نشریه مدیریت سلامت
پیاپی 84 (تابستان 1400)

Considering the COVID-19 pandemic and its severe effects on life, there is no doubt that an analysis of the components and drivers of abnormal behaviors can facilitate the emergence of moral behaviors. Therefore, we conducted this study in order to investigate the drivers of abnormal behaviors from the perspective of health managers during the COVID-19 pandemic.

This research is a cross-sectional, qualitative, and applied study that was conducted using snowball sampling method and semi-structured interviews with 13 managers at different management levels in so called social security hospitals in Mazandaran province in the first half of 2020. Also, validation of Lincoln and Guba reliability criteria and data analysis were performed by combined summary content analysis method with MAXQDA10 software.

Findings of this study show that a number of factors are among the drivers that cause the occurrence of abnormal behaviors in hospitals. These factors could be divided into three types: Structural factors that include inadequate payroll system, job characteristics, organizational misconduct, and managerial weakness; behavioral factors include stress, aggression in the organization, antisocial behavior, and individual psychological disorders; and environmental factors as well as internal and external environment of the organization.

Through increasing financial supports and incentives, results of this study help managers reduce stressors, create better conditions for employees, increase the quality of performance and services provided to patients, and improve the health level of the country.

The identification of factors affecting the prevalence of Covid-19 is vital in order to control the pandemic. Poverty and economic inequality are among the most important variables explaining the spread of coronavirus. This study evaluates the impact of poverty and economic inequality on the prevalence of COVID-19 worldwide.

This is an applied study which uses descriptive-analytical method. Also, the current study employs cross-sectional data and stable regression method to evaluate the effect of poverty and economic inequality on the prevalence and mortality rate of COVID-19 among 145 countries. The statistical population of this research study includes COVID-19 aggregate data extracted from Oxford-Martin Research Program and the World Bank in 2020-2021. According to the World Bank classification, we classified the surveyed countries, including Iran, in terms of their income levels into four income groups. Then, the impact of poverty and inequality indicators on the prevalence of COVID-19 has been analyzed among them. Also, econometrics and data analysis were performed using MATLAB software.

Estimates confirm the increasing effect of undernourishment and population aging on the spread of coronavirus for all income groups worldwide. In contrast, increasing stringency index reduces the morbidity rate of COVID-19. Significant variables in the prevalence of corona for Iran and countries within the upper middle-income group have also confirmed the effect of aging and stringency index. Finally, the variables explaining the increase in COVID-19 mortality rate in Iran and the upper middle-income group includes GINI coefficient, aging, and undernourishment.

Results of this study suggest that adequate nutrition in line with health expenditures and stringency index can play an effective role in reducing COVID-19 morbidity and mortality. Also, employing appropriate policies in order to increase economic equality will play a significant role in reducing COVID-19 mortality rate.

Nurses’ turnover reduces quality of health care and increases costs. Neglecting the nurses’ quality of worklife can lead to their turnover. The aim of this study was to determine the relationship between nurses’ quality of worklife and their intention to leave work in public hospitals in Herat, Afghanistan.

This was a descriptive-analytical study, investigating nurses’ quality of worklife and their turnover intention in public hospitals. We used census method, and all 258 respondents completed the standardized questionnaire on quality of worklife. Nurseschr('39') turnover intention was also measured by using an item. Meanwhile, we used descriptive statistics to present demographic variables. Meanwhile, Mann-Whitney test, Chi-square, and Spearman correlation coefficient were used to determine relationships between the study analytic variables. In this study, SPSS version 26 was used.

The quality of worklife and the intention to leave was at an average level. No relationship was found between turnover intention and demographic variables (p>0.05). Results from the Spearman correlation coefficient demonstrate a significant inverse relationship between turnover intention and some aspects of the quality of worklife including participation and involvement, job security, wages and salaries, career honor, and job stress. In other words, an increase in any of the aforementioned aspects results in a decline in intention to leave (P<0.05). The relationship between intention to leave and quality of worklife was inverse and significant (r=0.279, P=0.001).

Participatory management in decision-making, paying attention to salaries and benefits, and assuring nurses that they will not lose their job in the event of any socio-economic change can increase job satisfaction, and reduce their intention to leave work.

Palliative care provides interdisciplinary care focused on patient-centered outcomes such as quality of life, symptom burden, emotional well-being, and caregiver need. With the aging population and the prevalence of chronic diseases, the need for palliative care is increasing. Thus, the need to provide palliative care services at different levels of the health system, especially in hospitals, cannot be ignored. In this study, we intended to examine the types of hospital-based palliative care models and identify the disadvantages and advantages of each of those models.

This study was conducted as a comprehensive review in 2019. The required data were collected through an advanced keyword search, including hospital-based palliative care, palliative care in hospital, inpatient palliative care, palliative care establishment, palliative care development,and palliative care models in English  databases such as Web of Science, Science Direct, Scopus, and PubMed as well as Persian databases such as Magiran and  SID from 2005-2020.

Out of 3877 sources, 164 related sources were selected. Generally, nine hospital-based palliative care models were identified, including outpatient palliative care clinic, palliative care consultation service, palliative care day-care service, dedicated inpatient palliative care unit, palliative care outreach/home-care service, Swing beds, integration with the emergency department, integration with the ICU, and the integrated model. Some benefits and limitations were identified for each of the Hospital-based palliative care models.

