Journal of Education and Health Promotion

Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives

. Fatemeh Bahrambeygi; . Sakineh Rakhshanderou; . Ali Ramezankhani; . Mohtasham Ghaffari

Volume 13, Issue 1 , January 2023, , Pages 1-13

Abstract

  BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health ...  Read More BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health literacy inthis context seems necessary. The purpose of this research was to explain the concept of hospitalhealth literacy (HHL), its definition, and the related dimensions using the qualitative research method.MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open‑ended,and face‑to‑face interviews based on the interview guide were used to elicit participants’ perspectivesbetween July 2021 and January 2022. By using the content analysis method, researchers codedtranscripts and collated these codes into sub‑categories and then merged them into the main categoryand explored the dimensions of the concept.RESULTS: A total of 23 service providers and 25 service recipients were included in the study.Analysis of qualitative data led to the identification of 6 categories and 25 sub‑categories includingcognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, medialiteracy, and emotional literacy.CONCLUSION: The findings of the present study provide a deep understanding of the conceptof HHL that could be applied to develop valid and reliable measurement tools for assessing HHLamong a variety of populations. Also, it is hoped that the present attempt can be useful to guidefuture research and interventions as well as to provide a clear base for planning, implementing, andevaluating interventions aimed at promoting individuals’ health literacy in health settings.

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Investigating olfactory disorders in children with COVID‑19 disease admitted to Hazrat Masoumeh Hospital in Qom

. Narges Alizadeh; . Hanieh Hajian; . Zahra Movahedi; . Mohammad Agha Ali

Volume 12, Issue 10 , November 2022, , Pages 1-6

Abstract

  BACKGROUND: One of the most important sensory disorders that usually occur after viral infections,especially human coronaviruses and rhinoviruses, is anosmia or loss of olfactory sense. ...  Read More BACKGROUND: One of the most important sensory disorders that usually occur after viral infections,especially human coronaviruses and rhinoviruses, is anosmia or loss of olfactory sense. The aim ofthe present study was to investigate olfactory disorders in children with COVID‑19 disease admittedto Hazrat Masoumeh Hospital in Qom.MATERIALS AND METHODS: This descriptive‑analytical study was conducted on 85 childrenadmitted to Hazrat Masoumeh Hospital in Qom by using a convenience random sampling method.Data were collected using a checklist containing demographic data. The collected data were enteredSPSS 18 software and were analyzed using descriptive and analytical statistics.RESULTS: In the present study, the results showed that the mean age of participants was6.59 ± 3.27 years and more patients were Iranian (n = 69, 87.3%), had a history of underlyingdisease (n = 51, 64.6%), had a history of vaccination (n = 78, 98.7%), and did not have contact with asuspected patient (n = 43, 54.4%). Among the signs and symptoms of the disease, only the symptomsof fever (n = 71, 89.9%), weakness and lethargy (n = 44, 55.7%), and anorexia (n = 44, 55.7%) wereobserved in most patients. Moreover, 87.3% (n = 69) of the patients did not have olfactory. Furthermore,no association was found between age (P = 0.803), length of hospital stay (P = 0.397), white bloodcell (P = 0.624), lymph (P = 0.638), Polymorphonuclear (PMN) (P = 0.493), erythrocyte sedimentationrate (P = 0.507), C‑reactive protein (P = 0.085), and O2sat (P = 0.205) and olfactory disorders, but asignificant relationship was found between patient weight (P = 0.002) and olfactory disorders.CONCLUSION: According to the results of the study, it can be said that in order to increase thestrength of the immune system of children, especially overweight children, appropriate and plannedaction should be taken to prevent problems in these children.

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Effectiveness of educational intervention on reducing oxidative stress caused by occupational stress in nurses: A health promotion approach

. Davoud Panahi; . Elham Akhlaghi Pirposhteh; . Bayan Moradi; . Mohsen Poursadeqiyan; . Ali Salehi Sahlabadi; . Amir Kavousi

Volume 12, Issue 7 , August 2022, , Pages 1-8

Abstract

  BACKGROUND: Nursing is one of the most stressful occupations. Educational intervention regardingstress management can play an important role in reducing occupational stress among nurses ...  Read More BACKGROUND: Nursing is one of the most stressful occupations. Educational intervention regardingstress management can play an important role in reducing occupational stress among nurses Thepresent study aimed to determine the effectiveness of educational intervention on reducing oxidativestress caused by occupational stress in nurses: A health promotion approach in a hospital in westernIran.MATERIALS AND METHODS: The present interventional study was performed in 2019 among92 nurses working at the Kosar Hospital located in the city of Sanandaj in the country of Iran.Occupational stress was evaluated using the Osipow Occupational Stress Questionnaire. Oxidativestress was measured by taking blood samples and measuring the enzymatic activity of superoxidedismutase (SOD), malondialdehyde, and catalase (CAT) using SOD, malondialdehyde (MDA), andCAT kits. Educational intervention was carried out in the second stage. Three months after theintervention, data were taken again.RESULTS: The results of the present study indicated that there was a significant difference inoccupational stress between before and after the educational intervention (P < 0.05). A significantreduction in MDA (P = 0.038) and SOD (P = 0.048) was observed after educational intervention, butthis was not the case for CAT (P = 0.592). There was no significant correlation between occupationalstress with oxidative stress parameters before and after the educational intervention (P < 0.05). Nosignificant difference in occupational stress was observed between men and women. Among theoxidative stress parameters under evaluation, MDA was higher among men compared to womenand this was statistically significant.CONCLUSIONS: Educational intervention regarding occupational stress is effective in reducingoxidative stress among nurses. The group meetings teach stress management to the participantsand enable them to better manage their stress by utilizing their own capabilities. Thus, attention tothis issue is vital in maintaining the mental and physical health of nurses and, in turn, improves thequality of care rendered.

