فصلنامه پژوهش های سلامت محور
سال پنجم شماره 4 (پیاپی 19، زمستان 1398)

The development of various health care facilities has increased the production of medical wastes, which has contributed to environmental pollution and dramatic increase in waste management costs; therefore, the efficient management of hospital waste is of paramount importance. This study aimed to investigate the waste management status of selected hospitals in Isfahan.

This study was cross-sectional and descriptive. In this study, using the checklist provided by Environmental Protection Agency, the data of 14 university hospitals and 1 private hospital were collected. The validity and reliability of the checklist were assessed. Descriptive statistics such as mean and percentage of compliance with the standard were calculated.

The average medical waste generated was 379.28 kg / day for each hospital. Moreover, the lowest and highest rates of compliance with standard questions were observed in waste disposal unit (98%) and waste loading (100%), respectively. The studied hospitals performed well in terms of volume and type of waste produced and waste management process.

In large hospitals, at-source waste separation is more necessary. Implementing waste management guidelines, procedures, and policies is also crucial, and hospitals need to follow the move from theory to practice to reduce the amount of medical waste and reduce costs.

Our country is facing increasing costs of treatment and funding shortages. The reason for this crisis is the increase in the cost of medicine, medical equipment, and skilled manpower. The physiotherapy unit is one of the cost centers and accounts for a large share of hospital costs. Managers and policymakers must pay special attention to cost centers in order to make decisions about reducing costs and increasing efficiency.

The present study was a retrospective economic evaluation that was conducted in 2018 based on activity-based costing. The data were collected by referring to the Physiotherapy, Employment, Finance, Medical Equipment and Warehouse Units. To calculate the cost of physiotherapy services, the salaries of staff working in the units as well as the cost of the consumables, depreciation of buildings and equipment and energy were estimated in detail.

The total annual costs of the physiotherapy unit amounted to 8415722668 rials and the annual loss of the mentioned unit amounted to 1287632108 rials. The highest costs were for physiotherapists, accounting for 82% of the total costs, overhead costs, accounting for 8.1%, and depreciation of medical equipment.

According to the losses imposed on physiotherapy unit, one of the suggested options is unit outsourcing. Running evening shifts, paying fee-for-service due to high personnel costs, and hiring a non-faculty technical manager with a lower salary can be effective in reducing the average unit cost.

School Health Nurses in health-promoting schools have a decisive role in the effectiveness of these schools in promoting studentschr('39') health. The main purpose of the present study was to investigate the role of health literacy of health care providers in their quality of life in health-promoting schools of Tabriz education districts.

The present study was a descriptive-analytical one conducted in 175 health-promoting schools in Tabriz in 2019. A total of 120 school health nurses in health-promoting schools of five education districts were selected using stratified random sampling. Data were collected using the Health Literacy Questionnaire of Iranian Institute for Health Sciences Research and the World Health Organizationchr('39')s Quality of Life Questionnaire. Structural equation modeling was used to analyze data through Smart PLS software.

The results showed that quality of life with all its dimensions including physical health, emotional health, environmental health and social health are predictable based on all dimensions of health literacy.

Improving the health literacy of school health nurses through specialized training courses, conferences, scientific competitions and field visits to successful schools around the world can improve the quality of their lives.

Nowadays, many patients refer to outpatient clinics due to anxiety, depression, and somatization disorders. These disorders have catastrophic costs for the health care system. The present study examined the relationship between depression, anxiety, and somatization in outpatients.

This descriptive-analytical study was conducted in 2018 on 400 patients over 18 years old who referred to a selected clinic in Kerman and were selected using a convenience sampling method. Data were collected using the Hospital Anxiety and Depression Scale as well as Physical Health Questionnaire. Logistic regression statistical tests were used to analyze the data. Data were entered into SPSS statistical software version 20.

The results of this study indicated that 38.8% of outpatients had a somatization disorder, 73.5% had anxiety and 61.2% had depression. Depression was associated with an increased risk of somatization in such a way that a one-unit increase in the depression score increased the risk of somatization 1.12 times.

Training physicians to timely diagnose and treat mental disorders, especially depression has a significant impact on reducing the burden of physical and mental illnesses.

Lack of mental health as a special concern of the organizations could have distressing effects on individuals and organizations. Studies show that employee invisibility and communication apprehension could have a negative effect on mental health. The objective of this research was to investigate the effect of invisible employees on mental health based on the mediating role of communication apprehension in Rafsanjan University of Medical Sciences.

