فصلنامه پژوهش های سلامت محور
پیاپی 2 (پاییز 1394)

When severe kidney failure happens and kidneys do not work properly, alternative treatments such as transplantation and dialysis, including hemodialysis and peritoneal dialysis can be done. This study is to help physicians and patients in choosing an appropriate therapeutic method in terms of the impact on quality of life comparing different dimensions of hemodialysis and peritoneal dialysispatientsquality of life. In this cross-sectional descriptive analytical study, 143 patients with hem dialysis and peritoneal dialysis have been studied in a hospital in Kerman at the second six months of 2011. In order to survey thepatient's quality of life and comparing it from various dimensions, the EQ5D quality of life questionnaire was used. Data analysis was done by SPSS software version 19, and also using descriptive statistics such as frequency tables, mean, and standard deviation statistics, chi-square and Mann-Whitney analysis. The average scores for quality of life in patients with hem dialysis and peritoneal dialysis were 0.61 vs. 0.69, respectively and the difference was meaningful. The highest average score in the hemodialysis patients quality of life was related to depression and anxiety (0.95) and in peritoneal dialysis patients was related to personal care (0.96). In this study, there were not any statistically significant relationships between any of the studied variables and the quality of life except age variable in two groups of patients. This study revealed that peritoneal dialysis patients had higher quality of life particularly in the personal care and pain and had better life quality compared to hemodialysis patients.

One of the most fundamental goals of most countries is improving the quality and efficiency level of healthcare systems and efficient use of their resources. In this regard, the efficient use of facilities and equipments for the hospitals, that are considered as one of the most costly health care delivery organizations, is particularly important. The goal of this survey was the efficiency estimation of hospitals in Kerman Province (2007-2011). In this econometric study, performance of 10 hospitals in Kerman Province was analyzed in 5 years, using panel data for Stochastic Frontier Analysis (SFA) method. Production factors such as number of beds, doctors, nurses, and out patient admissions were used as inputs, and numbers of outpatient admissions have been selected as outputs. Frontier version 4.1 was used to analyze data. Based on SFA method, the average performance of hospitals was 0.648, so we concluded that the capacity of improving performance in these hospitals can be increased to 0.352 percentages. Based on findings of this study, adjusting surplus manpower, congenital planning for increasing efficiency and resourcing management should be the priority of objectives of the managers and directors so that we can increase the level of efficiency of hospitals and reduces costs to the minimum as possible.

One of the ways for addiction control and damage reductionis methadone treatment. However, the factors related to treatment failure have not been fully studied. In this study the characteristics related to treatment failure in Rafsanjan city has been studied. This descriptive and analytical cross-sectional study was done based on records of patients visiting two rehabilitation centers in Rafsanjan in 2011-2013. The records were evaluated in two groups of patients. The first group (291 patients) were people with treatment failure, and the second group (309 people) were those successfully treated. Data analysis was done usingt-test, chi-square, and logistic regression through SPSS 22 software. The mean age of participants was 37±10.5 years. The two groups were significantly different in regard to kind of substance use (P =¬0.001), existence of mental illness (P = 0.011), treatment center (P¬<¬0.001), the dose of methadone consumption (P¬= 0.018), and marital status (P¬< 0.001); but the difference in age, addiction duration, the concomitant use of two or more psychotropic substances, number of previous treatment, presence of physical illness, and the history of legal problems was insignificant. Methadone maintenance treatment is likely to be more effective if it is associated with treating the patient's mental illness, solving family problems, adequate doses of methadone, and reducing the health care costs.

The administrative health improvement is one of the administrative reform's priorities in our health care organizations, Being aware of the current status of administrative health is necessary to propose the strategies of administrative health improvement. This study aimed to determine the administration health status of teaching hospitals and contribute to improve the it. This cross-sectional and analytical-descriptive study was conducted in 11 teaching hospitals of Isfahan city in 2014. 555 of clinical and non-clinical staff were selected using simple stratified sampling method and completed the questionnaire. The data collection tool was a researcher-made questionnaire the validity and reliability of which were tested. The questionnaire was designed in two parts. The first part included 9 close ended questions about demographic information, and the second part contained 24 close ended questions related to the administrative health status with 5-item Likert scale. Collected data of 391 completed questionnaires were analyzed using SPSS software (version 16), t¬-test, and Analysis of Variance. More than half of respondents were female (56.53%) and the rest were male. Over 76/47% of participants were married. The mean score of administrative health from the view of employees was 2.11 (less than average). The most important threatening factors of the administrative health were lack of sense of commitment of employees (1.00), the lack of effective violations reporting (1.00), and information manipulating and disclosing. Females, younger than 25, MD degree and single respondents viewed the administrative health status better than others. Regarding the necessity of administrative health improvement, taking actions such as strategies to increase the employee's commitment, the establishment of an efficient comprehensive system of accountability and reporting, and informing about the importance of valid information and broadcasting them are recommended to reach better administrative health status.