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Disaster risk management challenges in military hospitals: A qualitative study

. Somayeh Azarmi; . Amir Hosein Pishgooie; . Simintaj Sharififar; . Hamid Reza Khankeh; . Hejrypour Seyyed Ziya

Volume 12, Issue 5 , June 2022, , Pages 1-8

Abstract

  BACKGROUND: Disaster can pose significant challenges to the health infrastructure in thecommunity. Hospitals are the central unit for providing health services in the disaster responseplan. ...  Read More BACKGROUND: Disaster can pose significant challenges to the health infrastructure in thecommunity. Hospitals are the central unit for providing health services in the disaster responseplan. With regard to the vital role of military hospitals in health response to disaster, this study wascarried out with the aim of investigating the disaster risk management (DRM) challenges in militaryhospitals in Iran.MATERIALS AND METHODS: The current study was qualitative research performed in 2020 inmilitary hospitals in Iran. Participants consisted of 12 managers and staff of the military hospitals inTehran and professionals in health in emergencies and disasters who were included in the study bythe purposive sampling technique. Semistructured individual interviews based on the interview guidewere exploited for the data collection, and a content analysis method was used to analyze them.RESULTS: DRM challenges in military hospitals were explained in the form of six categories:“management and leadership, planning, prevention and mitigation, preparedness, response, andrecovery” and 22 subcategories.CONCLUSION: Managers’ awareness of DRM challenges in hospitals, particularly military hospitals,and the design and implementation of solutions can lead to the promotion of hospital DRM andhospital preparedness to deal with disasters.

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Public‑private partnership in Iranian hospitals: Challenges and opportunities

. Ghazaal Etemadi; . Reza Rezayatmand; . Nasrin Shaarbafchizadeh

Volume 12, Issue 4 , April 2022, , Pages 1-9

Abstract

  BACKGROUND: Nowadays, various strategies are applied by governments to control costs and finance hospitals and the health sector. Public‑private partnership (PPP) option is one ...  Read More BACKGROUND: Nowadays, various strategies are applied by governments to control costs and finance hospitals and the health sector. Public‑private partnership (PPP) option is one of these strategies. Considering the growing importance of hospitals in different communities and their problems, this study aimed to identify PPP challenges, opportunities and solutions in hospitals. This study aimed to identify the challenges and opportunities of PPP in the country’s hospitals and then offered an appropriate solution to overcome these challenges.MATERIALS AND METHODS: This is a qualitative study and content analysis approach is undertaken. The participants were selected through purposive sampling and data were collected using a semi‑structured interview with experts in the public and private health sector until the saturation point achieved. Data analysis was performed through the thematic analysis of expert’s statements using MAXQDA. 10 software in this sector.RESULTS: According to the study results, 3 main themes (challenges, opportunities, and solutions), 10 sub‑themes, and 32 codes were identified in relation to the public and private partnership. 4 sub‑themes on challenges of PPP, 3 sub‑themes on partnership opportunities and 3 sub‑themes on challenges solutions were identified.CONCLUSION: The results of this study revealed that given the discussed challenges the most important challenge seems to be not evaluated outsourcings, incorrect usage of participatory models, and inadequate and inappropriate postoutsourcing supervision, however, it appears evaluated outsourcing backed with adequate supervision could solve many current hospitals’ problems.

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Determining the characteristics of a mental supportive workplace according to female hospital staff in one of Tehran hospitals: A qualitative study

. Mitra Faghihi; . Aliasghar Farshad; . Maryam Biglari Abhari; . Nammamali Azadi; . Morteza Mansourian

Volume 12, Issue 4 , April 2022, , Pages 1-12

Abstract

  BACKGROUND: Health‑care workers are exposed to complex types of health and safety hazards. A high percentage of hospital staff in Iran are women, who in addition to heavy and ...  Read More BACKGROUND: Health‑care workers are exposed to complex types of health and safety hazards. A high percentage of hospital staff in Iran are women, who in addition to heavy and stressful hospital work, also carry the burden of the family roles. It is in these circumstances that creating a supportive environment for women is of particular importance. Accordingly, this study is designed to determine the characteristics of a mental supporting work environment in the workplace from the perspective of female hospital staff.MATERIALS AND METHODS: This study was performed by a qualitative method and content analysis approach. Sampling was purposive and 26 women working in different wards of this hospital were included in the study. In this study, women with maximum diversity in terms of age, work experience, and employment ward were selected. The main method of data collection in this study was a semi‑structured interview. Interview texts were extracted and divided into meaningful units. To validate and confirm the results plus accuracy of the research, the criterion of data validity or data credibility, admissibility, data accuracy, verifiability, reliability, and transferability were used.RESULTS: Through the data analysis, 58 primary concepts with the same features were classified into 10 subcategories. Then, based on common features at a more abstract level, they were converted into four main categories including job stressors, women’s stress management, providing women’s psychological‑job satisfaction, and women’s work‑life balance.CONCLUSION: Creating supportive work environments for women, especially those operating in workplaces such as hospitals, which brings a lot of work pressure and workload for them, can be an important policy for organizations and hospital work environments.

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A survey of nurses, midwives, and physicians attitudes in regard to health reform plan at Jahrom University of Medical Sciences in 2020

