Analyzing the Factors Affecting Neonatal Mortality Control in Iran by Providing a Model.

INTRODUCTION: Despite Iran's success in reducing neonatal mortality rate, it is still far behind some developing countries and some Asian countries. The aim of this study was to summarize the measures taken and proposed solutions to design a model to control neonatal mortality. METHODS: This applied cross-sectional analytical study was performed using a factor analysis method derived from 4 models of neonatal mortality reduction. After reviewing different texts and patterns, the common and non-common dimensions of these patterns were set in a comparative table. The results of the comparative studies were designed in the form of a questionnaire and sent to 30 experts for reliability and validity. CVI and CVR validity and Cronbach's α reliability were confirmed and in order to validate the model, the final questionnaire was completed and summarized by interviewing 311 people from 7 provinces in a multi-stage interview method using multi-stage random sampling. Data analysis was performed using SPSS25 and AMOS-18 software. RESULTS: 6 factors were found to be effective in controlling neonatal mortality, including access to health care, health policy, health services, health information systems, family involvement, and evaluation. Access to health care services had the most significant effect with 23.19% of explained variance, and participation and evaluation with 1.19% of explained variance had the least effect. CONCLUSION: The proposed model has the greatest impact on the access to health care services and the least impact on the evaluation component.

Psychometric Properties of the Patient Self-Advocacy Scale: The Persian Version.

BACKGROUND: Advances in science and technology and the changes in lifestyle have changed the concept of health in terms of etiology and mortality. The aim of this study was to test the psychometric properties of the original Patient Self-Advocacy Scale for use with an Iranian population. METHODS: In the current study, 50 chronic patients between the ages of 25 and 75 were selected as samples. This study was conducted in May 2013 at Bou Ali Sina Hospital in Sari. The translation process and cultural adaptation of the Patient Self-Advocacy Scale were conducted. The face validity and content validity of the instrument were formally verified by analyzing the feedback of patients and health professionals. In order to evaluate questionnaire's reliability, the intraclass correlation coefficient (ICC) was calculated for each item and each domain; and the Cronbach's alpha was calculated for the entire instruments and each domain. RESULTS: Of the 50 patients participating in the study, 36% were male and 64% were female. The mean age of the patients was 42.5. To comply with the Iranian culture and the study target population, slight changes were applied to the process of translation and validation. In the present study, intraclass correlation coefficient for each item was 0.8-1, which demonstrates excellent reliability of the questionnaire. The Cronbach's alpha value was 0.75 for overall scale. CONCLUSION: The Persian version of Patient Self-Advocacy Scale was valid and reliable. Hence, it can be used by public health researchers and health system policy makers for programming and offering patient-oriented health services based on patients' comments, needs, and preferences.

Tuberculosis disease diagnosis using artificial immune recognition system.

BACKGROUND: There is a high risk of tuberculosis (TB) disease diagnosis among conventional methods. OBJECTIVES: This study is aimed at diagnosing TB using hybrid machine learning approaches. MATERIALS AND METHODS: Patient epicrisis reports obtained from the Pasteur Laboratory in the north of Iran were used. All 175 samples have twenty features. The features are classified based on incorporating a fuzzy logic controller and artificial immune recognition system. The features are normalized through a fuzzy rule based on a labeling system. The labeled features are categorized into normal and tuberculosis classes using the Artificial Immune Recognition Algorithm. RESULTS: Overall, the highest classification accuracy reached was for the 0.8 learning rate (α) values. The artificial immune recognition system (AIRS) classification approaches using fuzzy logic also yielded better diagnosis results in terms of detection accuracy compared to other empirical methods. Classification accuracy was 99.14%, sensitivity 87.00%, and specificity 86.12%.

Determining Core Components in Accreditation of Limited Surgery Facilities in Iran.

BACKGROUND: Limited surgery facilities, or day-care centers, have been expanding in recent years with the approach of reducing the number of patients referred to hospitals for treatment in relation to limited and ambulatory surgeries. This study was conducted to perform a comparative review of accreditation models for limited surgery facilities of selected countries and to obtain expert opinions in the field of policymaking and accreditation in Iran. MATERIALS AND METHODS: This applied and qualitative study was carried out by a comparative method in 2019. The accreditation standards of limited surgery facilities in nine selected countries/states were assessed. Semi-structured interviews were then held with 25 Iranian experts in policymaking as well as accreditation authorities. RESULTS: Evaluation of the core components of accreditation standards for limited surgery facilities in selected countries showed that the main concepts of care and treatment, human resource management, patient safety, drug management, patient education, health information management, quality improvement, service recipient rights, infection prevention and control, physical structure, management and leadership, and general facilities were among the key recurring concepts in all models. In the study of factors affecting the accreditation model of limited surgery facilities in Iran, 5 main topics and 43 subtopics were identified. CONCLUSION: Although the current assessment model of limited surgery facilities is an appropriate tool for evaluation, it still needs to be improved because of the uncertainty of evaluation model, training of accreditors and the content of standards.

Designing a Comprehensive Pattern of Structural-Psychological Empowerment for Employees of Medical Sciences Universities.

