Payesh
Year:2023 | Volume:22 | Issue:4|Papers Count:11

Objective (s): Organizational culture is the shared beliefs and values of the employees, which determine their attitudes, norms, feelings, habits and behaviors. Organizational culture has a great influence on hospital performance. This study aimed to measure the organizational culture of hospitals affiliated to Tehran University of Medical Sciences. Methods: This descriptive and cross-sectional questionnaire survey was conducted in 14 hospitals of Tehran University of Medical Sciences in 2020. A researcher-made questionnaire including 48 items in two dimensions of internal coherence and external adaptation and 4 components of teamwork, accountability, risk-taking and responsiveness was used to measure the organizational culture of hospitals. The questionnaire was designed specifically for healthcare organizations. The questionnaire determines four types of organizational culture of indifference, conservative, market and excellence for hospitals. The questionnaire was completed by 600 managers and employees. SPSS statistical software version 22 was used for data analysis. Results: The average score of organizational culture of hospitals affiliated to Tehran University of Medical Sciences was 2. 76 out of 5 points. The average score of internal coherence and external adaptation dimensions of organizational culture were 2. 69 and 2. 82,The average score of the components of teamwork, accountability, risk-taking and responsiveness were 2. 52, 2. 87, 2. 46, and 3. 18,and the average scores of the levels of beliefs, values, behaviors and symbols of organizational culture were 2. 81, 2. 86, 2. 56 and 2. 79 out of 5 points, respectively. Thirteen hospitals had an excellent culture and one hospital had a market culture. The average score of organizational culture in specialty hospitals was higher than in general hospitals (p<0. 05). Conclusion: Hospital managers should promote the organizational culture by strengthening the internal coherence dimension of the organizational culture and the components of teamwork and accountability. Also, measures should be taken to strengthen the levels of values and beliefs of the organizational culture.

Objective (s(: Designing the living environment according to the needs of the elderly can play a significant role in creating a high quality for them. Therefore, this study aimed to evaluate the status of the standards of the age-friendly city in Kermanshah from the perspective of the elderly and managers. Methods: This cross-sectional study was conducted in 1401 with the participation of 384 elderlies over 60 years and 36 city managers in Kermanshah. Older people were included in the study using the random cluster sampling method and managers by census method. The data collection tool was the WHO's age-friendly city evaluation checklist. Results: The overall score of Kermanshah was 2. 55 and 2. 33 from the point of view of managers and the elderly, respectively, ranging from 1-5. The highest score was related to communication and information (2. 8) and the lowest score was related to civic participation and employment (1. 94). There was a significant difference between the views of the elderly and managers in transportation, social participation, citizenship and employment participation, communication and information, and health and local services (p=0. 00). Also, there was a significant relationship between the total score of the age-friendly city and gender (p=0. 05), marital status (p=0. 03), employment status (p=0. 01), living arrangements (p=0. 00), and the number of children (p=0. 04). Conclusion: The status of an age-friendly city for Kermanshah is such that there is a need to carry out interventions in all domains and all urban districts in order to adapt the city to the needs of the elderly.

Objective(s): Family members of patients hospitalized in intensive care unit experience high levels of depression, anxiety and stress. Therefore, the present study was conducted with the aim of assessing depression, anxiety and stress in the family members of patients hospitalized in the intensive care units of selected hospitals in Tehran, Iran Methods: This was a cross-sectional study in which depression, anxiety and stress of 160 family members of patients hospitalized in the intensive care units were examined. The samples were selected using a multi-stage cluster sampling method (from February to December 2022). The data were collected using the Persian version of DASS-21 and were analyzed with descriptive statistics and linear regression model. Results: The results of the present study showed that the mean anxiety score of family members was 17. 84(SD = 7. 92), the average depression score was 17. 49(SD = 8. 34), and the average stress score was 18. 35(SD = 7. 50). The linear regression model simultaneously showed that for an increase of one year in age, the anxiety score of family members decreased by 0. 11, and this decrease was significant (P<0. 01). An increase of one year in age, the depression score in family members decreased by 0. 09, and this decrease was significant (P<0. 05). Also, an increase of one year in age, the stress score of family members decreased by 0. 12, and this decrease was significant (P<0. 05). There was no significant relationship between other demographic variables with depression, anxiety and stress. Conclusion: The anxiety of the family members of patients admitted to the intensive care unit was severe and depression and stress were moderate. With increasing age, the level of depression, anxiety and stress of the patients' family members decreased. Nurses are working in intensive care unit can play an important role in educating families about these units and also providing psychological support to them.

