نشریه مدیریت ارتقای سلامت
سال دوم شماره 1 (پیاپی 5، زمستان 1391)

Rehabilitation service is one the most important aspect of health system services. If quality is not appropriate، disability could increase in society. Total Quality Management (TQM) can make revolution to achieve the desired quality. The aim of this study was to determine gap analysis between expectations and perceptions on Total Quality Management in private Gorgan’s rehabilitation centers by using Fuzzy logic. This study was a descriptive-analytical، survey. Samples were selected from staffs of private Gorgan’s rehabilitation centers. Two survey questioners of «Measurement Gap between Expectations» and «Perceptions of TQM Components” was used. Validity of the questionnaires were measured by Content Validity Ratio (CVR) and Content Validity Index (CVI)، which was 0. 83 for both questionnaires and reliability was confirmed by internal consistency (α= 0. 932). After collecting questionnaires، questionnaires were analyzed by SPSS/17، EXCEL 2007. The total fuzzy average of expectation with 0. 822، 0. 923، and 0. 982values، was more than total fuzzy average of perceptions (0. 59، 0. 71، and 0. 83). Furthermore، findings showed a significant difference between expectations and perceptions in all factors of TQM. There was a significant difference between all factors of total quality management. It means that staffs mentioned present condition is lower than optimum condition and the organizations couldn''t supply their staffs’ expectations.

Spiritual intelligence offer adaptation، internal and external integrity، environmental harmony and problem solving. The medical students are potential workforce of future in medical and caring areas; hence it is essential to assess the spiritual intelligence in this group of academics to improve the quality of clinical care. The aim of the study was to investigate correlation of spiritual intelligence with some of demographic and educational factors among the students of Golestan University of Medical Sciences. This descriptive correlational study was conducted in 2011 on 282 medical and paramedical students of the university who entered the study through simple random sampling. The data gathered by a demographic questionnaire and «Spiritual Intelligence Questionnaire» that cover four main domains «general thoughts and beliefs”، “ability of dealing with problems”، “spiritual traits”، “self- awareness and compassion». The validity of questionnaire was confirmed with criterion- related validity and the reliability of questionnaire was obtained with alpha Cronbach coefficient of 0. 85. The data was analyzed with SPSS /16 using descriptive and analytical statistical tests. The significance level of test was considered as P<0. 05. The mean age of the participants was 20. 17±1. 70 year old and 76 percent of them were female. The average spiritual intelligence score from 5 likert score in four domains was 106. 65±13. 93 from 222. The mean and standard deviation of each four domain respectively; in «general thoughts and beliefs” was 2. 13±0. 56، in» ability of dealing with problems” was 2. 90±0. 62، in “spiritual traits” had value of 2. 20±0. 45 and finally in”self- awareness and compassion” standard deviation was 2. 59±0. 64. Although the average spiritual intelligence score in male students (2. 58±0. 36) was slightly higher than the one in female students (2. 51±0. 28)، however this was not statistically significant (p=0. 15). There was also no significant correlation between age، sex، marital status، ethnicity، major of study and grade point average with spiritual intelligence. The mean average of spiritual intelligence of students of Golestan University in «ability of dealing with problems» domain was higher than other domains. The study draws our attention to issue of spiritual intelligence، which is a fundamental concept in delivering comprehensive care.

Multiple Sclerosis (MS) is a progressive disease and degenerative myelin in the central neurons that its complications provide physical problems and mental illness. However، it seems that social support controlled psychological stresses and improved quality of life. The aim of this study was to determine the correlation of perceived social support and some of the demographic factors in patients with Multiple Sclerosis. In this descriptive-correlational study، 395 patients of the MS Society in Tehran were selected by continuous sampling. Data gathering instrument was “Social Support Questionnaire” of Nortouse (SSQ). Cronbach''s alpha for this instrument was 0. 90. Data was analyzed by SPSS/16. The results showed that 156 patients (39. 5%) had perceived social support at moderate levels. Between perceived social supports، age، educational level، employment status and monthly income were significantly correlated. However، between perceived social support and sex، marital status، family or relatives’ risk، disease duration and history of hospitalization، significant correlation was not found. Regarding the perception of patients، nurses can by identify the high risk groups and prevent them from the isolation and with appropriate supportive interventions، improve their quality of life.

Obsessive use of the internet is associated with isolation، depression، loneliness and anxiety which are called internet addiction. The aim of this was to determine the correlation between loneliness and internet addiction in Qom branch of Islamic Azad University students. In this descriptive-correlational study، 148 students of Qom Branch of Islamic Azad University were selected through random sampling. Date collection was carried out through “Loneliness Scale”، Yang “Internet Addiction Test” and demographic variables questionnaire. Data was analyzed by SPSS/12. The sample consisted of 56. 08% male and 20. 94% married people. Results showed there was a significant correlation between loneliness and two subscales of relationship with family (P<0. 001)) and affective symptoms (P<0. 001) with internet addiction. Also there was no significant correlation between factors such as age، gender and marital status with internet addiction. It is recommended to provide an appropriate and effective consultation times for the students، identify the causes of loneliness in them and providing appropriate solutions for the reduction، prevent secondary complications such as internet addiction.