. Yasaman Pourfarid; . Mohsen Hojan

Volume 12, Issue 2 , February 2022, , Pages 1-4

Abstract

  BACKGROUND: The health reform plan (HRP) is a plan to improve Iran’s health systems that began in 2014. The three main approaches of this plan include financial protection ...  Read More BACKGROUND: The health reform plan (HRP) is a plan to improve Iran’s health systems that began in 2014. The three main approaches of this plan include financial protection of the people, creating justice in access to health services, and improving the quality of services. It predicted that the level of health system responsiveness would increase. Achieving this goal is possible only with the correct implementation. The best people to measure the correct implementation are nurses, midwives, and physicians. Hence, this study was conducted to assess the attitude of nurses, midwives, and physicians about the implementation of the HRP.MATERIALS AND METHODS: This cross‑sectional descriptive study was conducted in educational hospitals of Jahrom University of Medical Sciences in 2020. By convenience sampling method, 325 nurses, midwives, and physicians participated in this study. Sampling was done in all work shifts, and in all wards. A researcher‑making questionnaire was used to collect data. The scoring did by the Likert scale from (completely agree = 4 to completely disagree = 1). Quantitative and qualitative face and content validity was calculated (IS: 0.84, CVI: 0.92, CVR: 0.87), and its reliability was calculated by Cronbach’s alpha method (0.78). The data were analyzed by SPSS software version 16. Descriptive statistics, Mann–Whitney U‑test, and Kruskal–Wallis test were used for the data analysis (P ≤ 0.05).RESULTS: In the study, 90.15% agreed with the implementation of the HRP. There was no significant difference between the male and female (P = 0.063). There was a significant difference between the educational degree (P = 0.006), married and the single participants’ attitude (P = 0.003), the nurses, midwives, and physicians (P = 0.001).CONCLUSION: HRP is more successful in the field of financial protection, so policymakers should pay more attention to justice in access to health services and improving the quality of services fields.

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Benefits of simulation‑based education in hospital emergency departments: A systematic review

. Shandiz Moslehi; . Gholamreza Masoumi; . Fahimeh Barghi-Shirazi

Volume 12, Issue 1 , January 2022, , Pages 1-10

Abstract

  BACKGROUND: The emergency department is one of the most important parts of all hospitals. Forthis reason, many simulation programs are performed in this department to increase the knowledge,skills, ...  Read More BACKGROUND: The emergency department is one of the most important parts of all hospitals. Forthis reason, many simulation programs are performed in this department to increase the knowledge,skills, and productivity of health‑care workers. The purpose of this study was to identify the benefitsof simulation in hospital emergency departments.MATERIALS AND METHODS: In the present systematic study, using “AND” and “OR” operators, wesearched for the keywords “benefits,” “simulation,” and “hospital emergency department” in PubMed,Web of Science, Scopus, Google Scholar as well as Persian language databases such SID, Magiran,Irandoc, and Iran Medex. Then, a three‑step screening process was used to select studies relevantto simulation and hospital emergency from 2005 to 2021 using the PRISMA checklist, and finally,the obtained data were analyzed.RESULTS: A total of three main groups, each with several subgroups, were extracted and identifiedas the benefits of using simulation in hospital emergency departments. They included improvingthe diagnosis of the disease (rapid prediction of the disease, rapid diagnosis, and patient triage),improving the treatment process (improvement of treatment results, anticipation of admission anddischarge of patients, acceleration of interventions, and reduction of medical errors), and improvingknowledge and skills (improvement of the speed of decision‑making, staff’s acquisition of knowledgeand skills, simple, convenient, and low‑cost training, improvement of staff’s preparedness in crisis).CONCLUSION: Based on the results of the present study, it is suggested to develop some trainingprograms in order to help staff upgrade their knowledge and performance as well as acquire practicalskills and also to improve the diagnosis and treatment process in hospital emergency departments.Virtual methods are also proposed to be applied as potential and cost‑effective platforms for learning,teaching, and evaluating the staff of hospital emergency departments.

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Risk analysis and safety assessment of hospitals against disasters: A systematic review

. Seyed Mobin Moradi; . Mahmood Nekoei‑Moghadam; . Ahmad Abbasnejad; . Naser Hasheminejad

Volume 11, Issue 10 , November 2021, , Pages 1-16

Abstract

  Both natural and man‑made disasters are increasing in occurrence at the world. Hospitals andhealth‑care centers are very complex and have a high potential for vulnerability depending ...  Read More Both natural and man‑made disasters are increasing in occurrence at the world. Hospitals andhealth‑care centers are very complex and have a high potential for vulnerability depending on externaland internal factors. Unfortunately, past experiences show that health‑care centers and the healthsystem are vulnerable to disasters. Therefore, risk analysis and safety assessment studies of hospitalsand other health‑care centers are absolutely necessary. This systematic review study was conductedon the basis of the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines.English language international databases (Pub Med, Scopus, Embase, Web of Science, and GoogleScholar) were searched through January 1, 2000 up to June 20, 2019. The quality of the studies wasassessed using the International Narrative Systematic Assessment tool. From 3630 titles identified inthis search, 24 studies were selected. The important findings of this study were grouped into five maincategories: risk analysis method, type of disaster, hospital safety methods, hospital components andkey outcomes of risk analysis, and hospital safety assessments. The nature of disasters is a threatto the lives and property of the people, and therefore hospitals must be available at the incidentsand disasters and they must be able to respond to the needs of the disaster‑affected community.The probability of an incident and its consequences can never be reduced to zero; because theseverity of many natural and even man‑made disasters is unpredictable and the probability of theiroccurrence is different; however, it is possible to identify weaknesses and strengths through riskanalysis studies as well as hospital safety assessments and implement retrofitting programs basedon the type of risks and safety status and reduce the level of risk to an acceptable level.

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Study of clinical features of patients with COVID‑19 hospitalized in an educational hospital in Iran

. Abbas Homauni; . Ladan Ghadami; . Hamed Abdollahi; . Alireza Namazi Shabestari; . Behzad Asanjarani

Volume 11, Issue 4 , May 2021, , Pages 1-5

Abstract

  BACKGROUND: The outbreak of new pathogens or the resurgence of pathogens that have alreadyspread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade ...  Read More BACKGROUND: The outbreak of new pathogens or the resurgence of pathogens that have alreadyspread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade thehuman respiratory system in the first place. Coronaviruses form a large family and are so calledbecause of the presence of crown like cristae on their surface.MATERIALS AND METHODS: This is a cross‑sectional, descriptive study conducted to assess thestatus of patients with COVID‑19 who were hospitalized in an educational hospital. For this purpose,142 patients hospitalized in this hospital were followed up 2 weeks after discharge and were inquired aboutthe symptoms they had upon admission to the hospital, the number of hospitalization days, the history ofunderlying disease, and so on. Descriptive data analysis was done with the SPSS software version 22.RESULTS: The findings of this research showed that overweight or obese people (about 66%)is more likely to contract the disease. It also seems that older people (37.3% older than 60 yearsold) and those with a history of diseases (69.6%) such as diabetes, high blood pressure, or heartdisease are more prone to COVID‑19. The most common symptoms of COVID‑19 patients includedfever (64.5%), shortness of breath (67.4%), and dry cough (50.4%).CONCLUSION: it seems that high risk group (obese people, old people, and people with a history ofdisease) is more likely to be infect with coronavirus so they should more careful than others. Anotherimportant issue is that policy‑makers must play an active role in public awareness of dangers ofCOVID‑19 and ways to prevent it.

