mohammad parvaresh-masoud

The concept of afiyah in Islamic thought represents a comprehensive understanding of well-being that extends beyond conventional health definitions. However, its theoretical foundations and practical implications remain underexplored in healthcare literature. This study aims to analyze the concept of afiyah within Shia Islamic contexts using Walker and Avant's systematic approach to concept analysis.

A comprehensive analysis was conducted using Walker and Avant's eight-step framework. Data were collected from the Quran, authentic Shia Hadith collections, scholarly commentaries, and academic databases. The search encompassed multiple languages (Arabic, Persian, English) and was validated by Islamic scholars.

The analysis revealed afiyah as a multidimensional concept encompassing physical, spiritual, and divine aspects of well-being. Four defining attributes emerged: comprehensiveness (kafiyah), divine origin, transformative nature, and holistic integration. The concept uniquely positions well-being as a divine gift that persists independent of physical health status.

This analysis provides a theoretical foundation for understanding Islamic perspectives on well-being, with implications for culturally sensitive healthcare delivery and nursing practice.

Emergency medical technicians (EMTs) face complex ethical dilemmas in their frontline role, involving resource constraints, time pressure, patient autonomy, and competing obligations. This qualitative study explored the experiences of EMTs, their decision-making processes, and the potential areas for enhancing ethical practices in emergency medicine, aiming to inform targeted policies and training programs that support EMTs and improve care quality. A total of 17 EMTs from Qom province participated in this study and in-depth interviews were conducted to gather rich and detailed insights into their experiences. The interviews were transcribed and analyzed using Graneheim and Lundman’s conventional content analysis to identify common themes and patterns related to ethical challenges. The findings identified five main categories of ethical challenges faced by EMTs including ethical dilemmas, professional conduct, communication and consent, ethical training and support, and organizational challenges. Within these categories, specific subcategories emerged, including decision-making challenges, conflict of interest, resource allocation, end-of-life care, dual relationships, emotional boundaries, privacy and confidentiality, breaking bad news, language barriers, and informed consent. Each subcategory shed light on the unique ethical challenges faced by EMTs. This study highlighted the complex ethical landscape in which EMTs operate and provided valuable insights into the challenges they face. The findings underscored the need for comprehensive ethical training, support mechanisms, improved communication strategies, and an organizational culture that promotes ethical conduct. It is essential to address these challenges to enhance the ethical practices and decision-making skills of EMTs, ultimately leading to improved patient care and outcomes.

Effective educational strategies are crucial for developing moral sensitivity in nursing students. Traditional lecture-based methods may lack engagement, prompting the exploration of game-based approaches. This study compares the impacts of game-based and lecture-based teaching on nursing students' moral sensitivity.In this quasi-experimental study, 46 fourth-semester nursing students from Rafsanjan University of Medical Sciences participated. The control group received traditional lectures, while the intervention group engaged in game-based learning focused on moral scenarios in eight 90-minute sessions.Of the initial 46 students, 42 completed the study. Both groups had similar demographics. Post-intervention, the game-based group showed a statistically significant increase in total moral sensitivity scores (P = 0.017). Additionally, they scored higher in “experience of ethical problems and conflicts” (P = 0.044) and in “sincerity and benevolence” (P = 0.007) compared to the lecture group. It was concluded that game-based teaching methods significantly enhance moral sensitivity among nursing students compared to traditional lectures, particularly in areas related to ethical conflicts and benevolence. Future research should focus on the long-term effects and integration of game-based learning in nursing education.

Vital signs and level of consciousness are one of the most important components of patient examination in traffic accidents. Vital signs show a suitable measure of the initial condition of the patient and also the effect of the interventions. In this study, to evaluate the effects of the type of helicopter emergency medical service (HEMS) or ground emergency medical service (GEMS) ambulance transport, the changes in initial vital signs and arriving at the hospital in traffic accident patients were compared.

