Journal of Health System Research
Year:2015 | Volume:11 | Issue:1|Papers Count:30

Background: Tetracycline antibiotics are used for disease control, prevention, treatment and increased growth in poultry. The use of tetracycline animals causes drug to remain in food of animal origin such as eggs.Methods: We searched databases, Google scholar, PubMed and Elsevier from 1991 to 2014 for keywords “tetracycline”, “residue” and “eggs” the necessary data were obtained.Findings: Factors such as withdrawal periods, boiling, frying, farm scale, housing system, geographic region and season affect onreducing the drug in foods.Lowering drugs in eggs by refrigeration is low andmore studies are needed to be taken over food's sources.Conclusion: According to this study's finding, more oversight over antibiotic's uses in poultry as well as public education on how egg's cooking will reduce human exposure to antibiotics.

Background: Aflatoxins are secondary metabolites produced by certain strains of the fungi Aspergillus such as Aspergillus flavus, Aspergillus parasiticus and, Aspergillus nominus. These fungi occur in the variety of agricultural products, such as cereals, nuts, spices and dried fruit. Aflatoxins are very toxic, mutagenic, immunosuppressive, teratogenic and carcinogenic compounds. The key target organ for toxicity and carcinogenicity is liver. European community and Codex Alimentary determined the maximum level of AFM 50 ng/kg in raw milk, liquid.Methods: The purpose of this study was to systematically review of the studies carried out in Iran in terms the presence and amount of aflatoxin M1in milk and dairy products.The databases such as SID, PubMed, Elsevier, Science Direct, WHO were searched for relevant subjects were searched from 2005 to 2013 and 42 relative articles were obtained, from which 23 original papers were included in the study..Findings: The contamination of milk and other dairy product in most studies were exceeded from the standard set by the Codex Aliment Arius Commission and ISIRI.Conclusion: According to results obtained in this study, pasteurized milk was mostly examined for the presence of Aflatoxin M1 in Iran, followed by sterilized milk. Both, presented a critical situation of contamination if the milk intake of infants and children come in to consideration.

Background: Organizational structure is away to determine organize and coordinate all of the activities of organizations. Coordination between appropriate organizational structure with goals and strategies will play important role toincrease efficiency and effectiveness. In this study, we described structural and contextual dimensions of organizational structure and the relations between them in Zahedan Khatam Hospital.Methods: A descriptive and quantitative study was conducted and 25 questionnaires were distributed among managers of Khatam Hospital. Analysis of the data was performed by SPSS software using different tests.Findings: Khatam Hospital has mechanical structure with high formalization and complexity and low centralization. There is a significant relationship between structural and contextual dimensions generally. Goals and environment dimensions have significant relationship but culture dimension has not. Goals dimension is the most important of contextual dimensions.Conclusion: Decentralization is a good point in the hospital compared with others. The results about organizational culture confirm this idea. There is a similarity between this study and others about the significant relationship between structural and contextual dimensions. We recommend to determine and aware the main goals and strategies to all employees for increasing efficiency and effectiveness in hospital.

Background: Health promoting behavior is one of the main criteria of health and it has a potential impact on improvement of health and quality of life. In addition it leads to a reduction in health care services expenditure. This study is conducted to identify the effect of self-efficacy and perceived barriers and social supports on the determination of health promoting behaviors in elderly in Dena city.Methods: In this descriptive-analytic study, 120 of elderly including 59 women and 61 men were selected by simple random sampling in Dena city. Data was collected by a questionnaire which included various parts (participants’ demographic characteristics, health promoting behaviors, self-efficacy, perceived barriers and social support of health promoting behaviors). The data was analyzed by descriptive statistics and Pearson correlation test, independent t-test and multiple linear regression analysis.Findings: The mean score of health promoting behaviors was 57.5 ± 10.7. There was a statistically significant positive association between self-efficacy, perceived social supports and health promoting behaviors in general and also stress management, physical activity, intrapersonal social relationship and prevention subscale (P<0.005). A statistically significant adverse association was observed between perceived barriers and health promoting behaviors in general and also stress management subscale.Conclusion: Findings of this research indicate a direct association between self-efficacy, perceived social supports and health promoting behaviors. Therefore health authorities may improve self-efficacy by planning health promotion training programs. Families may also increase social supports and therefore make a change in elderly behavior by providing needed emotional support for them.