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Determining the relationship between emotional intelligence and interpersonal sensitivity with quality of work life in nurses

. Saeed Tajigharajeh; . Mehdi Safari; . Tahere Sarboozi Hosein Abadi; . Shoaib Sarboozi Hosein Abadi; . Mehdi Kargar; . Mahmoud Panahi; . Mahdi Hasani; . Zeinab Ghaedchukamei

Volume 11, Issue 4 , May 2021, , Pages 1-9

Abstract

  BACKGROUND: Emotional intelligence and interpersonal sensitivity are known as important nursingskills. They have significant role in the promotion of nurses working life and the health ...  Read More BACKGROUND: Emotional intelligence and interpersonal sensitivity are known as important nursingskills. They have significant role in the promotion of nurses working life and the health care whichthey provide. The goal of this study was the determination of the relationship between emotionalintelligence and interpersonal sensitivity with quality of work life in nurses working in governmentalhospitals of Tehran city in 2019.MATERIALS AND METHODS: This investigation was a descriptive‑analytical and correlation studywhich was conducted among 256 nurses working in five governmental hospitals in Tehran. The studiednurses were selected through in access sampling method. The instruments of research includeddemographic, emotional intelligence, interpersonal sensitivity, and work life quality questionnaires.The analysis of data was done by descriptive and deductive statistics (t‑test and Pearson correlationcoefficient) and also SPSS.RESULTS: The conditions of emotional intelligence, interpersonal sensitivity, and work life qualityof nurses were, in turn, in average, severe, and weak levels. The correlation between emotionalintelligence and work life quality of nurses was significant (P ≤ 0.05) and they were positively correlatedwith each other (r = 0.311). The relationship between interpersonal sensitivity and work life quality ofnurses was significant (P ≤ 0.05) and they were negatively correlated with each other (r = −0.43).CONCLUSION: The development of emotional intelligence and sensitivity in reciprocally interpersonalrelations of nurses lead to fundamental changes in nurses’ attitude toward themselves, theircolleagues, patients and their profession and can promote their work life quality. Therefore, thesetwo skills are necessary for nurses and they should be taken into consideration by nursing schools,faculty members, instructors, and nursing managers

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Factors affecting emergency evacuation of Iranian hospitals in fire: A qualitative study

. Ali Sahebi; . Katayoun Jahangiri; . Ahmad Alibabaei; . Davoud Khorasani‑Zavareh

Volume 11, Issue 4 , May 2021, , Pages 1-9

Abstract

  BACKGROUND: Fire is one of the most important threatening factors for hospitals and needs specialattention. The present study was conducted to explain the factors affecting hospital ...  Read More BACKGROUND: Fire is one of the most important threatening factors for hospitals and needs specialattention. The present study was conducted to explain the factors affecting hospital emergencyevacuation following fire based on hospital administrators’ experiences.MATERIALS AND METHODS: This was a qualitative study conducted employing the content analysisapproach. Participants included 22 hospital administrators in Tehran, Lorestan, Kurdistan, and Ilamprovinces. The participants were purposefully selected and included until reaching principle of datasaturation. Data were collected through in‑depth semi‑structured interviews from November 2019to August 2020 and analyzed by the content analysis method.RESULTS: Factors affecting hospital emergency evacuation during fire were categorized into fivemain categories and 17 subcategories including response to incident (five subcategories of fire nature,emergency evacuation, service provision, coordination and communication; and collaboration andcompanionship), human factors (two subcategories of individual characteristics and competencies),hospital preparedness (three subcategories of planning, safety and security; and informationmanagement system), environmental factors (two subcategories of hospital design and infrastructure;and weather condition), and finally ethical values (five subcategories of human dignity, trust, altruism,responsibility and accountability; and empathy).CONCLUSION: The results of this study indicated that during fire in Iranian hospitals, several factorsin addition to available standard guidelines affect the emergency evacuation process that need tobe considered. Hospital emergency evacuation during fire is a complex process and necessitates afull and high‑level hospital preparedness, so using the results of this study can be used to developand practice evacuation plans and improve the hospital preparedness.

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Evaluation of social accountability in hospital managers

. Hasan Abolghasem Gorji; . Noureddin Niknam; . Zeinab Ghaedchukamei; . Abdulsamad Gharavinia; . Mehdi Safari; . Maasumeh Elahi; . Razie Rahmati; . Nezamaddin Mengelizadeh; . Nahid Aghaei; . Hamid Alaee Ghojogh; . Khosro Shakeri