End-of-life care is important considering the ethical issues, and the high health care costs are associated with it. Being informed of these costs can help managers in planning and making policy on this type of services. Hence, this study aimed to assess the costs of end-of-life care for patients admitted to hospitals in Kerman. The present study is a descriptive-analytical study which was performed retrospectively in Kerman University of medical sciences in 2013. The population consisted of all expired patients of two hospitals in Kerman whom all were studied according to a census basis. Data analysis was carried out using inferential (linear regression, Anova, and Independent T test) and descriptive statistics through SPSS 19. The most and the least studied cases related to cardiovascular disease (23%) and gastrointestinal disease (2.5¬¬%) respectively. On the other hand, the most and the least expenses were for neurological diseases and cancers respectively. However in Afzalipoor hospital, the highest and the lowest costs were for cardiovascular diseases and metabolic diseases respectively. And in Shafa hospital the highest and the lowest costs were for neurological and gastrointestinal diseases. The results of this study showed that the cost of end-of-lifecare in Iran, like other countries, is high, but little attention is paid to palliative care for patients in this stage, and the provided services will cause a waste of resources because there is no chance forrecovery for these patients. So we should pay special attention to palliative care.

Dental caries is a multifactorial disease. Diet has a major role in prevention of oral diseases as well as dental caries. The aim of the study was to evaluate the frequency and type of snack consumption among 3-6 year-old-children in Rbor and Baft in 2011. This cross-sectional study was conducted on 240 kindergarten children aged 3-6 years old in Baft and Rabor cities through multiple stratified systematic sampling methods. Data were collected by a demographic questionnaire (sex, parents’ education and their job, and number of children) and 2 checklists consist of daily type and frequency of snack consumption in kindergarten and at home. Data were analyzed in SPSS version 20 software using T and χ2 tests. In the present study, 125(52.1%) kids were boysand the rest were girls. 45.42% of snacks were cariogenic. The mean of weekly snack consumption by boys and girls were 45.68±18.98 and 46.05±18.10 respectively, and there were not any significant differences between them (P=0.879). The mean of snack consumption at home was meaningfully higher than that at kindergarten (P=0.000). Frequency of snack consumption in Rbor was higher than that in Baft, but the difference was not significant (P=0.493).There were not any meaningful statistical differences between fathers and mothers ‘educational level and the mean of weekly snack consumption (P=0.643 and P=0.762). Based on the findings of the present study the mean of snack consumption at kindergartens in Baft and Rabor was high. However snacks provide a part of energy for children's growth, choosing healthy snack is necessary for dental health.

Osteoporosis is the most common metabolic bone disease which is nowadays known as a public health problem. Physical activity to maintain healthy bones is an important factor in preventing osteoporosis. The aim of this study was to determine a model for predicting factors influencing physical activity among women for the prevention of osteoporosis according to the Precede Model in Kerman, Iran. This cross-sectional analytical descriptive study was performed on 120 women referred to health centers of Kerman city during 2014. They were selected randomly through multi- stages sampling method. Data were collected using the International Physical Activity Questionnaire (IPAQ) and a self-administrated questionnaire according to constructs of the PRECEDE Model (Predisposing Reinforcing, and Enabling Factors) andanalyzed by descriptive statistics (measures of central tendency, dispersion, frequency and percent) and analysis statistics (logistic regression, Pearson correlation) using SPSS software version 18. The results showed thatthe mean age of the participants were 32.44 ± 6.97 years. 29.2% of women had intense, 5.35% moderate, and 7.66% mild physical activity. The results also indicated that enabling factors was the most predictive factors of physical activity both in raw (P=0.023, OR=1/122) and adjusted models (P=0.041, OR=1/137). As enabling factors were the most important predictive factor for physical activity, it is recommended that health promotion interventions be planned according to these factors to improve physical activity and prevent osteoporosis mong women.

Challenges of service provision systems necessitate the presence of staff with higher motivation to work more efficiently, so paying close attention to job satisfaction of these staffs to enhance organizational efficiency sounds essential. The aim of this study was to investigate and among those staffs working in a Shohadaye Tajrish educational Hospital in Tehran. This was a cross-sectional correlative study on a 200-staff sample in a teaching hospital in Tehran which was selected by a simple accidental sampling in 2013. The research instrument was a questionnaire with 25 questions that was considered suitable for face and construct validity and reliability. Data analysis was done by parametric statistics and Pearson correlation on statistical level of 0.05 applying SPSS version 18. Results indicated that the highest average of the participants was related to satisfaction of coworker's dimension 4.05±¬0.87, and the least average belonged to satisfaction of salary 1.54±0.74. Furthermore, there was positive and statisticant relation between the whole satisfaction and all other five dimensions of the model. Finally the analysis among two variables (sex and age) and whole job satisfaction had significant relationship. It seems that correcting reward mechanisms in hospitals and applying managerial tools like performance-based-management can improve the staffs` performance and motivation. In addition, reinforcing the social relationships among coworkers may lead to incremental changes in one of the most important dimensions of the model and finally affect the whole satisfaction.