The data collected in this retrospective analytical descriptive study as a census included the type of transfer, age, gender, distance from the scene to the hospital, duration of the mission, mechanism of injury, patient’s condition and vital signs, and level of consciousness. The propensity score matching was used to control confounding factors. The analysis of the outcomes of systolic blood pressure, heart rate, respiratory rate, and level of consciousness of patients when they arrived at the hospital was done with a generalized linear model. Before and after the matching of HEMS and GEMS patients, vital signs, level of consciousness, and other initial variables were compared with the t-test and the chi-square test.

Initial vital signs before matching showed that HEMS patients had lower systolic blood pressure and consciousness in addition to higher respiratory and heart rates (P<0.05). After matching, no significant difference was observed in primary vital signs (P<0.05). After interventions and transfer, no significant difference was observed in vital signs arriving at the hospital in HEMS and GEMS (P<0.05).

After matching, HEMS and GEMS patients did not have significant differences in the level of consciousness and initial vital signs when they arrived at the hospital. There should be more accuracy in the triage and selection of patients who need to be transported by HEMS.

Conflicts arise when a person or group perceives that another person or group opposes their interests, beliefs, and values. Although conflict usually carries a negative sense, it may be productive for nurses, their colleagues, or patients in clinical settings.

This study aims to determine the prevalence of workplace conflict and the coping strategies used by nurses working in teaching hospitals in Qom City, Iran.

This is a descriptive-analytical study with a cross-sectional design. Study participants comprised 373 nurses in teaching hospitals affiliated with Qom University of Medical Sciences. They were selected using simple random sampling. Data collection tools were a demographic form, DuBrin workplace conflict questionnaire, and Putnam and Wilson’s organizational communication conflict instrument (OCCI). The obtained data were analyzed by descriptive statistics, the chi-square test, Fisher’s exact test, and a one-way analysis of variance (ANOVA) and multivariate linear regression model.

Most participants were female (63.8%) with a bachelor’s degree (88.3%). Their mean age was 34.78±5.96 years. The mean score of workplace conflicts was 10.04±3.93 and the mean score of the control strategy was significantly higher in nurses with a high level of workplace conflict (24.90±3.75). The multivariate regression results revealed that age, sex, marital status, educational level, type of employment, department of service, work experience, and three conflict resolution strategies could predict 32% of workplace conflict (adjusted R2=0.32, P=0.001).

Workplace conflict among nurses of hospitals in Qom is high. They mostly use the solution-orientated strategy followed by non-confrontation and control strategies.

Prehospital emergency care plays a vital role in the healthcare system and can significantly affect the outcomes of patients. Integrating medical science education into Emergency Medical Technicians (EMTs) training programs could improve prehospital emergency care and patient outcomes.

The present study was conducted to explore the perspectives of Iranian EMTs on integrating medical science education in prehospital emergency care.

This study was a qualitative descriptive design in Iran. Using the purposive sampling method, data were collected through in-depth individual interviews with 13 EMTs who had completed EMT training programs in Iran. Thematic analysis, a form of qualitative content analysis, was used to identify key challenges and barriers to integrating medical science education, as well as potential benefits and opportunities.

After multiple rounds of analyzing and summarizing the data and considering similarities and differences, 2 main categories and 6 subcategories were created based on the results of the data analysis, including: "inadequate training" and "lack of ongoing training and professional development opportunities".

The study highlights the importance of stakeholder collaboration and communication to develop effective EMT training programs. Integrating medical science education in EMT training programs could improve the quality of prehospital emergency care and, ultimately, the health outcomes of patients.

The main task of the emergency medical system is to provide primary care and transfer the patients to hospital. Studies have been conducted to investigate the outcome of air and ground ambulance patients, but they show different results. These different results may be due to the type of study, statistical methods, differences in prehospital emergency systems, and insufficient control of confounding variables. Thus, it is difficult to compare and generalize the results. This study aimed to investigate the outcomes of injured people transported by air and ground ambulance in road traffic accidents in Qom Province, Iran, during 2015-2019.

