Journal of

Backgound: Approximately half of the diabetics population type 2 are not aware of their disease .Lack of awareness can lead to development of diabetes and increase cost of treatment. The aim of this survey was to determine the level of population awareness in Bushehr port in south of Iran in Bushehr prov­ince.

Methods: In this cross-sectional study, 719 subjects (417 male and 302 female) aged over 18 years old, without diabetes and inhabitant in Bushehr port in 2005 were assessed. Multi-stage random simple sampling was used. A 39 question questionnaire was used with validity checked by researchers in Yazd Diabetes Research Center and reliability alpha-cronbach=75%.The data were analyzed with independ­ent t-test, pearson correlation coefficient , ANOVA and Multiple Logistic Regression models by SPSS package ver. 10.05.

Results: Mean and SD of scores of subjects knowledge levels were 16.96 and 6.29, respectively. The levels of males' awareness rate was more than females' (P=0.001). There was indirect relation between subjects awareness and their age (r=-0.203, P=0.001) and direct relation between awareness and the level of education (P=0.01, r=0.07).The mean of awareness scores was not similar between singles and married (P=0.042). Awareness regarding fundamental diabetes disease, primary symptoms, early com­pli­ca­tions, delay complications, diet awareness was low and concerning controlling methods of diabetes was high.

Conclusion: Awareness in relation to fundamental and complications of diabetes disease was low, so the people need more education about diabetes.

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: Teeth-mouth diseases include a cost between 10-5% of the total of cost of health care and have the damaging effects on childhood and in adult. Transtheoretical Model shows change of behavior dynamically. The purpose of this study was to determine Stages of change of inter-dental cleaning behavior based on Transtheoretical Model in male and female students in Yazd, Iran.

Results: In this study 54.8% female and 45.2% males participated with mean age of 17.35 ±.55 years. %49.6(59student) of students were in pre contemplation stage. Other participants were 5.3 % (19) in contemplation, 24.1 % (87) in preparation, 6.8% (31) in action and 12.5% (5) in maintenance stage. There was a positive significant relationship among stages of change with self-efficacy (r=0.33) and perceived benefits (r=0.19). Also a negative significant relation between stages of change and perceived barriers (r= -0.19) was oberved. Constructs of the model were statically significant predictors of stages of change and accounted for 0.15% of the variation that self efficacy was most important predictors (β=0.212).

Materials and Methods: This cross-sectional study was performed on pre-university 361 students in 8 schools cluster sampling. The instrument for collecting the information were questionnaires consisting of demographic characteristics, self-efficacy questions, decisional balance (perceived advantages and perceived obstacles) and stages of change of interdental cheaning behavior. Reliability and validity of questionnaires was confirmed. The data collected by interview and analyzed by SPSS.

Discussion and Conclusion : In this study, most of students were in pre contemplation stage. They will be probably exposed to dental caries. Not only Trans-theoretical Model can be a model to determine strategies to each stage of change of teeth-mouth self - care Behavior but can also be used in educational interventions.

Background and Aim: The hierarchical and bureaucratic form of governmental administration is changing into a new type of flexible and market-based public management called Enterpreneurial Management Revolution. According to Stevenson, entrepreneurial management comprises a number of opportunity-based management activities for the maintenance of organizations in order to have their contribution in social value creation. This research study aims to study the organizational performance of medical sciences universities of Tehran based on Stevenson Model.

Materials and Methods: This research is a field study in which a structured questionnaire containing 22 main questions on the Likert Scale was distributed among the staff members of medical sciences universities in Tehran. The validity of the questionnaire was confirmed by experts and its reliability was estimated using Test- Retest Method. The Cronbach alpha coefficient was found to be 0.95. The data collection device was given to 379 staff members, of whom 325 filled it out. The data were completely recorded and then analyzed by SPSS software version 18.

Results: The results of the study show that regarding entrepreneurial management approach, medical universities are at an average level.
According to the present research and all related studies, this is the case in all other governmental organizations.

Conclusion: The results of the study indicate that organizational restructuring, decentralization, and continuous improvement in processes are the milestones of entrepreneurial revolution strategies in medical universities and all other public organizations.

