مجله تصویر سلامت
سال دهم شماره 4 (زمستان 1398)

Awareness about prescribing pattern and comparing that with standards of the World Health Organization (WHO) can affect health policy-makers in adopting policies and implementing necessary interventions for rational use of drugs. The aim of this study was to determine the pattern of drug prescribing in outpatients covered by Social Security Organization in Semnan province.

In this study, 952,712 prescriptions in Semnan province in 1396 were investigated and indicators of use of drugs include average price of each prescription, average number of drugs in each prescription, percentage of prescriptions containing 4 drugs or more, percentage of prescriptions containing antibiotics, injections and corticosteroids, physicians by specialty and by the length of activity were extracted and compared with those provided by the WHO standards.

The average price of prescriptions was 254,377 IRR and average number of drugs per prescription was 2.65. Generally, 26.9 percent of the prescriptions included 4 or more drugs. Percentage of the prescriptions containing antibiotics, injections and corticosteroids was 55 percent, 29 percent and 11.1 percent, respectively. All of the examined indicators were higher than the recommended level by the WHO.

This study showed some evidence of irrational drug prescription especially in the polypharmacy, antibiotics and injectable drugs. Therefore, it is suggested that adequate supervision of the prescribing and training of prescribing principles for physicians should be considered in continuing education programs.

Job burnout is one of the social problems of the present era that many factors can effect on it. These factors that should be carefully surveyed include emotional intelligence and resiliency. The main objective of this study was to obtain a cognitive and comprehensive knowledge of the relationships between the three variables affecting job burnout, emotional intelligence and resilience among the staff working at the headquarters of Tehran University of Medical Sciences.

The present study was a correlational cross-sectional study which was conducted at the headquarter units of of Tehran University of Medical Sciences deputies. The statistical sample consisted of 287 employees of headquarter units staff selected by stratified random sampling method. Data were collected by Schutte Emotional Intelligence Questionnaire (S_EIS) (1998), Conner & Davidson (CD_RISC) (2003) and Maslach Burnout Questionnaire M_JB (1981). SPSS and Amos software version 22 were applied and path analysis was used to analyze the data.

The correlation coefficient between the main scales of the research by Spearman test showed that there is a significant and direct correlation between emotional intelligence and resiliency (r= 0.381, p<0.001). There is an inverse relationship between emotional intelligence and burnout (r=-0.143, p<0.05) and there is a statistically significant relationship between resiliency and burnout (r=-0.436, p<0.05)

The predictive power of emotional intelligence as one of the predictors of job burnout is such that with increasing emotional intelligence, job burnout reduction can be predicted among employees. On the other hand, the emotional intelligence is a feature that can be strengthened through appropriate training programs.

Social Security Organization (SSO) provides healthcare services to the insured directly and indirectly. The purpose of this study was performance trend analysis of direct and indirect treatment of the SSO over the past 25 years and examining the correlation between them.

In this descriptive study that required data were obtained from SSO website, trend of direct and indirect treatment sectors performance of SSO was analyzed during the past 25 years (1993 to 2018) using Dynamic Multiple Attribute Decision Making (DMADM) with the help of Excel 2010 software by considering each year as an alternative and 21 key attributes that weights were determined using Entropy method. Also, Pearson correlation coefficient between direct and indirect treatment performance was calculated with the help of SPSS 16 software.

The trend of both types of treatment was incremental until 2007, then direct treatment was decreasing, but indirect treatment up to 2013 had a decreasing trend and after that had an increasing trend. The correlation coefficient of Pearson was equal to 0.912 until 2013 and from 2013 onwards equal to -0.991 (p-value ≤0.05 for both) which shows a direct, strong and significant relationship between the performance of direct and indirect treatment up to 2013 and strong, significant and inverse relationship afterwards.

According to the results of data analysis, it seems that new strategy of SSO has been providing more healthcare services indirectly by healthcare purchasing from government and private sectors.

Job stress in nursing is one of the most important issues of this century. Many of the studies have addressed the factors linked with this variable. The aim of this study was to predict nurses’ job stress based on psychological capital and job performance.

This descriptive-correlation study population consisted of all nurses in the city of Kermanshah in (2016) and 152 nurses were selected by convenience sampling method. To collect the data, job stress, psychological capital and job performance Paterson questionnaire was used. To analyze the data, Pearson correlation and regression were applied using SPSS version 22 statistical software.

The relationship between psychological capital and job stress (P<0.05) and psychological capital and job performance (P<0.001) was significant. The overall model showed that these two variables together are able to predict job stress (P<0.05) and psychological capital alone is able to predict job stress (P<0/05: β=-0/19), while job performance alone does not have the ability to predict job stress (P>0.05: β=-0.03).

Based on these findings, nurses who have rich psychological capital, experience lower stress.

