and could read and write, and who provided consent to participate in the study. Participants who completed the questionnaires incompletely (more than 20% of questions unanswered) were excluded from the study. The data collection tool was a demographic and prolapse and incontinence knowledge questionnaire (PIKQ). Data analysis was performed using SPSS after checking for normality with Kolmogorov-Smirnov.
Results: The median age of the participants was 41. The median knowledge in the field of pelvic organ prolapse was 9 (total score range from 0 to 12), and in the field of urinary incontinence was 8 (total score range from 0 to 12), and the median overall score of the questionnaire was 17 (total score range from 0 to 24), and an interquartile range of 7. 98. (47.8%) of the women had poor and moderate knowledge, and 107 (52.2%) had good knowledge. The highest level of knowledge was related to the etiology domain, while the lowest was related to the diagnosis domain. An analysis of the relationship between demographic variables and the knowledge of pelvic floor disorders showed that, overall, there was no significant association between age (P=0.60), history of pelvic floor disorders (P=0.73), number of deliveries (P=0.67), and mode of delivery (P=0.37) with the knowledge score of pelvic floor disorders.The majority of participants (106 individuals, 51.7%) obtained their required health information from physicians, midwives, or other healthcare providers.
Conclusion: The results of this study showed that almost half of the participants had poor to moderate levels of knowledge, and the lowest level of knowledge among participants with both disorders was in the areas of diagnosis and treatment. It is recommended that educational programs be designed and implemented to increase the awareness of women in the community about pelvic floor disorders. Additionally, the use of a pelvic floor disorders knowledge questionnaire may aid physicians in monitoring educational and therapeutic interventions for patients and ensuring that they receive the information necessary to manage their condition effectively.
Materials and Methods: A descriptive-cross-sectional study was conducted in the women’s clinics of teaching hospitals of Mashhad University of Medical Sciences in the period from July and December 2024. 205 people were included in the study using a convenience sampling method with inclusion criteria. Eligibility criteria included Iranian women over 18 years who spoke Persian and could read and write, and who provided consent to participate in the study. Participants who completed the questionnaires incompletely (more than 20% of questions unanswered) were excluded from the study. The data collection tool was a demographic and prolapse and incontinence knowledge questionnaire (PIKQ). Data analysis was performed using SPSS after checking for normality with Kolmogorov-Smirnov.
Results: The median age of the participants was 41. The median knowledge in the field of pelvic organ prolapse was 9 (total score range from 0 to 12), and in the field of urinary incontinence was 8 (total score range from 0 to 12), and the median overall score of the questionnaire was 17 (total score range from 0 to 24), and an interquartile range of 7. 98. (47.8%) of the women had poor and moderate knowledge, and 107 (52.2%) had good knowledge. The highest level of knowledge was related to the etiology domain, while the lowest was related to the diagnosis domain. An analysis of the relationship between demographic variables and the knowledge of pelvic floor disorders showed that, overall, there was no significant association between age (P=0.60), history of pelvic floor disorders (P=0.73), number of deliveries (P=0.67), and mode of delivery (P=0.37) with the knowledge score of pelvic floor disorders.The majority of participants (106 individuals, 51.7%) obtained their required health information from physicians, midwives, or other healthcare providers.
Conclusion: The results of this study showed that almost half of the participants had poor to moderate levels of knowledge, and the lowest level of knowledge among participants with both disorders was in the areas of diagnosis and treatment. It is recommended that educational programs be designed and implemented to increase the awareness of women in the community about pelvic floor disorders. Additionally, the use of a pelvic floor disorders knowledge questionnaire may aid physicians in monitoring educational and therapeutic interventions for patients and ensuring that they receive the information necessary to manage their condition effectively.
Roya Rajaee, Marziyeh Najafi, Nasrin Donyaee, Masoumeh Vaziri Seta, Hojjat Rahmani, Ghasem Rajabi, Mahsa Akbari,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Budgeting in the health system plays a crucial role in enhancing the quality of healthcare services, increasing equitable access to health care, and reducing costs. Financial decision-making based on scientific data and evidence can improve the efficiency of the health system and ensure equity in resource allocation. This study aimed to examine the scientific status and trends of published literature on budgeting methods in the health system using bibliometric analysis to assist policymakers in making better financial decisions.
