Journal of

Background and Aim: Today provision of an adequate and appropriate health services depend on many factors. Human resources are one of the most important factors. Nursing managers with more exact understanding of nursing activity could prevent of human resource wastage. In other way goal achievement in an efficient remedial system depends upon favorite delivery services and one of the appropriate ways for quality of care evaluation is patient satisfaction measurement about care delivery. This study was conducted and implemented to measure the nursing care time and its relationship with patient satisfaction.

Materials and Methods: This descriptive and analytical study was done in internal ward in Gorgan 5th Azar educative and therapeutic center for one month. nursing activity checklist was used for measuring the time that spend for Nursing staff activity and patient satisfaction scale. Data were analyzed with SPSS for Windows package.

Results: In this research findings showed, 46.46% of nursing activity time was spent for direct care, 15.8% of total time was used for documentation activities and 22.5% of time spent for nurses' individual activity, whereas only 7.43 percent of total time was spend for patient assessments. 60.3% of patients were satisfied about care delivery and 24.8% of them had moderate satisfaction. A significant correlation was seen between patient satisfaction and nursing direct care (r =0.272, P= 0.001).By increasing The spent time for direct care, patients' satisfaction was also increased.

Discussion and Conclusion: Nursing managers' awareness from scientific methods of management, rules modification, use of new equipment and technology and also delegating of some nursing activity to nursing assistants could promote quality of care with increasing of nursing direct care.

Background and Aim: Patients' needs should be acknowledged properly in order to enable hospitals to take responsibility for their expenses. In this study, patients' satisfaction is assessed in various fields which are key elements of hospitals assessment program.

Materials and Methods: In this cross-sectional study, 120 consecutive patients which are randomly selected from Hospitals affiliated to Tehran University of Medical Sciences (TUMS) were enrolled. A questionnaire was completed for their demographic, occupational, insurance status and their satisfaction of clinical services, nutrition, hospital environment and hospital facilities.

Results: The age range of participants were11 to 80 years old 61.9% were females and 38.1% were males. Overall, 78.1% were satisfied in respect to hospitals general status while there were significant differences considering satisfaction in hospital environment and facilities, clinical services and nutrition among recruited hospitals.

Discussion and Conclusion: A strong correlation between the index of hospital environment and patients' satisfaction signifies further enhancements of hospital environment which could potentially increase patients' satisfaction. Also, the relationship between patients well being and satisfaction indicates health care staff role should be emphasized for patients' appreciation. Consequently, hospital administration should focus on current unsatisfied sections to improve health care quality.

Background and Aim: Given The importance of patient satisfaction levels of health care is an effective role in planning health services management system. This study aimed to assess patient satisfaction of hospital services and related factors was designed in Baharloo study Hospital.

Materials and Methods: This is a cross sectional. The data is collected by questionnaire and interview and after completing the questionnaire based on the number of samples required in this study, the information was collected into the computer and analyzed. The study statistical society was 320 patients hospitalized in all different parts of the hospital in the second six months of 1387 were selected in the form of the random sampling . To measure the patient satisfaction used satisfaction questionnaire with six demographic questions and 20 satisfaction terms. Questionnaires was given to the patients by trained persons (non-medical staff) in the last session of therapy.In young patients the questionnaire was completed by the patients family or friend and about cases with illiteracy or low literacy the questionaire was completed by Trained questioners.Listen.

Results: Satisfaction including satisfaction levels was as follows: heat and cooling systems (44.8%)- facilities (48.3%) - Food Quality (44.8%) - daily clothes and sheets change(41.6%)- Sanitation and hygience (48.3%) - room lighting ( 56%) - the speed of filing reception files(58.6%)- Nurse attitude (55.2) - time presence of clinical nurses on the patient's bedside (58.6%) - appropriate communication with sick relatives (55.2%). Highest level of patient satisfaction was as follows: satisfaction of nurse time presence on the patient's bedside (58.6) - the speed of filing reception files and the patient good guidance by receptionist(58.6%) and room lighting (58%).

Discussion and Conclusion: The largest percentage of patient dissatisfaction was regarding facilities of rooms, food quality and daily clothes and sheet change(24.1%).

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

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

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

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

Background and Aim: Staff satisfaction is one of the basic and important indicators for assessment of contract management. The aim of this study was to survey relationship between contract management and staff satisfaction in hospitals affiliated to the Tehran University of Medical Sciences in 2011.

Materials and Methods: This research was a cross-sectional and descriptive study. Six hospitals which were deployed a contract management system in recent years were chosen. A questionnaire with Likert scale was designed to measure the satisfaction.
One hundered and twenty three employees filled the questionnaire. The data analysis was performed using descriptive statistics and paired t test.