Today, turnover intention and withdrawal behaviors of the personnel have received world-wide attention. Finding independent factors and mediators affecting personnel' commitment is essential, especially in health centers. Accordingly, the purpose of the present study was to determine the mediator role of job satisfaction among mentoring functions and organizational commitment in hospital personnel.

This was a correlation study based on structural equation modeling. The statistical population included all the permanent, temporary and contractual staff in Poursina Hospital in Rasht. A total number of 403 employees were selected using quota sampling. The selected subjects completed Mentoring Functions Questionnaire (MFQ-9), Organizational Commitment Questionnaire (OCQ) and Job Descriptive Index (JDI). All statistical analyses were done using SPSS Version 22 and AMOS Version 18. Bootstrap method with Preacher and Hayes' Macro program was used to analyze the mediating relations.

The fit indices of structural equation modeling showed that the proposed mediator pattern has an appropriate fitness of data (GFI = 0.986, NFI = 0.972, TLI = 0.976, CFI = 0.986 and RMSEA = 0.049). Findings showed that mentoring has a positive and significant effect on organizational commitment (P<0.0001) and job satisfaction (P<0.0001) among personnel’s. In addition, the employees' job satisfaction played a mediating role between mentoring functions and personnel' organizational commitment.

It is suggested that managers can strengthen mentoring dimensions, while improve the personnel’s organizational commitment and prevent them from turnover intention.

Social relations are one of the most important elements of every society that have undergone significant changes during the history of human life. Given the growing population of the elderly and the confrontation of the Iranian society with the aging population, addressing the social needs and communication networks of the elderly is important. The main purpose of the research was to investigate the relationship between social support and social isolation of the elderly people in Tehran.

This cross-sectional study was descriptive-analytic. The present study was conducted in 1396 and among 384 elderly people 65 years old and above in Tehran who were selected by multistage cluster sampling method. The data collection tools consisted of a comprehensive social isolation (UCLA) questionnaire and a multi-dimensional social perceived social support (MSPSS). Data were analyzed using SPSS software version 25 using descriptive and analytical methods, using t-test and analysis of variance. A significant level was found for the comparison of the social isolation among the elderly groups of 0.05%.

Approximately 78% of the older adults in Tehran enjoyed good social support and the prevalence of social isolation in this population was 62%. There was no significant relationship between gender, age, ethnicity, socio-economic status of the elderly and their social support (p>0.05).

The elderly people of Tehran had high social support and there was a significant and inverse relationship between the two variables of support and social isolation of the elderly. This means that with the increase in social support, the level of social isolation of the older adults was reduced.

Participation in health care is a key principle for achieving "health for all". To make better decisions and decrease the management errors, this study was aimed to conduct a narrative review on how public can participate in community-based health promotion programs and extract the lessons learned from these interventions. This was a narrative review study. The research was done exploring databases such as Scopus, PubMed, and Google Scholar using keywords like community participation, health promotion, methods and lessons learned and their combination in English; same words were searched in Persian at databases such as SID, Magiran and IranMedex. Articles and related reports from 2000 to 2017 were reviewed. The use of communication channels that are diverse and relevant to public’s culture, the direct involvement of communities, the provision of economic incentives, and the creation of a participatory environment are among the most important ways of attracting community participation. Mobilizing local resources, creating a project perspective, following operational norms, core values and values of partnership, committing to transitions to interventions and policies are some of the lessons learned. Mutual trust, respect and freedom to share and communicate, interacting with key stakeholders, transferring executive and management responsibilities to key stakeholders and synchronous trainings and individuals’ participation in monitoring the program, all have a significant impact on increasing community participation in health promotion programs.

Fertility style is of great importance to human population growth rates. Identifying the different factors on fertility can influence the adoption of population policies on controlling population growth. The purpose of this review study was determination of demographic and clinical factors role on fertility patterns in Iran. A systematic search was conducted in Persian and English documents including, Cochrane Library, PubMed, Thomson Reuters, SID and Medical Library (MedLib), Magiran, Google Scholar and Science Direct (from 1991 to 2017). All types of full articles (observational or interventional) were reviewed. Keywords for search included fertility; prognostic factors; factor, demographic; determinant, fertility. By reviewing the abstracts of articles, 107 articles were selected, but overall, 31 eligible articles were included in the study. The results showed that, the marriage age, mother's education and employment are of the most important determinants of factors in fertility, also the age difference between couples, maternal and fetal complications in previous pregnancies, the number of previous children and their gender were reported as factors affecting the fertility style. It seems that the age of men and women at the time of marriage, the level of education of women and being employed are of the most important factors affecting fertility. There is also an imbalance in childbearing in different stratum of society; so that women's employment and higher education are important obstacles to childbearing.