Effect of TQM educational interventions on the management policy standard of health promoting hospitals.

The purpose of this study was to manage total quality management (TQM) to increase the standard of management policy and contribute to achieve the standards for health promotion hospitals (HPHs). This was a quasi-experimental intervention study. A total of 35 managers participated in this study were selected in the census. Based on the TQM components, educational items were provided as lectures, posters and pamphlets. The TQM questionnaire and HPHs checklist used to collect data in three different periods: before the interventions, immediately after the interventions and 3 months after the interventions (follow-up). The data analysis was done by means of SPSS software (version 23). The results showed that the average difference of the components of the qualitative groups (p < 0.001), education (p = 0.004), evaluation and feedback (p < 0.001), customer-orientation (p < 0.001), suggestion system (p = 0.024), leadership commitment (p < 0.001) was significant over the three periods. Excluding the employment status before the educational intervention (p = 0.002), there was no significant relationship between the demographic characteristics and mean score of TQM (p > 0.05). Based on the findings of this study, the educational interventions had a positive effect on quality management and management policy. Therefore, educational interventions should be accompanied by changes in the culture and management policies of the hospital to meet HPH standards.

Health promoting hospitals in Iran: A review of the current status, challenges, and future prospects.

Background: Health promoting hospitals (HPHs), in addition to their routine diagnosis and treatment services, concentrate on health enhancement and disease prevention. This study was conducted to systematically review studies conducted in the field of health promoting hospitals (HPH) in Iran to achieve HPH standards. Methods: Electronic search was conducted from October to February 2016 in Persian and English databases. Search was done IranMedex, SID, ISI Web of Knowledge, ScienceDirect, PubMed, and Google Scholar with the following keywords: Health promotion hospital (s), health promoting hospital (s), health promotion hospitals, HPH, and Iran. Based on inclusion and exclusion criteria and the aim of the study, 10 studies were selected to be reviewed. Results: The results showed that HPH standards in studied hospitals were very poor in overall standard and that the standard of management policy had the lowest mean. Studies conducted in the order modeling HPH in Iran showed that factors of patient empowerment and society had the greatest impact and needs assessment had the lowest impact. The results of interventional studies were reviewed in this study and it was found that implementing standards of HPH and educational interventions increase the standard of HPH. Conclusion: The review of the HPH studied indicated that the most important challenge in achieving the standards of health promotion hospitals is Iran's hospital policy, which is more treatment-oriented.

Relationships Between Lifestyle, Quality of Life, Organizational Culture and Job Satisfaction Among Nurses Related to Health Promoting Hospital (HPH) Standards.

Providing quality healthcare services through health promotion activities to patients, hospital-based professionals and the wider community is the goal of the health promoting hospital (HPH). There is, however, no formal structured pathway for "universally" providing health promotion services in hospitals. Accordingly, this study was conducted with the aim of presenting a model designed to promote and increase health-related satisfaction of hospital-professionals in health-promoting hospitals (HPHs) in Iran-as a potential tool to guide international HPH standards. Lifestyle, quality of life, organizational culture, and job satisfaction were measured using standardized questionnaires in specialized hospitals in Hamadan, Iran. A structural equation model (SEM) using partial least squares (PLS) software (version 2) was used to determine the validity and fit of the conceptual framework/model. The study revealed that several factors were identified as strong predictors of job satisfaction and wellbeing, including various dimensions of lifestyle such as spiritual health, physical activity, stress management, and interpersonal communication, dimensions of quality of life including physical and mental aspects, and organizational culture. The values of predictive relevance (Q2) for physical and psychological dimension of life quality, organizational culture, and job satisfaction were estimated to be 0.101, 0.250, and 0.040 and 0.251, respectively. Conclusively, the study found a goodness of fit (GOF) value of 0.415, indicating that the model had a high predictive power and fit well. Based on these results, it is suggested that implementing HPH interventions that focus on the outcomes of this model could lead to increased job satisfaction and wellbeing in hospitals. Additionally, the model could serve as a useful indicator of HPHs.

Exploring the views of medical staff in transforming a hospital into a health promoting hospital in Iran: a qualitative research.

