Journal of

Background: Study of the attitudes of health information management experts in health systems could be regarded in order to maximize utilization of information. The research reported here aimed to study of attitudes of medical records departments in Iran about mechanisms of development of health care system information technology.

Material and method: A cross- sectional research was developed by a questionnaire to study the atti­tudes of medical records departments of 17 universities by mail in Iran. 49 of them completed the questionnaire and returned it to us. Therefore the response rate was 70 percent. The data were saved by SPSS software and analyzed by statistical method.

Results: Faculty members of universities of medical sciences believe that the must hindrances of de­velopment of electronic health records in Iran are low budget and lack of standards.

Conclusion: Utilization of health information management experts attitudes could be assured the im­provement of health care information technology.

Background and Aim: Peptic Ulcer Disease (PUD), which is a prevalent disease, can have a considerable impact on patients' quality of life (QOL). The aim of this study was to explore the factors related to QOL based on PRECEDE Model in patients with PUD in Sanandaj, Iran.

Materials and Methods: A non-probability sample of 120 outpatients with PUD, referring to Beasat Hospital, in the city of Sanandaj participated in the study. The study took place between March and June of 2009. A descriptive, cross-sectional design was employed and the data were collected using a survey questionnaire based on PRECEDE model, consisting of QOL, Health Status, predisposing, reinforcing and enabling factors and self-management behaviors constructs. The data collected by interview and analyzed by SPSS v. 11.5. The statistical analysis of the data included Pearson correlation, t- test, one-way ANOVA and linear regression.

Results: Health status (p<0.01), reinforcing (p<0.01) and enabling (p<0.05) factors and knowledge (p<0.05) as a predisposing factor were related to quality of life of peptic ulcer patients. Moreover, health status (p<0.05) and social support as a reinforcing factor (p<0.01) had significant relationships with self-management behaviors. Finally, all of PRECEDE variables accounted for 68.9% of the variation of quality of life in PUD patients.

Discussion and Conclusion: With respect to the results of this study, preparing an educational program to promote self-management behaviors and quality of life in peptic ulcer patients is proposed. It was concluded that the PRECEDE Model may be used in developing countries, like Iran, as a framework for planning intervention programs in an attempt to improve the quality of life of patients with PUD.

Background and Aim: In any country, one of the fundamental goals of health policymakers is to facilitate the people's access to treatment and health care services. Therefore, the aim of this study was to identify factors that influence recievers' access to delivered services in urban health care services.

Materials and Methods: We performed this descriptive and cross sectional study in year 2008. We used the multi-stage sampling method for selecting 57 staffs of urban health care centers as statistical samples. The valid and reliable questionnaire for gathering data was designed. Data was analyzed by SPSS 2 version 13 software.

Results: Our findings indicate that mean scores of individual, geographical, financial and structural factor was 2.29 (61.4% with high impact), 2.42 (57.9% with high impact), 2.27 (56.1% with high impact) and 2.58 (86% with high impact), respectively. (Our mean score range was 0 to 3).

Conclusion: According to the assessment of employee's viewpoint of Urban Health Care Centers, all of four individual, geographical, financial and structural factors had high influence on person's access to health care services in Urban Health Care Centers. Consequently this study has presented suggestions (according to the findings) for improving access to delivered services in urban health care centers.

Background and Aim: Elderly is a physiological phenomenon with many inevitable complications, which their effects significantly can be reduced by individual's life style. Therefore in this study we have evaluated the impact of subjects' knowledge on their lifestyle.

Materials and Methods: This study was a semi experimental and interventional one that has been conducted in Urmia University of Medical Science. Thus 200 women between 54 to 80 years old were enrolled in this study and their knowledge, attitude and behavior toward a healthy lifestyle was surveyed before and 6 months after giving them a proper education. Subsequently the required information gathered from questionnaires and the data analyzed by mcmanaman paired and t paired tests. In this study all data analyzed by SPSS software and the P value lessu than 0.05 recognized to be statistically significant.

Results: The scores of before and 6 months after subjects get the required education were 29.165.86 vs. 34.266.32 respectively (P<0.001). This significant difference demonstrates the positive impact of life style education on attitude, behavior and knowledge of individuals in respect to their lifestyle. These results were even more magnificent comparing the literate and illiterate subjects.

