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Background & aim: Macro policies in the field of health tourism should be designed and implemented taking into account the facilities and environmental resources in order to provide a good opportunity to provide quality medical services to foreign patients referring to the country and create their satisfaction. The purpose of the present study was to identify and prioritize the factors affecting the management of health tourism development in Fars province. Methods: The present qualitative-exploratory study was conducted in 2019. 20 experts active in the field of health tourism were selected by purposive sampling method with maximum diversity. After obtaining informed consent from the participants, the research data were collected by semi-structured in-depth interview method and then recorded in Maxqda-10 software and analyzed using directional and summary composite content analysis. In this method, the units of analysis in each step were the paragraphs recorded by the researcher in the process of interviewing the participants. During the content analysis process, different codes were first reviewed, then grouped into subcategories, and finally 70 subcategories and 23 main categories. The five themes of structural, behavioral, environmental, conservation and development were integrated. The collected data were analyzed using paired comparison matrix test with hierarchical analysis process. Results: The results of the present study revealed that the factors affecting the management of health tourism development in Fars province consist of 5 main categories including: structural factors, development and optimization, environmental, behavioral, and protective. The relative weights identified for each of these factors were 0.512, 0.276, 0.128, 0.053 and 0.032, respectively. Conclusion: Structural, developmental and optimization, environmental, behavioral, and conservation factors had relative weight and significant incompatibility rates for health tourism development management. Therefore, the results of the present study inform high-level decision makers where and how to focus their efforts and resources to have the maximum impact on the management of health tourism development at the local and national levels.

Background & aim: Performance Indicators consist of standards, evaluation tools and identifications to check current situations in organizations. Hospitals as the center of gravity to provide health and therapy care are of no exception. The present study aimed to determe the performance indicators in selected hospitals of Tehran province. Methods: The present inquiry was a cross-sectional descriptive-analytical study. The statistical population of all public hospitals was covered by Tehran University of Medical Sciences and Shahid Beheshti. 14 educational and 9 non-educational cases were examined. Data collection tools were data entry forms for hospital performance indicators, which included general information on the studied hospitals and performance indicators, bed occupancy rate, average patient stay, and bed turnover rate. Data were analyzed using Chi-square and Kolmogorov-Smirnov tests. Results: The average patient stay was 5.89 days, which was only 7.15 percent desirable by standards. The bed occupancy rate was 76.35 and the bed turnover was 45.97 times a year. The status of these two indicators was optimal based on the standards available in 92.85% of the cases. Also, based on the results of the present study, the mean average patient stay was 2.91 days, which was desirable in 77.77% of the cases according to the standards. The bed occupancy rate was 62.70 and only 11.11% of the cases were favorable. The bed turnover was set at 65.44 times a year. In relation to this index, in 100% of cases, the situation was favorable. Conclusion: The non-educational hospitals of Tehran University of Medical Sciences were in a better position regarding the length of the patientchr('39')s stay than the indicators of the Ministry of Health and even compared to the hospitals of other provinces. In relation to educational hospitals, due to the fact that according to the Ministry of Health, the optimal condition of the average patient stay is less than 3.5 days and more than 4 days is a sign of weakness and inefficiency of the hospital, the studied hospitals with an average of 5.69 days. They differ significantly from the standard. In the other two indicators, both educational and non-educational hospitals were in good condition.

Background & aim: Community mental health is one of the axes of health assessment of different communities. Mental health plays an important role in ensuring the dynamism and efficiency of any society. The purpose of this study was to determine and investigate the factors affecting mental health from the perspective of people referring to health centers in Yasuj. Methods: The present paper was a descriptive-analytical study conducted in 2019-2020 in Yasuj, Iran. The statistical population of this study included all patients referred to health centers affiliated to Yasuj University of Medical Sciences on 900 people using simple random sampling method. According to Morganchr('39')s table, 200 were selected as a statistical sample by simple random sampling and completed the questionnaire. The collected data were analyzed using Pearson correlation coefficient, t-test and regression, Chi-square and Kruskal-Wallis statistical tests. Results: According to the results, in terms of effective factors on nurse and environmental health variables had a significant effect on mental health (p