Volume 11, Issue 3 , March 2021, , Pages 1-7

Abstract

  BACKGROUND: Today, hospitals need managers who, in addition to having the necessary skills formanagement and leadership, are accountable to stakeholders, especially the community. Accordingly,the ...  Read More BACKGROUND: Today, hospitals need managers who, in addition to having the necessary skills formanagement and leadership, are accountable to stakeholders, especially the community. Accordingly,the purpose of this study was to evaluate the social accountability of managers of public and privatehospitals in Tehran.MATERIALS AND METHODS: The present study is descriptive‑analytical and cross‑sectional andwas performed on 155 managers of selected public and private hospitals in Tehran. The researchtools included a demographic characteristic questionnaire and a researcher‑made social accountabilityquestionnaire for managers. Data analysis was performed using descriptive and inferential statisticsin SPSS 22 software.RESULTS: The situation of social accountability in the managers of public hospitals was at aweak level and in the managers of private hospitals in Tehran was at a good level. In comparingthe status of social accountability and its dimensions in the managers of public hospitals with themanagers of private hospitals, the status of social accountability in the dimensions of human resourcemanagement, quality improvement, executive management, and overall social accountability weresignificantly different from each other (P ≤ 0.05). However, in terms of governance, the statusof social accountability of public hospital managers was not significantly different from privatehospitals (P ≥ 0.05). Overall, the results of social accountability in private hospitals were betterthan in public hospitals.CONCLUSION: The social response status of managers in private hospitals was better than publicones. Lack of attention of managers to social accountability affects the quality of other educational,health, and medical services. This fact raises the need for managers to pay more attention to theissue of social accountability.

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Training needs assessment of intensive care nurses in Zabol University of Medical Sciences’ Hospitals

. Javad Vatani; . Shima Javadifar; . Mohammad Ali Shahabi Rabori; . Zahra Khanikosarkhizi; . Tayebeh Ilaghinezhad Bardsirii; . Ehsan Mazloumi; . Naser Dehghan; . Ali Sadeghi Moghaddam; . Alireza Khammar; . Mehdi Raei

Volume 11, Issue 3 , March 2021, , Pages 1-7

Abstract

  BACKGROUND: The improvement of the knowledge, skill, and attitude of nurses working at theintensive care unit (ICU) through implementing training need assessment and holding continuousin‑service ...  Read More BACKGROUND: The improvement of the knowledge, skill, and attitude of nurses working at theintensive care unit (ICU) through implementing training need assessment and holding continuousin‑service training courses are of main requisites for providing better health services to the community.Based on this, in the present work, we are looking for the identification and prioritization of the trainingneed of intensive care nurses in the Zabol University of Medical Sciences’ hospitals.MATERIALS AND METHODS: As a cross‑sectional, descriptive study, including two phases ofidentification and prioritization of training needs of ICU nurses, it was conducted by a close‑endedresearcher‑made questionnaire for collecting the data on training needs from the viewpoint nursingofficials, supervisors, and head nurses of the ICU wards in the first phase and a multiple‑choicescientific test plus a checklist for measuring the knowledge and skill of the nurses in the ICU in thesecond phase. In both phases, census method was used for collecting the data. The validity andreliability of data‑gathering tools, mentioned above, were tested and verified before gathering data.Data were analyzed with the descriptive statistics.RESULTS: The results indicated that ventilator setting according to arterial blood gas samplingand interpretation (77.81), cardiac monitoring, detecting dysrhythmia and taking immediateintervention (73.04), ventilator setting according to patient’s respiratory status (68.61), airwaymanagement, oxygenation and intubation (64.39), and adults cardiopulmonary resuscitation (61.77)were the high‑priority training needs of the nurses successively.CONCLUSION: To improve the quality of training programs and upgrading the knowledge, skill,and attitude of nurses working at ICU, the significance and the weight of each training titles shouldbe determined according to the standards and the continuous in‑service training plan along withnurses’ training needs and duties.

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The main factors of supplier‑induced demand in health care: A qualitative study

. Hesam Seyedin; . Mahnaz Afshari; . Parvaneh Isfahani; . Ebrahim Hasanzadeh; . Maryam Radinmanesh; . Rasoul Corani Bahador

Volume 11, Issue 2 , February 2021, , Pages 1-8

Abstract

  BACKGROUND: Induced demand is a major challenge for financing health promotion, wherebyproviders exploit patients’ information gap to manipulate their demand for health care. ...  Read More BACKGROUND: Induced demand is a major challenge for financing health promotion, wherebyproviders exploit patients’ information gap to manipulate their demand for health care. The purposeof this study was to identify the factors associated with induced demand for health‑care services inhospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018.MATERIALS AND METHODS: In this qualitative study, semi‑structured interviews were conductedwith 20 participants from IUMS hospitals, including faculty members, physicians, public hospitalmanagers, patients, and researchers with academic and practical experience. Inductive contentanalysis was used to analyze the data.RESULTS: Overall, 24 subthemes or factors were identified and classified into the health system,the insurer, health‑care provider, and health‑care recipient themes. Poor monitoring and control,the fee‑for‑service payment system, limited role of insurance companies, insufficient monitoring ofinsurance companies, the educational nature of our health centers, health‑care providers’ interests,and patients’ information gap were some important factors in induced demand for health‑care services.CONCLUSION: Our results showed that there are many factors that contribute to induced demand forhealth care. Given the four levels of factors identified in this study, health policymakers and managersmust develop strategies at each level to reduce induced demand for health care.

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Quality improvement in the surgery‑related processes: Managerial challenges and solutions from hospitals of Iran

