Search

Abstract Introduction Climate change is a long-term systematic climate variability caused by human activities that alters the composition of the global atmosphere. Health systems should be adaptive and resilient to climate change. Hence, this research aimed to strategically analyze the resilience of Iran’s health system to climate change. Method This study utilized a multiple methods approach. First, in-depth semi-structured interviews were conducted with 32 key climate change and health experts to identify the strengths, weaknesses, opportunities and threats of the Iranian health system’s resilience to climate change. Purposeful and snowball sampling techniques were used to ensure maximum diversity among the participants. Then, a questionnaire was developed based on the findings of the first stage and was completed by 33 climate change and health experts. Finally, the strategic position of Iran’s health system’s resilience to climate change was determined using the internal - external factors matrix. Findings A total of 84 internal factors and 101 external factors were identified that affect the resilience of Iran’s health system against climate change. The internal factors were categorized into seven dimensions (i.e., governance and leadership; health financing; health workforce; facilities, equipment and medicines; health information system; health services delivery, and key results). The external factors were categorized into six dimensions (i.e., political, economic, social, technological, environmental, and legal factors). The average score of internal and external factors were 2.47 and 2.12, out of 4 respectively. Iran’s health system was found to be in the strategic position of V in terms of resilience to climate change. Therefore, precautionary strategies such as strengthening the climate resilience of healthcare facilities, promoting healthcare facilities’ adaptation to climate change, public-private partnership, strengthening the health service delivery system, quality management and cost management, should be implemented to strengthen the resilience of Iran’s health system to climate change. Discussion Iran’s health system is facing significant weaknesses and challenges that have hindered its resilience to climate change. Iran’s health system can better prepare and respond to the health impacts of climate change, and safeguarding the health and well-being of its population by addressing these challenges and implementing adaptive and resilience strategies.

Objectives: In Iran’s accreditation program, the patient safety dimension is one of the main dimensions, holding the highest weight among the accreditation criteria. The purpose of this study was to identify the patient safety culture (PSC) in a tertiary referral hospital. Methods: The current study was conducted between March and April 2021 in a tertiary hospital in Iran. The sample size was 628 participants, selected through simple random sampling. The hospital survey on patient safety culture (HSOPSC) was used to assess provider and staff perceptions about patient safety issues, medical errors, and event reporting. The survey included 32 items that measure 10 dimensions of PSC. Normality tests, along with non-parametric Mann-Whitney and Kruskal-Wallis tests, were used to examine the relationship between PSC and demographic variables using SPSS 22 software. Results: Based on current findings, among the 10 dimensions of PSC, teamwork and organizational learning-continuous improvement received the highest scores (83% positive response), which were higher than these variables in the Agency for Healthcare Research and Quality (AHRQ) data. Conversely, staffing and work pace, as well as hospital management support for patient safety, received the lowest positive scores (43% and 55% positive response, respectively), which were lower than these variables in the AHRQ data. There was a significant positive relationship between dimensions of PSC and older age, female gender, staff with longer working experience, and longer work hours per week (P < 0.05). Conclusions: The majority of our participants felt that patient safety needs to be enhanced. Based on the findings of this study, it is recommended to emphasize the dimensions of “staffing and work pace” and “hospital management support for patient safety” more in the accreditation criteria to strengthen these dimensions in hospitals. Additionally, we have introduced a comprehensive guide for using an international tool to measure PSC, which hospitals can use to succeed in annual accreditation.

