Payesh
Year:2020 | Volume:19 | Issue:1 |Papers Count:10

Objective (s): Improving health conditions and changing socioeconomic status in Iran, along with unplanned urbanization, has led to change in the pattern of communicable to non-communicable diseases. The aim of this study was to design a plan for implementation of integrated prevention and control of non-communicable diseases in Iran. Methods: A 4-step qualitative study including document analysis, review of articles and scientific reports, in-depth individual interviews and focused group discussions and approval by the String Committee for Status Analysis and Service Gap Recognition was conducted. Then 5-year vision, strategic goals in the next 5 years and the main strategies and interventions and required re-organization were provided. Data were analyzed using content analysis method. Results: Strategic goals were formulated in two groups related to behavioral and biological risk factors. Three main strategies for prevention and control of non-communicable diseases included promotion of health literacy, utilization of primary care services, and stabilization of intersectoral cooperation to reduce risk factors related to nutrition, tobacco, alcohol, and physical activity. Designed plan requirements included centralization of parallel and dispersed structures in non-communicable diseases management of the Ministry of Health, training human resources, developing integrated service packages, setting research priorities, explaining the role of each organization, increasing awareness of all public and private managers, and nongovernmental organizations participation. Conclusion: In order to implement this program, in addition to the consideration of the deployment requirements, other measures such as integration into the country's health program, the approval in the Supreme Council of Health and Food Security of the country, and the development of a comprehensive provincial health plan based on this program are required.

Objective (s): Strategic planning (SP) is the art and science of strategic analysis of an organization, forecasting changes in an organization’ s internal and external environments, articulating strategic goals, developing strategies, and utilization resources to achieve competitive advantage. Iranian hospitals are facing challenges in formulating and implementing strategic plans. Hence, this study aimed to explore and identify strategic planning challenges in hospitals. Methods: This qualitative study was conducted using semi-structured interviews with 47 managers of 17 public, private, social security, charity and military hospitals in 2016. Hospitals were selected purposefully from Tehran province hospitals in Iran. Content thematic analysis was used for data analysis using inductive approach. Overall, 8 themes and 34 codes were identified from the data. Results: weak leadership and management, in-effective planning, inappropriate organizational culture, insufficient organizational learning, and ineffective management of employees, patient, resources and processes caused obstacles to effective strategic planning in hospitals. Lack of justification for strategic planning, incompetent strategic planning team, inaapropriate strategic planning model, lack of teamwork morale, poor communication and coordination, inadequate education and training, lack of managers’ , employees’ and physicians’ commitment and participation, lack of resources, lack of monitoring and evaluation were the main challenges of strategic planning in hospitals. Conclusion: Hospital managers are facing challenges in strategic planning. If these challenges are not managed well, more problems will occur during strategic plans implementation. Policy makers and managers have to address these barriers before implementing the strategic plans.

Objective (s): Managers play a vital rol in hospital productivity. Succession planning is the process of identifying, developing, evaluating and training talented employees, which can, in turn, ensure organizational management and leadership continuity. Hospitals lag behind other business industries in using succession planning. This study aimed to identify key success factors of succession planning in a hospital. Methods: This case study was conducted in a public hospital that implemented succession planning in Tehran, Iran in 2018. Research participants were drawn from a purposive sample of hospital managers and employees (45 persons). Indepth semistructured interviews were conducted using open-ended questions. Thematic analysis was used for data analysis using MAXQDA 11 software. Results: Thirty-three factors affecting hospital succession planning were identified and grouped into two categories (i. e., internal and external factors). Internal factors including management and leadership (i. e., managers’ support, stability and maturity and rules and regulations), strategic planning (i. e., organizational vision and goals, succession planning, and succession planning evaluation), organizational culture (i. e., mutual trust, effective communication, and organizational transparency), organizational learning (i. e., developing, executing and evluating succession education plans), employees’ management (i. e., clear job career, talent management, employees’ involvement and employees’ performamnce evaluation), patients’ management (i. e., patient satisfaction survey and paying attention to patients’ needs and expectations in succession planning), resources management (committing resources, flexible organizational structure, succession planning committee and knowledge management) and process management (formulation, implementing and evaluation robust succession planning processes) affect management succession planning. Besides, a hospital’ s succession planning can be influenced by political, economic, social and technological factors. Conclusion: Succession planning in hospitals could be affected by internal and external factors. Hospital managers should consider these factors in their management succession planning.