. Tina Beyranvand; . Aidin Aryankhesal; . Asgar Aghaei Hashjin

Volume 10, Issue 11 , November 2020, , Pages 1-8

Abstract

  BACKGROUND: There is a growing global movement toward quality and safety in healthcareand quality improvement (QI) in general surgery. The first step in any QI initiative is identifying ...  Read More BACKGROUND: There is a growing global movement toward quality and safety in healthcareand quality improvement (QI) in general surgery. The first step in any QI initiative is identifying thechallenges and barriers to achieve such goals and then to define appropriate actions. This studyaims to provide an overview of the QI challenges in Iranian hospitals’ surgery‑related processes andsuggest applied solutions accordingly.METHODS: This is a sequential (qual‑quant) mixed‑method study from November 2019 to January2020, involving 21 face‑to‑face interviews with hospital managers, quality officers, and surgery‑relatedclinicians and staff, followed by a Delphi consensus‑seeking stage to finalize solutions. MAXQDAsoftware was applied for organizing the concepts, and thematic content analysis was used foranalyzing the data as an inductive approach to extract the emerging themes and sub‑themes.RESULTS: The managerial problems were classified into four groups of (I) defects and delays incompleting patient medical records, (II) irregularity and the lack of transparency in the direction ofprocesses in the hospital, (III) inappropriate and unrealistic operating scheduling, and (IV) poorsafety considerations. The proposed solutions included imposing stricter regulations for competingfor medical records, such as reduction of payments, development of guiding brochures or protocolsfor patients on their arrival, assigning a certain number of experienced nurses and surgeons forschedule management, rewarding the report of medical and surgical error cases, and developing aregular monitoring program for the proper implementation of surgical safety guidelines.CONCLUSION: There are various managerial barriers that hamper QI in hospitals’ surgery‑relatedprocesses. Implementing simple but agreed solutions can lead to saving patients’ lives, reduction ofthe unnecessary use of resources, and enhance of patient and staff satisfaction.

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The association between nurses’ moral distress and sleep quality and their influencing factor in private and public hospitals in Iran

. Zeynab Rezaei Fard; . Arman Azadi; . Yousef Veisani; . Amirreza Jamshidbeigi

Volume 10, Issue 10 , October 2020, , Pages 1-8

Abstract

  BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress thatis an underlying issue in the nursing profession, which can lead to problems such as ...  Read More BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress thatis an underlying issue in the nursing profession, which can lead to problems such as reduced qualityand quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, thisstudy aimed to explore the association between nurses’ moral distress and sleep quality and itscomparison among nurses in private and public hospitals.MATERIALS AND METHODS: This was a descriptive‑analytical study involving 150 nurses workingin Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Datawere collected through the questionnaire of sociodemographic characteristics, the Corley’s MoralDistress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS softwareversion 22. Descriptive statistics such as frequency, mean, ANOVA, independent t‑test, multiple linearregression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated.RESULTS: The analysis revealed that moral distress was positively associated with sleep quality.Furthermore, the scores of nurses’ moral distress and sleep quality were different in private andpublic hospitals, so that the level of moral distress in the public hospital and sleep quality in theprivate hospital was higher and lower, respectively, but the difference was not statistically significant.Moreover, sleep quality, and the type of employment was the most important predicting variables ofmoral stress (B = 1.86) and sleep quality (B = 2.39), respectively.CONCLUSION: According to the study results, a positive and significant association was foundbetween moral distress and nurses’ sleep quality. It is recommended that appropriate strategiesand training program be formulated by the health‑care system to increase nurses’ ability to combatmoral distress adverse effects.

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Status, role, and performance of emergency medicine specialists in Iran: A qualitative study

. Hamid Ravaghi; . Ali Nasiri; . Afsaneh Takbiri; . Samaneh Heidari

Volume 10, Issue 8 , August 2020, , Pages 1-8

Abstract

  INTRODUCTION: The performance of the emergency department (ED) as one of the main parts ofhospitals, have a great impact on the performance of the whole‑hospital. In Iran, the official ...  Read More INTRODUCTION: The performance of the emergency department (ED) as one of the main parts ofhospitals, have a great impact on the performance of the whole‑hospital. In Iran, the official educationprogram of this discipline was started in 2001 and has expanded in most medical universities. Giventhe unprecedentedness of emergency medicine (EM), there are limited studies about this specialty.Thus, this study aims to explore the status, role, and performance of Iranian EM specialists.MATERIALS AND METHODS: This qualitative study was conducted using content analysis of 19semi‑structured interviews with EM specialists and key informant. Purposive sampling was conducted,and some teaching and nonstate hospitals in different geographic regions of Tehran city were selected.Conducting interviews continued until reaching the data saturation. Thematic analysis was employed.Extracted themes were reviewed and confirmed by some of the participants.RESULTS: The study results were categorized within five main themes; included the role of EDfrom EM specialists’ viewpoint, EM specialists’ viewpoint on their discipline, performance of EMspecialists (including medical, managerial, and economic performance), and role of EM specialistsin patient satisfaction; and opportunities and challenges of EM specialists.CONCLUSION: Overall, the study findings highlighted the effectiveness and positive medical,managerial and economic impacts of EM in Iran, inside and beyond hospitals. However, thestudy addressed significant opportunities some solvable challenges in educational, professionaland economic domains, and interdisciplinary relationships. Further studies are recommended forcomprehensive exploring viewpoint of other disciplines and stakeholders.

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Emotional Intelligence and SelfEfficacy among deputy’s administrative staff of Kerman University of Medical Sciences

. Arezoo Sarani; . Seyed Hossein Mousavi; . Sahar Salahi; . Fatemeh Hasani; . Zahra Esamaeili Abdar; . Hojjat Sheikhbardsiri

Volume 10, Issue 5 , May 2020, , Pages 1-6

Abstract

  INTRODUCTION: Emotional intelligence (EI) and self‑efficacy are important factors that lead tosuccess in work, life, and education. Various studies assessed the relationship between ...  Read More INTRODUCTION: Emotional intelligence (EI) and self‑efficacy are important factors that lead tosuccess in work, life, and education. Various studies assessed the relationship between EI andwell‑being, performance, and self‑efficacy in educational levels, but this topic has been rarelyassessed in the occupational and administrative environments. The present study aimed to examinethe relationship between EI and self‑efficacy among administrative staffs of Kerman University ofMedical Sciences.METHODS: The study employed a descriptive‑correlational design and was conducted in six deputiessupervised by the Kerman University of Medical Sciences in 2019, and 275 participants were selectedusing a census method. The research data were collected using the Goleman’s EI framework with areliability coefficient of α = 0.87 and Sherer General Self‑Efficacy Scale with a reliability coefficient ofα = 0.78. Data analysis was performed through Kolmogorov–Smirnov, analysis of variance, Tukey,and Pearson’s correlation coefficient techniques at P < 0.05 significance level.RESULTS: The mean score of EI was 98.8 ± 11.1 and the mean score of self‑efficacy was 60 ± 7.17.There was a significant positive relationship between the scores of EI and self‑efficacy. In addition,the findings indicated a positive significant correlation between self‑efficacy with self‑awareness,self‑regulation, and social skills.CONCLUSION: The findings of the current study confirm that EI has positive relationships withadministrative personnel’s self‑efficacy. Therefore, implications of the findings can help in the selection,training, counseling, and retention of administrative personnel to the improvement of medical sciencesuniversities’ occupational performance.