Conclusion: Based on our study we conclude that education has an important positive role in all elder groups improving their lifestyle.

Background and Aim: Theses are considered as one of the sources for research in the field of education. The aim of this study was to determine the popular topics during 1349-1389 (1970-2010) and to examine the amount of educational interference and the type of such interference in different theses.

Materials and Methods: This research study was done using the descriptive-analytic method and employing the content analysis technique. The choice of topics was based on the categories derived from the Medical Headings of the American National Library. All related theses (336 in this field) were reviewed and the data were analyzed by SPSS software.

Results: In this review, most finished theses belonged to Tehran University of Medical Sciences (62.5%), Tarbiat Modares University (25.3%), and Iran University of Medical Sciences (12.2%). MSc theses were mainly about diseases (23.8%) however, doctoral dissertations were mostly about the prevention of diseases(26.2%).

Conclusion: Although in the recent decade, there has been an increase in new topics and educational interference in theses, some important issues like the training of patients are still neglected. It seems that some strategies like preparing a suitable information bank of thesis in the field of health education can be a good guide for selecting new topics and ignoring old ones.

Background and Aim: The use of electronic operations in health care industry has many positive points such as health care quality improvement, reduction in costs, and increased efficiency. Besides talking about the concept of Mobile Commerce (M-Commerce) as well as its benefits and challenges, the present article presents suitable approaches to benefit more from this new technology in the field of health, especially in the private sector.

Materials and Methods: This review article was performed based on a literature review and a search through such valid sites as Science Direct, Emerald, and Magiran, and also an advanced search in Google. In this paper, the researchers studied national and international documents about the application of communication and IT tools -- particularly mobile and wireless tools, E-commerce, and M-commerce -- from 1996 to 2011.

Results: E-business can be considered as one of the subsets of E-Health, and M-commerce as one of the E-business models is a very useful tool in developing countries. With this tool, organizations located in remote places can have access to potential customers and gain valuble benefits. Efficient application of E-business models in Iran requires the identification of opportunities and barriers as well as the preparation of suitable and basic plans with regard to socio-economic factors together with the provision of executive, legal, technological, and communications infrastructures.

Background and Aim: Investigations have indicated that general health is associated with behavior style and interpersonal relationships. The present study was performed in order to investigate the relationship between general health and leadership style in managers at Shiraz University of Medical Sciences, and its effect on job satisfaction in staff.

Materials and Methods: 33 managers and 132 staff were randomly selected. Participants completed Pourbaneh leadership style, Goldberg general health and Herzberg job satisfaction questionnaires. In order to analysis data Pearson correlation coefficient, independent t test and Chi-square were used.

Results: There is a positive relationship between manager's general health and their leadership style and also between manager's leadership style and job satisfaction in staff. Also there is no significant difference between numbers of managers in 4 kinds of leadership styles.

Conclusion: Empathy, self awareness, high motivation and self confidence, are characteristics that cause positive relationship between general health and participative leadership style. These characteristics also increase self-confidence, motivation and thus increase job satisfaction in staff.

Background and Aim: Today, one of the challenges of doctors is how they can access medical information as quick as possible. Personal Digital Assistants (PDAs) and Smartphones are such information technologies that can be used to access health information. This study aimed to review the most important uses of Personal Digital Assistants and Smartphones in medicine and in accessing health information.

Materials and Methods: The researchers searched Pubmed, Google Scholar and Scopus to collect relevant articles about the use of PDAs and Smartphones among healthcare professionals. In this search, such terms as Handheld Computer, Smartphone, Personal Digital Assistant, Mobile phone and their synonyms were considered.

Conclusion: With regard to the vast amount of information produced daily, PDAs and Smartphones are useful devices for physicians and medical students because they can easily get the most recent bits of information at the point of care, and improve their medical knowledge through these devices. Utilization of PDAs and Smartphones in Medical Centers will improve the efficiency and quality of health services.

Background and Aim: Low weight at birth is one of the main health indexes in evaluating pregnancy period care, and recognizing its related factors is very important. The aim of this study was a comparison of pregnancy age, height, the distance between two pregnancies, gaining weight during pregnancy, economical condition, nutrition, general health of the mothers with low and normal birth weight.