Materials and Methods: This study is a bibliometric review with a descriptive–analytical approach, analyzing 222 scientific documents indexed in Scopus between 1974 and 2024. Data were analyzed using Excel, Bibexcel, VOSviewer, and Gephi software to map the knowledge structure, co-word relationships, and international collaborations in this field.
Results: The United States (30%), Taiwan (15%), and Canada (10%) were the leading contributors to scientific output in this field. Journal articles comprised nearly 90% of all publications. The most frequent keywords were “budget,” “health care cost,” and “financial management,” reflecting a strong emphasis on cost control and resource management. Three main budgeting approaches were identified: performance-based, traditional (historical), and needs-based. Traditional budgeting remains dominant in developing countries, particularly where information infrastructure and managerial capacity are limited. International collaboration involved 18 countries, with the strongest cooperation observed between the United States and Taiwan.
Conclusion: Improving the health budgeting system requires strengthening information systems, training managers, and enhancing international scientific collaboration. Resource allocation based on scientific data and bibliometric insights can optimize resource distribution and enhance equity in access to health services. Such measures would lead to greater health system efficiency and more comprehensive financial decision-making.
Materials and Methods: This study is a bibliometric review with a descriptive–analytical approach, analyzing 222 scientific documents indexed in Scopus between 1974 and 2024. Data were analyzed using Excel, Bibexcel, VOSviewer, and Gephi software to map the knowledge structure, co-word relationships, and international collaborations in this field.
Results: The United States (30%), Taiwan (15%), and Canada (10%) were the leading contributors to scientific output in this field. Journal articles comprised nearly 90% of all publications. The most frequent keywords were “budget,” “health care cost,” and “financial management,” reflecting a strong emphasis on cost control and resource management. Three main budgeting approaches were identified: performance-based, traditional (historical), and needs-based. Traditional budgeting remains dominant in developing countries, particularly where information infrastructure and managerial capacity are limited. International collaboration involved 18 countries, with the strongest cooperation observed between the United States and Taiwan.
Conclusion: Improving the health budgeting system requires strengthening information systems, training managers, and enhancing international scientific collaboration. Resource allocation based on scientific data and bibliometric insights can optimize resource distribution and enhance equity in access to health services. Such measures would lead to greater health system efficiency and more comprehensive financial decision-making.
Ebrahim Jaafaripooyan, Seyed Farshad Allameh, Neda Alizadeh, Tahereh Sharifi,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Retention of faculty members is one of the fundamental challenges of the country’s health system. Therefore, this study aimed was conducted with the aim of providing strategies for retaining faculty members in the health field.
Materials and Methods: This study was conducted in a combined manner in three stages in 2024. In a field review, related articles were reviewed from the Magiran, SID, PubMed databases and using the Google scholar search engine. Out of 18,977 identified studies, 37 articles were selected and reviewed after several stages of screening. In the second stage, 12 semi-structured interviews were conducted with relevant experts and managers using an inductive approach based on the rules of directional content analysis to identify the factors of retention of faculty members in the health field. Accordingly, the human resource management framework, which includes 5 stages of familiarization with the data, identification of the thematic framework, indexing, display with a diagram, and interpretation of the results, was used for data analysis in this study. MAXQDA-2020 software was used to analyze the research data. Finally, in the third stage, using a prioritization matrix, the solutions were scored and prioritized by 17 experts.
Results: Strategies were identified and classified into 10 areas based on the human resources management cycle, including recruitment, selection and hiring, growth and development, performance evaluation, compensation, organizational culture, improving working conditions, motivation, termination of employment, and external factors. Then, those in each area were prioritized based on their level of efficacy, with the highest priority solutions including improvement of the country’s financial and economic conditions (mean score=4.92 out of 5), an increase in faculty members’ salaries (4.90), removal of the salary cap (4.88), establishment of housing cooperatives (4.82), respect for the dignity and social status of retired professors (4.80), provision of recreational facilities for faculty members (4.79), enhancement of transparency, accountability, and adherence to the rule of law in the country (4.79), and increased faculty participation in decision-making processes (4.47).
Conclusion: Given the results, strategies such as focusing on improving the financial situation, promoting transparency, and increasing the well-being of faculty members can be effective in increasing the motivation and retention of faculty members in the health sector. Therefore, the implementation of these strategies by policymakers and education administrators is expected to improve the retention of faculty members in this sector.