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: Information is a factor for organizations success and organizations try to stay in this competitive world. In each organization, there are sections that have special role in information aspect in hospitals and healthcare centers, this role is for medical record section which organizes all of the patients' health care information. Paying attention to function quality in this section(medical record) is very important. Since health ministry introduce(EFQM) as an Excellence Model for hospitals, there fore, the role and importance of medical record section in implementation of this model and its criteria is determined.

Materials and Methods: All of the information databases was collected and those which were appropriate were selected. Then according to the article's goal, proper keywords were selected and documented through comparing with MESH. Finally related articles in credible journals were used in two Persian and English languages.

Results: After determining all the concepts and criteria of EFQM and matching them to the medical record section's goals, task's and functions, feasibility study of EFQM implementation in medical record section, is approved. With this comparism, importance of this section's role in signification model scores hospitals quality of performance is determined.

Background and Aim: Organizations have to establish modern management systems to progress and to obtain maturity. One of the techniques which started in Europe in the last two decades and is considered in management area of country during recent years is the model of organizational promotion (EFQM). The purpose of this study was Performance Evaluation of Rajaei Hospital Based on «EFQM» Organizational Excellence Model.

Materials and Methods: This cross-sectional study was conducted in year 2010 in Qazvin Rajai Hospital. Data collection tool, was EFQM organization Excellence Model questionnaire which was completed by all the managers. Validity and reliability of questionnaire was calculated. Results were analyzed using descriptive statistics.

Results: Results indicated that this hospital has acquired 99.183 scores out of 500 in enablers factor(88.36 percent of optimum score). Also has gained 183.71 scores out of 500 (36/75 percent of optimum score). Overall, this hospital has obtained 366.7 scores out of 1000 as the total score in the model for performance evaluation in year 2010.

Conclusion: Findings indicated that based on Excellence model criteria, this hospital is in a moderate level. Applying this model for Iranian hospitals which often meet serious problems in this area is informative and practical. Strong systematic view, paying attention to organizational process-based management and being result-oriented are advantageous of using this model.

Background and Aim: In strategic planning, there are several procedures to perform internal assessment or strength and weakness of organizations. Among other methods created for this purpose, Wiseboard model is the one in which the following six internal dimensions are considered: Organizational Structure, Leadership, Coordination, Reward System and Communication. This study measures three of these variables in hospitals of Tehran University of Medical Sciences (TUMS).

Materials and Methods: This survey is a descriptive, analytical and cross-sectional study conducted during 2010 and 2011. The research population comprised all those working at TUMS hospitals from which a random sample of about 580 people was selected. The questionnaire's reliability was estimated to be 91% and the data were analyzed by the SPSS software.

Results: Of the subjects, 75.4% were below diploma level, 13% above diploma, 7.8% higher diploma, 66.4 bachelor holders, 2.6% master holders, and 5.4% had a doctoral degree or higher. Some 72.6% of the subjects were in Clinical and 19.8% in Nonclinical fields. The mean values of Goal Setting, Organizational Structure, and Leadership came out to be 24.47, 20.37, and 22.06, respectively.

Conclusion: Based on the findings of this research study, TUMS hospitals have weaknesses in some aspects and they need improvement in some areas in the following order: Organizational Structure, Leadership, and Goal Setting.

Background and Aim: Cardiovascular diseases are the main cause of death and disabilities in the world. The purpose of the present study is to determine the perceived barriers and benefits of adopting health-promoting behaviors among individuals at risk of cardiovascular diseases referring to TUMS Teaching Hospitals in 2011.

Materials and Methods: This is a cross-sectional study in which 325 patients at risk of cardiovascular diseases were randomly selected. The data were collected using a self-made questionnaire having three parts: 14 items for demographic and health-related variables, 12 items for perceived barriers, and another 12 items for benefits. For data analysis, SPSS 18 was used.

Results: The mean age of patients was 53.56±11.27 about 47.7% of patients(n=155) were female and 52.3% (n=170) were male. There was a meaningful relationship between the mean of perceived benefits on the one hand and occupation, physical activity, type and frequency of physical activity, smoking and awareness of cardiovascular diseases on the other(p0.001). Moreover, the mean of perceived barriers showed a meaningful relationship with occupation, smoking and awareness of cardiovascular diseases(p0.05).

