فصلنامه پژوهش های سلامت محور
سال چهارم شماره 2 (پیاپی 13، تابستان 1397)

Patient safety culture is one of the effective factors in the prevention of medical errors and keeping patient safety, therefore, its assessment will lead to the identification of improvable factors and provision of corrective action solutions for the weaknesses. This study aimed to evaluate patient safety culture from the perspective of healthcare personnel of teaching hospitals affiliated to Alborz University of Medical Sciences. This cross-sectional descriptive-analytical study was conducted in 2018. The study samples were 168 personnel who were selected from two teaching hospitals affiliated to Alborz University of Medical Sciences, using simple random sampling. Data were collected using Hospital Survey on Patient Safety Culture (HSOPSC) with 12 dimensions. Data were analyzed using descriptive statistics and independent t-test by SPSS version 20. The total mean score of patient safety culture was 3.21. Of 12 dimensions, teamwork in units had the highest mean score (3.5), and non-punitive response to errors had the lowest mean score (2.7). There was no significant difference between total mean scores of organizational learning and continuous improvement; supervisor expectations and actions promoting patient safety; relationships and feedback of errors; and teamwork in the unites of two hospitals. Development of an encouragement culture instead of punishment/blame culture is one of the issues that politicians need to pay attention to. In addition, continuous training of staff at all levels and occupations in terms of patient safety culture will be effective.

Nowadays, burnout as a psychological syndrome is a major problem, especially in health services, that has been identified in a large number of health care providers. The aim of this study was to determine the extent of burnout and the relationship between demographic characteristics and burnout dimensions among primary health care providers. This cross-sectional descriptive-analytic study was conducted in 2019. The statistical sample included all primary health care providers (n=335) working in one of the medical colleges in Markazi province. Data were collected using Maslach Burnout Inventory (MBI). Simple and multiple regression tests were used. Data were entered into SPSS version 23 software. The mean score of emotional exhaustion, depersonalization, and personal accomplishments was 15.5, 4.9, and 33.8, respectively. Among health care providers, 21.8% had high emotional exhaustion, 23%, high depersonalization, and 47.5% had low personal accomplishments. The results of multiple regression tests indicated a significant relationship between gender, work experience, and place of service with burnout. Some strategies such as conducting training courses, providing advisory services, and optimizing human resources management, especially for women, urban employees, and those with high work experience, are suggested to reduce burnout.

Evaluation of the quality of hospitals services is very valuable. The results of evaluations can be useful to healthcare providers and patients by identifying the gap between the current and the desired status. SERVQUAL model is one of the methods for assessing the quality of health care services. This study aimed to evaluate the quality of services in a selected teaching hospital in Kerman city, from the perspective of patients. This descriptive-analytic study was conducted in a cross-sectional manner from October to March 2017 in a selected teaching hospital in Kerman. The study population included 83 patients with a history of hospitalization who were selected using convenience sampling. Data were collected using a SERVQUAL model. Data were analyzed using Pearson's correlation, independent t-test, and ANOVA by SPSS version 22. The average age of patients was 43.78±12.43 years. The quality of hospital services was improved compared to previous years. The highest and the lowest mean were related to "Tangibles" (4.04±0.58) and "Empathy" (3.84±0.46), respectively. There was a significant relationship between service quality and gender (P=0.01) and educational level (P<0.001).  Healthcare managers should use the results of such studies to plan and allocate optimal hospital resources and increase the quality of their services. Should improve the level of patients' satisfaction by directing resources towards areas affecting patients' perception and experience.

In case of disasters, hospitals as one of the first centers to admit casualties, need to be well prepared. Emergency response of hospitals to deal with disasters is essential to success in providing qualified emergency services. The aim of this study was to evaluate emergency response of teaching hospitals affiliated to Iran University of Medical Sciences against disasters. This cross-sectional descriptive study was conducted in 14 teaching hospitals affiliated to Iran University of Medical Sciences in 2017. To collect data, hospital emergency response checklist provided by WHO (2011) with 90 questions in 9 domains (command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery), was used. Data were analyzed using descriptive tests by SPSS version 15. Mean score of emergency response of the hospitals against disasters was 56.93. The highest and lowest levels of response were related to human resources (63.57) and Materials and inventory management (57.03), respectively. Planning and providing a systematic framework to deal with disasters is essential, and the major role of hospitals in providing services should not be ignored, it should be considered as a priority in planning and budgeting for disasters.

