Applying theory of planned behavior in predicting of patient safety behaviors of nurses.

BACKGROUND: Patient safety has become a major concern throughout the world. It is the absence of preventable harm to a patient during the process of health care, ensuring safer care is an enormous challenge, psychosocial variables influences behaviors of human. The theory of planned behavior (TPB) is a well-validated behavioral decision-making model that has been used to predict social and health behaviors. This study is aimed to investigate predictors of nurse's patient safety intentions and behavior, using a TPB framework. METHODS: Stratified sampling technique was used to choose 124 nurses who worked at the selected hospitals of Isfahan in 2011. Study tool was a questionnaire, designed by researchers team including 3 nurses a physician and a psychologist based on guideline of TPB model. Questionnaire Validity was confirmed by experts and its reliability was assessed by Cronbach's alpha as 0.87. Binary logistic regression analysis was performed to evaluate how well each TPB variables predicted the variance in patient safety behavior. Analyzing was done by SPSS18. RESULTS: Finding revealed that "normative beliefs" had the greatest influence on nurses intention to implement patient safety behaviors. Analyzing data by hospital types and workplace wards showed that both in public and private hospitals normative beliefs has affected safety behaviors of nurses more than other variables. Also in surgical wards, nurses behaviors have been affected by "control beliefs" and in medical wards by normative beliefs. CONCLUSION: Normative beliefs, and subjective norms were the most influential factor of safety behavior of nurses in this study. Considering the role of cultural context in these issues, it seemseducation of managers and top individuals about patient safety and its importance is a priority also control believes were another important predicting factor of behavior in surgical wards and intensive care units. Regarding the complexity of work in these spaces, applying medical guidelines and effective supervision must be seriously followed.

A Survey on Clients' Opinions in Isfahan's Public Hospitals About Effective Factors in the Fulfillment of Referral System.

INTRODUCTION: Cutting back on the staff and equipment and also reduction of costs and devices, balanced distribution of resources for optimal use and prevention of unreasonable costs for patients are some advantages of the fulfillment of referral system process. Accordingly the purpose of the present study is to determine factors affecting the fulfillment of referral system process from the viewpoints of clients of Isfahan's public hospitals so that health system could benefit its advantages. METHODOLOGY: The research is a descriptive-analytic survey and the population consisted of clients referring to public hospitals of Isfahan Province. Hospitals conforming to health network in cities of Falavarjan, ShahinShahr, Shahreza, Naein and some public hospitals of Isfahan city were selected for study. Cluster sampling was applied and at the end 400 subjects were selected by simple random sampling. FINDINGS: Results showed that awareness and satisfaction in urban communities and motivation in rural are of higher levels. Regarding insurance status, those covered by Social Security have the most referrals to all levels and those covered by Health Service Insurance have more referral to the first level. The mean score of awareness of clients about referral system among the hospitals investigated shows a significant difference (p-value≤0.05). CONCLUSION: Results indicate that from the viewpoints of urban clients, the rate of the awareness of and satisfaction with the way of offering health services at primary levels and from that of rural clients motivation affect the fulfillment of referral system process. Therefore improvement of these factors could make the system more efficient.

A scientometric study of general internal medicine domain among muslim countries of middle East (1991 - 2011).

BACKGROUND: The position of General Internal Medicine in the Islamic countries in the Middle East has been investigated in the present study. MATERIAL AND METHODS: The scientific productions of the countries in the area on Web of science database during 1990-2011 constitute were examined. RESULTS: The result of the survey showed that the share of these countries in world scientific productions is very low. Turkey, Saudi Arabia and Iran are the first to third ones in this domain in order. In view of annual growth rate, Kuwait having high growth rate, is the first one. Libya and Syria are the next ones. The scientific poverty line of Islamic countries in the area was surveyed. The result showed that in view of the scientific poverty line, the highest is Kuwait with the population of 0.04 percent of the world. Next to it, Saudi Arabia and Bahrain are the second and third ones. CONCLUSION: The results of this research showed that the share of Islamic countries in the Middle East in scientific production of this medicine domain is very low. It needs to be paid more attention by the countries in the area.