Conclusion: The findings of the present study revealed that demographic and health-related variables could affect the perception of barriers and benefits of adopting certain behaviors for the prevention of cardiovascular diseases. Therefore, using interventional and educational approaches appropriate for target group features can help us take effective steps towards health promotion.

Background and Aim: Hospital internal evaluation is considered as one of the most important steps in strategic planning. Therefore, besides the recognition of the weaknesses and limitations of the organization, especially affecting issues on the performance, the responsibility of the organization will be defined. This study was performed for the assessment of internal environment of the Gachsaran's Shahid Rajai Hospital based on Weisbord Organizational Diagnosis model.

Materials and Methods: In a cross-sectional study, 123 hospital staff were selected using random sampling formula. Data was collected using Weisbord Questionnaire which consisted of 35 questions in seven areas. Data analysis was conducted using SPSS statistical software and the t-test.

Results: Among six variables studied, variable communication with 3/15 ± 1/25 mean and standard deviation has the best situation and reward mechanism with the mean and standard deviation of 4/59 ± 1/32 was the worst. There was a meaningful difference among all variables except for the leadership variable.

Conclusion: Based on the findings of this study, Gachsaran's Shahid Rajai hospital has strength in the fields of goals, organizational structure, coordination, and internal organizational communication

Background and Aim: Assessment of hospital performance increases responsiveness and efficiency of limited resources. One of the most useful models of hospital performance assessment is Pabon-Lasso, a graphical model that determines the relative performance of hospitals using three indicators: Bed Occupancy Rate Bed Turnover and Average Length of Stay. The present study aims to compare the performance of Lorestan University of Medical Sciences (LUMS) hospitals using the above-mentioned tools.

Materials and Methods: In this descriptive cross-sectional study, fourteen LUMS hospitals were selected through census. The data-gathering instrument was the standard data form verified by the Ministry of Health and Medical Education. Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Rate were calculated and Pabon-Lasso graph was drawn using SPSS 15.

Results: The average length of stay, bed occupancy, and bed turnover rates turned out to be 3/21 days, 53/07% and 95/54, respectively. Five hospitals were in Zone III, indicating a satisfactory level of efficiency. Four hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. Three hospitals were placed n Zone II. And two hospitals were in Zone IV.

Conclusion: Among 14 studied hospitals, just 5 were considered as efficient. Therefore, it is necessary that policy-makers develop solutions to improve the performance of other hospitals and distribute health resources appropriately.

Background and Aim: Analysis of functions enables organizations to identify their special capabilities and weak points accurately and thus they can enhance capabilities and reduce impacts of threats and obstacles through such analysis. The main goal of this work is investigation of status of Weisbord Model's variables (6 variables) as functional dimensions of management in hospitals of Tehran University of Medical Sciences.

Materials and Methods: This was a descriptive - analytical study. The study population consisted of 384 staffs from hospitals of Tehran University of Medical Sciences. Standardized questionnaire for organization recognition was used for data collection. Descriptive statistics (frequency distribution, frequency percentage) and inferential statistics (Pearson correlation coefficient and significance level) were used for statistical analysis and data analysis was run using SPSS software.

Results: The results showed that there is a significant difference (p=0.0001) in hospitals in terms of the internal situation. Internal situation of all hospitals in the study was evaluated as favorable condition by obtaining 94.5 score out of 125. Among the hospitals, Hashemi-Nejad Hospital with highest score (113) showed the better condition and Rasoul Hospital had the lowest score (87) and lower condition as compared to other hospitals.

Conclusion: Necessity of systematic perspective in designing and development of fair compensation mechanism with presence of representatives of employees is an action which can considerably influence improvement of current situation in the hospitals and facilitates achieving predetermined goals of the organization

 Background and Aim: To optimize emergency services depend s on appropriate management structures and efficient and effective information system design . This study aim ed to investigate emergency department staff's information needs of emergency information system and to design a conceptual model of these needs.