Allergy is one of the most common diseases that is rapidly increasing. Since this disease is a psychosomatic disease, to evaluate the factors affecting it, a combination of biological and psychological factors should be considered. The aim of this study was to compare the personality traits and emotion regulation styles in patients with and without allergy with healthy people. This descriptive-analytical cross-sectional study was conducted in the Allergy Clinic in Urmia city in 2017. In this study, 100 patients (50 patients with allergy, and 50 patients without allergy) and 50 healthy people were selected through matching with the patient group using convenience sampling method. Data were collected using Personality Trait Questionnaire (PTQ) and Cognitive Emotion Regulation Questionnaire (CERQ). Data were analyzed using multivariate analysis of variance, Levin and Scheffe test. Neuroticism was more common in patients with and without allergy than those healthy people (P=0.001). Patients with allergy obtained lower scores of the extraversion trait and adaptive emotion regulation compared to the other two groups (P=0.001). There was no significant difference between the three groups in terms of agreeableness and openness to experience.  It seems necessary to use psychological interventions in the training of emotion regulation skills and pay attention to the personality traits in these patients.

Identification and elimination of the internship problems of Health Services Management students is essential for improving the quality and effectiveness of the courses in this field. Therefore, this study aimed to identify the internship problems of Health Services Management students in Shiraz University of Medical Sciences from perspective of the faculty members and educators. This is a qualitative study which was conducted phenomenological approach in 2018. In this study, 12 educators in the field of Health Services Management in Shiraz University of Medical Sciences, were interviewed. Samples were selected using purposive sampling. Data were analyzed using framework analysis by MAXQDA version 10. In this study, 4 main themes and 25 subthemes were obtained. The main themes included macro-level, faculty and faculty members, hospital, and student problems.  According to the results, the interventions at the level of policy-making in the medical education system in order to improve the educational curriculum and internship course, as well as the use of motivating factors for the better interaction of the hospital staff with the educators and students seem essential.

Obesity affects the health of people and imposes costs on them. Since there are two common treatment methods, Roux-en-Y gastric bypass (RYGB) surgery and laparoscopic sleeve gastrectomy (LSG), and there is not enough and aggregated evidence on the cost-effectiveness of these two treatment methods in patients in Iran, therefore, this study was conducted to review the studies on the cost-effectiveness of these treatment methods. This is a systematic review study. All articles published in English, which reviewed the cost-effectiveness of these two surgical methods during 2000-2017, were collected from the SCOPUS, PUBMED, MEDLINE, and EMBASE databases. The quality of these articles was evaluated by two researchers based on Grade's guidelines. The amount of body mass index (BMI) and reduced weight percentage in both methods showed the same effectiveness in weight loss. In Iran, the direct cost of RYGB services was $2991 in the public sector and $4221 in the private sector. For the LSG method, this was $1952 in the public sector and $3,177 in the private sector. ICER for the LSG method compared with the RYGB was $720 and $716 in the private and public sectors, respectively. Laparoscopic sleeve gastrectomy (LSG) is more effective than the RYGB because it has lower cost and the same effectiveness.

Self-rated health is one of the main health indexes of society which is affected by several economic, social and cultural factors. Accordingly, the purpose of this study was to find the level of self-rated health and its relationship with perceived social support and trust in health care system among residents of Shiraz City/ Iran. The study was descriptive-analytical which conducted as cross-sectional on 601 of Shiraz City citizens over 18 years old selected by proportional stratified-sampling method, from September 2016 to April 2017. Data were collected by Goldberg public health questionnaire (GHQ-28) to measure the Self-Rated Health and Winfield & Tuckerman Questionnaire to measure the perceived social support and a researcher-made questionnaire to measure trust in health care system. Pearson statistical test was used to analyze the data. Data analysis was done through SPSS software version 20. Mean score of self-rated health was 85± 12.65. In whole, 12% of respondents rated low level and 68.7% intermediate level of health. In addition, according to the results, self-rated health in physical, psychological and social domains had significant relationship with perceived social support and trust in health care system.  The attention of policy makers in the field of health to the concept of self-assessed health and influencing factors can play an important role in promoting the health of the community and preventing the occurrence of physical, psychological and social problems.