Materials and Methods: The research method was casual-comparative conducted as field-work. From all newborns born since (Jan 2008 to Nov 2009) 168 low birth weight babies with their mother and 157 newborns with normal weight from 20 maternity center at Guilan province were randomly selected. Mothers filled general health questionnaire with the reliability of 0.82. The data were analyzed using SPSS Software.

Results: There was a significant difference among mothers (case and control ) in terms of pregnancy age, height ,distance between two pregnancies, increasing weight during pregnancy, economical condition, nutrition condition and general health (mental), (p0.01).

Conclusion: Various factors affected newborns' weight at birth. Therefore, decreasing the rate of low weight will be one of the main social health indexes requiring cooperation of counter- groups and different organizations such as the Ministry of Health and treatment, psychotherapy, counseling centers and radio/television.

Background and Aim: Social capital is one of the social determinants of health, which might have an important role in health inequalities. The amount of social capital gained by individuals differs depending on social circumstances in fact, not all individuals can equally benefit from social resources of social capital. This study aims to examine the effect of social capital dimensions on being afflicted by cancer in patients referring to Cancer Institute of Tehran.

Materials and Methods: This is an analytic-descriptive study, the population of which included all patients aged over 14 and affected by stomach, colon and breast cancers, referring to Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. The sample consists of 106 subjects who have been chosen using the classified probability sampling method. The data collection device was a questionnaire together with a structured interview. Social capital emphasizes the two structural and cognitive dimensions. Moreover, it stresses personal social capital.

Results: Health inequalities and cancer are the results of simultaneous interaction between the different dimensions of social capital and behavioral/psychological and biological factors. People enjoying similar social capital in life experience cancer-related stress and unhealthy behavior in different ways

Conclusion: An increase or decrease in any of the social capital components can lead to a change in the number of those getting the disease.

Background and Aim: Health information System (HIS) is a comprehensive software used to unify and transfer hospital data effectively. It is vastly employed to improve input quality, decrease data-transfer time, increase satisfaction level, promote health services quality, and minimize hospital costs.

Materials and Methods: This is an applied-descriptive study. The research population consisted of 120 HIS users who worked before and after the HIS application at Masih-Daneshvari Hospital. For data collection purposes, a questionnaire was used. The data were then analyzed with SPSS software, and descriptive and inferential statistical methods.

Results: According to data analysis, the application of the existing communication system among the different sections and wards was very good (81%), the accessibility to patient medical information and facilitating treatment processes were good (44% and 61%, respectively), and the analysis of budgeting data (11%), the possibility of clinical researches (19%), the presentation of guides for operators (18%), and the accessibility to statistical and financial data (17% and 22%, respectively) were assessed as poor.

Conclusion: The results of this survey show that the application of Hospital Information System has a positive effect on accuracy, facility, and treatment processes, and emphasize the importance of programming to enhance the quality of hospital services.

Background and Aim: Urban health is one of the challenges of the 21st century. Rapid growth and expanding urbanization have implications for health. In this regard, information technology can remove a large number of modern cities' problems. Therefore, the present article aims to study modern information technologies in the development of urban health.

Materials and Methods: This is a review article based on library research and Internet searches on valid websites such as Science Direct, Magiran, Springer and advanced searches in Google. Some 164 domestic and foreign texts were studied on such topics as the application of ICT tools including cell phones and wireless tools, GIS, and RFID in the field of urban health in 2011. Finally, 30 sources were used.

Conclusion: Information and communication technologies play an important role in improving people's health and enhancing the quality of their lives. Effective utilization of information and communication technologies requires the identification of opportunities and constraints, and the formulation of appropriate planning principles with regard to social and economic factors together with preparing the technological, communication and telecommunications, legal and administrative infrastructure

Background and Aim: Learning may be the only sustainable competitive advantage for all organizations. A learning organization is an organisation where people continually expand their capacity to create results they truly desire new and expansive patterns of thinking are nurtured collective aspirations are set free people are continually learning from what others have learned. The aim of this research is to study whether a learning organization and its subsystems are established in Shahrekord University of Medical Sciences (SKUMS).