 Materials and Methods: This descriptive study was performed among nurses and emergency medicine professionals working in emergency units of 9 hospitals affiliated to Tehran and Shahid Beheshti U niversities of M edical S ciences . Data w ere collected by interviewing 25 staff members in the emergency department , model d esign by RUP method and UML language and questionnaire d istribution among 315 staff members in the emergency department. Data collected were analyzed by descriptive statistics and SPSS.

 Results: Most nurses and emergency medicine physicians believed that multiple data elements such as time of patient’s first visit and procedure , t he latest status of patient, medical procedure taken , and paraclinical procedure taken must exist in the emergency information system . Also 68.3% (108) of them agreed with the relationship between data elements required in the clinical practice process .

 Conclusion : It is concluded that the presence of identity , clinical , and paraclinical data in emergency information systems can produce an electronic medical record. According to these data, elements can improve the coordination between the hospital emergency and pre- hospital rescue teams , controlling of victim status , access to patient reports and quality of service to patients.

Background and Aim: Transforming government hospitals into autonomous units improved hospitals. This study was performed to evaluate the responsiveness of board of trustees hospital according to the world bank’s organizational reform model (Preker Model) in isfahan city.

Materials and Methods: The study was a qualitative research method. In this research, depth and semi-structured interviews were carried out and purposive sampling was used.

The study population were top managers of Amin and Alzahra hospitals . Sampling was started with the first participant until saturated level of information, participants completed the 8 cases.

Results: According to interviews, the current role and contribution of non-university institutions (e.g. municipalities representatives) in hospital board of trustees is neither bold nor transparent. These hospitals can address minimum changes in their mechanisms of accountability after developing board of trustees.

Conclusion : It is rational for hospitals as they undergo organizational reform and developing board of trustees, to have more rights for decision making. Further more, their accountability mechanism should change accordingly.

Background and Aim: Despite all inherent advantages of information technology in health sector, its implementation still faces many problems. One of the most important barriers is people’s resistance. This study was carried out to survey the factors affecting the acceptance of information technology by Health Information Management (HIM) staff of Tehran University of Medical Sciences (TUMS) hospitals based on Technology Acceptance Model (TAM) in 2011.

Materials and Methods: It is a descriptive-analytical survey. The population of the study consisted of the HIM staff (363 members) of TUMS hospitals. As the sample, 123 employees were selected. The data gathering tool was a questionnaire the validity and reliability of which were confirmed. The data were collected and analyzed by SPSS software, descriptive statistical methods and Spearman Test.

Results: The results showed that there was a positive direct relationship between perceived ease of use (PEOU) on the one hand and the staff’s attitude and their application of IT on the other hand (R=0.14, P= 0.05 R=0.36, P=0.05). Also, perceived usefulness (PU) had a significant direct effect on the staff’s attitude and their application of IT (R=0.22, P= 0.05 R=0.37, P=0.05).

Conclusion : Perceived ease of use (PEOU) and perceived usefulness (PU) are the factors affecting the acceptance of information technology by the HIM staff of TUMS hospitals. Therefore, it is suggested that the above two principles be considered when designing and implementing the IT systems.

Background and Aim: Motivation and satisfaction of manpower are the most important variables in the field of organizational behavior and because of the strong relationship between these two variables with the job and organization productivity, it’s necessary to look job characteristics as increasing factor of employee satisfaction and performance in redesigning jobs. The objective of this study was determining motivating potential score (MPS) of the jobs and survey the relation between MPS and job satisfaction in staff employees of educational and research deputy of TUMS (Tehran University of Medical Science).

Materials and Methods: This was a cross-sectional and descriptive-analytical study. The research context was to staff employee of education and research deputy of TUMS. Sampling frame of the study was simple random sampling. Data collection method was a questionnaire. Reliability of the questionnaire was ascertained with pilot study with and confirm with Cranach's Alpha. T-test and Pearson correlation were the analytical methods.

Results: The results showed the jobs of the study population have skill variety, task identity, task significance and potential motivation but haven't job authority and feedback. The findings showed there was significant relation between motivating potential power and its dimensions with the job satisfaction ( P<0.05 ).

Conclusion : The job characteristic have great impact on the job satisfaction so this model can be used for redesigning the jobs to increase job satisfaction.

