فهرست مطالب

Hospital Research - Volume:6 Issue: 3, 2017
  • Volume:6 Issue: 3, 2017
  • تاریخ انتشار: 1396/09/14
  • تعداد عناوین: 7
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  • Maryam Seyednezhad*, Leila Vali, Zahra Farahmandinia, Moghadameh Mirzai, Zhaleh Abdi Pages 1-12
    Background and Objectives

    Parents do not have the sufficient perception of the care their suffered children receive. This study aimed to investigate the relationship between barriers to care with parents’ perceptions of primary care and quality of life in thalassemia major children in Kerman, Iran.

    Methods

    The study was Descriptive-analytical and Cross sectional study. It was conducted in 2015. The sample included 150 children aged 6 to 15 years with thalassemia major and either of their parents. Data were collected using 3 standardized questionnaires: barriers to care questionnaire (BCQ), parents’ perceptions of primary care (P3C), and the pediatric health related quality of life (PedsQL). To determine the association between demographic characteristics and barriers to care, the t-test and ANOVA were used. Correlation coefficient was used to determine the relationship between barriers to care and parents’ perceptions of primary care and health-related quality of life (HRQoL).

    Results

    The mean and SD of BCQ was 63.93 (out of 100) and ±9.08, and the mean and SD for parent's perceptions of primary care (P3C) was 51.12 (out of 100) and±17.98. The mean score and SD of HRQoL reported by the children and their parents were (41.01 and ±22.38) and (40.63 and ±21.04), respectively. Perceived barriers to care was significantly related to the parents' perceptions of primary care (P<0.0001), HRQoL reported by children (P=0.021) and quality of life reported by parents(P= 0.020).

    Conclusion

    This study could provide important information for policy makers, managers, doctors, nurses and other health care team members and help them to develop and implement effective interventions to support children with chronic diseases and their families