Materials and Methods: This study was conducted in a combined manner in three stages in 2024. In a field review, related articles were reviewed from the Magiran, SID, PubMed databases and using the Google scholar search engine. Out of 18,977 identified studies, 37 articles were selected and reviewed after several stages of screening. In the second stage, 12 semi-structured interviews were conducted with relevant experts and managers using an inductive approach based on the rules of directional content analysis to identify the factors of retention of faculty members in the health field. Accordingly, the human resource management framework, which includes 5 stages of familiarization with the data, identification of the thematic framework, indexing, display with a diagram, and interpretation of the results, was used for data analysis in this study. MAXQDA-2020 software was used to analyze the research data. Finally, in the third stage, using a prioritization matrix, the solutions were scored and prioritized by 17 experts.
Results: Strategies were identified and classified into 10 areas based on the human resources management cycle, including recruitment, selection and hiring, growth and development, performance evaluation, compensation, organizational culture, improving working conditions, motivation, termination of employment, and external factors. Then, those in each area were prioritized based on their level of efficacy, with the highest priority solutions including improvement of the country’s financial and economic conditions (mean score=4.92 out of 5), an increase in faculty members’ salaries (4.90), removal of the salary cap (4.88), establishment of housing cooperatives (4.82), respect for the dignity and social status of retired professors (4.80), provision of recreational facilities for faculty members (4.79), enhancement of transparency, accountability, and adherence to the rule of law in the country (4.79), and increased faculty participation in decision-making processes (4.47).
Conclusion: Given the results, strategies such as focusing on improving the financial situation, promoting transparency, and increasing the well-being of faculty members can be effective in increasing the motivation and retention of faculty members in the health sector. Therefore, the implementation of these strategies by policymakers and education administrators is expected to improve the retention of faculty members in this sector.
Pezhman Sadeghi, Nader Jahanmehr, Reza Rabiei,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: Information systems serve different purposes in organizational and management hierarchies. The hospital intelligent management system is an analytical and decision-support management information system that provides information and important performance indicators for managers in hospitals. Considering the role of this system in increasing the efficiency and effectiveness and the lack of academic hospitals having the desired level of productivity, this research was conducted to investigate the effective factors in improving the acceptance of the intelligent hospital management system in the hospitals of Shahid Beheshti University of Medical Sciences (SBMU).
Materials and Methods: This descriptive and correlational research was conducted in 19 hospitals (12 teaching hospitals and 7 non-teaching hospitals) of Shahid Beheshti University of Medical Sciences in 2022. In this study, 126 senior and middle managers and experts of the productivity committee participated. The data of this study were collected Using the Unified Theory of Acceptance and Use of Technology(UTAUT) Questionnaire and for statistical analysis, SPSS software (statistical table and linear and multiple regression tests, sequencing, and chi-square) was used. The validity of the questionnaire was determined using the opinion of research experts and its reliability was also determined using Cronbach’s alpha coefficient (0.824).
Results: Most of the participants in the study were from teaching hospitals (63.2%) and were middle managers (50.8%). Behavioral intentions were identified as the most important factors in the use of system by senior and middle managers and experts of productivity committee (P<0.001). The effort expectancy had the greatest impact on the intention to use the system as compared to the expected components of Performance expectancy and social influence. Also, training and having educational programs on how to use the HIM and its applications can increase the intention and use of the HIM by employees (P<0.001).
Conclusion: Based on the results, the effect of the moderating variables in this study was insignificant. If senior managers and influential people encourage working with the system, and employees also make more effort to learn the system, and working with the system meets their expectations, employees will be willing to use the system. In other words, employees use the system when they believe that this system is user-friendly, valuable, and useful for them.
Materials and Methods: This descriptive and correlational research was conducted in 19 hospitals (12 teaching hospitals and 7 non-teaching hospitals) of Shahid Beheshti University of Medical Sciences in 2022. In this study, 126 senior and middle managers and experts of the productivity committee participated. The data of this study were collected Using the Unified Theory of Acceptance and Use of Technology(UTAUT) Questionnaire and for statistical analysis, SPSS software (statistical table and linear and multiple regression tests, sequencing, and chi-square) was used. The validity of the questionnaire was determined using the opinion of research experts and its reliability was also determined using Cronbach’s alpha coefficient (0.824).