In this retrospective analytical descriptive study, we used the numerical method and examined all road traffic accident patients transferred through ground or air to Qom Shahid Beheshti Hospital by the prehospital emergency from 2015 to 2019. The collected information included the type of transfer, age, sex, type of trauma, distance from the accident site to the hospital, initial vital signs, duration of the mission, and day of the accident. To control the confounding factors, we used propensity score matching. Outcomes studied included length of hospital stay, length of stay in the intensive care unit, duration of mechanical ventilation, and the need for immediate surgery. Logistic regression was used to analyze the need for immediate surgery and a generalized linear model for other consequences.

After matching, the number of patients in each group transferred by ground ambulances and helicopter was 566. Trauma to the head (P=0.028) and back (P=0.002) were more common in helicopter-transported patients. The patients transported by helicopter had a longer time to reach the scene (7.70 ±5.18 min) (P<0.001), a shorter duration of presence on the scene (12.17±8.33 min) (P=0.041), and a shorter duration of transfer (13.12±4.75 min) (P<0.001) than the ground ambulance. There was no significant difference between the patients who transferred by ground and helicopter ambulance regarding the length of hospital stay in the intensive care unit (P=0.718), mechanical ventilation (P=0.507), and hospitalization (P=0.089). The need for immediate surgery in helicopter-transported patients was 84.8% higher than ground ambulance patients (95%CI: 0.086-0.267; P<0.001).

The patients transported by helicopter were not significantly different from ground ambulances transported patients regarding staying in the intensive care unit, mechanical ventilation, and hospitalization, but they more needed immediate surgery. If the patients are triaged adequately according to the type of injury and the level of consciousness at the scene and transferred to the appropriate hospital by ground or air, they can enjoy the benefits of the type of transfer.

In the turbulent and stressful work environment of prehospital emergencies, the conflict among emergency medical technicians (EMT) and other health‑care providers is inevitable. This study aims to examine the concept of workplace interpersonal conflict (WIC) in prehospital emergencies.

The eight‐step Walker and Avant’s concept analysis approach was adopted to define the concept. Iranmedex, SID, Magiran, ISC, PubMed, Scopus, Embase, and Web of Science searched with keywords such as WIC and hospital emergencies. After an extensive review of online national and international databases, one dictionary, nine books, and 25 articles in English and Persian were retrieved for the purposes of the study.

The antecedents, attributes, and consequences of the concept identified. EMT must learn how to eliminate their destructive effects while enhancing constructive effects.

Conflict is an inevitable part of life, and EMT must learn how to reduce their destructive effects while increasing constructive results

Arterial blood gas interpretation is necessary to train nurses in intensive care units. The need to use modern educational methods to improve the knowledge of nurses with long-term durability is considered important. Regarding the importance of using technology in nursing education and the necessity of interpretation of arterial blood gas testing, this study was conducted to investigate the effect of arterial blood gas interpretation training on mobile phones on the knowledge of intensive care unit nurses.

This quasi-experimental study were performed on 114 critical care units nurses of three teaching hospital affiliated to Qom University of Medical Sciences.The hospitals were randomized in three groups (application smartphone, lecture) and controls were allocated. Lecture group content and application smartphone packages was the same content. In the educational application group on mobile phones, educational content was designed as software in the Android environment. The app was installed on the mobile phones of nurses working in the intensive care unit, and they were asked to use it during the day. In the lecture group, the same content was presented in person in two sessions. The control group did not have any special training in this field during this period. The study tool was a questionnaire that included demographic data and researcher-made scale on the interpretation of blood gases. The questionnaires were completed before and 4 weeks after the training in groups. Data were analyzed by using SPSS software 21 and descriptive and inferential statistical tests.

The mean age of the samples was 28.91 ± 2. 12 and 1.66 ± 0.89 years of professional experience in intensive care unit. In two groups, after the intervention, the score obtained from the blood gas interpretation test was increased The difference between the mean test scores of the educational application group in mobile phone (77.46) and lecture (73.79) compared to the control group (54.57) was statistically significant (p <0.001). In other words, using application smartphone had significantly more effect on nurseschr learning. In other words, using application smartphone had significantly more effect on nurseschr  learning.