    Keywords: Barriers to care, Thalassemia major, Parents’ perceptions, Quality of life, Children
  • Obstetricians' perspective on the Health Section Evolution Plan in Iran: A Quality-Case Study
    Alireza Jabbari, Mohammad Hossein Yarmohammadian, Marzye Hadian*l Pages 13-23
    Background and Objectives
    The Increase of unnecessary caesarean sections has become one of the serious concerns in some health systems. One of the seven packages of the health Reform Plan that was sent to all Iranian medical universities in 2014 was the "Promoting Natural Delivery (vaginal births)," It emphasized the need to reduce cesarean delivery and promote more natural delivery. The present study aimed to assess gynecologists’ perspective on the Health Section Evolution Plan in Iran.
    Methods
    This qualitative study was conducted in 2015. Semi-structural interviews were used for data collection. 11 gynecologists of Isfahan University of Medical Sciences through purposive sampling were interviewed. Thematic analysis method was used for data analysis.
    Results
    After analyzing the content of the interviews, four main themes including “making the natural childbirth franchise free”, “reducing C-section rate”, “motivating service providers", and “improving the standards of natural childbirth facilities”, and 5 sub themes including “not giving attention to the culture” , “obligatory increase of natural delivery rate”, “not giving attention to some reform laws at the natural childbirth”, “an unacceptable tariff payment system” and “payment delays on new tariffs” were determined.
    Conclusion
    Promotion of natural childbirth instructions has somewhat realized; however it has serious shortages and limitations. It is possible to solve a lot of problems by increasing the number of vaginal births through developing legal guidelines to respond to the possible problems as well as seeking leg
    Keywords: Obstetricians, Gynecologists, Promotion of vaginal births instruction, Promotion of natural birth, Health section Evolution Plan, Pregnant woman
  • Majid Bagheri Hossein Abadi, Ebrahim Taban, Narges Khanjani, Mina Galeshi, Siavosh Etemadinezhad, Seyed ehsan Samaei* Pages 24-34
    Background and Objectives
    Nurses in intensive care (ICU) wards often experience a wide range of stressful situations. Excessive work stress influences nurses’ physical and mental health and declines their life quality and the ability to work. High psychological stress can cause job dissatisfaction and job strain. The aim of this study was to explore the effects of psychological stress on job satisfaction among ICU nurses.
    Methods
    This descriptive-analytical study was performed on 402 nurses in the ICU of the teaching hospitals in Kerman and Babo in Iran from September 2016 to March 2017. Data were gathered by the Job Content Questionnaire (JCQ) and Minnesota Satisfaction Questionnaire (MSQ) and analyzed by logistic regression and ANOVA using SPSS 18.
    Results
    Significant relations were found between job satisfaction and some dimensions of JCQ such as psychological and physical demands, discretionary and binding decisions (autonomy in nursing), supervisor support and co-worker support. As the score of autonomous decisions and supervisor support increased, the chance of job satisfaction increased 2.33 and 1.56 times respectively. In addition, nurses with passive jobs and low job strain were more satisfied than the ones with active jobs and high job strain (P = 0.012).
    Conclusion
    More satisfaction in ICU nurses can be achieved by involving nurses in decision making and supporting them through their supervisors, alongside with reducing nurses’ psychological and physical needs through increasing the number of nurses in different wards.
    Keywords: Intensive Care Unit (ICU), Nurses, Job Satisfaction, Psychological Stress, Teaching hospital, Job strain
  • Mohammad Ranjbar, Sima Rafiei * Pages 35-48
    Background
    Entrepreneur organizations are considered as effective means of economic growth in every society. Trying to gain a competitive advantage leads organizations toward knowledge assets such as intellectual capital. This study aimed to investigate the relationship between intellectual capital and organizational entrepreneurship among employees of Yazd University of Medical Sciences in 2016.
    Methods
    This was a cross-sectional, descriptive-analytical study which performed among 223 employees of Yazd University of Medical Sciences in the year 2016. Method of sampling was stratified sampling. The standard questionnaires of Bontis Intellectual Capital and Scarborough entrepreneurship assessment were used to collect the data. Collected data were entered in SPSS version 20 and analyzed through descriptive analysis methods (Mean, Standard deviation), and Pearson correlation coefficient. 
    Results
    Mean of scores of employees was a modest level of intellectual capital (126.5+18.2), while the organizational entrepreneurship was also evaluated to be in a modest level (10.5+2.4). In terms of intellectual capital employees considered human capital dimension as the most important aspect (44.9+8.2). In addition, there was a correlation between human aspect of intellectual capital and organizational entrepreneurship (P=0.02).
    Conclusion
    Given the study results, paying special attention to human capital in every organization and empowering employees in terms of required knowledge and skills of innovation and entrepreneurship would be beneficial for the target society.
    Keywords: intellectual capital, Entrepreneurship, organization, employee, Medical university
  • Tahereh Shafaghat *, Nahid Hatam, Mohammad Kazem Rahimi Zarchi, Zahra Kavosi, Mohsen Bayati Pages 55-68
    Background and objectives
    Managers will be able to allocate resources optimally using performance evaluation data, specifically, efficiency evaluation of organizations. An efficiency evaluation of hospitals can be provided by determining the optimal scales for each hospital, to which optimal allocation of resources will be possible. Therefore, the present study aimed to evaluate the efficiency of hospitals using super efficiency model in comparison with the simple DEA model.