Objective(s): Self-care is considered the most important issue for preserving and maintaining health. The present study aimed to investigate the components of the health belief model and peer pressure on self-care behaviors in adolescents. Methods: This was a descriptive study. The samples were selected through multistage cluster sampling among adolescents from three regions of Tehran. Data was collected using a self-designed questionnaire. Logistic regression analysis was performed using SPSS software version 22. Results: A total of 384 individuals participated in the study [217 male (56. 5%), and 167 female (43. 5%)]. The mean age of the respondents was 26. 03 years (SD = 5. 03), and the mean self-care score was 0. 46 (SD = 0. 49). The results of the logistic regression analysis investigating the factors influencing youth self-care showed that with a one-point increase in perceived barriers, self-care decreased by 95% (OR=0. 04, 95% Cl: 0. 01-0. 14, p<0. 001),with one-point increase in peer pressure, selfcare decreased by 0. 69 (OR=0. 3, 95% Cl: 0. 12-0. 75, p=0. 010). Self-care in single individuals was 2. 80 times higher than married individuals (OR=2. 80, 95% Cl: 1. 94-6. 57, P= 0. 018), and in students, it was 2. 75 times higher than employed individuals (OR=2. 75, 95% Cl: 1. 10-6. 88, P= 0. 030). There was no significant relationship between self-care and other independent variables such as age, gender, educational status, perceived benefits, and perceived threat. Conclusion: The study results indicated that the beliefs of young individuals about health behaviors influence their self-care practices. Individuals who perceive more barriers tend to engage in less self-care. It appears that appropriate educational interventions can enhance the self-care practices of young individuals.

Objective (s): Breast cancer is one of the most common cancers in women, which seriously affects patients’,psychological wellbeing. There are many interventions to deal with psychological impact of the disease. This study aimed to review the effectiveness of spiritual therapy in breast cancer patient. The secondary aim was to review studies that compared the effectiveness of spiritual therapy with others psychological interventions. Methods: This scoping review examined studies published in Persian language with related keywords, including ‘, spiritual therapy’,and ‘, breast cancer’,in Google Scholar up to July 2023. The data were extracted and tabulated to summarize evidence. Results: Overall, 554 article were retrieved. After excluding unrelated articles, 27 articles (18 articles reporting effectiveness of spiritual therapy and 9 articles comparing effectiveness of the spiritual therapy with others psychological interventions) were selected for final review. All studies confirmed the effectiveness of spiritual therapy on improved quality of life, resilience and hope. It also reduced anxiety, stress, depression, fear of the cancer among breast cancer patients. The findings showed that spiritual therapy is more effective than other psychological interventions except 2 studies that showed other psychological interventions are more effective. Conclusion: The findings showed that spiritual therapy was effective on improving the quality of life, resilience, hope and decreasing the fear of cancer, anxiety, stress and depression.

Objective(s): Although breast cancer is one of the biggest threats to women's health, preventive behaviors among women are not desirable, especially in vulnerable populations. This study aimed to assess the effect of an educational intervention on promoting breast cancer preventive behaviors in middle-aged women. It was performed on the outskirts of Mashhad, Iran Methods: In this quasi-experimental study in 2017, women referring to comprehensive health service centers in the suburbs of Mashhad were randomly selected and divided into intervention (n = 60) and control (n = 60) groups. The educational intervention was performed in 4 sessions based on the structures of PEN-3 model. A self-designed questionnaire was completed immediately and two months after the educational intervention by the target group. Results: The mean of constructs of perceptual, empowering, and reinforcing factors were significantly higher in women with higher education. Despite the lack of statistically significant differences between the two groups before the educational intervention, but immediately and two months after the intervention, the mean scores of PEN-3 model constructs and preventive behaviors in the intervention group were significantly higher than the control group (P<0. 05). Conclusion: The findings showed that educational intervention based on PEN-3 model constructs was effective on improving preventive behaviors among marginalized women.

Objective(s): Sexual self-efficacy is one of the most important issues for having a sexual quality of life. The present study was conducted with the aim of assessing the effect of narrative therapy on sexual self-efficacy and sexual quality of life in women. Methods: This semi-experimental study was conducted on 82 women in reproductive age. Among comprehensive health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran, two centers were randomly selected. Then, 82 women were selected according to the inclusion criteria and randomly assigned to intervention and control groups ( n= 41 per each group). In the intervention group, narrative therapy was performed during four 90-minute sessions. The control group did not receive any intervention. Data were collected using the standard sexual self-efficacy questionnaire (SSEQ) and the sexual quality of life questionnaire (SQOL-F), before and one month after the intervention. Data analysis was done using mean and standard deviation, number and percentage, independent and paired t-test, Mann-Whitney and Fisher. Results: There was no significant difference between the intervention and control group in terms of demographic and clinical characteristics. Before the intervention, sexual self-efficacy was not significantly different in the intervention 11. 92(2. 06) and the control group 12. 63(3. 42) (P=0. 24),However, after the intervention this difference was significant between the intervention 20. 31(5. 18) and control group 13. 39(2. 87) (P=0. 001). Before the intervention, the sexual quality of life in the intervention 68. 02(8. 75) and the control group 68. 73(8. 47) was not significantly different (P=0. 71),but after the intervention, a significant difference was observed between the intervention 75. 56(7. 89) and the control group 60. 29(10. 21)(P<0. 001). Also, the analysis showed that the sexual self-efficacy and sexual quality of life in the intervention group had a significant difference (P<0. 0001) before and after the intervention, while this difference was not significant in the control group. Conclusion: It seems that applying narrative therapy is an effective approach to improve sexual self-efficacy and the sexual quality of life of women.