Considering the results of this study indicating the positive effect of application smartphone learning on nurseschr knowledge, Therefore, it is recommended as an alternative method or use other training supplements for teaching special cases such as blood gases interpretation in nursing.

The rate of patients’ admission to the emergency department is not planned exactly. Due to the bad condition of the patients, the triage management is also very momentous. Therefore, up-to-date training has a particular importance for nurses.

37 emergency nurses were selected by census method through quasi-experimental study. Data collection tools were four questionnaires of demographic characteristics, triage attitude assessment, triage accuracy and triage knowledge which determined the total staff performance. They were completed by them once before the training, one month after training and three ninety-minute training sessions. Data were analyzed by Wilcoxon, Man Whitney U, t-test and SPSS version 20.

59.5% of them were females, 51.4% were married, 94.6% did not have a bachelorchr(chr('39')39chr('39'))s degree, 64.9% had not rotating shifts and 62.2% had not the experience of participating in training programs about accidents and disasters. The mean score of nurses’ knowledge increased from97± 3.59before the intervention to 17.46 ± 3.22 after the intervention, also, the mean score of nurses’ accuracy ranged from 15.16 ± 5.86 to 20.89 ± 4.25; finally, the mean of attitude score ranged from 125.8 ± 15.9 to135.4± 14 (P <0.0001). The most impact of interactive learning was related to triage attitude with the mean score of  9.62. There was also a significant association of the knowledge improvement indicator with the last degree (P = 0.04) and the association of the knowledge improvement indicator with gender (P = 0.05).

Emergency nurses had better knowledge, accuracy and attitude than before interactive training programs. Significant increase in knowledge and attitude scores could indicate an increase in nurseschr(chr('39')39chr('39')) readiness and vigilance to perform better triage at emergency departments. The impact of interactive training on nurses’ attitudes on disasters triage can enhance emotional performance and create deeper cognitive learning which has everlasting effects on nurses’ performance; the emergency staff can have better performance through triage of accidents and disasters.

Team-based learning is a kind of participatory and new learning. The aim of this study was to evaluate the impact of teaching by team-based learning on learning and the academic motivation of emergency medical students in the triage course.

 Materials & Methods:

 This semi-experimental study was conducted as a census in the second semester of 2017-2016 on associate students of medical emergencies in part of the content of the two-unit course of medical emergencies in disasters, which is related to triage in children and adults. To measure the amount of learning before and after the implementation of this method and also to measure the amount of memory before the beginning of the method, after the end of it and about six months later, the test was held and the scores were compared. The Harter Academic Motivation Questionnaire was also used to assess academic motivation before and after the course. To analyze the data, SPSS software version 19 was used with descriptive and analytical indicators such as pair-t-test at a significance level of less than 0.05.

 In this study, the mean scores of external motivation and students' motivation increased significantly compared to the before implementation of team-based learning methods(P value=0.03), and the scores of internal motivation increased compared to the previous one(P value=0.05). Comparison of the mean of the scientific score obtained from the triage course also showed that the average score of the students after the implementation of the team-based learning method was significantly higher than before implementation of team based learning (P value=0.01).

The results of this study showed that the use of TBL teaching method has increased the motivation and improved the learning of medical emergency students. Therefore, the use of this method is recommended in teaching students.

Improving lifestyle, increasing lifespan and life expectancy have led to the phenomenon of aging in societies. The increasing population of older adults is one of the most important economic, social, and health challenges in the current century.

This study was conducted to measure the mental health of older adults in Qom City and its relationship with socioeconomic factors.

This is a cross-sectional descriptive-analytical study on 400 older adults over 60 years in the urban areas of Qom in 2018. A multi-stage sampling method was used for this study. The research tools were a demographic questionnaire, the Kessler Psychological Distress scale (K6), and a standard psychological well-being scale. Data were analyzed by Stata 12 software using the t-test. The significance level was considered less than 0.05.

