فصلنامه پژوهش های سلامت محور
سال دوم شماره 1 (پیاپی 4، بهار 1395)

Conflicts in hospitals, in addition to reducing Employee’s productivity and satisfaction, and also increasing hospital’s costs, has a negative effect on the treatment process. Therefore, acquiring necessary knowledge and skills for conflict management are essential for hospital managers. The present study aimed to investigate the conflict management strategies used by managers of hospitals affiliated with Tehran University of Medical Sciences (TUMS).
This is a descriptive – analytic study conducted as a cross-sectional one in 2015. The sample consisted of 563 managers of three levels of management including senior, middle, and executive managers in hospitals affiliated with TUMS. Using a high valid and reliable self-made questionnaire based on Thomas and Kilman’s model, the data was collected. Data analysis was performed by SPSS software 19, and using descriptive (Mean, Standard Deviation, Frequency and Percentage) and inferential statistics (Regression, Spearman and ANOVA).
The results show that collaborating style was the dominant style used by hospital managers. Compromising and accommodating styles were the next management strategies in order. There were significant statistical relationship between management style and management level (P=0.038), age (P=0.016), manager’s work experience (P=0.019), management experience (P= 0.021) and conflict management training courses (P=0.001).
The nature of healthcare organizations requires that managers use collaborating, compromising and accommodating styles in order to interact with various stakeholders. Holding suitable training course in the field of conflict management has a significant role in reducing devastate effects of conflict in the hospitals.

Health policymakers faced with new challenges such as increasing elderly population. This study aimed to investigate the consumption pattern and hospitalization costs of the elderly covered by Iran Health Insurance Organization in teaching hospitals of Sanandaj, Iran.
In this descriptive-analytical as a cross sectional one, the samples included 5753 elderly covered by Iran Health Insurance Organization who used hospitalization services in three teaching hospitals of Sanandaj in 2013. Using Chi square and t-test, data analysis was performed.
The frequency of elderly hospitalizations was 6703 cases. Mean of hospitalization rate was 1.04 times in men and 1.36 times in women. The elderly hospitalization costs were about 27.8% of the total hospitalization costs. The costs of hospitalization services were statistically different between elderly and non-elderly patients except the rehabilitation services. Although there was statistically significant relationship between the age of elders and their length of stay but no statistically significant relationship between elderly’s age and their hospitalization costs was reported. In addition, no significant difference between the mean costs of each hospitalization in men and women was reported.
It was concluded that the hospitalization costs are higher in elderly patients compared to the non-elderly patients, so managers and policymakers are required to have a program for funding the elderly’s health services costs. Considering the evidences in aged economic area including consumption patterns and services costs seems to be necessary.

Hospitals as the most expensive health care system is an operational unit, considering the cost efficiency of this unit is very important. The aim of this study was to evaluate the performance of the intensive care units of hospitals affiliated with Yazd University of Medical Sciences.
This is a descriptive - analytic study performed in 2014. Intensive care units of 8 hospitals affiliated with Yazd University of Medical Sciences were included in this study. Data envelopment analysis (DEA) was used to evaluate the economic efficiency of intensive care units. Input variables included the number of physicians, nurses, and active beds, as well as the number of equipment (ventilator), and output variables included bed occupancy rate and the number of patients discharged healthy. Input prices contained the doctors and nurses income, bed price, and depreciation cost of equipment (ventilator).
The findings show that among 8 studied hospitals, the efficiency of 5 hospitals were 1 and the efficiencies of the other hospitals were 0.174, 0.645, and 0.855. The mean economic efficiency of intensive care units of all hospitals was 834.0 in 2014.
By ameliorating the allocation of resources allocated for hospitals including human resources and equipment, the efficiency level of hospitals can be improved.

Hospitals are the most expensive health care organizations. In this study, identifying factors influencing hospitalization costs based on the three aspects of the health system including patients, health care providers, and insurance organizations were considered.
This was a qualitative and phenomenological study. In this study, 12 experts in the field of management and controlling hospital’s costs were selected through purposive and snowball sampling method. Data were collected using focused group discussion. Framework analysis was used for data analysis.
The factors affecting hospitalization costs were classified into three codes including patients, health care providers, and insurance organizations. Lack of knowledge and awareness and neglecting self-care were the main patient-related factors, and weak management and supervision, lack of medical guidelines, long-term recovery period, lack of implementation of family physician and weak commitments and structural problems of insurance organizations were the main factors related to the health care providers and insurance organizations.
The results showed that by increasing and improving self- care programs, providing health-oriented services, implementation of family physician program, specializing the hospital management, improving the quantity and quality of supervisions and reforming expert structure of insurance organizations, the hospitalization costs can be managed.