    Methods
    This is a descriptive-analytic and a cross-sectional study performed from 21 March 2015 to 20 January 2016. The study population consisted of 11 hospitals affiliated to Shiraz University of Medical Sciences. The data were collected into 3 sections: input indicators, output indicators, and environmental-social indicators. In this study, super efficiency and simple DEA models were used for evaluating the efficiency of the hospitals
    Results
    Based on the super efficiency model, hospitals 9, 5, and 4 had the highest efficiency. According to the input-oriented CCR model of DEA, among 11 studied hospitals, 4(36%) were efficient and 7(64%) were inefficient. Hospitals 3, 5, 7, and 9 were considered to be the most efficient ones with an efficiency score of 1. The mean efficiency score of the hospitals was 0.845 and their maximum and minimum efficiency scores were 1 and 0.462, respectively. In terms of surplus production factors, the input of specialists had the highest surplus value.
    Conclusion
    The study indicated that the super efficiency model led more accurate efficiency scores and provided a complete ranking of hospitals compared to the CCR model. Furthermore, managers should reconsider the number of hospitals and their allocation, improve their efficiency, and reduce repetitions by reducing their size or the scale of those kinds of hospitals which their efficiency was below the optimal line. Large hospitals should be divided into small-scaled and small-sized ones which could be managed more easily.
    Keywords: Efficiency, Data Envelopment Analysis, Super Efficiency, Hospital, Teaching Hospital
  • A Collaborative Blood Distribution System in a Network of Hospitals based on their Normal and Emergency Requests: a Mathematical Model and Solution
    Parisa Khakshour Saadat, Mohammad Mehdi Sepehri *, Aliakbar Pourfathollah Pages 69-85
    Background and Objectives
    A blood distribution network orchestrates distribution of safe blood products to hospitals. Blood shortage and blood wastage are two important factors which may affect efficiency of blood distribution network. Service delivery time is another factor that refers to the time interval between blood request by a hospital and transfusing it to the patient. Collaboration between hospitals can mitigate the three mentioned factors.
    Methods
    Mixed Integer Non-Linear Programming (MINLP) was used to model both current blood distribution network and collaborative blood distribution network mathematically. Two types of collaboration, including preventive and reactive, and two types of blood requests, including normal and emergency, were considered in modeling. The proposed model has been put into effect by considering platelets as blood product and applying real data of three high usage, medium-usage and low-usage hospitals in Tehran, Iran, during a planned horizon of 7, 14 and 30 days of July 2017 using IBM ILOG CPLEX solver.
    Results
    Preventive collaboration led to a decrease in blood wastage at low-usage hospital and a decrease in blood shortage at high-usage one. Reactive collaboration led to a decrease in blood shortage at all types of hospitals. Moreover, service delivery time of emergency requests was decreased using collaboration.
    Conclusion
    Determining the effect of preventive and reactive collaboration on blood shortage, blood wastage and service delivery time regarding both normal and emergency requests is the contribution of this paper. Managers of blood organizations and hospitals can save patients’ life and reduce costs of the whole blood distribution network by defining groups of hospitals which collaborate with each other under predefined protocols. The proposed model can be used to predict improvement in blood distribution network by implementing collaboration between hospitals.
    Keywords: Blood Distribution Network, collaboration, Blood Wastage, Blood Shortage, Normal request, Emergency Request, Service delivery time
  • Assessment of Managerial Practices at selected Teaching Hospital in Khartoum State: A case study
    Abdullahi Janay * Pages 86-97
    Background and Objectives
    Hospital management and its manner of governance influence different aspects of hospital performance. In Sudan; there we face scarcity of research about hospital management. The objective of this study was assessment of managerial practices of selected Teaching Hospital in order to improve the strategies of providing services and teaching.
    Methods
    A cross- sectional descriptive -analysis study was carried out in the period of January 1st to 15th of the year 2018. Sample size was 57 selected teaching hospital administrators, selected by randomly total coverage. The tool for data collection was a self-administered written questionnaire, which measures dimensions of planning, organizing, directing, evaluating, and materials, money, manpower and time management. Correlation test was used for data analysis through SPSS software version 20.
    Results
    Hospital administrators were 57.9% male and 42.1% female. 42% were married. 61% had a bachelor certificate. They gave overall high mean score on all dimensions of managerial practices; Planning=3.63, Organizing=3.66, Directing=3.69, Evaluating=3.57, Materials management=3.67, Money management=3.47, Manpower management=3.66, Time management=3.7 and Total variables=3.64.
    A weak significant relationship was observed between ‘materials management’ and ‘money management’, ‘money management’ and ‘directing’, and also between ‘time management’ and ‘planning’dimensions.
    Conclusion
    Hospital managers have to launch urgent initiative programs to concentrate on and enhance specific aspects of hospital administration to improve their general management, including preparedness to internal fire disasters, financing from other than government sources, adequacy of healthcare workers and evaluation of satisfaction rate of customers. Health policymakers have to give hospitals higher levels of autonomy in managing, including financial budgeting, and human resource management.
    Keywords: Hospital management, Teaching Hospital, Hospital Administrators, Managerial practices, Assessment