نشریه مدیریت ارتقای سلامت
سال دوم شماره 3 (پیاپی 7، تابستان 1392)

Workplace violence is one of the issues that nurses face in clinical practice, which needs to be studied. One of the most eventful clinical environments is a psychiatric ward. The aim of this study was to determine workplace violence status, vulnerable and preventive factors among nurses working in psychiatric wards. In this study, 183 nurses were selected from psychiatric wards in Razi Psychiatric Center in Tehran, by simple random sampling. Data gathered with "International Workplace Violence Questionnaire". The questionnaire contains 4 subscales, physical, mental, sexual and rational violence and three open ended questions. Content and face validity were measured by opinion of experts and reliability was confirmed by test-retest (r=0.73).Data analyzed with descriptive statistics methods by SPSS/18. Prevalence of workplace violence was 71% in one year period. Physical and psychological violence, respectively, with a frequency of 4.93% and 6.71%, respectively racial and sexual violence, respectively, with a frequency of 1.19%, and 5.5% lower than subjects who had suffered violence. Majority of samples’ reaction (39.9%) was to calm the aggressive person. Furthermore, most of them (61.2%) supposed that providing educational course of violence control and 59.6% thought that providing a management system to report control is necessary. Psychiatric nurses permanently exposed to a variety of physical and verbal violence. Providing function for prevention is suggested.

To achieve the most suitable treatment, triage is essential for the first clinical evaluation and classifying all patients referring to the emergency department. Accurate and rapid triage of patients is the key to a successful performance of emergency departments. This study aimed to determine prevalence of miss triage and outcomes under triage of patients in emergency department. In this descriptive study, a total of 300 files were randomly selected among patients referred to the emergency department of the hospitals that are educationally related to the Shahid Beheshti University of Medical Sciences where "Emergency Severity Index" (ESI) was actively implemented. Data was collected by demographics information and triage form based on triage algorithm "Emergency Severity Index". To determine the validity, face validity and reliability of the ESI was measured by inter-rater observation (0.85). Data were analyzed by SPSS/17. The under triage of 23.7% and over triage of 11.7% were assessed in the research. The largest amount of under triage was at the ESI level 3. Dying risk of under triage (with 95%) was 3.2 times higher than accurate triage and over triage. In addition, there was no meaningful statistical difference for the average period of hospitalization (P=0.77), duration of hospitalization at the emergency department (P=0.50) and waiting time for the initial examination (P=0.39) by the emergency physician in triage group comparing the under triage group. Findings showed that the degree of miss triage is higher than the acceptable threshold and doing an accurate triage or along with miss triage doesn’t have any impacts on the timing indicators.

One of the nursing challenges is nurse's motivation and job satisfaction. Applying motivational theories by nurse managers might be an effective strategy. The aim of this study was to determine the effect of using designed program based on “Expectancy Theory” by head nurses on nurse's job satisfaction. This study was a quasi-experimental study that was done in two hospitals in Zanjan providence. Data were gathered by "Nurse's Job Satisfaction Questionnaire". In this study, internal consistency reliability (Cronbach's alpha) of the questionnaire was measured (α=0.9). Method of sampling was census and nurses were selected in the case group(n=20) and nurses in the control group (n 19). They were matched in two groups. The applied program was based on “Expectancy Theory” that implemented in case group for 6 months. Data were analysed by Mann-Whitney, Wilcoxon Chi-Square and SPSS/16 used. The nurses in two groups were matched (P>0.05). Job satisfaction before and after in two groups did not different significantly, it showed by using Wilcoxon test (P>0.05). But findings showed that nurse's job satisfaction in case group increased 7%. The program based on “Expectancy Motivational Theory” had clearly implementation steps for applying this theory that it would be practical guide for nurse managers. Use of this theory for improving nurse's job satisfaction is suggested.

At present, the organization for success, have no choice except to formulate appropriate strategies with human resources; otherwise today's complex environment and incompatibility of the strategies will lead to inefficient use of human resources. The aim of this study was to determine the correlation of human resource strategies based on Allen Ylsy Model with organizational performance in Aiat Allah Kashani hospital staff. This study is a descriptive-correlation study that was performed on 247 personnel’s of Aiat Allah Kashani hospital in Shahrekord. Stratified samples were randomly selected and collected demographic and researcher’s made “Staff Function Questionnaire on Allen Yelsy Model” in two components for assessing the Allen Ylsy Model and personnel performance were used in 43 questions. Content and face validity of this questionnaire were confirmed through 7 specialists. Reliability was obtained by using Cronbach's alpha 0.92. Data were also analyzed by descriptive statistics and inferential statistical test using SPSS/18. The results showed that there is a significant solidarity between human resource strategy and organizational performance (P<0.05). The most important strategies that had correlation with organizational performance included, personnel relations (33.3%), strategy (14.2%) and performance management strategies (2%). However, strategies to attract, hire and compensate predictive, had not significant correlation with personnel performance. Due to impact of human resource strategies on the performance evaluation has been studied more than the average, it is suggested that management should focus on strategies to improve organizational performance benefits they are entitled to. In this regards, providing HR position in Kashani Hospital is recommended.