Background: Job stress is one of the most important occupational hazards in present time, so that, creates, a lot of damage for individuals and organizations and nursing is a stressful jobs. This study aim the impact of health education on reducing occupational stress in nurses was conducted.Methods: A quasi-experimental research was done in 2011 public haspitals of Hamedan on 58 Nurses, who were randomizing, in the intervention and control groups.For measure of job stress, nursing stress scale (NSS) and to assess of knowledge, attitudes, skills and behaviors, was used self-made questionnaire.Training program during the fifth session in 3 weeks, for the intervention group was done and nurses for 1/5 month, were followed.For data analysis was used software of spss and statistical t- test Findings: Average score of job stress, before training, the two groups did not differ significantly.but, after training, the average score of job stress in the intervention group than control group, had a significant reduction (p<0.001).Also, the average scores of knowledge, attitude, skills and behavior, after training, had a significant increase in the intervention group (p<0.001).Conclusion: Findings were confirmed the impact of health education programs in increasing behaviors and reduce job stress among nurses.

Background: Investigating factors affecting the adoption of preventive behaviors in women with osteoporosis using patterns that identify the effective factors which influence and reinforce on behavior is necessary. This study aims to determination the preventive treatment of osteoporosis in women in Fasa using the health belief model and social cognitive theory in 2014.Methods: In this cross-sectional study, 401 women 30 to 50 years covered by health centers in Fasa were randomly chosen. Scale factors for health belief model (perceived susceptibility, severity, threat, benefits, barriers and self-efficacy, practice guidelines) and the self-regulation, social support structure of social cognitive theory, and function feeding and walking were determined to prevent osteoporosis in women. Finally, using the SPSS version 16software through tests, descriptive statistics (mean and standard deviation) test and analysis including Pearson correlation analysis, multiple linear regression, ANOVA and t-test were analyzed and significance level of less than 0.05.Findings: The average age of women was 40.9 ± 6.2 years. The variables of perceived susceptibility, motivation, social support and self-regulation for walking behavior and variables of perceived sensitivity and self-regulation for feeding behavior were predicted. There was a significant association between walking performance and perceived susceptibility (r=136, p=0.007), motivation (r=120, p=0.016), social support (r=0.068, p=0.030) and Self-regulation (r=118, p=0.018). In this study, there was a significant association between nutritional performance and perceived susceptibility (r=0.068, p=0.003), Self-efficacy (r=0.039, p=0.042) self-regulation (r=0.069, p=0.070) and there was a significant inverse correlation with perceived barriers (r=.047, p=-0.050). The variables under study expressed 29.1% of the variance in walking behavior and 20/2% of the variance in feeding behavior in osteoporosis prevention.Conclusion: This study indicated health belief model, self-regulatory structures and social support in predicting feeding and walking behavior for the prevention of osteoporosis. Hence, these models can be used as a framework for designing and implementing educational interventions for the prevention of osteoporosis in women and can help to improve and maintain their health.

Background: Breast cancer is considered as the most common as well as most effective malignancy in adult female population, has leaded to deep psychological and emotional problems such as depression, anxiety and stress. One of the possible factors lead to develop of depression, anxiety and stress in people based on cognitive models, is the cognitive distortions and dysfunctional attitudes towards the situation.The components included high prevalence and huge effects of breast cancer´s depression, anxiety and stress on different aspect as well as key role of dysfunctional attitudes in development of these elements; encouraged us to design and perform a study with aim to investigation the dysfunctional attitudes and its´ relationship with stress, anxiety and depression in breast cancer patients referred to a specialized cancer hospital Isfahan, Iran.Methods: This descriptive, analytic cross sectional study was conducted on cancer patients who were selected using simple sampling. A total number of 297 hospitalized patients with breast cancer were enrolled in 6 months. The clinical and demographic characteristics information, dysfunctional attitudes questionnaire (DAS-26) and the depression, anxiety, and stress scale (DASS-42) were used. All analyses were performed with descriptive and analytic statistical methods in SPSS for Windows 18.0 (SPSS Inc., Chicago, IL, USA).Findings: Mean scores of dysfunctional attitudes were 87.35 (27.53). Also mean scores of stress, anxiety and depression were 14.16 (9.38), 11.64 (8.27) and 12.06 (9.52) relatively. Based on study findings there was a statistically significant relationship between dysfunctional attitudes with stress, anxiety and depression in patients with breast cancer.Conclusion: With regard to results of this study, breast cancer patients with higher scores dysfunctional attitudes had more stress, anxiety and depression. In addition low dysfunctional attitudes score was an important protecting factor against stress, anxiety and depression in these patients.