Myocardial infarction is a life threatening event and often reduces the quality of life of patients and their families’ particularly close and intimate persons such as spouses. The aim of study was to determine quality of marital relationship of spouses of patients with and without a history of myocardial infarction. This descriptive-comparative study has been done on 162 spouses of patients with myocardial infarction admitted in educational hospitals of Zahedan University of Medical Sciences by convenience sampling method and 162 spouses of healthy persons (324 married individuals). Data were collected by “Perceived Relationship Quality Components (PRQC) questionnaire with approved validity and reliability in Iran. Data was analyzed with SPSS/16. 42% of the samples were male and 58% female، with an overall mean age of 47. 89±5. 95، average length of common life 25. 32±7. 48. In addition، 56. 7% of the respondents had diploma or higher education. The results also illustrated that the mean score of quality of marital relationship on the dimensions of satisfaction، passion and love in patient’ spouses with a history of myocardial infarction was 13. 37±5. 03، 10. 67±4. 56، 19. 56± 2. 56 respectively and in healthy persons spouses was 18. 92±2. 85، 18±3. 14، 20. 37±1. 36. U-Mann Whitney test results determine that these differences are statistically significant (P<0. 001). MI disease has a negative impact on the overall quality of marital relationship، especially on the dimensions of satisfaction، passion and love between couples. Hence، the inclusion of family educational programs and couple therapy in heart disease rehabilitation program is important in order to improve the quality of marital relationship and subsequent quality of life patients and their family’s needs.

Addiction is a modern social issue، especially in countries like Iran. One of the side effects of substance abuse، it is its negative impact on the academic performance of students. The aim of this study was to determine the correlation between drug use، alcohol، smoking and psychiatric drugs with the academic progress in university students in Bam city.

In this descriptive-correlational study، 760 students of Islamic Azad University، School of Nursing and the Payamenoor were randomly selected in Bam. Data were collected by questionnaire «Drug Use Questionnaire» that consisted of two parts. The first part included 5 questions about demographic characteristics and the second part consisted of 12 questions on smoking، psychiatric drugs، alcohol and drugs. Validity of the questionnaire was measured by content validly (by asking 10 experts people) and reliability coefficient of the questionnaire was 88. 0. Collected data was analyzed by the software SPSS/17.

The drug use in students in psychiatric drugs was 13. 8%، in alcohol was10. 8%، in drugs this value was 9. 9% and finally in tobacco was5. 7%. Average score for the previous semester and final semester of students with use cigarettes، alcohol، drugs and psychiatric medications than other students were significantly lower (P <0. 001).

Usage of smoking، alcohol، drugs and psychiatric medications in the students was significant. Employing these drugs has negative effects on students’ achievement. Therefore، university is authorized for prevention and treatment of students. This certainly will lead to a much healthier society. Keywords: Academic progress، Drug use، Students، Bam.

Today، Quality Management Systems are widely used in many numbers of hospitals in Iran. But، it still seems important to investigate if with all the expenditure for implementing، settling، registering and maintaining of these systems، there is any meaningful difference in the performance indicators in the hospitals using Quality Management System and the ones lacking it. The aim of this study was to determine the comparison of bed turnover rate between the hospitals using Quality Management System and the ones lacking it in Zanjan province. In this descriptive study، data on the bed turnover indicator of the hospitals in Zanjan province were extracted from the statistical information in the Medical Record Department of hospitals. Instrument for data collection was “Hospital Performance Indicators Form” including bed occupation rate، bed turnover rate and the average length of patient’s stay. To measure content validity، judged of experts (8 expert teachers) was used. Then data were analyzed by SPSS/15 using the independent T-test and the meaningfulness of the difference in this indicator was tested between the hospitals with Quality Management System and the ones without it. The bed turnover rate in the hospitals using Quality Management System was 0. 81 days with a standard deviation of 0. 04، while this rate was 1. 02 days with a standard deviation of 0. 05 in the hospitals lacking this system. This difference based on P=0. 006 was statistically significant. The hospitals using Quality Management System had better performance in bed turnover than the other hospitals. Therefore، managers can consider this issue in expanding this system.

This review article attempted to synthesize research studies using healthy behaviors in the Pender’s Health Promotion Model (HPM) in nursing students. The aim of this systematic review was to determine the health promoting lifestyles of nursing students. The methodology includes a systematic review of 14 studies from across the world، which meets predetermined criteria، to draw implications for health promotion. All studies published in the years 1998 -2012 in Medline، Elsevier، Nursing consult، Proquest and Google databases using computers keywords، were collected، evaluated and compared. All available studies based on the healthy behaviors in the HPM were recruited، coded، and analyzed. The researchers carefully rated the quality of each study and numerous variables were investigated. Health promoting life style and 6 variables in health promoting life style including interpersonal relationship، health responsibility، spiritual growth، stress management، nutrition and physical activity were also assessed. 1130 quantitative studies were found in relation to health promotion and of these، 14 were selected for full-text articles. This systematic review showed that physical activity was at the lowest level among dimensions of health promoting behavior. This article provides evidence for future research direction، which can be focused on developing health promotion programs based on the above-mentioned variables.