نشریه مدیریت ارتقای سلامت
سال هفتم شماره 3 (پیاپی 31، خرداد و تیر 1397)

Addiction is a psychosocial illness that affects individual’s psychological and physiological dependence. One of the most important issues in this regard is the patient's problems and relapse of substance use. The current study aimed at determining the problems of people discharged from addiction treatment centers and factors associated with relapse of substance use in East Azerbaijan Province, Iran.
The current qualitative and quantitative (descriptive-analytical) study was conducted on the statistical population of addicts and their families, managers, and specialists of welfare addiction centers in East Azerbaijan Province. After interviewing 30 participants, selected by purposeful sampling, and reaching data saturation, a questionnaire was developed. The statistical population of the quantitative section was people discharged from addiction treatment centers in East Azerbaijan Province, and the study samples were selected using cluster sampling method from three addiction treatment centers; hence, 260 people who had at least one time experience of relapse of substance use were selected. An author-made questionnaire was developed based on the research question as the problems of people discharged from addiction treatment centers. Content validity index and reliability of the author-made questionnaire were examined using internal consistency (Cronbach's alpha). Data were analyzed with SPSS version 21.
In order of preferences, psychological and physical problems (mean rank = 12.87), lack of influential beliefs (11.49), lack of trust and social acceptance (10.74), weakness in tolerance and overcoming temptation (9.76), unemployment and poor socioeconomic status (9.20) were the five main problems of the studied people (X2 = 2489.9, P Personal problems, poor socioeconomic status, and family problems were reported as an important factors playing a significant role in the relapse of substance use. Therefore, multi-dimensional planning is recommended to authorities to prevent the relapse of substance use.

Comparison of mental health is necessary for human growth and prosperity, and in consequent, the growth of society. Therefore, paying attention to individual’s mental health is necessary as a part of health care. The current study aimed at comparing the management of mental health services in Iran and selected countries.
The present descriptive-comparative study was performed in five countries that met the inclusion criteria in three stages. In the first stage, a review study was conducted to analyze the current status of mental health services in Iran and the world. Secondly, South Korea, Philippines, Egypt, and Brazil were compared with Iran. In the third stage, mental health services in the selected countries and Iran was evaluated by the assessment instrument for mental health system. This instrument measures six domains of mental health services management. Content validity and reliability of the instrument were already measured based on internal consistency in previous studies. In order to collect the data, a researcher-made short-form, summarizing the above-mentioned instrument and information about mental health management in the selected countries was used. The short-form had 33 items in six domains of mental health services management. After reviewing the data, the results for each country were analyzed.
In the domain one, most countries had clear mental health policies, but the policies were different among them; although Iran and Philippines had no specific regulations in mental health. In the domain two, there was an inappropriate distribution of psychiatric beds and specialists in all the countries, although there were some differences in terms of mental health centers, the number of centers, and type of provided services among the countries. In the domain three, there was a difference among the countries regarding the protocols and prescribing drugs. In the domain four, there was an inappropriate distribution of human resources in all the countries, although the staff number, type of staff, and expertise were different among them. In the domain five, the association of patients and families varied across the countries. In the domain six, there was a difference in the information gathering system and the number of mental health researches among the countries.
Comparison of the selected countries and Iran showed differences in the management of mental health services. In Iran, there is no specific rules for the management of mental health services; also, there is no system to collect data and control the disease, and even the made policies are not implemented properly. Also, although Iran has desirable human and inhuman resources in comparison with the selected countries, it has no proper management and planning. Therefore, the establishment of rules and regulations as well as a system for the management of mental health services in Iran is suggested.

Diabetes mellitus is one of the most common metabolic disorders in the world. It has many risk factors, and the prediction of these factors is important to prevent it. The current study aimed at determining the factors associated with the incidence of type 2 diabetes using the Bayesian regression model of spike and slab.
In the current descriptive study, data from 819 participants in the diabetes screening program at Zahedan Health Centers, Iran in 2014 were analyzed. The convenience sampling method wasused. The demographic information was collected from patient's records, including gender, age, history of blood pressure,ect., and fasting blood glucose level. For prediction and variable selection, the Bayesian regression model of spike and slab was used, then validity of the model was assessed by mutual validation method. Data analysis was performed with R software version 3.3.2.
The family history of diabetes and age were significantly correlted with diabetes in the subjects;the family history of diabetes with a 100% reliability coefficient was the most effective variable.
The Bayesian regression model has a good ability to dignose diabetes; while recognizing less effective variables, the predicting ability of the model was also maintained. Given the factors associated with the incidence of diabetes, the implementation of screening plans with priority given to the elderly and those with a family history of diabetes is suggested to control the outbreak of diabetes.

