نشریه مدیریت ارتقای سلامت
سال هفتم شماره 4 (پیاپی 32، امرداد و شهریور 1397)

  Global attention to health has led governments in developed and developing countries to adopt strategies to improve their health systems. Iran has also begun a healthcare reform in recent years. The purpose of this study is to explain the experiences of nurses with the implementation of the Health System Development Plan. This research was of qualitative and phenomenological method and its sampling was done purposefully. The participants were 15 nurses working in the hospitals implementing the Health System Development Plan in Tehran province. The data were collected through semi-structured interviews and analyzed according to the Colizii method. The participants' experiences, which included 13 women and 2 men between the ages of 24 and 61, appeared in 29 sub-themes and 6 themes. The topics were: shortage of human resources, challenge with payments, shortage of facilities, need for job support, health care service and workload. Nurses have note to the various aspects of human resource shortages, increased workload and burden, lack of satisfaction with payments and financial issues, occupational safety and security status. It is suggested that nurses' experiences be used to improve their satisfaction and quality of care

Hospitals with high performance and optimal use of resources are among the ultimate goals of healthcare policy makers. The current study aimed at assessing the efficiency of hospitals affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, using data envelopment analysis and Tobit regression in 2017.

In the current descriptive study, the statistical population included all hospitals affiliated to Hamedan University of Medical Sciences (n = 15). The required information and statistics were collected from the Deputy of Treatment at the university in two stages using the standard checklist provided by the Iranian Ministry of Health and Medical Education. The efficiency of data envelopment analysis was assessed in the first stage. The input variables of data envelopment analysis included the number of staff (physicians, paramedics, etc.) and the number of active beds, and the output variables included the number of patients (outpatients and admissions) and the number of surgeries and occupied beds. In the second stage, efficiency as a dependent variable, and hospital size and population were considered as independent variables in Tobit regression. Deep2.1 software was used to estimate the data envelopment analysis and Stata 15 software was used for Tobit regression.

The average technical efficiency of the hospitals was 0.933. The average management efficiency was 0.951, and the average efficiency of the scale was 977.0. Of the total hospitals surveyed, six hospitals had a capacity of < 1, and nine hospitals have an efficiency of 1. Also, hospital size and population size were significant as an environmental variable in Tobit regression.

In hospitals with < 1 efficiency there is a surplus in the number of input variables. It is recommended that the hospitals shift toward maximum efficacy by optimizing the number of staff and active beds

In order to be aware of the success rate, especially in complex and dynamic environments, organizations are in urgent need for assessment. The current study aimed as identifying and prioritizing the performance assessment indicators of physical education institutions at medical sciences universities using balanced scorecard approach and analytical hierarchy process. The current descriptive study was conducted on 120 managers, experts, and professors of physical education departments at Iranian medical sciences universities selected by census method. Data collection instruments included balance scorecard approach and analytical hierarchy process questionnaires. The reliability of the balanced scorecard approach questionnaire was determined by Cronbach's alpha method and the analytical hierarchy process analysis questionnaire, by calculating the inconsistency rate. The collected data were analyzed with SPSS version 20, LISREL 8.8, and Expert choice software. According to the results, six sub-criteria for financial, seven for customer, four for internal process, and four for growth and learning criteria were determined. The results of the hierarchical analysis process showed that among the four criteria of balanced scorecard approach, financial, customer, internal processes, growth and learning criteria were ranked first to fourth respectively, in terms of priority. The criteria and sub-criteria identified based on the balanced scorecard approach and hierarchical analysis process methods can be used to assess the performance of physical education departments in the Iranian medical sciences universities. Therefore, this model is suggested to managers and experts of physical education to assess the performance of organizations

In a competitive world, the provision of customer orientation health services is so importance. One of the important areas of the health system of the countries is the provision of optimal services for pregnant women. Therefore, the aim of present study is exploring of customer orientation in pregnant mothers' health services from the perspective of stakeholders. This study is a qualitative type of phenomenology (phenomenology). The method of collecting data was a semi-structured interview that was conducted in order to understand the midwives, doctors and pregnant mothers and their companions from a client in the health services of pregnant mothers. The method of collecting data was a semi-structured interview that was conducted in order to understand the midwives, doctors and pregnant mothers and their companions from a client in the health services of pregnant mothers. A total of 57 interviews were conducted and 10 doctors, 10 midwives, 7 nurses, 15 patients and 15 patients were contributed. The sampling method was Purposive sampling. In this study, interviews continued until the acquisition of rich concepts and the non-extraction of new data. The consumer-oriented for pregnant mothers’ health services has the main categories of access and acceptability, dignity, acceptance of responsibility, support. Subcategories include physical and financial access, cultural and social accountability, privacy and respect and independence, good communication and quality and standard care, legal care, commitment and accountability, and understanding needs, and raising awareness and support for the mother as well as protection safety and supply and continuity of care and, ultimately, follow up and coordination. The consumer-oriented for pregnant mothers’ health services involves care that is based on the availability, acceptability and observance of the pregnant mothers, along with the acceptance of the responsibility and support of the client. It is suggested that mothers' health planners consider the above concepts to design and formulate policies and plan maternity care services.

