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Background: Self-medication is one of the main socioeconomic and health problems in different societies and irrational drug consumption can sometimes lead to unfavorable outcomes and even death. The present study has been performed to investigate self-medication and its relevant factors in students of Shahid Sadoughi University of Medical Sciences in Yazd. Methods: This analytical study investigate 300 students of Shahid Sadoughi University of Medical Sciences Using Cochran's formula in Yazd (2020). The samples were selected by stratified sampling proportional to the strata size and the data were collected by a researcher-made questionnaire from Gholipoor etal's article (2012) and analyzed by descriptive statistics such as frequency, percentage, mean ± SD and multiple response analysis (MRA), chi-square and binary logistic regression. All statistical analyses were done by SPSS 20 (α=0.05). Results: The total self-medication rate was estimated 39%. The most common causes of self-medication among the students were the experience of the disease (50.4%) and considering the disease non-risky (47.0%).The most common self-medication case was cold (53.0%) and the most common way of supplying the drug for self-medication was purchasing from drugstores (52.1%).The results of multiple logistic regression showed that the only variable having a significant effect on the probability of self-medication was income (p = 0.02); odds of self-medication in students with an average income of 20-30 million Rials was about twice as high as students with an income of more than 30 million Rials (p = 0.02, OR = 1.8). Conclusion: Self-medication is not a safe habit and it can cause complications such as drug interaction, addiction, drug poisoning, concealment of the disease and in general, health risks. Meanwhile, the students’ attitude towards self-medication can affect the behavior of their future patients. So, it is suggested to inform students in this area.

Background: Perceived organizational justice is a concept used to describe job-related justice. Considering the role of perceived organizational justice in the healthcare system to increase the satisfaction, motivation, and efficiency in providing quality services, this study was conducted to investigate the situation of perceived organizational justice in the Iranian healthcare system through systematic review. Methods: In the present study, an electronic search was conducted on the Persian websites SID, Iranmedex, Medlib, civilica, Irandoc and English Web of science, Pubmed, Scopus, and Google scholar using the Persian and English keywords of ‘Justice, Equality, Equality, Organizational Justice, Perceived Justice, Health System, University of Medical Sciences, Health Centers, Hospitals. As a result, 520 articles were studied and evaluated step by step and 469 papers were removed after reading the title and abstract. Finally, the full text of 51 articles was reviewed. Finally, 30 articles that measured the average level of perceived organizational justice were selected and other articles were excluded due to lack of necessary criteria and irrelevance. To analyze the heterogeneity between the studies, the meta-analysis method was used using Stata 14 software and Q test and index. Results: To study the status of perceived organizational justice in the health care system in a systematic and meta-analysis, all 30 studies were illegible. With regard to the dimensions of distributive, procedural, and interactive justice, 23 studies of 30 studies had the required conditions to enter the research. The total mean score of perceived organizational justice was obtained as 60.71 and the mean scores of 54.74, 58.52, and 62.41were calculated for dimensions of distributive, procedural, and interactive justice, respectively. Conclusion: The findings showed that the situation of perceived organizational justice in the Iranian health care system was favorable. The dimension of interactive justice, related to managerschr('39') behaviors and relationships with employees, was relatively more favorable than other dimensions of organizational justice. Moreover, the situation of perceived organizational justice and its dimensions in private hospitals was more favorable than other research environments, including public hospitals, staff units, and hospitals selected using the mixed method.

Background: Reflection has been extensively used in different areas for better thinking about previous experiences and reaching to new behaviors, which leads to an improvement in personal skills and knowledge. Reflection ability is one of the most essential competencies for healthcare professionals and medical students, which is emphasized in several medical courses and references. This ability is improved with practice and repetition. Therefore, reflection in medical education is very important. Thus the aim of the present study was evaluation of reliability and validity of the tool for assessing this skill and determination of reflection ability level of health care management students. Methods: The present descriptive and cross-sectional research, performed in two phases. The study population were 30 students of health care management. In the first phase, after the translation of the questionnaire, the reliability and validity of the questionnaire was determined. In the second phase and for evaluation of reflection ability level in health care management students, the Groningen Reflection Ability Scale questionnaire was completed by students and data analyzed with independent t-test and Pearson correlation statistical tests. Results: The reliability and validity of the questionnaire were confirmed (Cronbach's alpha = 0.73). The reflection ability score of students was 82.13 ± 4.24. After a statistical analysis of data among genders, although the reflection scores of males (83.58 ± 4.37) were higher than females (81.17 ± 3.97), but this difference was not statistically significant (P-value ≥ 0.05). Also, the difference between demographic variables and reflection ability scores was not statistically significant (P-value ≥ 0.05). Conclusion: This study showed that the GRAS questionnaire is a useful tool for assessing the reflection ability and students have medium scores of reflection ability so educational managers should pay serious attention in planning related fields.

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods : Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results : The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion : The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.

Introduction: In order to achieve the highest level of effective interaction between the insurance organizations and the health system, efforts should be made to identify existing communication challenges for policymakers and decision makers. The present study was conducted to identify interactive behaviors aimed at designing an insurance mechanism based on game theory to cover the existing gaps. Methods: This study consisted of two phases of qualitative and quantitative. In the qualitative phase, data were collected and classified by a semi-structured interview with a number of insurance professionals in insurance organizations and the health system. In the quantitative phase of the study, interactive behaviors between the two organizations were studied. Finally, with the help of Gambit software, the insurance mechanism was designed. Results: In the qualitative phase, the data were collected in three main categories: behavioral and communicative, structural and financial and deductibles and 11 sub-categories. In the quantitative phase, 35 optimal interactive behavioral strategies were delineated. Conclusion: The best behavioral strategy for interaction between insurance organizations and health system, to fill gaps in insurance system and to improve the interaction between the two organizations, was introduced in the form of 35 strategies to provide an insurance mechanism.