BACKGROUND: The concept of empowerment requires the abandonment of traditional models. The need to design and develop employee empowerment patterns has been emphasized in several studies. The present study aims to design a comprehensive structural-psychological empowerment pattern for employees of medical sciences universities. MATERIALS AND METHODS: Our exploratory research was conducted on 410 employees of medical universities of Tehran, Iran, and Islamic Azad University. Firstly, a primary pattern was designed according to a review of available literature, texts, patterns, and tools. Then, the psychometric analysis was done using validation (face validity, content validity, construct validity, factor validity) and reliability (internal consistency and stability). Lastly, the final pattern was introduced after having been approved by experts. Data were analyzed using SPSS version 24 and AMOS made by USA IBM software. P<0.05 was considered as the significance level. RESULTS: Based on our study, 83.9% of participants were holders of bachelor's degrees or higher degrees. The results of validation (face, content, structure, and confirmation validity) and reliability (internal consistency [α=0.90] and stability [0.91]) showed that the structural-psychological empowerment pattern was appropriate, which was validated with 31 items and 8 domains. The scope of this pattern included resources, self-sufficiency, competence, support, effectiveness, and opportunity, significance, and information domains. The highest impact on the model was related to the support domain (impact factor=0.87). CONCLUSION: The present pattern is an appropriate and verified Iranian model in the field of structural-psychological empowerment, which is suggested in the cultural context of Iran, especially in medical universities.

Factors Affecting the Independence of Hospital Management in Iran University of Medical Science / Factores que afectan la independencia de la gestión hospitalaria en University of Medical Science en Iran

Introduction: Governmental hospitals have so far managed in different ways to increase the efficiency of hospitals, each of which has its disadvantages and advantages. This study aimed to determine the factors affecting the independence of hospital management in Iran University of Medical Science. Material and Methods: This descriptive-survey study was conducted pragmatically at hospitals of Iran University of Medical Sciences to identify obstacles and provide the necessary infrastructure by conducting study and follow-up. The sample was 94 people including university dean, deputies and chief executives of hospitals, educational and research deputies, therapists and professionals. Questionnaire was used as data collection tools and field data collection method. Results: The mean age of participants was 47.24 ± 5.41 years. Cronbach's alpha of 41 questions was assessed to test the reliability of the questionnaire. The total alpha coefficient was 0.843. The results showed that the mean score of all domains based on experience time was not significantly different (p> 0.05). The mean score of all domains in the first and third items based on education was statistically significant (p <0.05). In other items, there was no significant difference based on education level (p> 0.05). Conclusion: In general, according to the results and extracted five items, the independence of hospital management can improve the efficacy of services and satisfy the patients and staff.

Introducción: Los hospitales gubernamentales hasta ahora se han manejado de diferentes maneras para aumentar la eficiencia de los hospitales, cada uno de los cuales tiene sus desventajas y ventajas. Objetivo: determinar los factores que afectan la independencia de la gestión del hospital en la Universidad de Ciencias Médicas de Irán. Material y métodos: este estudio de encuesta descriptiva se realizó pragmáticamente en los hospitales de la Universidad de Ciencias Médicas de Irán para identificar obstáculos y proporcionarla infraestructura necesaria mediante la realización de estudios y seguimiento. La muestra fue de 94 personas, incluidos decanos universitarios, diputados y directores ejecutivos de hospitales, diputados de educación e investigación, terapeutas y profesionales. El cuestionario utilizó como herramientas de recolección de datos y método de recolección de datos de campo. Resultados: La edad media de los participantes fue de 47,24 ± 5,41 años. Se evaluó el alfa de Cronbach de 41 preguntas para evaluar la fiabilidad del cuestionario. El coeficiente alfa total fue de 0,843. Resultado: Los resultados mostraron que la puntuación media de todos los dominios basada en el tiempo de experiencia no fue significativamente diferente (p> 0,05). La puntuación media de todos los dominios en el primer y tercer ítems basados en educación fue estadísticamente significativa(p<0,05). En otros ítems, no hubo diferencias significativas en función del nivel educativo (p> 0,05). Conclusión: En general, de acuerdo con los resultados y extraídos cinco ítems, la independencia de la gestión hospitalaria puede mejorar la eficacia de los servicios y satisfacer a los pacientes y al personal.

Organizational Justice and the Shortage of Nurses in Medical & Educational Hospitals, in Urmia-2014.

OBJECTIVE: One of the most important reasons of turnover is perceptions of organizational justice. The purpose of this study was to investigate the effect of perceived organizational justice and its components on turnover intentions of nurses in hospitals of Urmia University of Medical Sciences. METHODS: This cross-sectional study was among nurses. 310 samples were estimated according to Morgan Table. Two valid and reliable questionnaires of turnover and organizational justice were used. Data analysis was performed using the software SPSS20. Using the Kolmogorov-Smirnov test, the normality and relationship between variables with Pearson and Spearman correlation test were analyzed. RESULTS: Most people were married and aged between 26 and 35 years, BA and were hired with contraction. The mean score of organizational justice variable was 2.59. The highest average was the interactional justice variable (2.81) and then Procedural fairness variable (2.75) and distributive justices (2.03) were, respectively. The mean range of turnover variable was 3.10. The results showed weak and negative relationship between various dimensions of organizational justice and turnover in nurses. CONCLUSION: Organizational justice and turnover had inverse relationship with each other. Therefore how much organizational justice in the organization is more; employees tend to stay more. Finally, suggestions for improvement of justice proposed.

Patient involvement in health care decision making: a review.

BACKGROUND: Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions. OBJECTIVES: Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making. MATERIALS AND METHODS: To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article. RESULTS: BASED ON THE REVIEW OF ARTICLES AND BOOKS, TOPICS WERE DIVIDED INTO SIX GENERAL CATEGORIES: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making. CONCLUSIONS: IN MOST STUDIES, FACTORS INFLUENCING PATIENT PARTICIPATION CONSISTED OF: factors associated with health care professionals such as doctor-patient relationship, recognition of patient's knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.