Payesh
Year:2018 | Volume:17 | Issue:6 |Papers Count:11

Objective (s): Evaluation of hospital performance helps improve the quality of services, and enhance patients’ health outcomes and satisfaction. This study aimed to evaluate Iranian hospitals’ performance using a systematic review of the last two decades of the literature. Methods: A systematic review was conducted to find empirical research publications on Iranian hospitals’ performance between 1997 and 2018. Six electronic databases and two search engines were examined using appropriate key words. Bibliography section of the retrieved papers and related journals were also assessed for papers that were not indexed in the databases yet. All retrieved papers were assessed using a checklist before analysis. Results: In all 2570 publications were identified. Of these 162 empirical studies were reviewed. Studies on evaluation of hospital performance mainly focused on the efficiency dimension and less attention was paid to the effectiveness indicators. In most studies, data envelopment analysis and Pabon Lasso methods were used. Hospitals’ efficiency was reported low to moderate. Some studies used systemic models such as European Foundation of Quality Management and Malcolm Baldrige models for hospital evaluation. In these studies, the results’ scores were lower than the enablers’ scores. Bed occupancy, lengths of stay, bed turnover interval and mortality rate was the most frequently used indicators in evaluating hospitals. Conclusion: Hospital performance studies mainly used non-systemic models and focused more on efficiency aspect of the performance. Systemic and comprehensive models should be considered for hospital performance evaluation.

Objective (s): Hospital accreditation is a systematic external evaluation of a hospital’ s structures, processes and outcomes by an independent professional accreditation body using pre-established optimum standards. Iran national hospital accreditation system (i. e., standards, methods, and surveyors) has changed in 2016. This study aimed to evaluate the efficacy of national hospital accreditation system of Iran. Methods: This cross-sectional study was carried out using a valid and reliable questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of all hospital managers in Zanjan province, Iran. SPSS software was used for data analysis. Results: The mean score of managers’ satisfaction of hospital accreditation system was 3. 00± 0. 27 and 2. 98± 0. 36 out of 5 in 2015 and 2017. Hospital managers’ satisfaction of the new accredtation system has decreased by 0. 66 percent in 2017. However, the differences was not statistically significant. Managers’ satisfaction of accreditation standards increased by 1. 8% while their satisfaction of accredtation methods and standards implementation has decreased by 11. 6 and 8. 5 percent respectively. Conclusion: The changes applied to Iran national hospital accreditation system did not satisfy hospital managers. Hospital managers’ and employees’ opinions and concerns should be considered in any attemp to revise the hospital accreditation system.

Objective (s): Looking at the conceptual evolution of health, trends in governance and how it is used by governments seeking improvement in health outcomes, shows the emergence of a meaning consensus that the population health, could not be seen any more in the biomedical narrow viewpoint and as a performance of one ministry. Methods: This is a qualitative paper, using documentary descriptive and analytical research methods to express, an epistemological narrative of the health policy late logic. Results: Policymaking for health, should be based on an understanding of what has a major impact on the population health; what have being described as ‘ health hazard’ , ‘ health protector’ and ‘ health promoter’ . Such an understanding has led to a new paradigm appearance entitled ‘ Governance for Health’ . Conclusion: Governance for health is not necessarily an intervention but a ‘ value system’ and a kind of ‘ sociocultural perception’ to ‘ sustainable development’ that may lead to equal opportunities for better health and inequity reduction. In addition, participatory focus on intersectoral collaboration and multi-sectoral coordination for health, reinforces the systemic features of public policy and could lead to more effective programs in all policy areas. Realizing such an ideal integrated governance for health requires ‘ political will and commitment’ .

Objective (s): Decision making about characteristics of reward system is one of the main challenges in organizations. The current study was carried out in order to design and provide a reward system for staff working in hospital affiliated to Tehran University of Medical Sciences (TUMS) hospitals. Methods This study was performed in two steps from May 2014 to January 2016 in Tehran. First, the research team identified the main axes of reward system using semi-structured interviews with experts and stakeholders. Then the list of final criteria for rewarding was prepared in addition to weight for each criterion using ‘ pairwise comparison analyses. Secondly, in order to identify the executive requirements, the model was implemented in one hospital as a pilot. Results: The main aspects of reward system were scoring method; type of reward; awareness program; evaluation; executive requirements (including structure and process). After pilot study criteria and scoring method were improved. Conclusion: Although the findings were promising, it seems for model success defining executive requirements (including process and structure) proportionate to available capacities and advocacy from head and senior managers is essential.