Results: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Conclusion: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Background and Aim: Self-reliance is a psychological belief that is formed in an individual during growth and is not changed easily and quickly.
The present study aims to evaluate the relationship between nursing managers' self-reliance and patients' satisfaction in hospitals affiliated to Tehran University of Medical Sciences(TUMS).

Materials and Methods: In this cross-sectional study, 400 individuals(200 nursing managers and 200 patients) were interviewed in various clinical wards of TUMS hospitals. Nursing managers' self-reliance and patients' satisfaction were evaluated using a structured questionnaire.
The data were entered into Stata 11 software and analyzed with non-parametric ANOVA and Spearman's correlation coefficient tests. The significance level was determined to be p<0.05.

Results: Of the nursing managers, 58(29%) were male and 142(71%) were female. The mean and SD of their self-reliance were 134.9 and 19.8, respectively. The patients, however, comprised 81(40.5%) males and 118(59.5%) females. The mean and the standard deviation of patients' satisfaction were 57 and 18.2, respectively the only individual factors affecting their level of satisfaction were educational level(p<0.005) and insurance status(p<0.0001). Besides, a multivariate analysis showed that there was a significant negative association between managers' self-esteem and patients' satisfaction(P=0.04).

Conclusion: The findings revealed that female managers had less self-esteem than male managers. Moreover, it showed that managers' higher self-esteem would cause patients' lower satisfaction. Furthermore, patients with higher education and/or with health insurance were more satisfied than others.

Background and Aim: The Emergency Medical services(EMS) is a community-based health management system that has coordinated with the entire health care system and the employees are the most important asset of it. The purpose of this study was to identify the stressful factors that cause dissatisfaction of employee in the pre-hospital EMS in Kerman.

Materials and Methods: This study was a qualitative study and sampling was targeted. Acception criteria for the study was more than three years of experience as a technician operating in urban and road sites in the EMS. In this study, semi-structured interviews were conducted with 15 personnels and data was analyzed using "frame structured analysis" was used.

Results: This study identified four main axis and fifteen sub axis. The main issues related to the tensions and dissatisfaction include the employees personal problems, organizational problems, poor coordination, and problems with the community.

Conclusion: Considering Psychotherapy for staff and the creation of job rotation between the bases are the constructive suggestions for improving employee performance and improve the system of EMS is Kerman.

 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: 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: Today universities admit International Students as well as national students. Tehran University of Medical Sciences has been also started admitting International Students in regards of its Internationalization aims. Student’s satisfaction is of high importance in order to gain the given goals. The purpose of this study was to evaluate the satisfaction of International students of TUMS.

Materials and Methods: This was a descriptive study. The target group was international students of TUMS, the participants were selected through availability sampling. The research instrument was researcher-made questionnaire which the reliability calculated as 0.97 by Chronbach’s alpha. The data was analysied by Microsoft Excell version 2010.

Results: The overall satisfaction of the students was 70% (satisfied and completely satisfied) while the overall dissatisfaction was 10% (dissatisfied and completely dissatisfied).

Conclusion: Given satisfaction of more than half of the International students, TUMS has performed reasonably. Based on the results obtained in this research the university may pay attention to the fields reported as dissatisfied.

Background and Aim: Scientific and technological developments have promoted the status of organizational learning as a reasonable way to deal with the present changing circumstances. The development of organizational learning improves the performance of employees, and makes them feel satisfied. The aim of this study is to investigate the relationship between job satisfaction and organizational learning capabilities among the employees of Tehran hospitals.

Materials and Methods This descriptive, analytical study was conducted among 290 employees in 2014 in Tehran hospitals. For data collection, a three-part questionnaire (including demographic characteristics, Gomez`s Organizational Learning Capability Questionnaire and Minnesota Job Satisfaction Questionnaire) was given to 290 employees. Data were analyzed using the SPSS-20 software with Spearman test.

Results: Mean scores of organizational learning capability and job satisfaction were (3.03± 0.61) and (2.8± 0.61), respectively. Among the dimensions of organizational learning capability, the highest score pertained to systematic perspective (3.29± 0.78); regarding job satisfaction, the highest score was related to organizational climate (3.23± 0.1). The results showed that there was a significant correlation between the dimensions of organizational learning capability and job satisfaction. Also, a significant correlation was observed between organizational learning capabilities and job satisfaction.

Conclusion: Organizational learning improves the performance of employees and is positively correlated with their satisfaction. Also, employee satisfaction is one of the factors affecting their performance. Therefore, managers can make employees satisfied and develop their organization through improving organizational learning.