Background: Midwives and physicians can reduce transmission of disease like HIV and Hepatitis by considering infection control criteria. Based on remarkable IUD and vasectomy frequency, existing problems in infection control in Isfahan Health Centre and not many recent studies on infection control in family planning units in literature review, this study was designed to evaluate the status of infection control of this centre according to the infection control criteria in 2013.Methods: This was a descriptive and analytical study. Research sample consisted of 78 midwives and skilled physicians who provide IUD insertion and vasectomy in 65 family planning and vasectomy units in health centre. Data gathered by the questionnaire was related to staffs (personal and clients services protection) and checklist was related to unit`s environment (infectious waste removal, work place, cleaning, disinfection and sterilization of instruments).Some of indexes were «MUST to do».Responses, scoring and were evaluated in two ways: 1. Calculation scores and percentage of criterias for rating staffs and units: poor (0-59%), moderate (60-79%) and good (≥80%).2. Calculation of desirability percentage of staffs and units: accepting at least 75% scores and 80% of “MUST to do” points.Findings: In infection control, the staffs and units were rated as followed. The staffs: 12.8% (n=10) poor, 60.3% (n=47) moderate, 26.9% (n=21) good and the units: 35.2% (n=19) poor, 53.7% (n=29) moderate and 11.1% (n=6) good.11.5% of the staffs (n=9) and 7.01% (n=4) units were in desirable conditions for adaptation to infection control criteria.Conclusion: The desirability of adaptation to infection control criteria is not good enough, except in the vaccination of hepatitis B and infectious waste removal. Therefore, it seems that training the staffs and continuous monitoring, as well as the purchasing standard disinfectants should be a priority in healthcare programs.

Background: Absenteeism from work can have serious negative impact on work. The aim of this study was to assess the Prevalence of absenteeism and its effective factors in the industry of Mazandaran province.Methods: This study was a longitudinal study that coducted on 128 accident cases led to absenteeism in 2007 to 2012 was studied. Absenteeism from work was calculated by using of the absenteeism indicators including Lost Time Rate, Gross Absence Rate, Sick Absence Rate, Unauthorized Absence Rate, Average Absence per Employee and Cumulative Bradford factor. After collecting the data, for analyzing the results, SPSS version 20 software and chi-square tests and analysis of variance and odds ratios were used.Findings: Results showed that the rate of loss of time, the total amount of absenteeism, absenteeism due to sickness, total days of unauthorized absence from work and the average number of days of absence per individual were 0.956%, 1.055%, 0.726%, 0.3265% and 216.41% respectively. Also Cumulative Bradford factor in 2010, 2011 and 2012, was 86, 19 and 71 respectively. Between the accident factor and absenteeism, month of occurrence and absenteeism, nature of injury and absenteeism, work shift and Cumulative Bradford factor, Cumulative Bradford factor and accident factor, and the salary and incident were statistically significant relationship.Conclusion: Based on the results, absenteeism from work in 2012 was more than years ago, that shoud be detect and control. Also, it was found that several factors such as age, shift work, employment status, type of accident, months of the year and can be affect on the rate of absenteeism from work. Study of absenteeism from work can be reduced the prevalence of absenteeism in the organizations and thus, increased productivity and production.

Background: Disposal of pharmaceutical compounds to environment as an emerging pollutants cause significantly concerns and it is necessary to use the new methods of sewage treatment for removal of these compounds. The aim of this study was to feasibility using of O3/H2O2 process on diclofenac impact on the specific methanogenic activity of anaerobic biomass.Methods: Twelve anaerobic digestions at batch mode carried out before and after using an O3/H2O2 process at the 500ml reactors with 30% anaerobic biomass and 70% substrate. The replacement liquid method was used. Duration of each test was range 8-16 days.Findings: Cumulative methane production in concentrations of 25, 50, 100, 175, 250 and 350 mg/l of diclofenac were 764.24, 845.42, 82, 102.09, 25.42 and 1.64 ml respectively. These productions were 8.61, 26.65, 4.1 and 4.1 ml in concentrations of 25, 100, 250 and 350 mg/l respectively after 180 min pretreatment with O3/H2O2 process and demonstrate that methane production was reduced in all concentrations after ozonation process.Conclusion: It is concluded that the high concentration of diclofenac has inhibition effects on the anaerobic digesters and after the ozonation process pretreatment on diclofenac, the intermediates compounds can be produced which probably had very diverse effects on the anaerobic bacteria in digesters and also had a lower biodegradability.