Considering the mental health status, based on the K6, 55% of the elderly showed signs of low depression anxiety, 34% moderate, and 11% showed severe anxiety symptoms. Regarding the status of well-being, 49.50% were in good condition (11.3 ± 3.3), 27.75% were in moderate condition (13.8 ± 2.9), and 22.75% were in poor condition (7.3 ± 2.6). Anxiety and depression had significant relationships with gender, having an illness, marital status, having a caregiver, and income.

The results showed that about half of the elderly in Qom had moderate anxiety and depression disorders, as well as moderate mental well-being, which indicates the moderate level of anxiety and mental disorders in the elderly in Qom.

Pre-hospital emergency is usually the first phase of treatment. The most serious emergency cases before any action in health care unit is to know what services are the cause of satisfaction or dissatisfaction of the patients with the overall emergency care. The aim of this study was to evaluate the satisfaction of recipients of pre-hospital emergency care in Qom City.

In this descriptive study 400 patients who transported to the hospitals by Qom EMS were selected by using simple random sampling. Data were collected by using of satisfaction questionnaire. The data gathered through telephone interviews. Data were collected by using a demographic questionnaire and a Consumer Emergency Care Satisfaction Scale (CECSS) and then analyzed by SPSS v. 16 software using descriptive and Chi-square tests.

The results showed that the satisfaction rate from emergency ambulances and the efficiency of the emergency staff was moderate, and the satisfaction from technicians, the rate of acting professionally, performance of technicians, and the general opinion of patients were high. Also, the highest level of satisfaction (70%) belonged to technicians and the least satisfaction (26%) belonged to ambulance.

Although the satisfaction rate of Qom pre-hospital emergency staff related to the performance of ambulance was low due to some shortcomings and deficiencies;however the overall rate of satisfaction from pre-hospital emergency care in Qom City was at a good and acceptable level.

The most common complaint of heart patients is pain and chest discomfort. The delay in transmitting patients from the onset of symptoms to reaching a treatment center is one of the most important reasons for the deaths of these patients. There is a direct relationship between the early services provided by the pre-hospital emergency room with positive therapeutic outcomes and the reduction of mortality. By using telephony triangulation protocol, delayed call center experts dispatch ambulances to patients at higher risk and job misconduct. The purpose of this study was to investigate the outcome of telephony triage in patients with complaint of pain and chest discomfort in the first half of 1996 in the Qom province of Qom according to the modified protocol of New Jersey. In this descriptive-analytical study, 550 callers with 115 emergency services in the first half of 1396 were selected through a random sampling method, with a complaint of pain and chest discomfort. Data were collected using valid and reliable checklist The data were analyzed using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (Chi-square and independent tests). from 550 registered cases, 202 people were transferred to the hospital by ambulance and 347 were not sent by ambulance, and 347 of them were contacted by 196 people, and the result of the absence of ambulance was questioned. Ultimately, experts from the Qom Emergency Center in Triage suggested patients with chest pain complained of in accordance with the New Jersey protocol in the 68/39% correct and 36/31% wrong.
According to lateral findings, there was no significant relationship between sex and work shift with triage method, but there was a significant relationship between age and contact history with triage modthod. Experts at the Qom Emergency Center using the New Jersey Protocol have performed non-urgent trials by maintaining the safety of patients at a desirable level, but there is a need for careful consideration in identifying urgent cases.