Results: Most of the participants in the study were from teaching hospitals (63.2%) and were middle managers (50.8%). Behavioral intentions were identified as the most important factors in the use of system by senior and middle managers and experts of productivity committee (P<0.001). The effort expectancy had the greatest impact on the intention to use the system as compared to the expected components of Performance expectancy and social influence. Also, training and having educational programs on how to use the HIM and its applications can increase the intention and use of the HIM by employees (P<0.001).
Conclusion: Based on the results, the effect of the moderating variables in this study was insignificant. If senior managers and influential people encourage working with the system, and employees also make more effort to learn the system, and working with the system meets their expectations, employees will be willing to use the system. In other words, employees use the system when they believe that this system is user-friendly, valuable, and useful for them.
Marzieh Latifi, Elahe Pourhossein, Amirhesam Alirezaei, Tannaz Hajialireza Tehrani, Maryam Pourhossein, Sanaz Dehghani,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: Sleep disorders are strongly associated with physical, mental, social health, as well as cognitive functioning. This study aimed to compare the quality of sleep between individuals on kidney transplant waiting list and kidney transplant recipients to develop an appropriate program to improve their health and quality of life.
Materials and Methods: This cross sectional descriptive-analytical study was conducted on 196 patients, including 100 patients who registered on the kidney transplant waiting list and 96 kidney transplant recipients at the Sina Hospital, Tehran University of Medical Sciences (TUMS). Convenience sampling was used. Patients completed a standardized Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality. The self-reporting method was used to complete the questionnaires. Clinical and demographic data were collected from patients’ medical files of Sina Hospital by kidney transplant coordinators. Statistical analysis was performed using SPSS, with a significance level set at less than 0.05.
Results: The mean age of the participants was 47 years, with an age range between 18 and 69 years. Sixty-eight-point Thirty-six percent of the patients were male. Based on results, no significant difference was found between patients in kidney waiting list to kidney transplanted patients in demographic variables (age, gender, marital status, number of children, job, level of education, cause of kidney disease). According to independent T- test, the mean score of sleep quality of patients on the waiting list and kidney transplant recipients was (7.75±3.55) and (4.54±3.57), respectively, indicting the significant differences between two groups (P<0.001). Also, the Pearson correlation test reveals a significant positive correlation between age and sleep quality (P=0.038, r=0.612), and a significant negative correlation between duration of dialysis and the average sleep score (P=0.040, r=-0.062).
Conclusion: It is essential to emphasis attention to the quality of sleep in kidney patients, especially during the pre-transplant and dialysis era.
Additionally, kidney transplantation can be considered an effective solution for improving sleep quality and reducing complications related to kidney failure, although some patients continue to experience sleep problems after the transplant.
Materials and Methods: This cross sectional descriptive-analytical study was conducted on 196 patients, including 100 patients who registered on the kidney transplant waiting list and 96 kidney transplant recipients at the Sina Hospital, Tehran University of Medical Sciences (TUMS). Convenience sampling was used. Patients completed a standardized Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality. The self-reporting method was used to complete the questionnaires. Clinical and demographic data were collected from patients’ medical files of Sina Hospital by kidney transplant coordinators. Statistical analysis was performed using SPSS, with a significance level set at less than 0.05.
Results: The mean age of the participants was 47 years, with an age range between 18 and 69 years. Sixty-eight-point Thirty-six percent of the patients were male. Based on results, no significant difference was found between patients in kidney waiting list to kidney transplanted patients in demographic variables (age, gender, marital status, number of children, job, level of education, cause of kidney disease). According to independent T- test, the mean score of sleep quality of patients on the waiting list and kidney transplant recipients was (7.75±3.55) and (4.54±3.57), respectively, indicting the significant differences between two groups (P<0.001). Also, the Pearson correlation test reveals a significant positive correlation between age and sleep quality (P=0.038, r=0.612), and a significant negative correlation between duration of dialysis and the average sleep score (P=0.040, r=-0.062).
Conclusion: It is essential to emphasis attention to the quality of sleep in kidney patients, especially during the pre-transplant and dialysis era.
Additionally, kidney transplantation can be considered an effective solution for improving sleep quality and reducing complications related to kidney failure, although some patients continue to experience sleep problems after the transplant.
Hojjat Rahmani, Payam Bahadori, Hossein Dargahi, Mohammad Arab, Nasrin Abolhasanbeigi Gallehzan, Mohsen Mardali,
Volume 19, Issue 6 (3-2026)
Volume 19, Issue 6 (3-2026)
Abstract
Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.
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