Background: Introduction: Today what creates value for health care system is ongoing relationship with the customer, and successful organizations are only those who are able to make clients for lifetime and can do the mission of responsiveness to customers in shortest time, with best quality and with lowest cost. One of the strategies that help these organizations is creating an ongoing relation with customers.Methods: This research is a descriptive- analytical one. The study population were the nurses of selected hospitals in Esfahan, that sampling was carried out by randomized stratified method. Tools for data collection were researcher questionnaire of communication with customers management whose validity and reliability is confirmed. For determining factors, we used of confirmatory factor analysis. The method of data collecting was structural equation method and software used were Amos and Spss.Findings: In duty dimension of customer communications management, services diversity has the highest score (2.9) and in management of productivity customer communication has the highest score (3.2). Among the dimensions, productivity ultimate model has the highest score and interaction with customers and customer maintenance have the lowest score.Conclusion: The health care organizations can remain in the competitive market by implementing customer relationship management. This is essential that studied hospitals improve the obtaining information, customers' satisfaction and loyalty, new customers' attraction and maintaining strategies.

Background: Lead is one of the priority toxic pollutants from industrial wastewater, such as batteries, paint, weapons, glass, printing, etc. In this study, was investigated magnetic iron oxide nanoparticles maghemite for the removal of lead from synthetic wastewater of battery industry.Methods: In this study was used the influence of various factors such as pH, initial concentration of lead, and contact time on lead removal from synthetic wastewater by nanoparticles maghemite was investigated.After separating adsorbent by magnetic field, remaining lead concentration was measured by atomic adsorption (perkin elmer 2380). The results were analyzed by the software SPSS Version 18.Findings: Results showed that in the pH value of 7, the initial concentration of lead of 50 mg/L and 0.1 g.per liter Nano maghemite dose and contact time of 40 min and stirring speed of 150 rpm 63.91 percent lead removal was obtained. Adsorption capacity was 61mg/g.Conclusion: Maghemite nanoparticles had high adsorption capacity, rapid and effective. Removal efficiency of lead was directly related to pH and time and reversely to initial concentration of lead. The absorption model was fitt well to Freundlich isotherm.

Background: The importance of fertility as the most important factor in change of structure and size of a population has caused fertility and those factors which affect it to find a specific place among demographic studies. Since studying different population aspects, such as mortality, fertility, and immigration, may be an effective step toward designing and planning population programs and policies, the aim of this study was to determine those factors which affect the fertility behavior differences in various ethnic groups in Shahr-e-Kord.Methods: In this descriptive survey, 266 married women, who were 15-49 years old, were studied through stratified random sampling in Shahr-e-Kord. Participants were assessed by a questionnaire which was consisted of economic, social, fertility behavior, and cultural and ethnic parts. The questions were scored according to the Likert scale (1-5). The data were managed by SPSS system and analyzed by descriptive statistics, inferential statistics, statistical independence test, ANOVA, Kappa coefficient of agreement, and the generalized linear model.Findings: Among social factors, there was a significant relationship between the age of marriage and the number of children (P=0.000). Among cultural factors, the education (P=0.012) and tribal affiliation (P=0.005) variables affected the fertility behavior significantly. Among economic factors, there was a significant relationship between the husband's occupation (P=0.020) and ownership of the residence (P=0.022) variables and the differences in the fertility behavior. The results showed that there was a relative agreement between the participants and their husbands on the desired number of children (K=0.547), and this agreement was slightly insignificant in the case of the repetition of fertility (P>0.05).There was a significant relationship between the cultural-ethnic factor and the fertility behavior; this systematic relationship was nonlinear and it was equal to 0.093 (P=0.000).Conclusion: Among the studied factors, cultural-ethnic factors had the most effect on the fertility behavior. The level of education and tribal affiliation were also effective in women of various ethnic groups. Among social factors, the age of marriage had a significant effect on the fertility behavior.Women training to enhance their knowledge and training can be an effective step in changing theirs attitudes about reproductive.