Objectives: One of the current concerns of hospitals is how to become a health promoting hospital (HPH). This qualitative research aimed at exploring the views of members of the medical staff in two Iran hospitals about the defined standards to transform the hospitals into a health promoting one.Methods: The research reported in this paper was a content analysis qualitative study. The license numbered (IR.UMSHA.REC.1395.388) was obtained from the ethics committee of Hamadan Medical Science University. Sampling was carried out through the snowballing method. Also, 55 interviews were conducted with the members of the medical staff. To collect data, the semi-structured interview guide was used based on the standards of HPHs. The framework analysis method was used to analyze the data qualitatively.Results: From three central questions on the basis of the main study question, nine themes were earned. Policies governing the hospitals were in the direction of converting them to health promoting organizations including the creation of a health promoting work environment, empowering personnel and health promoting corporate culture. Also, suggestions to create a HPH included improving management, paying attention to patients and their satisfaction, as well as increasing effective interpersonal relationships in the hospital.Conclusion: The findings showed that it can be a key strategy in this field to use staff's solutions for the existing problems and their opinions on the challenges against establishing the standards for HPHs. People usually accept more comfortable and easy changes in decision-making and implementing processes of which they are involved.

Beliefs and performances of elementary school students to prevent road traffic injuries, using Health Belief Model: a study from Hamadan, Iran.

BACKGROUND: Road traffic injuries (RTIs) are important health problems and increasing knowledge on their prevention-related issues can be credible. This study aims to assess beliefs and performances of students to prevent road traffic injuries and their related factors, using Health Belief Model (HBM). METHODS: This cross-sectional study carried out on a random sample of 500 fourth and fifth grades students of elementary schools in Hamadan city, west of Iran. The data gathering tool was a self-administered questionnaire designed on the basis of HBM constructs and also the knowledge and performance of the students in relation to prevent RTIs. To increase the accuracy of this study, the students' road-crossing behaviors were observed in a simulated street in the school, using an observation checklist. Data were analyzed by SPSS 16. RESULTS: The mean age of the participants was 10.51±0.50. About preventing RTIs, the mean scores of the students' knowledge was 64.139, and regarding HBM constructs, the mean scores of their perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy were 82.817, 82.453, 82.451, 89.917, 84.343 and 91.250, respectively. The mean score of the students' self-reported performances about traffic injury prevention was 48.750 and the mean score of their observed road-crossing behavior in the simulated street was 45.000. The final model of multiple linear regressions showed that the students' sex (p=0.001), their knowledge (p less than 0.001), perceived susceptibility (p=0.002), perceived barriers (p=0.032), self-efficacy (p=0.001), and their observed road-crossing behaviors (p=0.019) predict the students' self-reported injury prevention performances. CONCLUSIONS: Regarding prevention of RTIs, knowledge and performance of the studied students are undesirable. The study findings can help designing more appropriate prevention programs for them.

Home-related injuries among under-five-year children and mothers' care regarding injury prevention in rural areas.

This cross-sectional study was conducted in rural areas of Twiserkan (Toyserkan) County, in Iran, to assess factors associated with home-related injuries among under-five-year children and their mothers' care regarding injury prevention. Mothers who had their under-five-year-old children injured within a 12-month period were identified from recorded information in Twiserkan Health Center. Then, data were gathered using pre-tested questionnaire and through interview with injured children's mothers. The questions were about characteristics of the children's injuries and their mothers' care regarding injury prevention, using PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) model with focus on knowledge and attitude; enabling and reinforcing factors; and mothers' preventive behaviours. The study results showed that 197 out of 210 total identified mothers took part in the study. The reported injuries were 11.68%, 39.09%, and 49.24%, respectively, for severe, moderate, and mild cases. Fall was the most frequent injury with 35%. Among PRECEDE model constructs, there was a statistically significant correlation between mothers' knowledge and injury severity among children. Home-related injuries are an important health problem among study population and their prediction and prevention are necessary. Enhancement of mothers' knowledge can be helpful to improve child injury prevention.

Phenomenological needs assessment of parents of children with cochlear implants.

