فصلنامه پژوهش های سلامت محور
سال ششم شماره 2 (پیاپی 21، تابستان 1399)

Spirituality is a new concept that has emerged in the literature of management and business in the West in recent years and is even referred to as a new model. The present study aimed to investigate the relationship between organizational spirituality and organizational commitment in staff members of Kerman University of Medical Sciences.

This study was a descriptive-analytical one conducted in 2017. The statistical population of the study was the staff members of Kerman University of Medical Sciences among whom 130 members were selected using stratified random sampling and entered the study. The data were collected using Milliman’s Organizational Spirituality Questionnaire as well as Meyer and Allen’s Organizational Commitment Questionnaire. The data were analyzed using analytical statistical methods including linear regression, t-test, and Anova via SPSS software (version 16).

The results of this study indicated a significant relationship between organizational commitment and work experience variable (P =0.021). The results of regression analysis showed a positive and direct relationship between organizational spirituality and organizational commitment (P < 0.001). 

The managers and those in charge of an organization should look for ways to ensure the spirituality of the subordinates in order to be able to achieve more organizational commitment. Moreover, proper planning and fostering the beliefs and values of the employees can increase the organizational commitment and thus the productivity of the organization.
 

Burnout can negatively affect various aspects of the physical and mental health of medical staff especially medical residents and cause a decline in their performance. The objective of this study was to investigate burnout among medical residents of Kerman University of Medical Sciences in 2018.

This was a descriptive-analytical cross-sectional study carried out in 2018 on 150 medical residents of Kerman University of Medical Sciences selected by convenience sampling. The data were collected using the Oldenburg Burnout Inventory. The data were analyzed via SPSS20 software using Chi-square, independent t-test, and logistic regression.

The means of exhaustion and disengagement subscales were 22.63 and 20.97, respectively. The mean of disengagement was significantly higher in females than in males (P =0.03). The means of burnout and exhaustion were significantly lower in fourth-year residents than in first-year residents (P=0.01). Moreover, there was a positive and significant correlation between the mean of disengagement and the mean of exhaustion (P= 0.001).

It is necessary for the university’s vice-chancellor for education and culture to adopt appropriate policies and strategies to deal with job stress and its leading factors in medical residents.
 

There are different statistical methods to identify the factors effective in increasing and decreasing the patients’ length of stay (LOS), each of which having its own advantages and disadvantages. This study aimed to determine the factors affecting LOS in a selected hospital using the available count models and comparing them with the Hurdle model as a new model.

This descriptive-analytical study was conducted using a retrospective cross-sectional design in a selected hospital in Isfahan in 2019. Using Poisson and Hurdle (binomial and Poisson) count models, the effect of demographic factors of the hospitalized patients and the reasons for visiting the hospital on LOS was analyzed. The goodness of fit of the models and their comparison were performed using deviance statistic.

The mean of LOS was 8.89 days and the median of LOS was 3 days. From among the three models, the binomial Hurdle model was determined appropriate in which, the constant and variables such as age, social security insurance and uninsurance, hospital emergency visits and 115 emergencies, and reasons for visiting psychiatric, orthopedic, and ophthalmic wards were significant. By changing the type of insurance from the reference of other insurances to social security insurance, the mean of LOS decreased by 0.088 units and for uninsured patients, this decrease was by 0.539 units.   

Considering the values of the deviance statistic for Poisson, Hurdle Poisson and negative binomial Hurdle models, the negative binomial Hurdle model is the most appropriate for analyzing these data.
 

The establishment of a referral system leads to improved relations between general practitioners and specialists, improved service quality, reduced waiting time, and reduced costs. The purpose of this study was to explain the opportunities and threats outside the organization in establishing an electronic referral system in Golestan province.

This qualitative study was conducted using phenomenological analysis in Golestan province in 2019. The participants were 45 managers, experts, family physicians, specialists, and patients selected via purposive sampling. The data were collected using semi-structured interviews and analyzed via content analysis.

After analyzing the interviews, 7 themes and 18 sub-themes were obtained. The most important opportunities available were the existence of upstream documents and laws, the allocation of one percent of value added to cover the costs, the existence of a Nab (Health information software) independent system in the province, and the reduction of out-of-pocket payments. The main threatening factors were the change of officials of the Ministry of Health and the Health Insurance Organization, the patient’s insistence on visiting a specialist, the patient’s failure to see a specialist despite appointments, Poor notification, delays in payments to doctors, and poor communication infrastructure. 

Selecting appropriate strategies by taking advantage of opportunities can facilitate the process of implementing the electronic referral system in Golestan province and modeling it in other provinces. Adopting strategies such as formulating national policies, reforming the outpatient payment system, and reducing out-of-pocket payments can help improve the current situation.
 

Patients’ health and progress in recovery are affected by their adherence to treatment strategies. Identification of effective methods and treatments on increasing treatment adherence can improve patients’ adherence to treatment and consequently their health.

The present study was a descriptive-analytical one conducted as an intervention in Tehran in 2020 for twelve weeks on thirty patients with bulimia nervosa in two groups who were selected using convenience sampling. The treatment adherence questionnaire was used to collect data. The statistical tests of mixed analysis of variance between groups and within groups were used to analyze the data. The data were entered into SPSS statistical software (version 25).

Cognitive-behavioral therapy with both face-to-face and online methods significantly increased adherence to therapy. The mean of adherence to treatment in the group receiving online training was significantly higher than that of the group receiving face-to-face training.

It is necessary to evaluate the adherence to the treatment of patients with bulimia nervosa in clinics and provide cognitive-behavioral therapy for those with bulimia in order to correct their misconceptions about their body image and control their stress.
 

Potential occupational hazards in health center staff include needle head injuries, sharp objects (needlesticks), and exposure to patients' discharge. The objective of this study was to determine the effect of needlestick prevention training based on the health belief model on exposure behaviors in health personnel working in Zahedan hospitals.

The present study was a descriptive-analytical one conducted in Zahedan using an interventional design in 2019 on 166 health and medical personnel of four hospitals in two experimental and control groups. The samples were selected using simple random sampling. Data collection tools were health beliefs standard questionnaire and exposure behaviors questionnaire. To analyze the data, t-test and Analysis of Covariance (ANCOVA) were used. Data were entered into SPSS statistical software version 22.

The results of this study showed that needlestick prevention training had a significant effect on the components of health belief model including perceived sensitivity, perceived severity, perceived benefits, perceived barriers, cue to action, and behavior as well as exposure behaviors.

It is necessary to train the health care staff by holding training courses on the required information concerning the prevention of injuries caused by the sinking of the tip objects.

Social determinants play a major role in people's health. Accessing, understanding, appraising, and applying information about social determinants of health enable people to play an active role in creating a healthier environment for themselves, their families, and their communities. The present study aimed to determine the health literacy level in social determinants of health among employees of the Health Department of Arak University of Medical Sciences and its related factors.

The study was conducted as a descriptive-analytical cross-sectional survey study on 200 employees selected from Arak University of Medical Sciences in 2019, through the stratified sampling method. The data collection instrument was Health Literacy on Social Determinants of Health Questionnaire (HL-SDHQ). One-way analysis of variance, independent t-test, and linear regression were used to analyze the data through SPSS (v 16).

The participants’ health literacy was mostly moderate (67.5%) and only 19% of participants had the desired level of health literacy. Among the dimensions of health literacy, the understanding of information was more desirable. Among the demographic variables, age was predictor of health literacy (β = -0.28).

It is necessary to implement more specific educational sessions on how the social determinants affect people's health. Also, it is essential to train employees in executive strategies appropriate for their job duties to influence the determinants.