Background: Identify talented people to donate predisposed a major role in supplying healthy blood. If the time interval between donations decrease, the chance that voluntary of blood donation be a regular donor increase. The aim of this study was to determine factors affecting the interval between blood donations in a sample of first-time blood donors.Methods: Data of a Cross-sectional Study of 864 blood donors in Shahrekord Blood Transfusion Center were used. In survival analysis framework, the times of blood donations are recurrent events. To identify the risk factors affecting the survival time of the return intervals between donations, Cox model with shared gamma frailty was fitted to the data and estimate of the parameters obtained based on Bayesian approach using Markov Chain Monte Carlo algorithm by WinBUGS.Findings: ANOVA analysis on information related to age, sex, job and exposure with cigarettes in selected population from two city showed that the selected population in two cities is completely homogeneous and similar. And a Significant differences between the average concentration of lead in the nail of subjects under study in two cities is there (P<0.001).The average concentration of lead in nail samples in Isfahan was 0.1037 mg/g and the average concentration of lead nail samples in Chadegan city was 0.0875 mg/g.Conclusion: Because of better fitting of Cox's shared frailty model, the correlation between the intervals of blood donations was confirmed. With increasing awareness and culture, the lower-weight and higher-age people should be encouraged to donate more.

Background: Bread is a staple food for Iranian people but Phytate as a component that found in bread flour induces mal-absorption of minerals in the gastrointestinal tract. This study was about measuring the phytate in some selected breads in Isfahan.Methods: We measured phytate in six various breads including: Whole meal bread, Sangak, Barbari, combynei, Taftoon, Tanoori- which are consumed in Isfahan. The method of measuring of phytate was Early and Beturk.Findings: The phytate content of breads was as follows: Sangak>Whole meal bread>combyni>Tanoori>Barbari>Taftoon, respectively.Conclusion: The remaining amount of phytate was depends on some parameters such as percent of bran in bread flour, amount of yeast, amount of baking soda and the rest time of dough.

Background: Geographical Health Research examines the effect of environmental factors on human health examines. The environment where human and nature both is greatly influenced by the climatic conditions. The types of skin cancer world wide as well as Iran are among the most common diseases and According to studies, are influenced by environmental factors. The objective here is to analyze the environmental and climatic factors influencing skin cancer outbreak in Isfahan province.Methods: The climatic and the medical data regarding the cancer disease patent in 11 cities from 2005-2011 are analyzed through frequency analysis, volume zoning distribution, overlapping of the variables and correlation analysis.Findings: A total of 4.104 patients constitute the statistical population where 1.507, that is 36.72% are female and 2.597, 63.28% are male. The frequency analysis of the disease when distinguished by age and gender in the study period indicated over 50 years of age for both the genders and higher rate among men. The distribution of the disease showed the critical core to be central part of Isfahan province.Conclusion: The short statistical period of (7 years), with respect to the correlation analysis was not enough to obtain a high reliability rate as a result. The results obtained from correlation and variables’ overlapping analysis in the geographic data system indicate that the outbreak of skin cancer is rarely related to the climatic (The Average and Absolute maximum Temperate, Minimum relative humidity, Precipitation, Sunshine hours, Wind speed) and topographic variables; hence the origin of this disease must be searched in other factors such as genetic...etc and more researches on the effects of solar radiation and Ultra violet radiation on skin cancer are recommended. Etc

Background: Job stress is one of the important social phenomenon’s in life and serious threat to the health workforce. Job Stress is caused when there is an imbalance between worker skills and job requirements. The purpose of this study was to Evaluation of effective factors on occupational stress in firefighting personnel.Methods: A cross-sectional and descriptive- analytical study was conducted in 50 man firefighters in sanandaj. After Basic data collection, national Institute of Mental Health job stress Questionnaire was used to assess job stress which consists of 3 sections interpersonal relationships, physical and environmental conditions and Job favorites. Collected data were analyzed by SPSS19.Findings: 86% of the studied personnel were married and 14% of them were single. Participants ‘ages category were 16% Less than 30 year, 52% between 30-40, 32% more than 40 year. Participants work experience category were 22% less than 5 years, 28% between 5-10, 30% between 10-15 and 20% had more than 15 years. Their mean job stress was 172.7 and was estimated high stress level and physical and environmental agent had the highest mean score of stress. Statistical analysis showed that job, work experience, and job satisfaction are significantly associated with job stress.Conclusion: It seems that firefighters were being at risk of job stress disorder and type of job and work experience is the main factors affecting it. Job stress can decrease job satisfaction.

