فصلنامه پژوهش های سلامت محور
سال سوم شماره 4 (پیاپی 11، زمستان 1396)

One of the areas where hemophilic patients need help to improve their affective health is in strengthening their affective capital and flow at work experiences. The aim of this study was to determine the effect of job success training on affective capital and flow at work of hemophilic patients. The present study was an interventional, descriptive-analytic study. In the first phase, 20 hemophilic patients selected through random sampling were divided into the two groups of experimental and control groups (n= 10). The experimental group received job success training package in eleven 2-hour sessions. The members of both groups were asked to complete the affective capital and the flow at work experiences questionnaires before the intervention, after the intervention and in a follow up, 45 days after the intervention. Data analysis was performed using repeated measures analysis of variance and through SPSS 21. Mean age of participants was 32.4 years. There was a significant difference between experimental and control groups in affective capital and flow at work experiences in both the post-training phase and follow-up phase. This means that the job success training package was effective on the affective capital and the flow at work experiences for experimental group. The job success training package can be used to improve the affective capital and flow at work of hemophilic patients and consequently the capacity of these patients.

Background & Objectives: Charity hospitals with increasing public participation in the provision of health services could play an important role in assisting government for providing health care and promoting society health. Since most deprived people use the services of these hospitals, paying attention to these organizations and their management can help improve the quality and equality of health services distribution. Thus, this study aimed to explore the challenges of management of charity hospitals in Tehran province and provide solutions for these challenges in 2017. This qualitative phenomenological study was conducted in 2017. Data were collected through semi-structure interviews with 26 participants from various organizations including top and middle hospital managers, experts from Vice-chancellor in treatment affairs of Universities of Medical Sciences in Tehran, and the Endowments and Charity Affairs Organizations. Snowball sampling method was used to select the respondents. Data were analyzed using a thematic analysis method. The challenges of charity hospitals could be categorized into 5 main codes including financial resources, human resources, physical and structural resources, management, and cultural challenges, and 13 sub codes. Endowment selling and creating endowment funds in charity hospitals to develop sustainable financial resources, supervision of Ministry of Health (MOH) and Universities of Medical Sciences (UMS) for teaching, quality improvement, development of human resources, reconciliation with the goals of the health system, participation in macro policy making and planning, development of structural standards for the management of these hospitals and their announcement by the MOH, are the main solutions for these challenges.

Implementation of clinical governance (CG), as a strategy for improving the quality, safety and effectiveness of health services, has encountered challenges in Iranian hospitals. This study aimed to identify barriers to clinical governance implementation in Tehran hospitals, Tehran, Iran. This descriptive cross-sectional study was carried out in 92 hospitals in Tehran that had implemented CG in 2014. Data were gathered using a researcher-made questionnaire assessing the human resource, managerial, cultural, procedural and structural barriers of CG. Data analysis was performed through SPSS software (version 20) and using descriptive and inferential statistics. The mean score of CG implementation barriers in Tehran hospitals was 3.36 out of 5. Human resource (mean score: 3.69) and cultural barriers (mean score: 3.02) were the most and least barriers of CG implementation respectively. Simultaneous implementation of accreditation, lack of a continuous improvement culture, staff insufficient motivation, CG bureaucracy and lack of time had respectively the most negative effects on CG implementation. Commitment and participation of senior managers, staff and doctors were low in CG and indeed had a significant relationship with the CG managerial barriers in hospitals. Tehran hospitals encounter many barriers in implementing CG. Policy makers should consider the structure and culture of the hospitals and staff organizational maturity to develop an appropriate CG model. Besides, hospital managers should address the existing barriers and create an appropriate organizational structure and culture to facilitate CG successful implementation.

One of the most valuable assets of any organization is its brand because it causes more profit margins, better cooperation channels and other benefits for the organization. The aim of this study was to investigate the factors affecting brand identity of hospitals in a semi- governmental hospital in Tehran/ Iran. In this descriptive-analytic study, 403 hospitalized patients in a semi-governmental hospital were selected by available sampling method in 2016. The data gathering tool was a researcher-made questionnaire based on the Kapferer model (including 30 questions in 6 domains of brand personality, brand physique, brand culture, relationship, self-image and reflection). Data were analyzed using one-sample t-test in SPSS 16 software. The highest mean scores were attributed to the importance of service quality (4.21), known cases (4.15) and easy access (4.02). The least mean scores belonged to patients' mental and psychological needs (2.31), the distinctive character (2.45) and happy and motivated staff (2.63). There was a significant relationship between total mean score (3.51) and brand personality, brand physique and brand culture (P<0.05). Hospitals cannot survive without attention to the patients' demands. Therefore, by implementing any of the factors affecting the hospital brand identity, it is possible to improve the hospital brand status in the minds of the patients as a superior and valuable brand.