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Identification of common indicators of hospital performance evaluation models: A scoping review

. Vahid Rasi; . Bahram Delgoshaee; . Mohammahreza Maleki

Volume 10, Issue 3 , March 2020, , Pages 1-7

Abstract

  BACKGROUND: Hospitals in developed countries allocate itself about 40% of health‑care costsand in developing countries up to 80%. In this study, researchers reviewed the related article ...  Read More BACKGROUND: Hospitals in developed countries allocate itself about 40% of health‑care costsand in developing countries up to 80%. In this study, researchers reviewed the related article in thefield of the hospitals’ performance evaluation due to the identification of common indicators usedin different models with the aim of providing simple list for evaluating hospitals’ performance to theresearchers who are interested to these issues.METHODS: The databases for the search included Medline, Google Scholar, and Scopus. A searchstrategy leads to the extraction of 403 related articles that after the removal of inappropriate andduplicate articles, 42 studies were selected for the scoping review.RESULTS: This scoping review showed that 9 of 42 selected articles use data envelopment analysismodel, 6 of them Pabon Lasso model, 3 of them balanced scorecard, 3 of them organizationalexcellence model, and the remaining articles used key performance indicators to evaluate hospitalperformance. A process approach was used to categorize the common indicators  because theliterature review indicated that common indicators mainly evaluate data, process, output, or impact ofperformance. The findings included 36 input, 39 process, 27 output, and 8 impact common indicatorsfor evaluating performance.DISCUSSION: This scoping review of related literature indicated that despite differentiation in the timeand place of past studies in the field of performance evaluation models, there are some indicatorsthat are common in most popular performance evaluation models. These simple lists can apply forevaluation of hospitals’ performance instead of complicated models.

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Financial burden imposed on the insured patients for private treatment: Evidence from a state of Iran

. Manal Etemadi; . Mohammad Shiri; . Elham Rostami; . Mohammad Mohseni; . Masumeh Seyedi

Volume 9, Issue 12 , December 2019, , Pages 1-8

Abstract

  INTRODUCTION: Protection against financial risks is one of the important goals of the healthsystem. The present study aims to determine the rate of exposure to catastrophic expenditures ...  Read More INTRODUCTION: Protection against financial risks is one of the important goals of the healthsystem. The present study aims to determine the rate of exposure to catastrophic expenditures inthe insured inpatients.METHODS: The present study was cross‑sectional one which is conducted in 2016. The statisticalpopulation comprised all the insured patients presenting to a private hospital in Qom who presentedto the hospital within 4 months from December 2015 to March 2016. Random convenience samplingmethod was used, and the sample size was estimated at 267 people using Cochran formula.A questionnaire was employed for data gathering. Data were analyzed using Chi‑square test andlogistic regression using SPSS software version 20.RESULS: Patients exposed to catastrophic expenditures of treatment accounted for the 54.8% ofthe cases. The highest rate of being exposed to the catastrophic expenditures was related to theinsured patients of the Universal Health Insurance Fund (UHIF). People with rural insurance, onaverage, paid the highest cost of treatment in the hospital. The surgical ward and critical care unitaccounted for the biggest percentage of the patients who incurred catastrophic expenditures. Beingrural, longer length of stay, lower education of the head of the household, lack of supplementaryinsurance coverage, and being in UHIF coverage have a substantial relationship with being exposedto catastrophic expenditures.DISCUSSION: The socioeconomic status of the insured people in the UHIF and the Rural InsuranceFund was worse than other funds in terms of less utilization and higher rate of exposure to catastrophicexpenditures, and this issue requires the adoption of specific targeted policies for these groups inrespect with reducing out‑of‑pocket payments through mechanism such as stepwise copayments,maximum out‑of‑pocket limit, fee exemptions or waiver and providing supplementary insurance toreduce the exposure to catastrophic expenditures.

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The effect of education and implementation of “National Hospital Disaster Preparedness Plan” on an Iranian hospital preparedness: An interventional study

. Mehdi Beyramijam; . Seyedeh Moloud Rasouli‑Ghahfarokhi; . Abazar Fathollahzadeh; . Aziz Rahimzadeh; . Mohammad Ali Shahabirabori; . Mohsen Aminizadeh

Volume 9, Issue 11 , November 2019, , Pages 1-5

Abstract

  INTRODUCTION: Hospitals as the first place for injuries have to keep up and increase activities inemergency and disasters. Therefore, any hospital necessarily requires disasters plan ...  Read More INTRODUCTION: Hospitals as the first place for injuries have to keep up and increase activities inemergency and disasters. Therefore, any hospital necessarily requires disasters plan to improve itspreparedness. The aim of this study is to investigate the effect of education and implementation of“National Hospital Disaster Preparedness Plan (NHDPP)” on  Vali Asr Hospital preparedness in Iran.METHODOLOGY: In a pre‑ and post‑intervention study, NHDPP educated in five sessions, and itwas used as a guide in the promotion of Vali Asr Hospital preparedness in Iran. The Iranian versionof “Hospital Disaster Preparedness (HDP) assessment tool” was used to measure the hospitalpreparedness score. Finally, the quantitative data analyzed by using IBM SPSS Statistics for Windows,Version 22.0. Armonk, NY: IBM Corp.RESULTS: Before intervention, the HDP score was measured in total and in the nine dimensionsof preparedness. But after the intervention, it increased, 33% in command and control dimension,33% in communication, 21% in safety and security, 26% in triage, 36% in surge capacity, 24% in thecontinuity of vital services, 27% in human resources, 13% in support and supplies management, and7% in post disaster recovery dimension. Furthermore, the total HDP score increased about 24.5%after the intervention.CONCLUSION: This study demonstrates that the “Iranian HDP plan” leads to improve the ValiAsr HDP score. Therefore, by planning and implementation of effective educational programs, it ispossible to improve the hospitals’ preparedness in Iran.