Self-care, an important aspect of healthy lifestyle, means to follow a healthy life style to prevent diseases. Given the importance of self-care, this study aimed to evaluate self-care activities among women referred to health care centers in Kerman during 2015.
This is a descriptive – analytic and cross-sectionalstudy performed on 240 women who referred to health care centers in Kerman during 2015. They were selected using multistage sampling method. Data were collected using a two-part researcher-made questionnaire. The first part included demographic data and the second, 17 questions on screening performance. Data were statistically analyzed by SPSS 20 and Chi-square.
The results show that there was no significant relationship between different aspect of physical self-care and education, job, and income (P>0.05) but sleep quality was better in housekeepers (P=0.02) compared to the employed women. Screening analysis show that Pap smear in employed working (P=0.006), and in women with high education and income (P=0.004) and also lipid profile screening in women with high income(P=0.001) compared to the housekeepers were significantly performed.
Considering the results, it is concluded that physical activity as well as screening common cancers among studied women is not satisfactory. Therefore, educational programs should be considered in order to enhance public awarenessas well as finding out the inhibiting factors for self-care activities.

The first step in any educational programs is determining the educational needs of the target group. Providing adequate information to couples helps them to start their marital life based on a correct basis. The aim of this study was to determine the pre-marriage educational needs of couples who are about to get marry.
This descriptive-analytical and cross-sectional study was performed on 250 couples attending in Pre-marriage counseling classes. Available sampling was used in this study. Data were collected by a questionnaire including demographic variables and 47 questions in 7 areas including family planning, congenital diseases, common cancers in men and women, sexual relationships, relationship with spouse and family, and Islamic and legal issues. Data were analyzed using analytical statistics Chi-square, t-test, ANOVA, and correlation coefficientthrough SPSS 21.
The results show a significant relationshipbetween the need for training and education in women and men (PIt seems thatcomprehensive information on sexual issues and relationship with spouse and family should be also added to educational content in order to help young couples to have healthier marital life.

Improving patient safety culture in healthcare organization is the first step in reducing medical errors and improving patient safety. The aim of this study was to assess the patient safety culture from the nurses viewpoint of teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences.
In this Descriptive-analytical study, 310 nurses of four teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences in Tehran, were randomly selected. Data were collected by the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. The first part of the questionnaire included nurses’ demographic information, and the second part consisted of 42 questions to evaluate 12 dimensions of patient safety culture. The questionnaires were distributed among nurses and completed by them. The data were analyzed using independent t-test and One- way ANOVA tests by SPSS 22.
Among dimensions, two dimensions of organizational learning (81%) and teamwork in hospital units (76.1%) showed the highest rating, respectively. However, giving feedback in response to errors showed the least rating (32.75%). There was a significant relationship between safety culture of nurses, and gender and type of employment (PConsidering the results, manager’s actions for improving patient safety including giving feedback in response to the errors, providing the opportunity for the periodic report of events, and exchanging patients’ information in the studied hospitals seem to be crucial.

The Emergency Operation Center (EOC) is a prehospital community-based health management system that its main capital are its employees. However, occupational stress in personnel have negative effect on their quality of life and can lead to leaving the occupation. The aim of this study was to evaluate occupational stress and its effect on quality of life and desire to continue serving in personnel of Emergency Operation Center in Kerman.
In this descriptive-analytical study, 200 personnel of Emergency Operation Center in Kerman in 2013 were included using stratified sampling method. The data was gathered using questionnaires HSE and WHOQOL BREF and analyzed by using chi-square test, Pearson correlation coefficient, and linear regression.
The results show that level of occupational stress in 49.3% of personnel was moderate and the quality of life in 52.9% of them was high. It was also found that the score of desire to continue serving in personnel was 4.15%. Therefore, there was reverse relationship between quality of life and occupational stress but direct relationship between quality of life and desire to continue serving in Emergency Operation Center.
The results of this study showed that reducing occupational stress can increase the personnel’s quality of life and consequently the desire to continue serving in Emergency Operation Center. The main stressors in personnel is how administrators support them and make changes in the organization; therefore, it is recommended to managers to more support the personnel for reducing stress in them.