نشریه مدیریت ارتقای سلامت
سال ششم شماره 5 (پیاپی 27، مهر و آبان 1396)

Efficiency and effectiveness of hospital beds are crucial aspects in hospitals. This study aims to compare the performance index of selected hospital with the national standards.
In this descriptive-comparative study, several performance indexes of selected hospital is compared with the available standard. The instrument to collect data is “Form No. 201 of New Health Information System” which the validity and reliability is confirmed through Cronbach's alpha coefficient. The data is collected through census method between “2013 – 2015” and is analyzed by SPSS.19.
The finding show that indexes of ratio of beds to fixed (80%), rate of admissions per bed (24%) and bed turnover interval (2 days>) are desirable.
The hospital performance indexes are desirable, but there is a need for promotion and improvements. Therefore, it is necessary that managers take the necessary proceedings to increase the efficiency, effectiveness and productivity of the hospital.

Female infertility is a problem that affects almost every aspect of women's lives. Infertile women usually experience stress, anxiety and depression. This study aimed to compare the effect of Iranian Positive Therapy and Acceptance -Commitment Therapy (ACT) on depression, anxiety, and stress of infertile women in Isfahan City.
In this quasi-experimental study with a pretest-posttest design and three-month follow-up, 45 infertile women referred to the Isfahan Fertility and Infertility Center were selected by the purposeful sampling and randomly assigned to three groups of Iranian Positive Therapy, acceptance and commitment therapy and control in 2016. Data were collected using the Depression, Anxiety and Stress Scale-DASS- 42. The validity and reliability of this questionnaire were confirmed in the previous study. In the present study, reliability was measured by the Cronbach's alpha. Data were analyzed by the SPSS 18 Software.
There was a significant difference in stress, anxiety and depression in the post-test and follow-up between the experimental (Iranian positive therapy and acceptance and commitment therapy) and control groups (P 0.05).
Both of the therapeutic methods are equally effective in reducing anxiety, stress and depression in infertile women. Therefore, it can be recommended that these therapies be performed to reduce psychological problems in infertile women.

The decisions in the process of evaluation and selection of suppliers should be made by examining all possible options, otherwise the organization will face many problems at the implementation stage. The aim of this study was to determine the important factors in the evaluation of hospital equipment and services providers of Imam Hossein Hospital in Zanjan.
The method of this study was descriptive. The data of this study was related to the equipment purchases of Imam Hossein Hospital in Zanjan. Data was collected based on the opinion 5 experts, who had at least a bachelor's degree and at least 5 years of work experience in the hospital by “Assessment Equipment Suppliers Form”. Data was analyzed and ranked using the MATLAB 2014 software.
A total of 15 cases of matrix that matched the initial decision matrix were identified and were generated separately for each method.TOPSIS-GA = 3 and TOPSIS-PSO = 8 and AHP-GA = 1 and AHP-PSO = 3.
The results indicated the possibility of substituting the price benchmark for timely delivery, and delivery deadlines and after-sales services are shown. Due to liquidity problems, Imam Hossein Hospital could offer to the supplier alternative 6 that with a slight increase in price against increased delivery speed and a longer payment deadline and increased after-sales service, it would be the hospital's top choice for supply of its equipment needs.

Autism spectrum disorder (ASD) imposes a lot of difficulties and calamities on parents particularly mothers due to close relationship with their children. The present study aimed to examine the effect of transdiagnostic treatment on entrapment and boredom of mothers of children with ASD.
This randomized clinical trial study was conducted on all mothers with ASD children in Isfahan City. Forty participants were initially selected using the convenience sampling method and were randomly divided into two equal groups of control and experimental (n= 20, each group). The transdiagnostic treatment was conducted during 12 sessions of 60 minutes each.
Data were collected using the Entrapment Scale and Multidimensional State Boredom Scale. The validity and reliability were measured and confirmed in the previous studies. Data were analyzed by the SPSS 21 software.
Results showed a significant difference in internal entrapment (P = 0.001), external entrapment (P = 0.004), disengagement (P = 0.005), high arousal (P = 0.001), low arousal (P = 0.004), inattention (P = 0.010) and time perception (P = 0.022) between the two experimental and control groups in both pre-test and post-test.
It seems that the unified transdiagnostic treatment is an appropriate method for reducing psychological problems (such as entrapment and boredom) in mothers with ASD children. Therefore, it is suggested to use this approach with other treatments in educational and treatment centers.