All hospital-based palliative care identified models can help hospitals to strengthen the palliative care approach, but given the limited resources of each hospital, hospital officials must choose between them and develop the model at their hospital after modifying and adapting that to the existing culture, structure, and facilities.

Employee relationships at universities are a set of frameworks, policies, and methods that can lead to the effectiveness and efficiency of human resources. Considering the importance of the employee relationships system at universities, we in the present study aims to identify the components of the employee relationships system based on knowledge-based organizational structures at medical universities.

This is a qualitative study with a phenomenological research strategy. The population we recruited for this study was professors of health services management, presidents of universities of medical sciences in the 9th district of Amayesh, and professors of Public Management Department at Islamic Azad University, Birjand Branch. We used semi-structured interviews to collect data. Also, we conducted interviews through content analysis (open and axial coding).

According to the results of this study, we were able to identify eight main themes that are as follows: Relationships based on trust, informal and organic relationships, relationships based on transparency, relationships based on knowledge and expertise development, cooperation between organizational, goal-based relationships, ethical charter relationships, team relationships.

According to the results, we can make the claim that proper relationships among employees at universities are a prerequisite toward the improvement of knowledge management, which further leads to increased efficiency, motivation, and efficiency of employees at the university. In order to create a knowledge-based organizational structure, policymakers should pay more attention to these factors in employee relationships.

Alzheimerchr('39')s disease registry system is of great help in generating big data through collecting data over time. Visual analysis tools such as dashboards can be used to convert this data into knowledge. Based on the needs of stakeholders, we in the present study determined the key indicators of Alzheimerchr('39')s disease; then, based on the Alzheimerchr('39')s disease registry system, we designed and evaluated the dashboard.

In the first stage, we determined the key performance indicators through a questionnaire completed by 31 members of the Alzheimerchr('39')s disease research core at Iran University of Medical Sciences. In the second stage, we designed the dashboard based on previous studies and using QlickView software. Finally, we designed the dashboard by the System Usability Scale which was conducted by four members of the Alzheimerchr('39')s disease research core and three medical and health information technology graduates.

Among the 15 key performance indicators approved by members of the Alzheimerchr('39')s disease registry, three indicators have got the highest score; these indicators are as follows: the ratio of patients with a history of mental disorders compared to the total number of patients, the ratio of patients with a history of depression compared to the total number patients, and comparing the prevalence and incidence of the total population. Then, we evaluated the usability of the dashboard by the system usability scale whose average score was 71.7.

Implementing the Alzheimerchr('39')s disease dashboard will play an important role in meeting the needs of each stakeholder and increasing the ability to analyze information in order to make better decisions.

Career boundaries are effective in all aspects of the medical profession. Since many factors can shape a junior doctor’s choice of career, the concept of career has always been the focus of medical discussions and has even been able to be used as a perspective in medical education. The aim of the present study was to provide a conceptual framework of career boundaries in the medical profession.

The present study is fundamental in terms of purpose and qualitative in terms of approach. The statistical population of this study included physicians who were selected by non-random snowball sampling. The criterion for entering the sampling was their having more than five years of work experience, and the criterion for completing the sampling was the researchers’ reaching theoretical saturation: a total of 19 people participated in the study. In order to collect the data, a semi-structured interview was held, and for the analysis of the collected data, the systematic grounded theory was used.

The research findings indicated that the conceptual framework of career boundaries in the medical profession includes individual differences and social institutions as causal conditions, work-family boundaries, geographical boundaries, social boundaries, organizational boundaries, moral boundaries, and legal boundaries as the central phenomenon. Findings also included understanding boundaries, reviewing boundaries and crossing boundaries under strategies, educational and cultural contexts under the context conditions, macro-factors and micro-factors under the intervening conditions and future of the career, and re-planning the career and work-family balance as the consequences.      

Paying attention to the conceptual framework of boundaries can be a great help in planning, deciding, managing, and developing a career for physicians and other occupations. In addition, employed physicians, especially physicians who are at the beginning of their careers, job seekers, and university graduates can be aware of the boundaries of their careers. In addition, they become aware of the consequences of their career boundaries to make choices more openly and increase their chances of career success.

Iran has natural resources such as oil that can affect health; however, whether a natural source of oil can have a positive effect on health or not is a question for economists. In this study, we empirically examine how economic dependence on natural resources affects health with respect to institutional corruption.

The present study is an applied study with longitudinal analytical-descriptive method using smooth transitional regression method between 1984 and 2017. The research population in this study was the annual data of the whole country. Also, the dependent variable is life expectancy, and the main independent variables are oil rents to GDP. Other independent variables used include the corruption index, GDP per capita, and literacy level. Data analysis was also performed with Eviews software (version 12).

Results of the estimates showed that the effect of economic dependence on natural resources on health and corruption in Iran during the study period was inversely U-shaped. The estimated threshold for the share of oil rents in GDP in life expectancy was 3.070%. The results indicate that the corruption reduction index has a positive and significant effect on health. But GDP has had a negative impact on life expectancy.

According to the results of this study, in order to reduce the negative effects of dependence on natural resources, we recommend that appropriate policies such as attention to other productive sectors and strengthening other economic infrastructure to reduce dependence on natural resources should be applied in order to improve existing conditions in the country. Considering the positive effect of reducing corruption on health, we also recommend that appropriate policies should be implemented to improve the institutional quality.