فصلنامه طب و تزکیه
سال هجدهم شماره 1 (پیاپی 73، بهار و تابستان 1388)

Infertility is one of the crises that in the majority of societies make lots of stress for couples. Infertile couples, strongly experience many problems and disorders in their marital life and in maintaining relationship with each other. this study aim to investigate and categorize the disorders of Iranian infertile couples. For the purpose of this study, 39 researches about the Iranian infertile couples were chosen and analyzed by content analysis.The results show that there are 53 potential disorders in the life of Iranian infertile couples in three levels:. 1- intra personal (23), 2- inter personal (17) and 3- extra personal (13). Also these disorders are categorized in 5 dimensions: cognitive (21), emotional (17), behavioral (13), biological (1) and environmental (1).

Economic efficiency of any organization is based on economic knowledge of its board of decision makers. Hospitals as important organizations in terms of economic and health activities have to a right economic decision making attitude. With regards to in efficiency of Iranian hospitals and their wasteful performance, the present study intended to describe and analyze the economic knowledge among hospitals board of decision makers. A cross-sectional approach was taken in order to search for reason of efficiency among hospitals. Study has focused on the board of decision maker’s mentality about economic concepts particularly those relevant to health and hospital economics. Teaching hospitals affiliated with Tehran, Iran and Shahid Beheshti Medical Science Universities, hospitals affiliated with Social Insurance Organization and Private hospitals in Tehran were determined as the sample of this study. Head and manager of hospitals together with head of nursing, accounting and administration officer were considered as members of board of decision makers in hospitals. On the hole 55 people interviewed as study population. Collected data was processed through SPSS software. Knowledge of the members has measured through a 3 point scale: appropriate (positive), in appropriate (negative), and midpoint. Generally, 10% of the members had appropriate level of knowledge about hospitals economic concepts. The appropriate level of knowledge observed for economic dimensions of budget, cost and cost analysis, insurance and payment methods were 17%, 11%, 11% and 0% respectively

Strategic planning in clinical specialities is a beginning forthe linkage of these disciplines with the Islamic Republic of Iran’s vision for the year 1404, and the related development plans. It is a starting for opening of a field of competition with the region and the world, and institutionalization of a planed movement towards the realization of the country’s vision in the area of medical sciences. Since this is the first experience of the country in this filed, right entry into the planning process, right conduct of the process, and more importantly, implementation of the prepared plans can help to institutionalize the planning process and will end with many useful outcomes. This study was conducted with the aim of exploring the perspectives of the members of the planning committees about theprocess of the strategic planning and its outcomes in clinical specialty disciplines. This was a qualitative study. Using a purposive sampling method, we selected four planning committees and interviewed with the secretary and one the active members of each committee. The interviews were semi-structured, and we used an interview guide for conduction of the interviews. The interviews were tape recorded, transcribed, and through an iterative process coded, and summarized. The participants observed that strategic plan is a plan for determining the future direction of the clinical disciplines. All of the interviewees stressed on the necessity of the strategic planning. They believed that planning process started without enough preparation of the participants. They remarked that the planning process had many outcomes other than the strategic plan. They told that they could use the experiences from the implementation of the plans in the future rounds of the planning. But, they were very concerned about the implementation, that is, they either had doubts about the implementation of the plans, or they believed that the devised mechanisms for the implementation were inadequate. The lessons learned from the first experience of the strategic planning in clinical specialties must be used in the next round of the strategic planning, and for the institutionallzation of the planning process in the clinical disciplines as well.

Iranian council on graduate medical education determines the admission rate for freshman residents in Iran. This council looks for evidence on various sources to determine the need for specialist training. This survey is designed to study the occupational status of applicants of residency position who attended the admission exam on the year 2008. The physicians attending the residency admission exam were asked to answer structured questionnaire. Among the 16,262 applicants, 10,816 answered the questions; 52.5% were male with the mean age of 33.2±4.85. The mean age of the females was 29.8±3.69. For 50% of the responders, the main motivation for residency was improving job position followed by attaining job security. Thirty seven percent of the responders described their current occupational situation as un-acceptable. There was a substantial under employment among the responders as they only spent 68% of their time to practice medicine. Under-employment of general practitioners and their occupational situation should be considered in the national health system policy. Precise calibration of freshman admission rate is necessary to prevent the extension of under-employment to specialty level in Iran.

Electronic Health Record is a comprehensive and organized electronic set of clinical, social and financial data that it document given care to one person. Access to information and data of patient is one of the positive features of EHR but this facility of access increase risk of relevance of confidentiality. So far, many solutions were given for preservation of the patient’s rights. This paper with purpose of giving the solutions of preservation of the patient’s rights in EHR systems begin to review information of valid database for example AHIMA and, Pub med and site of valid organization standard such asASTM,HL7 and ISO and related texts 2000 - 2008. To preserve of patient’s rights about confidentiality of their information in EHR system is applied by establishment of standards that they provide access users to information and in other hand it should supply security methods. Reading, writing and arrangement of information by users should control and in this case, controlling access devices and level of access, encrypting, decrypting, labeling and identifier would help us. Authentication that means attestation of information is done by digital signature and standards and guidelines should be establish in this field and if EHR is going to use both of patients and clinicians and it would accept in legal court as a records, it s necessary to aspects of medico legal. Conclusion and Because EHR is source of information patient and it have been used for purpose of education, research and treatment in different levels and by users, It should design in that way it don’t hurt to security and confidentiality of information and just authenticated persons. Formulation of standard and guideline is the most necessary solution of the preservation patient’s rights because it would moderate the problem of variety of systems and would ensure the integrity of EHR systems. With consideration to this paper, the most important domain of standardization includes identifier, privacy guidelines, confidentiality, access, prescription management, authority and credit of users, modification and authentication of health information, internet and intranet health care guideline and security of systems. Security and privacy of exchanging data is also significant field. Finally we should pay attention to this point that cultural and structural restrictions effect on privacy and confidentiality of information.