Introduction: The satisfaction rate of patients is a valuable tool for evaluating the quality of providing health care and gives important data regarding the expectations of patients and the degree to which they are being met. Considering the importance emergency medical service (EMS) centers in providing proper care, this study was carried out aiming to evaluate the satisfaction rate of those receiving services from EMS centers of Yazd and Birjand. Methods: The present cross-sectional study was carried out on 150 of EMS recipients registered on the list of EMS centers of Yazd and Birjand in 2012. Systematic sampling was used and required data were gathered using the standard questionnaire of satisfaction for EMS center recipients that consisted of 2 parts; demographic data and 16 questions regarding satisfaction of recipients. Data were analyzed using SPSS 18 and descriptive tests. Results: 150 participants were studied (56.7% male). The most common reason for calling was trauma due to motor vehicle accidents (32%) in Yazd and weakness and nervous system diseases (18%) in Birjand. 10% of the participants in Yazd province had low satisfaction, 39% had intermediate, and 51% had high satisfaction. In Birjand satisfaction rate was intermediate in 16% and high in 84% of those studied in Birjand. The highest satisfaction rate in Yazd was regarding cooperation of emergencies center with the patient and their manners in facing them. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival. In Birjand, the lowest satisfaction rate belonged to the quality and existence of equipment in the emergency team. Conclusion: The results of the present study showed that satisfaction level of EMS recipients in Yazd and Birjand was intermediate. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival in Yazd, and the quality of equipment in Birjand.

Background: The world is changing continually and organizations as the subsystems of the world should be adapted with these changes by helping to develope of creativity and innovation.This study to evaluate the relationships between conflict management styles and creativity of staff in training hospitals in Kerman province. Materials & Methods:This is a cross-sectional study from aspect of descriptive -analytical. For gathering data, the standard questionnaires of conflict management for managers and creativity for staff applied. The participants in the study were all disciplinary managers from selected hospitals in one group and all disciplinary staff of selected hospitals in another group.Data analysis used in SPSS software. Results:The results showed that there is a significant and opposite assosiation between enforcing styles and negotiating styles between managers (P

مقدمه: میزان رضايتمندي بيماران ابزار سنجش مهمي براي ارزیابی كيفيت ارائه خدمات بهداشتي درماني است و اطلاعات مهمي راجع به انتظارات بيماران و ميزان برآورده شدن آنها فراهم مي كند. با توجه به اهمیت و جایگاه مهم مراکز مدیریت حوادث و فوریت های پزشکی و ارائه موثر خدمات از سوی آنها، این مطالعه با هدف بررسی میزان رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی در شهرستان های یزد و بیرجند انجام پذیرفته است. روش کار: مطالعه مقطعی حاضر در سال 1391 بر روی 150 نفر از گیرندگان خدمت موجود در لیست مرکز مدیریت حوادث و فوریت های پزشکی شهر های بیرجند و یزد انجام پذیرفت. نمونه گیری به صورت سیستماتیک و اطلاعات مورد نیاز توسط پرسشنامه استاندارد رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی که شامل دو قسمت؛ مشخصات دموگرافیک و 16 سؤال مربوط به رضایتمندی گیرندگان خدمت بود، جمع آوری گردید. داده ها با استفاده از نرم افزار SPSS 18 و آزمون های توصیفی مورد تجزیه و تحلیل قرار گرفتند. يافته ها: 150 نفر مورد مطالعه قرار گرفتند (7/56 درصد مرد). شایعترین دلیل برقراری تماس در شهر یزد، ترومای ناشی از تصادفات رانندگی (32درصد) و در شهر بیرجند ضعف و بیحالی و بیماری عصبی (18درصد) بود. 10 درصد از پاسخگویان در استان یزد رضایتمندی کم، 39 درصد رضایتمندی متوسط و 51 درصد رضایتمندی مطلوبی داشتند. به همین ترتیب 16 درصد از پاسخگویان در شهر بیرجند رضایتمندی متوسط و 84 درصد رضایتمندی مطلوب داشتند. بالاترین میزان رضایتمندی در استان یزد از همکاری مرکز فوریت ها با بیمار و رفتار پرسنل با بیمار بود. همچنین کمترین میزان رضایتمندی نیز متعلق به پیگیری وضعیت بیمار تا رسیدن آمبولانس و زمان انتظار بیمار تا رسیدن آمبولانس بود. در شهر بیرجند نیز کمترین میزان رضایتمندی مربوط به کیفیت امکانات و تجهیزات تیم اورژانس بود. نتيجه گيری: نتایج حاصل از این مطالعه نشان داد که میزان رضایتمندی گیرندگان خدمات از مراکز مدیریت حوادث و فوریت های پزشکی، در شهر یزد و بیرجند در سطح متوسطی بوده است. کمترین میزان رضایتمندی از خدمات مرکز مدیریت حوادث و فوریت های پزشکی در شهر یزد مربوط به حیطه پیگیری وضعیت بیمار تا رسیدن اورژانس و نیز زمان انتظار بیمار تا رسیدن آمبولانس و در شهر بیرجند مربوط به کیفیت امکانات و تجهیزات بود.