Controlling diabetes is important to reduce its complications and prevent the disability. The aim of this study was to determine the HbA1c level in patients with type 2 diabetes in the first three years of care and its related factors.
In this descriptive-longitudinal study, 214 patients with type 2 diabetes referred to the health centers of Golestan University of Medical Sciences and under the “National Plan for the Prevention and Care of Diabetic Patients” were assessed during2013-2016. Random cluster sampling was performed to select the patients. The information including sex, age, history of hypertension and smoking as well as the amount of HbA1c associated with the blood test at the time of entry into the plan and at the first three years, once a year (4 repetitions in total), was collected from the patient records. The data were analyzed using the repeated measures ANOVA method by the statistical software R 3.3.2.
The mean HbA1c reduced in three years. The results showed that four factors including age, history of hypertension, history of smoking, and BMI had a significant relation with HbA1c (P The amount of HbA1c has been controlled during the implementation of “the National Plan for the Prevention and Care of Diabetic Patients”. Regarding the related factors, it is recommended to consider the importance of controlling blood pressure, and weight and to stop or reduce smoking in the patients.

Heart failure as a chronic disease is a growing problem in communities. Social support and illness perception are two important factors in the self-care of patients. The aim of this study was to determine the correlation between social support and self-care in patients with heart failure by the mediating role of illness perception.
In this descriptive-correlational study, 149 heart failure patients in Tabriz, Iran, were selected using the convenience sampling method in 2016. To collect the data, a demographic questionnaire, the European Heart Failure Self-Care Behavior Scale, Brief illness Perception Questionnaire, and Social Support Scale were used. The validity and reliability had been measured in the previous study. Data were analyzed by the SPSS. 21 and Sobel test.
There was a significant correlation between social support and self-care (r = -0.518, P Illness perception can be considered as a mediator and also a bridge between social support and self-care. It is suggested that nurses, health psychologists and doctors to consider these variables in primary priorities of self-care education.

Controlling inappropriate use of health services is one of the ways to limit health care costs without sacrificing services’ quality. The aim of this study was to evaluate unnecessary admissions and hospital stays and to estimate its financial burden in selected hospitals of Alborz University of Medical Sciences.
In this descriptive study, 310 patients admitted to the internal wards of two hospitals were selected using the quotas sampling from July to September 2014. The data collection tool was the Appropriateness Evaluation Protocol questionnaire that its validity and reliability were confirmed. Data analysis was performed using the SPSS 18 software.
The results showed that 8.5% of admissions and 9.9% of hospital stays were unnecessary, and 20.3% of the patients had at least one unnecessary hospitalization day. The most important reasons for the unnecessary stay were waiting for the results of clinical diagnostic tests and delays in timely visits of the physicians. The amount of financial burden due to unnecessary hospitalization during three months of study was 125,928,000 Rials, as well as the financial burden arising from the absence of work for patients due to unnecessary stay was equal to 24,241,600 Rials.
Part of hospital resources is wasted due to unnecessary admissions and stays. Increasing non-hospital care facilities to reduce referrals to higher-level centers, refinement of incomplete care’s processes through quality improvement practices, and the establishment of physician-resident plans in hospitals are recommended for reducing unnecessary admissions and hospital stays.

The ability to communicate effectively with patients is considered as one of the most important characteristics of nurses. The aim of this study was to determine facilitators and barriers of communication between the nursing student and patient during 2000-2015.
In this systematic review, full text of articles related to nurse -patient communication were retrieved from English and Persian databases (PubMed, Embase, ScienceDirect, ProQuest, Magiran, SID and Medlib). Using the "Nursing Students", "Patients" and "Communication” search strings and their equivalent in Persian language, the titles of articles were searched. In addition, the data extraction form which was developed according to the study’s objectives was used to collect data. From the 38 related papers that were identified, 26 articles were excluded because they were not in line with the inclusion criteria. Nine additional studies relevant to the research were directly added through manual search. In total, 21 English and Persian papers were identified and considered in this review.
Seventeen of 21 articles (80.96%) were descriptive studies, of which four (19.04%) were qualitative studies. Six of 17 descriptive articles (35.29%) were from intervention studies. Twelve of the papers (57.14%) were conducted in Iran and nine (42.86%) were investigated in other countries. The results showed that improving the nursing students’ theoretical knowledge and clinical experience of communication, giving feedback, listening, empathy and assertiveness skills, and cultural and social characteristics of the wards were facilitators or inhibitors of the communication between the nursing students and patients.
Based on the findings, individual, educational and environmental factors may act as facilitators or inhibitors of the communication between nursing student and patient. As such, it is suggested that nursing educators teach students about these factors and consider them in practice.