نشریه مدیریت ارتقای سلامت
سال پنجم شماره 4 (پیاپی 20، امرداد و شهریور 1395)

The Multi-State Model can be used to determine the natural trend of disease progress. The aim of this study was to use Multi-State Model in analyzing breast cancer data.
In this descriptive-longitudinal study, data of 573 women with breast cancer were studied. Sample patients referred to Esfahan Sayed o Shohada Hospital between 1999 and 2006 and were followed up until April 2015. Data was analyzed using R 3.2.2 software.
The mean and standard deviation of women age was 47.2±10.8 years. The transition probability from first treatment state to recuperate state was 25%. The transition hazard ratio from first treatment state to recuperate state in a 5 year period time was 9. The sojourn time was 3.85 years for the first treatment, 1.11 years for recuperate, and 0.04 years for the death.
Based on transition probabilities and also survival mean in each state, the physicians could suggest the most suitable supportive care and treatment for patients especially during the first state of treatment.

Sex conversion in Iran, similar to any other countries around the world raises some socio-medical problems. In most countries, the process of sex change in gender studies has been less explored. This study aims to determine the correlation of social support and sexual function of men with gender identity disorder after sex reassignment surgery in Tehran, Iran.
‪ In this descriptive-correlation study, 85 transgendered men that admitted to Mirdamad Day Clinic in Tehran were selected through convenience sampling. Data was collected by demographic questionnaires, and “Female Sexual Function”. Multidimensional Scale of Perceived Social Support" Validity and reliability were assessed by 10 experts and data was analyzed using SPSS version 17.‬‬‬ ‪
The overall prevalence of sexual dysfunction was 84%. The highest frequency was related to scope of pain (77%) and the scope of orgasms (53%). Further, 51.8% of the patients had lower social support. The mean of family support had the highest value (53.3%) among scopes.‬‬‬
This study showed that gender identity disorders had low social support and sexual functionality after surgery. Therefore, patients should be advised of the possible sexual dysfunction consequences before the surgeries.

The nursing profession is mainly based on the quality of care. Different approaches to provide nursing care in nursing management can affect the quality of service. This study aimed to compare the effect of “Primary Nursing” and “Case Method” on patient's quality of physical care.
This study is quasi-experimental study that was performed in two Critical Care Units (CCU) of the Ghaem Hospital and two CCU of Imam Reza Hospital in Mashhad. 59 patients (33 patients in the “Primary Nursing” group and 26 patients in the “Case Method” group) were studied. Data was collected using “Quality of Patient Care” (QUALPAC). The content and face validity was confirmed by 10 members of the Faculty of Nursing and Midwifery in Mashhad University. Furthermore, the reliability was achieved by Cronbach's alpha. In this study, both “Primary Nursing” and “Case Method” approaches were implemented in CCU and their impacts on patients’ quality of care was evaluated. Data were analyzed using SPSS/16.
The mean of patient quality of physical care in “Primary Nursing” group (5.2 ± 44.4) was significantly higher than the one in the “Case Method” (6.5 ± 29.8) (P The patient quality of physical care in the division of labor "Primary Nursing" is higher than "Case Method". Therefore, the "Primary Nursing" is recommended.

Knowledge management is an important concept and it clarifies how individual and organizational understandings convert to knowledge. The aim of this study was to determine the correlation between organizational creativity and knowledge management of nurses at hospitals in Borujerd city in Iran.
This study was a descriptive-correlational study consists of all nurses working at Borujerd hospitals. 175 nurses based on inclusion criteria and convenience sampling method was participated. To collect data three questionnaires include demographic, “Rand-sip’s Creativity Questionnaire” and “Hemmati Knowledge Management Questionnaires” were used. In this study, reliability was calculated for two questionnaires by Cronbach's alpha method. Data was analyzed using SPSS/19.
Average score of organizational creativity and knowledge management among nurses were 50.92±13 and 52.65±3.32 respectively. Results show, a significant positive correlation between organizational creativity and knowledge management of nurses (P