The fear of surgery, death, and the debilitating symptoms of the illness make hospitalized patients develop anxiety and depression that may disrupt their performance. Religious care aimed at addressing the religious needs of hospitalized patients can have a significant role in increasing the hospitalized patients’ ability to cope with their illness. Therefore, the researchers aimed to set up a religious-based plan and perform it by the presence of a clergy next to the patients’ bedside and determine its effectiveness on decreasing anxiety and depression of hospitalized patients.
In this randomized controlled clinical trial with control group, 142 hospitalized patients were chosen in the form of random sampling in Nekoui hospital of Qom. They were divided into a test and a control group. Then, the demographic questionnaire and the Hospital Anxiety Depression Scale were completed by them. The religious-based plan by the presence of a clergy next to the patients’ bedside was performed in the test group. The two groups were followed after the intervention. All ethical issues were observed in this study and the researchers declared no conflict of interests.
In terms of overall score of hospital anxiety and depression, the results of ANCOVA showed a statistically meaningful difference between the two groups after the intervention (F=35.75, P The presence of special medical teams like responsible clergies who are familiar with health issues and the provision of religious care can decrease patients’ anxiety and depression. Such a religious intervention also has a significant role in boosting patients’ morale and reducing their woes.

Moral distress is among the various types of distress that involves nurses and can lead to multiple complications. It is therefore rather important to identify the factors related to moral distress. The purpose of this study was to examine the relationship between futile care perception and moral distress among intensive care unit (ICU) nurses. This cross-sectional study used a descriptive-correlation method and was conducted on 117 ICU nurses of Qom hospitals in 2016. Data were collected using a 17-item futile care perception questionnaire, and Jameton’s moral distress questionnaire containing 30 questions. Data analysis was performed using SPSS 16, descriptive statistics and univariate regression analysis. The results showed that the mean age of the participants was 34.99, and most (about 66.7%) were women. Univariate regression analysis indicated that when ICU nurses’ perception of futile care and work experience increased, their moral distress also increased significantly (P = 0.03 and P = 0.02, respectively). It can therefore be concluded that moral distress is associated with futile care and ICU work experience. It seems that some interventions are necessary in future to place nurses in clinical situations involving futile care, and thus reduce their level of moral distress.

Triage is the key for success in management of large numbers of injured and limited resources, and without preparedness of nurses to would seem an impossible task. This study has been conducted with the aim of determining the effect of training through the method of simulation on the knowledge and performance of nursing students in carrying out the pre-hospital triage.
This semi-experimental study was conducted on 70 students of nursing who were selected based on the study’s inclusion criteria and through the randomized sampling method. The researcher tools included “triage test having 10 questions of four options each and practical test including examining the correct performance of triage based on START criteria by using 10 designed simulated mockup models and based on the injury received by the victim and the level of injury”. The validity of the test was verified through the formal and content validity method, and the reliability of the knowledge questionnaire based on the Cronbach-Alpha Coefficient was obtained to be equal to 0.87. After examining the level of knowledge on triage before training, the triage training workshop was held in two sessions of two hours each and through the simulation method, and again the scientific test and practical test were performed. For data analysis, the paired t-test and independent t-test were used, and the Kolmogorov Smirnov test was used to examine data normality. Data were analyzed using SPSS software-version 16.
The results of statistical analysis showed that the level of students’ knowledge significantly increased from 4.6±1.94 before training to 7.40±1.35 after training. Their performance significantly increased from 4.90±1.6 to 8.30±1.5.
The results of the study showed that training with the simulation method on mockup model was effective on the preparedness of nurses for triage when accidents and emergencies occur. It was also found that training improves their preparedness in this regard. It is recommended that for better preparedness of nurses in triage in case of accidents and medical emergencies, this training method should be used.