Background: Isfahan is one of the most polluted cities in Iran because this city has a large number of polluting industries and heavy traffic. With regard to the fact that in recent years using the nail as biological indicator index for level of contact with heavy metals has been considered. This research carried out in order to use the nail as a biological marker to study air pollution in Isfahan compared with Chadegan city that has a clean air.Methods: Two groups of 65 people aged (5-50) of women and men in both cities were selected. Then 1 gram of fingernail from each of them was collected. After the samples preparation and digestion the concentration of lead in nail samples was determined by atomic absorption apparatus.Findings: ANOVA analysis on information related to age, sex, job and exposure with cigarettes in selected population from two city showed that the selected population in two cities is completely homogeneous and similar. And a Significant differences between the average concentration of lead in the nail of subjects under study in two cities is there (P<0.001).The average concentration of lead in nail samples in Isfahan was 0.1037 mg/g and the average concentration of lead nail samples in Chadegan city was 0.0875 mg/g.Conclusion: It was found that significant differences between average concentrations of Lead in the nail of subjects under study is related to place of residence them and exposures to environmental contaminants including air pollution from industries in Isfahan city has been effective on concentration of lead in nail samples.

Background: Repeated events in cohort studies can be terminated by loss to follow-up, end-of-study, or a major failure event such as death or stable disease. In this regard, the major failure event can be correlated with recurrent events, thus the usual assumption (no-informative censoring of the recurrent event process by death) required by most statistical analyses, can be violated. Joint modeling as an appropriate way of analysis for this kind of data, can investigating two processes, simultaneously and leads to unbiased and efficient parameter estimations.Methods: In the present study, joint frailty model with maximum penalized likelihood method is introduced and used for analyzing real clinical data of cohort study was included first-degree relatives (FDR) of type 2 diabetes patients who attending to Isfahan endocrine and metabolism research center. The R-software (version 2.15.2) was used to fit the models.Findings: The hazard ratios adjusted by energy intake showed that pre-diabetes recurrent rate is 3.48 times higher in Individual with carbohydrate greater than 65 percent energy intake, than Individual with lower than 40 percent energy intake. The hazards for terminal events as diabetes adjusted by energy intake indicated that the rate of diabetes 0.19 times higher in individual with protein 12-15 percent energy intake than individuals with protein lower than 12 percent energy intake and 0.19 times higher in individuals with protein greater than 15 percent energy intake than individual with protein lower than 12 percent energy intake.Conclusion: Adjusting life style through the nutritional status and anthropometric measure adjustments can effect on the prevalence of diabetes between FDRs who have genetics risk factors.

Background: The job burnout affects the physical and mental health and as job stress final outcome can be seen in many professions among nursing. The aim of this study was survey the relationship between shift work and job burnout in the different wards of Alzahra hospital. Using the results of this study in health-medical planning could cause the reduction of burnout and consequently increasing of quality of services, patient satisfaction, reduction of absence of work, increasing of effectiveness of expenses and efficiency.Methods: This survey is adescriptive- analytical study and the population under the research was nurses with and without job rotation in Alzahra hospital of Isfahan and sampling accomplished stratified method.Required data was collected via two questionnaires including public questionnaire about background variable in target groups and maslach’s burnout Inventory (MBI). To do this recourse in different shifts to the hospital and thereinto explaining the aims of study and teaching guideline and how to complete the questionnaire was given nurses who had announced their partnership.Findings: In comparing the levels of job burnout among the nurses in different shifts, the most level of burnout in the dimension of emotional exhaustion and depersonalization was at the afternoon shift and declining of personal accomplishment was at the night shift. The most level of burnout in the dimension of emotional exhaustion there was in vessels ward, in the dimension of depersonalization in the dialysis ward and the least level of personal accomplishment in the ICU ward. This study demonstrated that the relationship shift work with dependent variables in different wards is varied (p<0.001).Conclusion: The highlevels of emotional exhaustion and depersonalization, the low level of reduction of personal accomplishment in nurses in the study can be warning for the managers, because the lake of appropriate management for control of this situation can be lead to many damages in the health system.