Abstract Background Diabetes self-management education is an effective factor for improving outcomes and quality of life in patients with diabetes. However, little information is available on the factors associated with participation or non-participation in self-management education programs in people with diabetes. The aim of this study was to explore the factors affecting on the attendance of patients with diabetes in the diabetes self-management education program. Methods A cross-sectional study was conducted in 2019 on 384 patients with diabetes referred to the main comprehensive health centers of Mashhad, Iran. All patients were linked with a diabetes self-management education program that lasted three months and involved 12 sessions. We explore the factors affecting on attending in diabetes self-management education program using Andersen’s behavioral model. Data for independent variables (predisposing, enabling, and need factors) were gathered at the beginning of the training program using registration forms. Dependent variable (attendance of patients with diabetes in the training program) was checked at the end of the program. Univariate and multivariate analysis were done with SPSS v.25. Results The results of this study showed that women were less likely to participate in the self-management education program than men (OR=0.414; P

Abstract Introduction Self-care behaviors in diabetic patients is considered an important factor for controlling the diabetes. Therefore, diabetic patients need training the self-care behaviors to control this disease. This study aims to investigate the reasons for diabetic patients’ non-participation in a self-care training program. Method This qualitative study was carried out between 1 April to 1 July 2019. We used in-depth semi-structured interviews with 30 diabetic patients who did not participate in the self-care training program. Data analysis was conducted using content analysis with MAXQDA software. Findings The results of this study showed that there are 5 themes and 14 sub-themes for patients’ non-participation in self-care training program. Themes included access; individual, familial and social factors; attitude and awareness; motivator factors and need Factors. Also sub-themes were physical access, time access, physical abilities, social-familial responsibilities, attitude to disease, attitude to education, attitude to health, awareness, incentive, communication, teaching methods, perceived risk, access to other educational resources and self-efficacy. Conclusion According to the results of this study, simple physical and time access, offering high-quality education, providing virtual and distant training, organizing and designing modern training methods can lead to increase participation in self-care training programs.

Background and Objectives: Students’ interest and academic motivation is one of the most important challenges of the universities, which is highly effective in the outputs of the education systems. Different factors affect this motivation and future job is one of them. In this regard, the purpose of the current study was to determine the relationship between the academic motivation and students’ attitude towards future job in the students of Torbat Heydariyeh University of Medical Sciences in 2018. Methods: This cross-sectional analytical study was conducted on 291 students, who were selected using stratified random sampling and entered into the study. Data were collected using valid and reliable attitude toward Future Job questionnaire as well as Harters’ Academic Motivation standard questionnaire. Data analysis was performed using SPSS version 22. Results: Our study indicated that mean score of the attitude toward the future job score in 59.1 percent of the students was moderate and lower and the mean score of the academic motivation in 43 percent of them was moderate and higher. Moreover, according to the regression analysis results, attitude towards future job (29%) and academic grade (13%), were predictors of the students’ academic motivation. Conclusion: Considering significant relationship between the academic motivation and student’s attitude towards future job and unfavorable level of academic motivation, necessary measures should be taken to reduce concerns about future Job in the students and consequently to increase their academic motivation.

Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Several keywords, including "patient rights", "patient bills of rights" and "patients rights’ charter" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the "right to privacy and confidentiality" (70.16%) and "right to access an efficient complaining system" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers.

Introduction: Future research is an interdisciplinary study that can influence all sciences. Students are Future human resources for health systems; whose futures research ability can be improved through education over the years. The purpose of this study is to determine the relationship between future research ability and quality of learning experiences of medical students of Mashhad in 2018. Methods: In this descriptive correlational study, the research population was all students of Mashhad University of Medical Sciences, 370 of whom were selected through two-stage stratified random sampling. Data collection tools included validity and reliability questionnaires of Parsa et al.'s future research ability and Neumann's quality of learning experiences. Data were analyzed using one-way ANOVA, multiple regression and Spearman correlation tests. Results: Students' future research ability was slightly higher than average (138.5±24.5) and Mean quality of learning experiences was moderate (34.2±7.1). There was a direct and significant correlation between the dimensions of futuristic ability and the dimensions of the quality of learning experiences that the severity of this relationship was weak (p0). Conclusion: Given the weak relationship between students' futuristic skill and the quality of their learning experiences, there are likely to be stronger factors that can predict or enhance students' futuristic skill. Therefore, more studies are recommended to identify the factors affecting it in higher education as a human resources producer to achieve optimal development and future.