Abstract Background & aim: Awareness about the different aspects of health during puberty plays an important role in the health of girls and finally on their health future pregnancy. The aim of the present study was to to compare the effect of role playing and classical training methods in the the improvement of puberty health among secondary school girls in Yasouj City, Iran. Methods: In this study, the educational need during puberty school girls in the interview was determined. The two schools girls were randomly selected (students any school-60). Next, a knowledge and attitude questionnaire and a behavior checklist related to the main puberty health problems were completed. Then one of the schools randomly was selected as educational interventions schools and other were studied as controls. After grouping the students into four groups of 15, intervention were conducted in four sessions including: role-play, question and answer, and lecture. In the control group, all number of school students received training on puberty health through a classical education (lectures). The results were subsequently compared. Data were analyzed by Student t-test paired t-test, and analysis of variance. Results: The results of this study showed that the level of knowledge, attitude and behavior related to health matters during puberty showed significant improvement in the girls before and after implementation of educational intervention through role play (p

Abstract Background & aim: MRI is a new and expensive diagnostic technology which has been increasingly used globally. This aim of study was to determining the administration of MRI for the Lumbar vertebrae using the appropriate RAND Method. Methods: This qualitative study was based on consensus. The population study included 9 professionals involved in prescribing the procedure based on Rand. Two criteria were identified: Valid clinical guidelines and expert opinion. Scoring criteria were the numbers 1 to 9. Numbers in the range of 1 to 3 unfit, 4 to 6, unreliable, and 7 to 9, placed in an appropriate range. An agreement was done when 7 specialists agreed marked the same range. Results: 97 scenarios were selected for the lumbar spine MRI in the extracting phase. 18 other scenarios were added by panel members. Finally, a total of 115 scenarios were identified. After implementing two rounds, the scenarios were categorized into three ranges. Sixty eight (%59.1) of the scenarios were considered as appropriate, 44(%38.2) as uncertain, and 3(%2.6) as inappropriate. Conclusion: A developed scenario in this project for MRI lumbar vertebrae treated with Guide is perfect for specialists. It is recommended that insurance companies and other institutions use this as a benchmark for the payment of MRI lumbar vertebrae fees. RAND appropriateness Method is useful for identifying stakeholder views in settings with limited resources. Key words: Lumbar Spine, Low Back Pain, RAND Appropriateness Method

ABSTRACT: Introduction & Objective: Results of different studies show that a relatively large number of healthcare services offered are inappropriate or unnecessary. Benign prostatic hyperplasia is a benign enlargement of the prostate gland. Clinical features of this disease are one of the most common problems encountered by elderly males. The aim of this study was to assess the appropriateness of benign prostatic hyperplasia surgery. Materials & Methods: In this qualitative study which was conducted in 2008-9, in Tehran University of Medical Sciences, the RAN/UCLA method was used, which was designed in 1980 by the RAND institute and the University of California in Los Angeles. Regarding the stages of our method, scenarios and indications for benign prostatic hyperplasia surgery were chosen from the latest approved scientific resources and subsequently sent to urology specialists, who were chosen as members of the specialized panel. Panel members gave scores ranging from 1 to 9 to each indication and scenario based on scientific resources, clinical experiences and patient’s condition in two separate panel sessions. After compilation, the indications were finally grouped as appropriate, equivocal, and inappropriate so that they could be used to determine appropriateness of benign prostatic hyperplasia surgery in hospitals. In this study, the most suitable and most approved clinical guidelines related to benign prostatic hyperplasia, the Guidelines Evaluation and Research Appraisal (AGREE) were used.The selected guidelines were used as scientific resources for choosing the indications of benign prostatic hyperplasia surgery. SPSS version 16 and kappa weighted value were used in analysis process of the study. Results: Out of 282 scenarios grouped as 9 conditions related to benign prostatic hyperplasia surgery, which were extracted from scientific sources, 73 cases (25.9%) were considered as appropriate, 14 cases (5%) as equivocal and 7 cases (2.5%) were considered as inappropriate. Also 22 cases (7.8%) were considered as appropriate indications for drug therapy and none were found to be suitable for waiting and watching. There were 94 scenarios related to surgery that 75 scenarios (80%) were grouped in appropriate and 8 scenarios (8.5%) identified inappropriate. Conclusion: At the present time, due to the lack of scientific evidence for suitable decision-making in providing health services, methods based upon agreement, including the one used in the present study, and the use of treatment standards derived from similar studies, are amongst the most important measures taken to improve the standard of health, provide suitable health services, and to reduce unnecessary costs. In addition, RAM appropriateness method could be an ideal method in determining the appropriateness of health care and in reducing the rate of inappropriate services provided. The similarity of results derived from other studies performed by the RAND method in determining the appropriateness of benign prostatic hyperplasia treatment with the current study shows the validity and reliability of this method. Keywords: Appropriate criteria, Benign Prostatic Hyperplasia (BPH), Appraisal of Guidelines for Research and Evaluation (AGREE).