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Cost analysis based on performance indicators during Healthcare Reform Plan in selected educational hospitals

. Pouran Raeissi; . Farbod Ebadi Fard Azar; . Aziz Rezapour; . Mohammad Afrouzi; . Saeed Sheikh Gholami; . Noureddin Niknam

Volume 9, Issue 10 , October 2019, , Pages 1-10

Abstract

  INTRODUCTION: Hospitals are the main axis of health‑care reforms or national health plans;therefore, accurate recognition of hospital costs based on operational indexes to these plans ...  Read More INTRODUCTION: Hospitals are the main axis of health‑care reforms or national health plans;therefore, accurate recognition of hospital costs based on operational indexes to these plans isnecessary. The impact of implementing national health plans on the performance of health systemsis ambiguous and misleading; therefore, the aim of this study was to assess the impact of HealthcareReform Plan (HRP) on the micro level (e.g., educational or university hospitals).METHODS: This study was a descriptive retrospective study that research variables are checkedin 1 year before and mean of 3 years after implementation of HRP by self‑administrated checklist inselected public‑educational hospitals covered by the medical universities in Tehran. The final analysisof the data was performed using cost–performance ratio and independent t‑test for comparing thevariables’ changes before and after HRP.RESULTS: Unlike adjusted hospitalization costs, most operational indexes were not significant.The per capita cost adjusted of hospitalization in first and mean of 3 years after HRP increased49.49% and 16.31%, respectively (P < 0.001), the adjusted cost per day was increased by 24.48%and 21.46% (P < 0.001), and adjusted cost per bed was increased 47.06% and 20.07% comparedto before HRP (P < 0.001).CONCLUSION: Given the lack of alignment in adjusted cost changes in exchange for functionalindicators, certainly, it cannot be argued that HRP had a favorable or undesirable effect on thehospitals.

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Causes of conflict between clinical and administrative staff in hospitals

. Mohammad Panahi Tosanloo; . Davoud Adham; . Batoul Ahmadi; . Abbas Rahimi Foroshani; . Abolghasem Pourreza

Volume 9, Issue 10 , October 2019, , Pages 1-6

Abstract

  BACKGROUND: Providing the high‑quality services in hospitals depends on to minimize conflictbetween all members within a health team. This study aimed to identify the causes of conflictsexperienced ...  Read More BACKGROUND: Providing the high‑quality services in hospitals depends on to minimize conflictbetween all members within a health team. This study aimed to identify the causes of conflictsexperienced by clinical and administrative staff in hospitals.METHODS: A cross‑sectional study was carried out in 2018. The sample included 320 clinicaland administrative staff from six hospitals affiliated to Ardabil University of Medical Sciences thatwere selected using two‑step clustering sampling method. Data collection was accomplished byself‑administered questionnaires. Descriptive statistics, t‑test, and ANOVA were used for dataanalysis.RESULTS: Total conflict score revealed that clinical staff had higher levels of perceived conflict thanadministrative staff. In terms of organizational position, the study results showed a significant differencein the reported conflict between nurse groups and other groups (physicians and paramedical,administrative, financial, and logistic staff). The most important causes of conflict in the viewpoint ofclinical staff were organizational and job characteristics (3.54 ± 1.28), poor management (3.51 ± 1.12),and inefficient communication system (3.42 ± 1.33). For administrative staff, on the other hand,poor management (3.18 ± 1.33), inefficient communication system (3.17 ± 1.36), and attitudes andperceptions (3.06 ± 1.41) were shown to be paramount factors.CONCLUSION: Clinical and administrative staff of hospitals are like parts of a train track. Theirrational relationship between them will result in distortion and lower quality of services. Therefore,effective strategies to decrease staffs’ experience of conflict need to be developed. This might createa healthier and more productive work environment which positively affects the care quality.

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Health promotion perception among health‑care providers working in educational hospitals of Isfahan, Iran: A Qualitative study

. Atefeh Afshari; . Leila Ahmadi Ghahnaviyeh; . Mehdi Khezeli; . Seyede Shahrbanoo Daniali

Volume 9, Issue 7 , July 2019, , Pages 1-6

Abstract

  BACKGROUND: Although the World Health Organization has emphasized the need for reorientationof hospitals toward health promotion (HP), HP in hospitals of Iran is a new concept. This ...  Read More BACKGROUND: Although the World Health Organization has emphasized the need for reorientationof hospitals toward health promotion (HP), HP in hospitals of Iran is a new concept. This studyinvestigated the concept of HP among health‑care professionals working in educational hospitalsof Isfahan, Iran, 2015.METHODS: A descriptive exploratory qualitative approach was employed in this study, withsemi‑structured interviews to investigate HP concept. The study settings included four selectededucational hospitals affiliated to the Isfahan University of Medical Sciences. A purposive sampleconsisted of 15 health‑care professionals who were participated in the study.RESULTS: Most of the participants perceived HP as a concept synonymous to health education anddisease prevention. Other meaning attributes to HP were improved quality of life and well‑being,clinical practice, individual and group approach to increase health, and holistic view to health. Someempowerment strategies were described by participants, but most of the participants rarely wentbeyond traditional health education strategy aimed at an individual target. A sizeable number ofparticipants used interchangeably the terms “health promotion” with “prevention,” “health education,”and “hygiene”.CONCLUSIONS: It seems that participants of this study had limited knowledge about HP. Health‑carestaff have a decisive role for reorienting hospitals toward HP; thus, there is a need for ongoingin‑service training for health‑care professionals of hospitals to focus on HP.

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