Every year a large number of our countrymen lose their lives due to traffic accidents. Traffic accidents lead to considerable social and economic burden, and in case of serious neglect, it may be turned into a national disaster. This study was carried out to investigate the epidemiology of road accident deaths in Qom Province.
This cross-sectional study was performed to investigate the road driving accident deaths in Qom Privince in the first 5 months of 2014 (March 21 to July 23 using the data provided by the Legal Medicine Organization. Data were analyzed by Chi square test (for comparison of differences in number of deaths in terms of gender and age).
The total number of deaths was reported 80 individuals in the first 5 months of 2014. The highest statistics of death was related to the Qom–Aveh road with 11 deaths, and 29 deaths were due to vehicle rollover. Most of the victims (17 cases), were in the age group of 0-10 years, followed by 21-30 and 31-40 age groups, each with 15 cases; 59 deceased individuals were male, and 28 individuals had primary education level, while this rate was two cases in individuals with bachelor's degree. Forty-one deceased individuals, were drivers. Fifty-seven subjects died at the scene of the accident. Multiple fractures and head trauma, were the most common cause of death with 38 and 36 subjects, respectively. Seventy deaths were related to the main roads and 17 deaths occurred on Thursday.
Due to high incidence of traffic accidents and death cases, there is a need for comprehensive programming by responsible organizations, such as traffic center, relief and rescue systems, and cultural institutions to deal with this phenomenon. Therefore, investigation of death causes and comparison of its mechanism can lead to good results.

Providing and making airway is the first known measure that comes to mind at an emergency situation. Laryngeal mask airway (LMA) is an alternative for airway management, which its insertion training in beginners and professionals is easier than endotracheal intubation. This study was conducted to compare the speed of insertion and success rate in using two LMA and ETT methods in nursing students.
In this quasi-experimental study, 49 last year nursing students were selected by simple random sampling method. After airway management training course, the students were tested on endotracheal intubation and LMA insertion in a manikin. Data were analyzed using t-test at the p The time for endotracheal intubation was obtained 28.73 s and for LMA was 5.05 s. Also, gender of the students had no significant relationship with airway management (p=0.45). Ninety-eight percent of the student succeeded to insert LMA with no error, but this rate for ETT was just 28%.
Given that shorter time, lower error, and ease of insertion of LMA in comparison with the ETT method, use of this method is recommended as an appropriate alternative for endotracheal intubation, especially in emergency situation.

The demand for medical emergencies often begins with a call to a dispatch center. Appropriate performance of this unit significantly influences providing effective services.
The current study aimed to compare the effect of using telephone triage manual revised by New Jersey and the conventional methods on accuracy of triage done by 115 emergency medical dispatchers of Qom, Iran, in 2012.
This quasi-experimental study aimed to compare the effects of two conventional and New Jersey revised methods on performance of emergency medical dispatchers of Qom. Conventional (September and October) and New Jersey data (December and January) were extracted and compared. November was skipped due to emergency medical dispatcher familiarity with the program.
Performing the new method non-significantly changed the response time (P = 0.053) and communication skill (P = 0.053). Scientific and medical skills (P = 0.000) were significantly changed. Overall performance significantly improved (P = 0.000).
The revised New Jersey method significantly increased appropriate overall performance of the communication experts and decreased their dysfunction.

When the issue of the quality of the patient's care is addressed, determination of infection degrees in reference to the quality of such cares has gained a high priority. Therefore, infections in ambulance equipment might play a significant role in reduction of the quality of the hospital cares. This study was conducted wishing to determine bacterial infection degrees in ambulances servicing in pre-hospital emergency medical services of Qom University of Medical Sciences, Iran. In this analytical cross-sectional study, 132 sampling of the equipments of 12 ambulances were done. Samples were stored on BHI broth as an amplifier for 24 hours. Then, they were introduced to blood agar and Eosin Methylene Blue (EMB) agar culture environments. After 24 hours, negative staphylococcus coagulase and bacillus were specified by different environments, solutions, diagnostic discs, gram staining, catalase test, oxidase test and coagulase test. Then data were analyzed by SPSS16. The results showed that the highest infection prevalence rate was observed in stretchers (12 samples, 100%) and the lowest in oxygenation moisturizers (1 sample, 8.4%). From infected equipments, in addition, four instruments (37%) were mobile and eight of them (63%) were immobile. Results indicated that an infection degree of the utensils and instruments which were used in ambulances employed servicing in the Qom Province Medical Emergency Response Center of Iran is high, that might have their roots in non-application of disinfectants for disinfecting ambulance surfaces and equipment. This is a mandatory for healthcare agents to utilize the protective covers, especially medical gloves.