The prison environment for young prisoners can be accompanied by different changes. The current study aimed at comparing spiritual health, psychological well-being, and high-risk behaviors among young prisoners sentenced for drug, financial, and theft offences in Zanjan, Iran.
The current descriptive-comparative study was conducted on the statistical population comprised of all prisoners within the age range of 18 to 35 years sentenced for theft, drug, and financial offences in Zanjan. Their number was 340. The sample size was calculated using the Cochran formula as 163 subjects. The subjects were selected by simple random sampling method and classified into three groups. The data collection instruments were high-risk behaviors, psychological well-being, and spiritual well-being questionnaires. The content validity and reliability of the questionnaires were assessed by Cronbach alpha. Data analysis was performed with SPSS version 24.
There was a significant difference in the religious indices among the studied groups, in such an extent that the average religious indices in the drug and theft groups were higher than those of the financial group (P Religious indices and high-risk behaviors were different in different individuals depending on the type of offences. Therefore, it is recommended to pay more attention to this issue in medical treatments and psychological counseling.

Quality of services is the main criterion for the success of an organization, and work ethics is recognized as one of the main factors influencing the development of organizations. The current study aimed at determining the correlation of work ethics with service quality gap in rehabilitation centers of Welfare Organization of Isfahan, Iran.
In the current descriptive-correlational study, 150 staff of rehabilitation centers of Welfare Organization of Isfahan selected by census sampling method as well as 170 clients selected by convenience sampling method were enrolled. Staff data were collected by the work ethics inventory and client’s data by the service quality gap questionnaire. The validity of the instruments was confirmed in both previous and the present studies; reliability of the instruments was assessed with Cronbach's alpha. Data were analyzed with SPSS version 16.
The work ethics among the staff of the rehabilitation centers was 207 (above average). There was a gap in all aspects of service quality. The highest average gap was attributed to tangibles (-9.65), followed by reliability (-7.86), responsiveness (-6.40), empathy (-5.56), and assurance (-4.70).
The work ethics of rehabilitation centers staff of Welfare Organization of Isfahan is desirable, although the expectations of the clients are not met. The authorities hereby are recommended to improve the quality of services provided to clients.

Mother's health is very important for the child's development. If the child has certain conditions, the health of the mother can be affected. The current study aimed at comparing the general health status between the mothers of educable children with intellectual disabilities and mothers of normal children in Birjand city, Iran.
The present descriptive-comparative study was conducted on all mothers of the educable children with intellectual disabilities as well as the mothers of normal children. The sample population included 76 mothers of children with intellectual disabilities and 100 mothers of normal children. Mothers of children with intellectual disabilities were selected using the purposive sampling method and mothers of normal children were selected by multi-stage cluster sampling method. To collect data, the general health questionnaire was used. Data were analyzed with SPSS version 19.
There was no significant difference in the general health status between mothers of children with intellectual disabilities and mothers of normal children (P 0.05).
Mothers of children with intellectual disabilities are not different from the mothers of normal children in terms of the general health status. It is suggested to implement training courses in order to develop adaptation and raise more attention to the general health aspects of mothers of children with intellectual disabilities.

Improving the psychological characteristics of the staff of the Welfare Office, who experience high levels of tension, is very important. The purpose of this study was to determine the effect of acceptance and commitment training on cognitive flexibility and self-compassion of the employees of the welfare office of the city of Varamin.
This quasi-experimental study had a pre-test and post-test design with experimental and control groups. The statistical population consisted of all employees of the Welfare Office of Varamin during year 2016. Of these, 30 volunteers entered the study and were randomly assigned to two equal groups. The experimental group received eight sessions of 90 minutes with the acceptance and commitment method. Both groups completed the "Dennis & VanderWal's Cognitive Flexibility Inventory" and "Neff's Self-Compassion Scale" in the pre-test and post-test phases. Reliability for both instruments was measured by Cronbach's alpha method. Data was analyzed using the SPSS version 19 software.
There was a significant difference in cognitive flexibility and self-compassion variables in the post-test stage between the experimental and control groups. In other words, acceptance and commitment training significantly increased the cognitive flexibility (F = 49.040, P Acceptance and commitment training increased cognitive flexibility and self-compassion among employees of the Welfare Office of the city of Varamin. Therefore, the use of this educational method is recommended to improve cognitive flexibility and compassion.

Identifying the perceptions and expectations of receivers of health services is the first step in the codification of quality improvement programs. The aim of this study is assessment of the quality of services provided to the patients with cataract using importance–performance analysis method.
The present study is descriptive. The statistical population of the two groups is selected. The first group included 10 ophthalmologists and 10 researcher in the area of health services management and the second group of 396 patients, obtained through the Cochrane formula. The components of service quality were obtained from various articles and during the meetings with 20 specialists for designing “Service Quality Questionnaire” with 32 questions in the 5-point Likert scale. According to the questionnaire, the “Questionnaire in Quality of Service According to Patient's Viewpoint” was developed. Reliability of this questionnaire was calculated by Cronbach's alpha. Data were collected from patients. Data analysis was performed using SPSS.16 and EXCEL software was used.
The geometric mean of the responses of patients with cataract in the "accessibility" component in terms of the performance of the hospital was 2.697, which indicates the high performance of the hospital in this component, as well as a score of 3.28 indicates the importance of this component for the people. Based on importance–performance analysis method, the component "Understanding and Recognizing Patients" with a weight of 0.074 in the first quarter meant significant importance for patients but lower hospital performance.
For patients, the "understanding and recognizing patients" component of the needs of patients with cataract is very important. Therefore, it is suggested that professional behavior training courses be conducted for hospital and hospital staff in order to assess the needs of patients in relation to health services.