BACKGROUND: The use of cochlear implants has been a remarkable success in reducing disabilities in those with impaired hearing, which have made a significant change in the patients' quality of life. Only by relying on cochlear implants, disabilities cannot be eliminated in the hearing impaired, and, alongside this intervention, rehabilitation practices such as through family and community support are necessary. AIM: To explain the needs of parents of children with cochlear implants to increase the quality of rehabilitation services and family-based interventions. METHODS: A descriptive phenomenology study was performed with the participation of 16 people, including eight mothers, three fathers, and five experts involved with the rehabilitation of children aged 2-7 years with cochlear implants. The research setting was centers with speech therapy service providers for hearing-impaired children in the city of Shiraz (Iran) in 2015. Information was gathered through in-depth interviews with participants and analyzed by using Colaizzi's nine-step analysis method and MAXQDA (Ver10) applications. RESULTS: The mean age of participants was 34 years, and the average age of diagnosis of hearing problems in children was 12 months. The obtained data from the analysis of interviews about the needs of parents of children with cochlear implants were categorized into 19 sub-contents and five contents, as follows: the need for access to health care services; psychological needs; mood-related needs of a child; educational needs and financial requirements. CONCLUSION: Parents of children with cochlear implants have numerous needs, and they encounter problems based on their situation and experiences. The results indicate the necessity of close cooperation among different professionals such as an audiologist, pediatrician, psychologist, and speech therapist for the program's success.

Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

OBJECTIVES: The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). METHODS: This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. RESULTS: The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). CONCLUSION: The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

The Effective Factors for Fruit and Vegetable Consumption among Adults: A Need Assessment Study Based on Trans-Theoretical Model.

INTRODUCTION: The World Health Organization recommended consuming at least 5 servings of fruits and vegetables (FV) per day in order to reduce the risk of non-communicable diseases (NCDs). The purpose of this study is to determine the influential factors related to intake of FV among adults in Kermanshah city based on Transtheoritical Model. MATERIAL & METHODS: This is a cross-sectional study which is conducted in Kermanshah city. Participants (n=1230) are selected by multi stage sampling; 30-50 year olds people covered by health centers. In order to collect data, we used a TTM-based questionnaire. The results are analyzed using SPSS-16 and Lisrel 8, with P< 0.05 as statistically significant level. RESULTS: The mean age of the participants is 37.75 and 65% of them are women .The mean score of knowledge is 2.4; that is, 80% of men and 78% of women in this study are in poor knowledge about FV consumption. In case of fruit and vegetable consumption behavior, 50% and 61% of participants are in pre-contemplation/contemplation stage, respectively. The average number of fruit servings is 1.42 and the average number of vegetable servings is 0.99 per day. Also, ANOVA test results showed a significant correlation between constructs of TTM and stages of change so that individuals' progress through stages of change from pre-contemplation to maintenance added on the scores of self-efficiency, processes of change, and decisional balance. CONCLUSION: This study indicated that, TTM constructs such as self-efficacy, processes of change, and decisional balance are good predictors for FV consumption.

Factors associated with mothers' beliefs and practices concerning injury prevention in under five-year children, based on health belief model.

BACKGROUND: Injuries are the first leading but predictable, avoidable and preventable cause of death among under five-year children worldwide. The present study aimed to identify the factors associated with mothers' beliefs and practices concerning injury prevention in under five-year children. METHODS: This cross-sectional study was conducted from August to October 2011 in Hamadan County, the west of Iran, enrolling 580 mothers with at least one under five-year child. The data collection instrument was a questionnaire including 85 questions regarding demographic characteristics; knowledge; practices; Health Belief Model (HBM) constructs; and history of injury occurrence among the children. The reliability of the questionnaire was evaluated by a pilot study using Cronbach's alpha coefficient. Data had been collected through interview with mothers, by trained interviewers. RESULTS: Almost 22.59% of mothers reported at least one injury in their under five-year children. Of 131 injuries occurred, 85 cases were mild, 23 cases were moderate, and 23 cases were severe. About 52.67% of injuries occurred in boys, 37.41% in less than one-year children, 73.28% at home, and 61.07% when the children were playing game. Fall (24.28%), burn (20.61%) and poisoning (14.50%) were the common causes of injuries. There was a positive correlation between mothers' practices and knowledge, perceived benefits, cues to action and self-efficacy and a negative correlation between mothers' practices and perceived susceptibility, severity, and barriers. CONCLUSION: Knowledge, perceived severity, perceived barriers, cues to action, and self-efficacy of mothers toward the injuries in children were among the most important predictive constructs, which may be used for planning educating programs.