Education is one of the fundamental pillars of development of capabilities, skills, and competencies in different sectors of society. Application of modern education methods seems to be necessary due to rapid changes of social requirements. The aim of this study was to compare the effects of scenario and lecture-based education methods on knowledge and attitude of emergency medical technicians towards patients with chest trauma.
A total of 160 emergency medical technicians were participated in this quasi-experimental research. The participants were divided into two groups of scenario- and lecture-based education. Required information were collected by knowledge and attitude questionnaire before and after the intervention. Data were then analyzed by paired t- and chi-square tests.
The mean of knowledge (p Considering the effect of scenario-based education and its role in utilization of learner’s intellectual capability and creativity, it seems that scenario-based education is an appropriate alternative for traditional education methods.

Burnout has negative effects on nurse's health,and also onpatients’ satisfaction and safety. This study was conducted to determine the relationship between Burnout and nurse's job characteristicsin teaching and therapeutic hospitals affiliated to GolestanUniversity of medical sciences. In this descriptive-analytical study, 206 nurses who engaged in the teaching and therapeutic centers of Golestanuniversity of medical sciences were selected via random sampling. Thedata wascollected by demographic data sheet and Copenhagen burnout questionnaire and analyzed by descriptive statistical, logistic Regression. The mean age was 34.66±7.38and68% of the participants were female. Overall,34% ofthe nurses had burnout. The prevalence of personal, work-related and client-related burnout was 33.5%, 41.3% and 22.3%, respectively. Age, job experience and type of employmentwere the risk factors of personal, work and client-related burnout. Being supervisor, working in the psychiatric ward and having private job, were the causes of increased personal burnout. In line with the increase of age and job experience increasing, the officials should pay more attention to burnout,andin some ward of the hospitals and job positions they need considering a unique career planning.

Many patients with cancer have multiple symptoms affecting their sense of well-being and their physical and social performance that will be reduced quality of life and increased their unfavorable outcome. The purpose was to evaluate the quality of life (QOL) and effective factors in Iranian cancer patients undergoing chemotherapy.

This cross-sectional analytical study including118 cancer patients who underwent chemotherapy at Qom chemotherapy Center and had inclusion criteria, that completed an Iranian version of the brief form of the WHOQOL assessment instrument and a demographic checklist. Data were analysed using SPSS-PC software, descriptive analysis, independent sample t-tests, one way ANOVA models, Tukey’s Post Hoc test and linear regression.

Most patients had a relatively average level of overall QOL. QOL scores were low in older and less educated patients, but these scores were not affected by the marital status or types of cancer. No significant regression was observed between duration of disease and treatment and mean QOL scores.

Overall, patients in the present study had a relatively average level of global QOL that could be the impact of religious beliefs or family support on their quality of life. The results emphasize that older and less educated patients have lower QOL scores. These patients may require a greater level of support and education to improve their QOL.

Health staffs have different attitudes and beliefs toward elders that have effect on their behaviors in health service delivery to elders. This study was done for determination of Golestan province health centers general practitioners (GPs) attitude toward elders. In this cross sectional study, 152 general practitioners of Golestan province health centers were selected via random sampling. The Kogan's Attitudes toward Older People Scale (KAOPS) questionnaire was used as data gathering tools. Data analysis was done in SPSS 16 software using Pearson correlation coefficient, paired t-test, t-tests and one way ANOVA test. Mean (standard deviation) of participants age was 34.73 (6.26) years. Mean (standard deviation) of total score of attitude toward elder scale was 115.48 (10.22) (score range in scale 34-204). 54.2 percent of GPs have lower score than mean. Negative attitude mean score were higher than positive attitude mean score which was statistically significant (P= 0.0001). According to our finding, only half of GPs had favorite attitude toward elder. Whereas negative attitudes were higher than positive attitude toward elder, designing some programs for change in attitude of heath care staffs is necessary.