Materials and Methods: This descriptive-survey study was conducted in 2012. Marquardt's standard questionnaire was used to measure learning organization based on Likert's scale with a Cronbach's Alpha coefficient of 0.946. The research sample consisted of 177 staff members (bachelor's degree holders and bove) in seven vice-chancellorships of SKUMS, selected through simple random sampling.

Results: The findings of the study are twofold. (1) According to the results of one-sample t-test with a 95% confidence interval, the mean scores in learning organization and sub-systems of learning dynamics, people empowerment, knowledge management and technology application subsysems were higher than the assumed mean of 3 however, the figure turned out to be equal to the assumed mean for the organization transformation subsystem, and (2) Based on Freidman Test, there was a significant difference between the means of at least 2 learning organization subsystems.

Conclusion: According to the research findings, more attention should be paid to the subsystems of learning organization establishment and balanced development of these subsystems.

Background and Aim: Regarding the importance of communicators' presence in health programs and the fact that in recent years, we have witnessed a decrease in their cooperation or a cut in their relationship with the headquarters. This qualitative study was performed to clarify communicators and instructors' administrative-recreational experiences in breaking off with the headquarters.

Materials and Methods: This qualitative study was carried out on 60 healthcare communicators, 20 ex- communicators and 35 instructors selected through purposive sampling. The data were collected using focus discussion groups and semi-structured interviews with the participants. For data analysis, qualitative content analysis was employed.

Results: The findings of data analysis revealed two main levels: recreational and administrative. The key themes of the former included medical facilities, gifts, employment, futurism and camp and of the latter consisted of credit resources, instructors' conditions, organizational posts and orientation.

Conclusion: Expressing what is expected from communicators when selecting them can play a significant role in keeping them up with their jobs. Holding meetings between authorities and communicators' representatives to discuss their problems and present solutions, holding reward ceremonies, preparing the grounds for attracting financial resources to support communicators' programs, appreciating them and enhancing the communicators and instructors' academic level, and creating organizational posts for instructors can be effective in maintaining their presence and enhancing health communicators' program.

Background and Aim: Focus on organizational health could ensure the future success of any organization. Considering the fast changing conditions of hospitals and the necessity of effectiveness, employees are required who can show voluntary behavior towards the organization and customers. Therefore, this study mainly aims to survey the relationship between organizational health and organizational citizenship behavior in selected hospitals of Tehran University of Medical Sciences(TUMS).

Materials and Methods: This cross-sectional, descriptive-analytic study was conducted in 2010. The population of the study comprised the entire staff of TUMS selected hospitals. In total, 312 employees were selected. The researchers gathered their data using questionnaires of organizational health and organizational citizenship behavior. For data analysis, both descriptive statistics(percentage, mean, standard deviation and variance) and inferential statistics(Pearson correlation and regression) were applied. The data were analyzed using SPSS18 software.

Results: The correlation between the organizational health and five dimensions of organizational citizenship behavior(Conscientiousness, Altruism, Helping Behavior, Civil Virtue, Sportsmanship, and Courtesy) was significant(p = 0/0001).

Conclusion: Given this significant correlation between organizational health and organizational citizenship behavior, organizations can make improvements in employees' behavior. This can be achieved by creating harmony among members and through continuous improvement and growth.

Background and Aim: Financial reforms in the healthcare system go back to 1384. This study aims to analyze and summarize the most important strengths of implementing the first phase of the reform in units affiliated with the Ministry of Health and Medical Education from the experts' point of view at middle and operational levels.

Materials and Methods: In this qualitative research study, 15 coaches of the new financial health management reform along with 8 financial managers of Medical Universities were selected purposefully to participate in expert panels to be interviewed. Data were saturated following the interviews. The data analysis process was conducted applying Kruger method with one of the researchers having no conflicts of interest with the topic.

Results: Human resources enabling, effective trainings, integrated information system, dynamic culture, structural appropriateness, efficiency and effectiveness, and perfect facilities were the seven themes extracted from the content analysis of the interviews each theme was further divided into some sub-themes.

Conclusion: Recognition of the strengths of the first phase of health system's financial management reform may help bring about the possibility of more correct and exact planning to direct these changes and maintain the achievements as well as designing a long-term horizon and determining an ideal vision for the next phases of the reform.