It is important to promote normal delivery due to the potential risks of cesarean section and its economic burden on families. The aim of the present study was to analyze the factors influencing the agenda setting of normal delivery policy under the health system reform of Iran, using the "Kingdon Multiple Streams" model. In this retrospective case study, the agenda setting of the normal delivery promotion policy in Iran was qualitatively analyzed using documentary analysis and reviewing the available documents and evidences and applying Kingdon multiple streams model. The effective factors on agenda setting of normal delivery promotion policy in Iran were the role of media in revealing high cesarean section rate (problem stream) and their ability to force the government to reduce it and gaining the support of gynecologists. Moreover, the setting of the new government and presenting the new health system reform (policy stream), the full support of the Supreme Leader, the President and the Parliament of Iran, as well as the key role of health insurance and other bodies of the system (Politic stream) provided the opportunity for the implementation of normal delivery promotion policy in 2015. Analysis of normal delivery promotion policy in Health System Reform of Iran using Kingdon multiple streams model helps to understand the content of this policy and the reasons of its agenda setting better.

Women have a basic role in ensuring the health of future generations and their employment forms an important part of their life. Changes in the traditional roles of women and their growing demand for participation in various job positions, have become an undeniable fact of Iranian society. The purpose of this study was to investigate the effect of formal and informal employment on women's quality of life. This was a cross-sectional descriptive-analytic study performed from December 2016 to July 2017 on 112 formal employed women and the same number of informal employed women who were randomly selected. To assess subjects’ quality of life, SF-36 standard questionnaire was used as a valid tool. Data were analyzed using Mann-Whitney and independent t- test statistical tests and through SPSS version 21 software. According to the results, 49.1% of women working in the informal sector did not have high school diploma and were younger than 24 years old. The mean score of quality of life in women employed in the formal sector (78.95 ± 13.6) was significantly better than that of women employed in the informal sector (84.77 ± 10.21) (P<0.05). Due to the rapid growth of the informal sector following social and economic issues, the number of women working in the informal sector is increasing. Lack of insurance and adequate salary are some of the problems in the informal sector. Government intervention in the informal sector through implementing related laws is a strategy to solve the problems of women working in the informal sector of the country.

Infant mortality rate is one of the main indicators in the assessment of community health. About 65% of children under one year of infant mortality are mortality and undoubtedly the first step in promoting this index is to identify the causes of their mortality at this time. The present study was conducted to determine the rate and causes of infant mortality in the neonatal intensive care unit of Shahid Sadoughi Hospital in Yazd. This descriptive-analytic study was performed on 243 infants admitted to the neonatal intensive care unit of selected educational hospital in Yazd during the first period of April to the end of March, 1395. The data collection tool was a checklist. ANOVA and Chi-square tests were used. Data were entered into SPSS software version 19. Of the 243 infants under study, 39 (16.4%) of the newborns died. The highest incidence of neonatal in 56.4% of cases was prematurity. Cardiac arrest was the cause of death in 47.5% of infants. Fee of newborns with infant weight and infant age during admission and maternal gestational age were statistically significant (P = 0.0001). Maternal and child-care care should be given more importance in health programs and policies, and measures should be taken to prevent possible contaminating factors for infant death.

Background & Objectives: Reducing personal resistance against changes via assertiveness and maturity could help the organization to achieve goals. The aim of this study was to evaluate the effect of assertiveness on personal resistance with moderator role of staff maturity in Kerman University of Medical Sciences. This cross-sectional descriptive-analytical study was performed on 169 Headquarters employees in Kerman University of Medical Sciences in 2016. To collect data, three questionnaires including assertiveness questionnaire (22 questions), personal resistance questionnaire (21 questions), and maturity questionnaire (26 questions), were used. Data were analyzed using partial least squares (PLS) by SmartPLS 2 software. Assertiveness had a reverse effect on the personal resistance. It had also a reverse effect on the dimensions of personal resistance including inappropriate emotions, passive reactions, and lack of creative responses, but it had no effect on the employees' low motivation. The employees maturity as a moderator variable reduced the effect of assertiveness on the personal resistance. Considering the importance of decreasing personal resistance in workplace which increases the productivity of workforce, it is recommended to perform some interventions to reinforce the employees' personal skills like assertiveness.