 Background and Aim: The purpose of the present study was to assess and prioritize the factors affecting the quality of services of pharmacies in Bushehr using Kano model and TOPSIS method and to provide practical strategies for quality improvement in the current situation.

 Materials and Methods: This Study was practical and descriptive. The samples contained the pharmacies customers and visitors in 1390 and the data were obtained using questionnaires measuring the quality of service and standard (Kano). Finally, the indicators were prioritized by applying the technique of group decision-making (TOPSIS).

 Results: According to the TOPSIS prioritization, Uni-dimensional requirements (10 requirements), basic requirements (6 requirements), attractive requirements (8 requirements), and finally, requirements of indifference (3 requirements) had the greatest impact on improving the quality of services in pharmacies in Bushehr, respectively, based on the Kano model.

 Conclusion: Strong and positive correlation among the indices of the quality of services in the pharmacies and customer’s satisfaction was observed, Planning to improve the services would lead to satisfaction improvement.

 Background and Aim: Information literacy is a set of skills required to identify rightful information resources and access to them. These skills are empowering goal oriented use of information resources. This study aimed to determine the ability rate of information literacy among health services administration students in Jundishapur University of Medical Sciences based on SCONUL seven pillars model.  

 Materials and Methods: This cross-sectional descriptive-analytic study was conducted using a questionnaire developed based on SCONUL information literacy seven pillars model. Validity of the questionnaire was confirmed through content analysis and coefficient of Chronbach’s alpha was 0.93. The study population included students of health services administration in Ahvaz Jundishapur University of Medical Sciences in 2013. The sample size included 40 cases collected randomly. Data analyzed through SPSS descriptive statistics and non-parametric statistical tests.

 Results: The mean score for the studied components of information literacy abilities among the study population was 0.5±0.43. Information Literacy score among freshmen was significantly different from other students (P<0.03). Students who passed Computer Basics and Research Methodology educational courses showed significant differences from other students in the information management (P<0.01).

 Conclusion: Given the increasing development in information technology, the need to develop information literacy skills is considerable especially among those who are going to be engaged in the health sector. Although studied students’ information literacy estimated relatively well, it seems necessary to take measures to improve their information literacy in all components.

 Background and Aim: Entrepreneurial roles can be performed by managers at different levels. In fact, entrepreneurship can be interpreted as a tendency adopted by managers towards their environment in which they should have the ability to discover new opportunities for their innovative activities. This study aims to identify factors affecting entrepreneurial behavior of research centers managers at Tehran University of Medical Sciences (TUMS).

 Materials and Methods: Considering the sample size determined through Cochran’s formula, 90 questionnaires were distributed among TUMS research centers managers. The data were analyzed based on structural equation modeling applying partial least squares approach through Smartpls.2 software.

 Results: Of the 90 questionnaires distributed, 67 were acceptable for study. The model created for effective factors enjoyed an acceptable goodness of fit index (GOF=0.49). Factors loading for the observed variables were above 0.4 and the constructs had an acceptable level of reliability and validity.

 Conclusion : The results show that contextual and behavioral factors have a positive effect on entrepreneurial behavior and that structural factors have a negative effect on it. 

Background and Aim: In a severely inflationary environment with unemployment, social problems increase and, therefore, high health care expenses are imposed on the society.

Materials and Methods: This was a correlational study. Panel data model and EVeiws 6 software were used in this study. The data were collected from the World Bank website. The required pre-tests, including F-Limer and Hauseman tests, were given to check the appropriateness of data and to determine a appropriate model. Following the pre-tests, the results were estimated in the form of a regression model.

Results: The results indicated that F-test and t-statistic were significant, and that R² statistic was high. In the three models, R² was 99%, 99% and 98%, respectively. Moreover, it can be said that employment is positively related with life expectancy, but negatively related with infant mortality and total fertility rate. Also, inflation is negatively related with life expectancy, but positively related with infant mortality, and total fertility rate. Finally, Gross Domestic Product (GDP) is negatively related with total fertility rate and life expectancy, but has no meaningful relationship with infant mortality (p = 0.31).

Conclusion: Employment, inflation and GDP are the variables that have the greatest impact on health indicators. however, life expectancy is more sensitive to explanatory variables.