Objective (s): Several studies have showed associations between anxiety during pregnancy and adverse maternal and child health outcome. This study aimed to explore this relationship among Iranian pregnant women. Methods: This was a qualitative study. To collect data purposive sampling and face-to-face semi-structured in-depth interviews were used. Women were asked to explain their experiences and perceptions on socioeconomic issues and induced anxiety during pregnancy. A conventional content analysis approach was used for analyzing the data. Data analysis was conducted using MAXQDA software. Results: Twenty eight pregnant women from different social backgrounds, educational levels and ethnicity aged 18-41 years old participated in this study. Socioeconomic determinants of induced anxiety were found to be: pregnancy interference with the social role, gender discrimination, financial responsibilities of raising a child, unnecessary interfering of significant others, quality of support. Conclusion: The findings suggest that timely screening of at risk mothers and strengthening prenatal related education specially trying to change incorrect believes are essential for reducing anxiety during pregnancy.

Objective (s): The present study aimed to determine the effect of cognitive-behavioral counseling on quality of life in women with polycystic ovarian syndrome. Methods: The present randomized controlled clinical study recruited women with polycystic ovarian syndrome attending a teaching hospital affiliated to Iran University of Medical Sciences in 2017. Participants were randomly assigned to intervention and control groups. In addition to the routine treatment techniques، the intervention group received ten sessions of individual cognitive-behavioral counseling at one-week intervals. The quality of life and its dimensions were assessed and compared before and three weeks after the last session of counseling using a valid and reliable questionnaire Data were analyzed using descriptive and inferential statistical tests. Results: A total of 44 women with polycystic ovarian syndrome entered into the study (22 in the intervention group and 22 in the control group). The mean age of women was 29. 5± 3. 86 years in the intervention group and it was 30. 4± 0. 78 years in the control group. No significant difference was found between intervention and control groups in any of the demographic and reproductive characteristics. Pretests showed no significant difference between the two groups in mean scores of quality of life and its dimensions. However، in the posttest and after cognitive-behavioral intervention، mean scores of quality of life and all its dimensions (except for menstruation problems) improved in the intervention group. This improvement also was significant when scores compared to pretest and compared to control group (P<0. 05). Conclusion: The present study showed that cognitive-behavioral counseling improved quality of life in women with polycystic ovariansyndrome.

Objective (s): The present study aimed to investigate on knowledge, attitudes and responsible environmental behaviors among female secondary school students Methods: This was a descriptive study of a sample of students in Ilam in 2016. Students were selected using cluster sampling and entered into the study at all three grades of secondary school. Data was collected by a self-designed questionnaire. The environmental status of school was also assessed by the observations. Data were analyzed by using descriptive and inferential statistics (including chi-square, Pearson correlation coefficient, and regression). Results: In all 330 female students were entered into the study. The mean scores were 10. 3 ± 2. 8, 73. 6 ± 11. 1 and 45. 9± 14. 8 for knowledge, attitude, and behavior respectively. There was a significant correlation between knowledge-attitude, and attitude-environmental behaviors. The results of regression analysis showed that attitude (P < 0. 001), income (P = 0. 033) and school grade (P = 0. 028) were associated with environmental behavior. Conclusion: The findings indicated that attitude and students’ social class are important factors in responsible environmental behaviors.

Objective (s): This study aimed to examine the extent of knowledge among young male students on HIV transmission, particularly sexual transmission and its associated factors. Methods: A cross sectional study was conducted among a sample of male college students in Tehran, Iran. Sampling method was two-stage stratified sampling method and students from three state universities and one non-profit private university were selected. Dependent variables were knowledge on HIV transmission and knowledge on sexual transmission of HIV. Data was collected via a structured questionnaire and were analyzed using descriptive statistics and Pearson correlation, t-test, Chi-square test. Results: In all 1357 were studied. The mean age of students was 22 (SD= 2. 76) years. The analysis of data indicated that incorrect responses about various means of HIV transmission varied from 13% to 58%. Most misbelieves and misinformation comprised of ‘ transmission through insect, blood transfusion using a clean strange, touching infected blood with no tears, using common toilet, using common syringe, sexual contact with infected partner’ . Although the mean score of knowledge about HIV transmission and sexual transmission of HIV was at an average level, there was an important heterogeneity with regard to means of HIV transmission. Despite that 87% of male college students were aware of transmission of HIV through sexual contact with infected partner, but detailed information about sexual transmission of HIV was poor. About 50. 3% and 37. 7% of respondents were not aware of HIV transmission through non-vaginal penetrative sex [oral sex and homesexual relation]. Associated individual and social factors of HIV knowledge and knowledge on sexual transmission of HIV were also examined in this paper. Conclusion: The results highlight the need for comprehensive education and eliminating misconceptions about sexual transmission of HIV. Particularly, education on HIV among adolescents and young people should be tailored to their specific socio-economic status and among high-risk groups of young people.