This descriptive-analytical study was conducted based on a cross-sectional design in 2019 on 276 university staff who were selected by stratified random sampling. Data were collected through three questionnaires. For statistical analysis, structural equation modeling as well as SPSS software (version 23) and Amos (version 20) were used.

The total mean scores of invisible employees, mental health, and communication apprehension variables were 2.22, 3.55, and 2.47, respectively. The invisible employees variable had no effect on mental health (path coefficient = -0.100, P =0.117), however, it had a direct effect on communication apprehension (path coefficient = 0.743, P =0.001). Moreover, communication apprehension had a negative effect on mental health (path coefficient = -0.881, P =0.001).

To promote mental health, university managers must consider effective communication between employees in the workplace. Furthermore, in order to reduce invisible employees, managers must value them, not ignore them in the workplace, use their experience in various tasks, and appreciate their efforts.

Aging and the need for more health care in the elderly population have incurred large expenditures. Based on the importance of the aging population phenomenon and the increase in lifetime in recent decades, this study aimed to systematically review the studies on costs of elderly health care.

In this systematic review, the articles published in PubMed, Google Scholar, Science Direct, Scopus, and Ovid Medline databases from 2000 to 2017 were derived using a systematic search strategy.

The results of the reviewed studies showed that by increasing the consumption of long-term care and home care, the costs would increase and by reducing the consumption of acute hospital care, such costs would decrease. Based on the results, the average cost of elderly health care in the reviewed studies was 48101 US dollars in 2015. Moreover, the highest average costs were for inpatient services (19003US dollars) and long-term care and home care (12583US dollars).  

Considering the high costs of hospitalization of the elderly, measures like establishment of day care centers and home care instead of hospitalization should be taken into consideration in the elderly health care programs to reduce the number of hospitalizations.

In the competitive market of medical services, providing quality services and building a strong relationship that shapes patient loyalty is a key factor in gaining market share. Therefore, the present study was conducted to determine the effect of environmental factors on the level of satisfaction, emotions, and behavioral intentions in hospitalized patients.

The present study was a descriptive-analytical cross-sectional one conducted in the first half of 2019. A total of 210 patients admitted to selected public hospitals in Shiraz were included in the study by simple random sampling. The data collection tool was a researcher-made questionnaire. Data were entered into SPSS software (version 22) and Smart pls (version 3). Confirmatory factor analysis and structural equations were used to test the hypotheses.

Environmental factors had an effect on behavioral intentions, emotions, and satisfaction of hospitalized patients with path coefficients of 0.377, 0.654, and 0.590, respectively. Satisfaction with a path coefficient of 0.548 and emotions with a path coefficient of 0.001 had an effect on behavioral intentions. Moreover, it was proved that emotions and satisfaction had a mediating role in the impact of environmental factors on the behavioral intentions of hospitalized patients.

The hospital should pay attention to providing and strengthening environmental indicators and improving the physical space and it should prioritize these factors in its future plans. Also, allocate a separate part of the annual hospital costs to this matter.

According to World Health Organization, patient safety is a serious public health issue, an important aspect of the quality of health care, and a vital prerequisite for universal health coverage. The objective of this study was to investigate nurseschr('39') perceptions of patient safety culture (PSC), barriers to medical error reporting, as well as the relationship between the two.

This descriptive-analytical study was conducted in six public hospitals in Tehran on 420 nurses who were selected using multistage sampling. The Hospital Survey on Patient Safety Culture (HSOPSC) and a researcher-made questionnaire on barriers to medical error reporting were utilized. Data were analyzed using correlation tests, t-test, analysis of variance (ANOVA), and multivariate regression analysis using SPSS software (version 20).

The mean score of patient safety culture was 52.01 and the mean score of barriers to error reporting was 3.13. Manager expectations and actions had the highest mean score (69.8) and non-punitive response to errors had the lowest mean score (23.6) among the dimensions of patient safety culture. Fear of the consequences of reporting an error was the most important perceived barrier to error reporting (3.37). There was a significant negative correlation between safety culture and perceived barriers to error reporting (P<0.001).

Setting up an anonymous reporting system as well as increasing managerschr('39') support for error reporting and providing positive feedback to nurses are essential steps to improve error reporting.