Today, bulimia nervosa is one of the common psychological disorders that disturb cognition, emotions, and behaviors of the affected people. The current study aimed at determining the efficacy of acceptance and commitment therapy in cognitive emotion regulation and body image concerns in females with bulimia nervosa. The current semi-experimental study with pretest-posttest design and control group was conducted on 160 females with bulimia nervosa referring to counseling centers in Mashhad, Iran. The sample consisted of 30 females with bulimia nervosa selected by purposeful sampling method and randomly assigned to either the experimental or control group. The research instruments were the Garnefski cognitive emotion regulation questionnaire and the Littleton body image concern inventory. Reliability of the instruments were measured by Cronbach's alpha. The acceptance and commitment therapy package was performed in eight 90-minute sessions for the experimental group. Data was analyzed with SPSS version 22. Negative emotion control strategies, positive emotion regulation strategies, and worries about body image before intervention in the experimental group were 50.07, 32.33, and 81.53, and in the control group were 49.60, 33.40, and 81.20, respectively with no significant difference between the groups. However, after the intervention, the negative emotion regulation strategies, positive emotion regulation strategies, and concern of body image in the intervention group were 28.47, 56.0, and 69.13 and in the control group were 49.53, 33.40 and 83.4, respectively, which showed a significant difference between the groups (P ≤ 0.01). The acceptance and commitment therapy can reduce negative strategies and increases the positive strategies of emotional cognitive regulation. The findings also showed that concern about the body image is reduced by intervention. Therefore, it is recommended to use this therapeutic approach to improve bulimia nervosa and emotion regulation in such individuals

By increasing the shift and its effects on health, identifying factors that can contribute to reducing shifting problems is essential. The purpose of the present study is to determine the correlation between sport activity, nutritional patterns and drug abuse with the health consequences of shifting in nurses. In this descriptive-correlational study, the statistical population consisted of all nurses (455 people) employed in educational hospitals in Bojnourd. In this study, 228 subjects were selected using randomized stratified sampling method. A “Survey of Shift Workers Questionnaire” and “Life Style Questionnaires” were used to collect data. Reliability and validity of these questionnaires have been measured in previous studies. Data analysis was performed using SPSS 22. Correlation coefficient between sport activity and shifting health outcomes (r = -0.463, P < 0.0001) and correlation coefficient between nutritional patterns and shifting health outcomes (r = -0.183, (P < 0.005) were negative and significant. Also, the correlation coefficient between drug abuse and shifting health outcomes was positive and not significant. (r = 0.116, P = 0.80). Regression analysis showed that only sport activity can predict the shifting health outcomes in nurses (R2 = 0.214, P < 0.0001). Sport activity and nutrition patterns have a negative and significant correlation with shifting health outcomes in nurses. Furthermore, the role of predictive shifting health outcomes effects was also confirmed by sport activity. Therefore, it is recommended to provide conditions for conducting sport activity courses in order to reduce the nurses' shifting health outcomes

The style of leadership and employee interest in their work in hospitals are effective in achieving organizational goals. The aim of this study is to determine the correlation between servant leadership style and job passion with organizational effectiveness in hospitals affiliated to Zahedan University of Medical Sciences. This research is a descriptive-correlational study. Using Morgan's table of 250 people, 148 managers of hospitals affiliated to Zahedan University of Medical Sciences were selected by simple random sampling method. To collect data, three questionnaires "Servant Leadership Style", “Schaufeli et al Job Enthusiasm”, “Parsons Organizational Effectiveness Questionnaire”. Validity of questionnaires were confirmed by content validity and reliability by Cronbach's alpha method. Data analysis was performed with SPSS 19.. There is a positive and significant correlation between servant leadership style and job enthusiasm (r = 0.763. P < 0.000). There is a positive and significant correlation between job enthusiasm and organizational effectiveness (r = 0.617. P < 0.000). In addition, there is a positive and significant correlation between servant leadership and organizational effectiveness (r= 0. 700, P < 0.000). Applying leadership style in hospitals will increase job enthusiasm and facilitate hospitalization. It is suggested that hospital managers, by implementing the style of service leader, promote the enthusiasm and willingness to work in the organization and facilitate and expedite the achievement of the goals of community health

"Health Assistant Plan" is one of the health system designs whose effectiveness has been less considered.The aim of this study is to determine the correlation between social accountability and quality of service delivery in "Health Assistant Plan" of Imam Hossein Medical Education Center, Tehran.

In this descriptive-correlational study, 384 patients referred to Imam Hossein Medical Education Center of Tehran participated by convenience sampling method. Data were collected using “Health Assistant Plan Evaluation Questionnaire” which developed in this study. Validity of the questionnaire was confirmed by content, face and construct validity through factor analysis. The reliability of the questionnaire was confirmed by internal consistency and Cronbach alpha. Data was analyzed by SPSS. 16.

There was a significant and positive correlation between social accountability and the quality of service delivery (r = 0.562, P = 0.001). The mean scores for the dimensions of human of dignity, autonomy, quality of facilities, access to support, communication clarity and behavioral aspects were less than average. The mean scores dimensions of privacy and confidentiality, the choice of therapist, equipment and physical facilities, environmental health, access and care were more than average.

There was a correlation between social accountability and the quality of services delivery at Imam Hossein Hospital. It is suggested that health planners and health officials consider the two main principles of social accountability and quality of service delivery.