Objective(s): Fear of childbirth is the most reason for cesarean section and it is greater in primigravida women. This study aimed to determine the effect of training based on Group Investigation Model on fear of childbirth in primigravida women. Methods: This was a field trial. Samples of primigravida women (n = 72) who referred to health centers in Ferdows, Iran in 2018 were entered into the study and randomly assigned to intervention and control groups. In the intervention group, the training program was held in 6 sessions each lasting for 90 minutes. Two sessions were held each week. Data were collected by using a demographic and Wijma fear of delivery questionnaire. Data were analyzed by using SPSS software version 16 using Chi-square, t-teste and pair t-test. Results: The mean age of the participants was 26. 20 ±,5. 19 years. At baseline there was no significant difference in fear of childbirth score in the two groups (P=0. 57). However, the results showed a significant decrease in the fear of childbirth after intervention in the intervention group compared to the pre intervention (P <0. 001). Also, after intervention the results showed that fear of childbirth was significantly different in intervention and control groups (P <0. 001). Conclusion: The Group Investigation Method for educating pregnant women was an effective and applicable intervention for reducing the fear of childbirth. The model might be useful in reducing the fear of childbirth and subsequently desire for vaginal childbirth and reducing the cesarean section.

Objective(s): Elder abuse is one of the serious and dangerous forms of domestic violence that have been the focus of communities and health care professionals for the past few years. Therefore, the purpose of this study was to validate the Persian version of the Elder Abuse Suspicion Index©,(EASI) among older community in Iran. Methods: This cross-sectional study was conducted in Ahvaz (Khuzestan Province), Iran 2019 on 2020 older people. After translation, the convergent validity, and the degree of agreement between the two evaluators (Cohen's kappa) were performed to assess construct validity. Reliability was assessed by calculation Cronbach’, s alpha coefficient. In addition, the known group comparison was also investigated. The ROC curve was used to calculate sensitivity, specificity and cut off point. Results: The Persian version of this index had acceptable face validity and content validity. The results of convergent validity and concurrent validity, the correlation between the EASI©,and the domestic mistreatment towards the elderly in the family questionnaire was 0. 74 at a significance level. The known groups comparison was significant. The overall kappa coefficient between two evaluators was determined to be 0. 873. Also, the value of Cronbach's alpha coefficient for the index was estimated at 0. 716. Sensitivity and specificity based on ROC curve at cut point 1 were equal to 62% and 96%, respectively, and the area under ROC curve was determined to be 0. 807. Conclusion: The findings indicated that the Persian version of the Elder Abuse Suspicion Index©,(EASI) is a valid instrument and can be used at primary care settings.

Climate change is one of the most important challenges of the current century. High temperatures, ice melting, sea level rise, floods, droughts and wildfires are the consequences of climate change. Climate change affects human health directly by changing weather patterns (extreme heat, floods, hurricanes, storms and droughts) and indirectly by changing the quality of water, air and food. Climate change increases the risk of respiratory and cardiovascular diseases,food, water and vector borne illnesses,infectious diseases, injuries and premature deaths. Iran is very vulnerable to climate change due to its geographical location, dry and semi-arid weather conditions (80%) and economic structure. Iran's health system is facing the double challenge of dealing with the human impacts of climate change and reducing its significant contribution to the country's carbon footprint. As a result, the country's health system should be adaptive and resilient to climate change to decrease vulnerability and increase adaptive capacity and ensure continued health services. Therefore, Ministry of Health should formulate national strategic and operational plans to strengthen the adaptability and resilience of the country's health system to climate change. Such plans provide a roadmap for healthcare policymakers, managers and employees to protect and improve people's health in unstable and changing weather conditions.

Among the global health threats posed by the Covid-19 pandemic are the re-emergence of monkeypox, and Marburg. Recently in the first week of August 2022 in China it was reported that Langya virus (LayV) belongs to the family Paramyxoviridae under the genus Henipavirus. Research on LayV is needed to strengthen surveillance activities and identify hosts and reservoirs of animal species and adopt a sanitary concept to limit animal-human contact. LayV is an RNA virus that has a high mutability in its genome and the severity of the disease is reported to be relatively low,Also, due to the emerging nature of the disease, the reported cases are limited, and more studies and more detailed epidemiological research are needed to determine the possible human risks. However, appropriate preventive measures are necessary to control and limit the spread of the disease to other countries and regions.