Background and Aim: Job rotation is one of the management policies in human resource management. If these policies are done with proper planning, they can impress job satisfaction and job burnout of the employees. Present survey has been conducted in order to find relationship between job rotation with job satisfaction and job burnout.

Materials and Methods: A descriptive analytical methodology was used in 2013. The statistical community included all personnel with job rotation at the deputy of development in Tehran University of Medical Sciences (n=200). A researcher-constructed questionnaire was used to collect data. The data was analyzed by SPSS.

Results: The mean job rotation and job burnout among men were more than women. A direct and significant relationship exists between job rotation and job burnout among the women. Job rotation and job burnout were inversely and significantly correlated.

Conclusion: Job rotation can have influence on increasing employees’ incentives and satisfactions and reduce Job burnout. Thus, the managers need to create an environment which contributes to knowledge transactions within an organizational framework together with promotion of encouraging their mentalities and with designing a good incentive system for teamwork, through the movement of workers in different occupations.

Background and Aim: Organizational productivity and efficiency depends on staff members’ job satisfaction and performance. Without the participation of staff members, hospitals cannot play an important role in promoting the society’s health. This study aimed to determine staff’s job satisfaction in a teaching hospital of Tehran university of Medical Sciences (TUMS).
Materials and Methods: This descriptive, analytical cross-sectional research was conducted on 172 staff members of a teaching hospital, who had been selected through random sampling. The data-collection tool was a researcher-made questionnaire. The validity of the questionnaire was confirmed by the clinical governance department members and Cronbach’s alpha reliability estimate turned out to be 0.88. 
Results: Para-clinical and service employees getting the mean scores of 72.55 and 70.71 demonstrated desired job satisfaction; nursing and administrative-financial staff members, however, showed a relatively desired job satisfaction with mean scores of 60.04 and 53.52, respectively; and the difference between job groups was significant (p=0.02) regarding job satisfaction. The highest job satisfaction figure was related to job success and the lowest pertained to the nature of the job. There was a meaningful relationship between job satisfaction on the one hand and staff members’ gender, marital status, and type of employment on the other.
Conclusion: Staff’s job satisfaction in the studied hospital has increased due to the establishment of Iran’s Healthcare Reform Plan at the beginning of 2014. However, compared with other job groups, nurses are less satisfied; therefore, it is necessary to improve nursing job satisfaction through timely payments based on job performance and difficulty level.

Background and Aim: The number of patients who leave hospital against medical advice could reflect patient dissatisfaction and it is a notable important problem. The present study aimed to identify the causes of discharge against medical advice at a hospital of Shiraz University of medical sciences.
Materials and Methods: This was a qualitative study using grounded theory. Data were collected through telephone interviews with patients or their concomitants. All interviews were recorded by researcher and thematic method used to analyze the data. Based on it, causes of discharge against medical advice were determined and solutions were provided.
Results: Causes of discharge against medical advice were categorized into 3 general themes: "causes related to the status of the hospital", "causes related to hospital staff", and "causes related to patients" that each of them include some sub-themes. Between the sub-themes, the issues relating to the hospital staff and economic status of patient had the most and the least frequency respectively.
Conclusion: The research findings make it possible for the hospital managers to find solutions to prevent creation of DAMAs and side effects for early discharged patients, patients' readmission and imposing additional costs on them. These solutions can be mentioned as attention and understanding of authorities, preparing some amenities for patients, holding justification meetings for medical personnel and students and reengineering some hospital processes.

Background and Aim: The patient is the main customer for hospital services. Patient satisfaction can reflect if the services are performed correctly. The aim of this study was to determine the relationship between the degree of client tribute plan and inpatients and outpatients satisfaction in Shiraz hospitals.
Materials and Methods: This descriptive-analytic and cross sectional study was done among 211 inpatients and 1,175 outpatients in 8 Shiraz hospitals. The instruments for data collection were two client tribute plan and patient satisfaction questionnaires. Data collected by interviews and observation. Data were entered into SPSS. Descriptive statistics and Pearson correlation test were used for data analysis.
Results: Forty five point four percent of patients and 44.1 percent of outpatients assessed the hospital service satisfaction as weak. The mean score of inpatient and outpatient satisfaction was 60.53±8.9 and 54.22±12.6 respectively. There were significant relationship between type of admission and satisfaction (p=0.001). Mean score of client tribute plan was 182.44±11.8 that placed in the appropriate level. There were no significant relationships between client tribute plan and inpatients and outpatients satisfaction (p=0.143).
Conclusion: Although client tribute plans perform properly, patient satisfaction is low. In this regard, it is recommended that review client tribute plan clients in healthcare systems and adopt its contents with the needs of patients.