Nurses are important resources in a community health system. Therefore, attention to mental health to this group seems to be essential. The aim of this research was to determine the effect of cognitive- behavior religious training on hopelessness, worthlessness and dissatisfaction on nurses’ life. This study was quasi-experimental, in which 66 employed nurses in the Shahid Hashemi Nejad Hospital in Mashhad were selected and divided into two groups of experimental and control. The intervention was formed of 10 sessions of 90 minute long. Sessions were held three days a week for the experimental group. The instrument for collecting data was "Identity Crisis Questionnaire". Content validity was measured by 12 experts and reliability was determined by Cronbach's alpha (α=0.93). The questionnaires were completed before and after a month of intervention. The data was analyzed by SPSS/18 and use of descriptive and analytical statistics includes paired and independent and covariance. Overall mean scores of hopelessness, worthlessness and dissatisfaction on nurses’ life was 44.12 ± 11.76 before intervention and 33.47 ± 14.18 one month after change of intervention (P<0.001). While control group did not have any significant change, but overall mean scores of one month before and after had a significant change (P<0.06). Cognitive- behavior religious training is inexpensive, effective, essential and safe method to help mental health of nurses. It is recommended to enhance mental health of nurses and improve the quality of care, from this type of training is used.

Job stress is an interaction between working conditions and the individual characteristics of the employee. The aim of this study was to compare job stress and related factors of welfare organization employees with and without physical disability in Tehran. In this descriptive-comparative study, the statistical population included all employees of welfare centers in Tehran. The type of sampling method was convenience and the cases included all the 53 employees affected by physical disabilities and the control group included 61 people with similar characteristics and job positions, without disabilities. In order to measure the job stress severity and its influencing factors, the “Occupational Stress Scale” prepared for Health and Safety Executive (HSE) and “Factors Influencing Job Stress” questionnaire were used respectively. In this study reliability was measured by Cronbach's alpha which for “Occupational Stress Scale” and was 0.73 and “Factors Influencing Job Stress” had reliability of 0.80. The collected data were analyzed by SPSS-16 software using statistical tests K2 and independent t-test. No significant differences were found in demographic characteristics between the two groups. The job stress in employees with physical disabilities was significantly different with the employees without (P<0.05), with higher stress in the physically disabled (mean=113.7 and standard deviation=11.3) compared to non-disabled (mean=97.2 and standard deviation=11.2) (P<0.001). The importance of factors influencing job stress was also higher in the employees with disability (mean=119.2 and standard deviation=13.2) compared to non- disabled (mean=105.2 and standard deviation=12.5) (P<0.001). Job stress of employees with physical disabilities is more than the employees without physical disability and also the factors influencing the stress are different. Paying more attention to the programs designed to promote the skills of job stress management and also decreasing and/or eliminating factors related to job stress of employees with disabilities are recommended.

Treatment of diseases is largely depended on the interaction between doctor and patient, and the result of cooperation with clinicians is rapid and successful treatment. Moreover, the relationship is one of the critical factors of the patients` satisfaction, especially next reference of patients. This study is aimed to determine the correlation between knowledge and satisfaction of patients from patient- physician relationship at the hospital affiliated to Tabriz University of Medical Sciences.

This study has been done in descriptive-correlational method on 309 people who referred to 11 teaching hospitals and medical which covered by Tabriz University of Medical Sciences. Data was gathered through three questionnaires of "Knowledge of Physician-Patient Relationship", "Satisfaction of Physician-Patient Relationship" and "Physician-Patient Relationship". Validity of the questionnaires was approved by 3 experts and the reliability by calculating Cronbach's alpha (α=0.87, α=0.87, α=0.79). Data analysis was performed by SPSS/16 and using the Pearson correlation coefficient, t-test and ANOVA.

The mean score of knowledge and satisfaction of patients from physician-patient relationship was respectively, 2.09 ± 10.5 and 6.58 ± 34.08. Also, the average scores of correlation between physician and patient were 6.04 ± 35.86, respectively. Significant correlation was observed between satisfaction levels of physician - patient relationship (P<0.01). On the other hand, there wasn`t a significant correlation between knowledge of physician- patient relationship and physician- patient relationship.

The results of this study showed that patient’ knowledge and satisfaction of physician–patients` relationship in Tabriz hospitals were high. It is recommended that a system to be designed to assess the relationship between physician and patient correctly until it give important information.

Puberty and sex education always is one of concerning issues in child training, as many of parents are not easy in discussing it with their children. Traditionally, mothers have the main responsibility of child health training are and care health decisions. The aim of this study was to explain the mother's experiences with sex and puberty informal education for their own children.

This qualitative study, conducted in 2012 over 24 mothers with 6-18 year old children. The sampling method was purposeful with maximum variation. To evaluate reliability and dependability, the credibility, transferability and conformability were used. The data was gathered by individual semi-structured interactive interviews, recorded, transcribed and was analyzed according to Morse' content analysis method.

One of the analyzed data was "motherhood tasks and girls preparation for the puberty". Sub-themes were "menstrual hygiene training", "respect for religious issues", "gender roles" and "hidden training of sex issues. The last category consists of two sub-themes. "In preparation for the role of gender" and "vulnerability of the opposite sex".

Formal adult education in the nation's health care system is essential. Despite the cultural changes puberty on Iran, the dominant secular culture of family and community, the puberty are discreet and quiet.