Coronary artery disease is major problem that has high incidence and prevalence rate. One of the most important issue in coronary artery patients is quality of their lives. The aim of this study was to determine the factors affecting the quality of patients’ lives with coronary artery disease using fuzzy regression.
In this descriptive study, 70 patients with coronary artery disease who referred to Dr Shariati Hospital (Tehran-Iran), were selected by convenience sampling. Data was used from previous studies that investigated the effect of “Continuous Care Model" as an intervention method on patients. Data has been collected by “Short Form Health Survey 36” (SF-36). Validity and reliability has also been confirmed. Data has been analyzed by MATLAB/7.
In the control group, the effect of age, body mass index, and blood lipids had an increasing trend with the quality of patients’ life. While, the blood pressure and the level anxiety have decreasing trend with the quality of patients’ life. In the case group, the age has increasing trend with quality of life of patients, whereas the mass body index, blood lipid, and level of anxiety have declining trend.
In this study, the age variable had a similar relation in both groups. Furthermore, "Continuous Care Model" led to decreasing trend in the blood lipid variable. Due to limited number of samples and variables related to human desires in clinical studies, it is recommended to use fuzzy regression.

The effect of cognitive-emotional factors of personality on identification and treatment of psychiatric disorders is important. The aim of present study was to compare cognitive and emotional dimensions of individuals’ with psychiatric disorders with those of normal individuals.
This descriptive-comparative study was carried out in 2013. Participants consists of 90 individuals afflicted with psychiatric disorders (addicted, depressed, anxious patients) referred to Rahvar counseling center in Northen Khorasan province and a control group with 30 normal individuals that were selected by convenience sampling. Data was collected by “Temperament and Character Inventory” (TCI-56). The content validity and also reliability is previously confirmed using Cronbach’s alpha. Data were analyzed by SPSS/18.
There were no significant differences in self-directedness dimension between groups. In self-transcendence dimension and cooperation, the mean score of individuals in all three groups were significantly lower than the normal group. There was significant difference between addicted, anxious and normal groups in perseverance dimension. In novelty-seeking dimension, the mean score of the addicted group compared to depress and anxious group was higher. Moreover, the score of harm-avoidance of anxious group was significantly higher than the one on in the addicted and normal group. In dimension of reward-dependence, the mean score of addicted group was significantly lower than the normal group (P There were significant differences in the cognitive-emotional dimensions of personality among addicted, depressed, anxious, and normal individuals. It is recommended to evaluate the role of cognitive-emotional dimensions of psychiatric disorders patients. Measuring each sub scale can serve as a valuable tool for clinicians as it enables identification of the psychiatric disorders patients’ personality profile

Cerebral palsy is one of the most common chronic motion disability in children that can have a negative impact on the general health of mothers. This study is aimed to determine the effect of education "Self-Management 5-A's Program" on the general health of mothers of children with cerebral palsy.
This quasi-experimental study was conducted between 2015 and 2016. In total, 47 mothers of children between age of 4 and 12 years with cerebral palsy in Kurdistan province were selected using census-sampling method. After intervention stage the final sample was reduced to 23 mothers in intervention group and 16 in the control group. Data was collected by the demographic questionnaire of mothers and children and the “Short Form 36 Health Survey” (with confirmed validity and reliability). Questionnaires were completed by mothers before and after learning the "Self-Management 5-A's program". Data were analyzed using SPSS/22.
The mean of mothers’ age in this study was 33.5 and the average age of children was 6.2 years. At the pre-intervention stage the mean of general health of mothers in intervention group was 27.60 and the control group was 26.25. No significant differences were identified between two groups (P = 0.804). However, after intervention the mean of general health of mothers did not change in control group. This value in intervention group was 38.26 which was significant (P=0.009).
The general health of mothers of children with cerebral palsy is weak. While, educating mothers with the "Self-Management 5-A's program" can facilitate and enhance their health, it is suggested to consider and align education programs based on the mother’s needs.

Cancer is one of type of chronic diseases. Hope therapy can increase the resilient and life expectancy of cancer patients. The aim of this research is to determine the effectiveness of group based hope- therapy on increasing resilience and hope in life expectancy of patients with breast cancer in Zanjan City.
The present study was quasi-experimental with pre-test - post-test and control group. In total, 30 women that were diagnosed with breast cancer in 2016 in city of Zanjan were randomly selected. Data was collected by demographic questionnaire, “Conner-Davidson Resilience Scale’ and “Schneider‘s Life Expectancy Questionnaire”. The validity and reliability of these instruments had been confirmed. Group hope therapy was conducted in 8 sessions (90 min per session) over one month. Questionnaires were completed in the first and last session. Data was analyzed by SPSS/20.
Analysis show that, the hope therapy by group therapy method increases the resilience (P> 0.001) and life expectancy of breast cancer patients (P>0.001).
While the hope therapy can enhance life expectancy and resilience of cancer patients and their quality of lives, this type of therapy is recommended.