Objective (s): This article discusses about developing concept of causality in inheritance of children born through assisted reproductive technologies with third party intervention by referring to jurisprudential standards, philosophy of law, general rules of contracts and the legal systems in different countries including Iran. Methods: A through review was conducted in order to develop the concept of causality in inheritance of children born through A. R. Ts with third party intervention. Results: We can rationalize reciprocal inheritance of the child born by assisted reproductive technologies (ARTs) with third party intervention and adoptive parents by virtue in An-Nissa Sura, Verse 33, where the implied terms by contract and jurisprudential principle that says ‘ Imam is the heir of a person who has no heir’ . And if so there is no genetic relationship between the two parties in guarantee of crime and matrimony, but the reciprocal inheritance is predicted, and now we can apply this structure in the mentioned relationship. Conclusion: The legislator, through contract and the implied terms, can design a specific model for reciprocal inheritance between these children and their adoptive parents, despite the absence of genetic relationship between them, so that these children can inherit from their parents as other children.

Objective (s): Patients suffering from different illnesses might need spiritual care especially those who are suffering from chronic diseases. The aim of this study was to perform a need assessment study of spiritual care. Methods: This was a qualitative study. First a questionnaire was designed based on literature review and experts opinions. Then this questionnaire was administered to a panel of experts using the Delphi method. The panel were experts in psychiatry, social medicine, epidemiology, quality of life, medical ethics, pediatric, nursing, occupational medicine and religion. Results: Experts indicated that patients with chronic diseases, patients with acute diseases at recovering period, incurable diseases, the patients at the end of life and also their families have priority for receiving spiritual care. Moreover they indicated that those with addiction, psychiatric diseases, sexual problems, HIV positive and infertility problems need spiritual care. Conclusion: Spiritual care could be integrated into the mainstream medical treatment. However, patients’ medical condition, culture, medical ethics and patient choice have important role in delivery of spiritual care.

Objective (s): The epidemiological transition causes changes and accumulation of diseases and deaths in old age. This study presents information on the leading causes of deaths for elderly (aged 60 and over) in Iran for this group for 2011 to 2017. Methods: This was a secondary analysis and is primarily based on data available in the Census and Civil Registration Organization. Deaths in 17 groups of causes according to the international classification of diseases-10 [ICD-10] were analyzed by sex and age groups. The main causes of deaths identified using YLL index and compared by time, gender and age. Results: During the study period more than 65 percent of all deaths occurred in elderly adults. About half of the deaths of elderly were related to cardiovascular diseases. Deaths due to cancer and tumors, and respiratory diseases were about 10%. The number of YLL for men and women in the year 2016 were 118027 and 1174054, respectively. Conclusion: The epidemiological transition has taken placed and was associated with the spread of chronic diseases and the emergence of deaths attributable to social factors.

Objective (s): This study aimed to investigate the pattern, prevalence, behavioral and socio-economic factors that relate to tooth loss among Shahid-Beheshti University of Medical Sciences employees. Methods: The data used for this was derived from a cohort study of Shahid-Beheshti University of Medical Sciences employees. The study was assessed tooth loss among 1381 participants using ordinal regression modeling. Additionally data from self-administered questionnaire were used. Results: Prevalence of tooth loss and edentulous in both genders was 68. 1% and 1. 8% respectively. In general tooth loss among women were lower than men (P<0. 05). According to adjusted ordinal regression model, smoking (OR=3. 12-CI: 1. 03-9. 44), age (OR=1. 10-CI: 1. 07-1. 12), use of toothbrush (OR=0. 42-CI: 0. 23-0. 76), tooth floss (OR=0. 64-CI: 0. 46-0. 90), gender (OR for female gender =0. 61-CI: 0. 43-0. 86) and socio-economic status (OR=0. 77-CI: 0. 65-0. 91) significantly were associated with tooth loss. Conclusion: Health workers had a relatively high prevalence of tooth loss, despite being employed in a health sector (medical university), and expected to have relatively better knowledge of oral health and better access to the oral health services.

Objective (s): This study aimed to compare the effect of two training methods in-person and mobile based virtual network on improving fast food consumption behavior in high school girls in Ahvaz, Iran. Methods: This interventional study was performed on 61 high school girls in Ahvaz (31 in-person group and 30 virtual network group). Data were collected before, immediately after and 2 months after the intervention by using a theory of planned behavior and food frequency questionnaires. Data were analyzed by SPSS version 24. Results: The constructs of the theory of planned behavior in both groups significantly increased compared to before the intervention. Fast food consumption behavior was also significantly decreased in two groups compared to before the intervention. There was no significant difference between two training methods. Only two months after the intervention, fast food consumption behavior was significantly different between the two training methods. Conclusion: Planned Behavior Theory-based training using both in-person and virtual network methods was effective on improving of fast food consumption behavior. There was no significant difference between two methods.