  Background and Aim: Family physician is the core in the world efforts for quality improvement, cost effectiveness, and equity in the health care systems. The main purpose of this present study was to investigate situation of the family physician program and identify referral route in this program in six pilot cities in Khuzestan province .

  Materials and Methods: A cross-sectional descriptive study was conducted in 2011. Pre-designed checklists were used for collecting data. In this study, 15 healthcare team in six pilot cities for family physician program in Khuzestan province were examined and their specified referral levels for each city was investigated and compared with the national instruction to identify current gaps.

  Results: The least number of staff belonged to nutrition, nurses and physicions respectively. In the second referral level cities, Specialists did not welcome the program . In Mahshar, a second level city, five specialists have been registered to family physician program. In the third level, 28/5 percent of specialist were enrolled in this program.

  Conclusion : It seems that it is necessary to facilitate patient access to physicians under contract with family physician program and referral system in second and third levels. Therefore, establishing a motivation system for attracting specialist and improving their maintenance situation can also be beneficial.

 Background and Aim: Today, many families either have pets or work in animal husbandry units. It is very important to investigate the mental outcomes of animal care and also to study their keepers’ personality traits. This study aims to perform a comparative examination of owners’ mental health and character specifications or those of animal husbandry units’ personnel.

 Materials and Methods: In this descriptive study, about 500 people were selected through available sampling technique. They had contact with animals or worked in a husbandry unit in the suburbs of Tehran. After referring to the veterinary clinic of Tehran University, they were studied using a general health questionnaire and an international personality question bank. The collected data were analyzed using SPSS software as well as multivariate and follow-up tests.

Results: The results of the present study show that all general mental health sub-scales except for anxiety are different in these groups. However, no difference was observed regarding responsibility and extroversion. Meanwhile, the adaptability of dog owners was lower than that of sheep owners moreover, cattlemen were more irritable than sheep owners.

Conclusion : In sum, the mental health of pet owners of the present study is at a lower level compared to that of those in other countries. It seems that the difference is due to religious and cultural differences existing between the two.

 Background and Aim: One of the effective factors on staffs’ job satisfaction is their general health and personality types. This study is aimed to study the relationship between general health and personality types with the staffs’ job satisfaction .

 Materials and Methods: Seventy One women and men employee, aged 21 to 56 years working at Yazd health center were examined with full enumeration and by using General Health Questionnaire(GHQ), Job Descriptive Index(JDI) and the five-factor personality inventory(NEO). Research method was descriptive-correlation type and data were analyzed by using statistical tests like Pearson correlation, independent t test, ANOVA and stepwise regression.

 Results: The results showed that the relationship of the staffs’ general health with their neuroticism was direct (r=0/542) and with extraversion and agreeableness was reverse(r=-0/38, -0/34). But, it was not correlated with flexibility and responsibility . General health is inversely related to the three job satisfaction components(nature of work, job promotion, salary & job satisfaction total score) and it was irrelevant with the satisfaction of coworkers and supervisors. Lower general health was associated with neuroticism and good general health was associated with extraversion and agreeableness. Lower general health was also associated with lower job satisfaction and vice versa. Also there was a correlation between nature of work satisfaction and extraversion(p=0/01).

 Conclusion : We conclude that by decreased or increased general health of staffs and effect of their personality traits, job satisfaction would decrease or increase. Many cause decreased or increased of job satisfaction

Background and Aim: Decision support systems(DSSs) refer to one of the types of information technology applications that can help clinicians to make right and timely decisions about patients. The aim of this study is to learn more about DSSs and their applications and effects on health care.

Materials and Methods: In this systematic review, articles which were published between 2000 and 2012, which were available as full texts through databases and search engines -- such as PubMED, EBSCO host research, Google scholar and Yahoo -- and which were also of clinical-trial type were examined besides, certain books in this area were used as primary sources.

Conclusion : The findings show that DSSs were applied in five areas in health care, which had a significant effect on improving the process of care and the performance of providers. These areas are as follows: disease progress management(15.15%), care and treatment(27.27%), medication(27.27%), evaluation(27.27%), and preventation(12.12%). In general, improvement can be seen in three areas: quality of care and patient safety, cost effectiveness, and provider’s level of knowledge.