Background: Hospital accreditation is assumed as an effective control mechanism for health systems to improve quality and efficiency. Current study thus, seeks to look into the relationship between hospitals’ accreditation and efficiency Materials and Methods: In order to measure efficiency, hospital inputs and outputs included the ratio of physician and nurse to bed, mortality and nosocomial infection rate and quality of inpatientservices were used. A sample of 554 hospitalized patients selected using stratified random sampling method. Data gathering instruments were researcher-developed questionnaire and checklists. DEAP and SPSS software deployed to assess correlation between accreditation rank and technical efficiency Results: Average hospitals’ technical efficiency score was 0.94 indicating an improvement capacityof %5.1 for hospitals efficiency. The mean quality score was 4.13 out of 5( in the range of 3.9-4.3)There was no correlation between hospitals accreditation rank and their technical efficiency Conclusion: According to the results, it seems efficiency should be also considered in accreditationmetrics. In addition, for measuring efficiency, performance based inputs and specifically outputs tohave reliable results should be chosen

Background & Objectives: Charity hospitals with increasing public participation in the provision of health services could play an important role in assisting government for providing health care and promoting society health. Since most deprived people use the services of these hospitals, paying attention to these organizations and their management can help improve the quality and equality of health services distribution. Thus, this study aimed to explore the challenges of management of charity hospitals in Tehran province and provide solutions for these challenges in 2017. Methods: This qualitative phenomenological study was conducted in 2017. Data were collected through semi-structure interviews with 26 participants from various organizations including top and middle hospital managers, experts from Vice-chancellor in treatment affairs of Universities of Medical Sciences in Tehran, and the Endowments and Charity Affairs Organizations. Snowball sampling method was used to select the respondents. Data were analyzed using a thematic analysis method. Results: The challenges of charity hospitals could be categorized into 5 main codes including financial resources, human resources, physical and structural resources, management, and cultural challenges, and 13 sub codes. Conclusion: Endowment selling and creating endowment funds in charity hospitals to develop sustainable financial resources, supervision of Ministry of Health (MOH) and Universities of Medical Sciences (UMS) for teaching, quality improvement, development of human resources, reconciliation with the goals of the health system, participation in macro policy making and planning, development of structural standards for the management of these hospitals and their announcement by the MOH, are the main solutions for these challenges. Keywords: Charity hospitals, Qualitative study, Challenges, Tehran Citation: Jaafaripooyan E, Javadi Ghale E, Arab M, Sharifi T. Challenges of Charity Hospitals in Tehran: Evidence of Private Sector Participation in the Provision of Health Care. Journal of Health Based Research 2018; 3(4): 323-37.

Introduction: The Emergency Operation Center (EOC) is a prehospital community-based health management system that its main capital are its employees. However, occupational stress in personnel have negative effect on their quality of life and can lead to leaving the occupation. The aim of this study was to evaluate occupational stress and its effect on quality of life and desire to continue serving in personnel of Emergency Operation Center in Kerman. Methods: In this descriptive-analytical study, 200 personnel of Emergency Operation Center in Kerman in 2013 were included using stratified sampling method. The data was gathered using questionnaires HSE and WHOQOL BREF and analyzed by using chi-square test, Pearson correlation coefficient, and linear regression. Results: The results show that level of occupational stress in 49.3% of personnel was moderate and the quality of life in 52.9% of them was high. It was also found that the score of desire to continue serving in personnel was 4.15%. Therefore, there was reverse relationship between quality of life and occupational stress but direct relationship between quality of life and desire to continue serving in Emergency Operation Center. Conclusion: The results of this study showed that reducing occupational stress can increase the personnel’s quality of life and consequently the desire to continue serving in Emergency Operation Center. The main stressors in personnel is how administrators support them and make changes in the organization; therefore, it is recommended to managers to more support the personnel for reducing stress in them. Key­words: Occupational Stress, Quality of Life, Desire to Continue Serving, Emergency Operation Center Citation: Sharifi T, Sepehrian R, Namdari M. The Effects of Occupational Stress on Personnel’s Quality of Life and Desire to Continue Serving in Emergency Operation Center. Journal of Health Based Research 2016; 2(1): 93-104.