Barriers to Knowledge Sharing among Nurses in Educational Hospitals of Kerman City, Iran

Introduction: Considering the importance of knowledge sharing in recent years and the nurses' need to act based on research in order to use their findings, experiences, and information for conscious decision making in clinical practices and in interaction with others, this study aimed to identify barriers to knowledge sharing among nurses in order to examine the challenges facing it. Method: This qualitative study was conducted using semi-structured interviews with 21 nurses in educational hospitals of Kerman City, Iran. All the interviews were recorded and then transcribed line by line and finally analyzed using Colaizzi method. Results: The barriers were identified in six main categories including "culture", "financial facilities", "politics, rules and regulations", "communications", "human resources", and "management process". Conclusion: Effective knowledge sharing among nurses with the aim of increasing knowledge level and enhancing their services in the hospitals is essential. In addition, it is necessary to use strategies to face challenges and this requires management and policymaking more than before. Keywords: Knowledge management, Nurses, Barriers, Educational hospitals, Ira

Implementing Quaternary Prevention Using the Rural Family Physician Program in Iran: Grounded Theory

Background: The present study investigated the possibility of implementing quaternary prevention using family physicians in Iran’s health system.Methods: The present study was a qualitative study conducted with a grounded theory approach. Thirty-four participants, who were faculty members and experts, were selected by purposive and theoretical sampling using the snowball approach until data saturation. The data were collected through semi-structured interviews. The interviews took 20 to 60 minutes each, based on the circumstances and the participant’s willingness to continue. Data analysis was performed along with data collection by Strauss and Corbin’s constant comparative analysis. Using Lincoln and Guba criteria, the accuracy and strength of this research were confirmed.Results: The dimensions model of quaternary prevention using family physicians in Iran were specified in six axial categories: causal conditions, contextual conditions, intervening conditions, strategies, and outcomes. The phenomenon was the promotion of quaternary prevention, including defining quaternary prevention, family physicians, the philosophy of quaternary prevention, and the philosophy of family physicians—social, political, economic, cultural, and technological conditions as contextual and intervening conditions. Causal conditions were doctors, patients, and the health system. Two main strategies were intersectoral administration and intra-sectoral governance. Outcomes included efficiency and the provision of security for society.Conclusion: For quaternary prevention promotion and to offer ethically and rationally acceptable scientific services to the people, it is necessary to promote the position of the family physician as the primary implementer of quaternary prevention in healthcare. Getting to the PHC umbrella is achieved through intra-sectoral leadership and inter-sectoral governance, which supports the patient and reduces unnecessary care

An Investigation of Prescription Indicators and Trends Among General Practitioners and Specialists From 2005 to 2015 in Kerman, Iran

Abstract Background: The World Health Organization (WHO) aims to promote strategies that ensure efficacy, safety, suitability, and cost-effectiveness of medicine prescription. Health systems should design effective mechanisms to monitor prescription and rational use of medicines at all healthcare settings. This study aimed to determine and analyze prescription patterns of general practitioners and specialists in Kerman/Iran from 2005 to 2015. Methods: This is an explanatory mixed method study. Data were gathered during two phases. At the first phase, prescriptions issued by physicians during 2005-2015 were reviewed to extract information required to develop eight main prescription indicators. In the second phase, the indicators trends were presented to experts participating in expert panel to have their opinions and analyses on the data obtained in the first phase. Experts were selected based on their experience and expertise in medicine and/or health policy and/or experience in implementation of polices to promote rational use of medicines. Some experts attending the panel were a sample of physicians whose prescriptions were included in the first phase. Results: Findings revealed that two indicators of the average price of prescriptions and the maximum number of medicines in each prescription had an increasing trend over the study period. Reasons including unprecedented devaluation of the Iranian Rial and willingness of young physicians to prescribe more medications were proposed as the primary contributors to the observed increasing trends. However, other indicators including types of prescribed medicines, average number of medicines per prescription, the percentage of prescriptions with more than four medications, a percentage of encounters with a corticosteroid prescribed, a percentage of encounters with an antibiotic prescribed, and a percentage of encounters with an injection prescribed decreased in the study period. Reasons of controlling initiatives adopted by the Ministry of Health, the higher responsibility of physicians, adoption of continued medical education (CME) programs, and improved knowledge of pharmacists, physicians, and patients about irrational use of medicines were proposed by participants as the main reasons for the decreasing trend. Conclusion: Findings indicated that prescription indicators were better in Kerman than those of country average over the study period based on comparing the results of this study and others in Iran. However, they were non-desirable when compared to the international average. The number of factors contributes to the irrational use of medicines, including lack of knowledge among healthcare providers and patients, patients’ misunderstanding about the efficacy of some particular medicines, the high cost of drug development and manufacturing, and unavailability of effective medicines

Does a socially well integrated university have anything to do with faculty retention? A study on Kerman University of Medical Sciences-2011

Purpose – The purpose of this paper is to measure the relationship between organizational social capital and retention of faculty members in Kerman University of Medical Sciences in 2011. Design/methodology/approach – Using a stratified multistage sampling, 120 faculty members were recruited to fill the questionnaire. Findings – There were a direct and positive bilateral (r¼0.65) relationship between social capital and retention of faculty members. Originality/value – The university officials and policy makers need to pay closer attention to some issues such as providing welfare facilities, salary and wages, benefits, interests and appreciation for faculty members. Keywords Socia

Mammography in Rural Areas of Iran: A Qualitative Study for Designing a Social Marketing Intervention

Introduction: Breast cancer is the most common cancer leading to death in women. So, early detection and treatment of it is very important and increase the patient survival. Mammography is one of the most effective methods for diagnosis of the breast cancer. We aimed to study for designing a social marketing intervention in rural areas of Bojnourd, Iran to propagate using mammography among women. Method: In this qualitative study, 46 women in four focus group discussions (FGD) discussed their views and ideas about mammography. All discussions were voice-recorded and written by two note takers. Using ATLAS.ti5.2 software, the collected data were analyzed. Results: Five main themes including mammography in general, barriers to doing mammography, appropriate communication methods and channels and opinion leaders for them to do this exam, were extracted. Conclusion: Designing a social marketing-based intervention can be useful for propagation of using mammography among women. Keywords: Breast cancer, Mammography, Qualitative study, Social marketing, Rural wome

The Projection of Burden of Disease in Islamic Republic of Iran to 2025

Objective: Iran as a developing country is in the transition phase, which might have a big impact on the Burden of Disease and Injury (BOD). This study aims to estimate Burden of Disease and Injury (BOD) in Iran up to 2025 due to four broad cause groups using Disability-Adjusted Life Year (DALY). Methods: The impacts of demographic and epidemiological changes on BOD (DemBOD and EpiBOD) were assessed separately. We estimated DemBOD in nine scenarios, using different projections for life expectancy and total fertility rate. EpiBOD was modeled in two scenarios as a proportion of DemBOD, based on the extracted parameters from an international study. Findings: The BOD is projected to increase from 14.3 million in 2003 to 19.4 million in 2025 (95% uncertainty interval: 16.8, 21.9), which shows an overall increase of 35.3%. Non-communicable diseases (12.7 million DALY, 66.0%), injuries (4.6 million DALY, 24.0%), and communicable diseases, except HIV/AIDS (1.8 million DALY, 9%) will be the leading causes of losing healthy life. Under the most likely scenario, the maximum increase in disease burden due to DemBOD is projected to be observed in HIV/AIDS and Non-communicable diseases (63.9 and 62.4%, respectively) and due to EpiBOD in HIV/AIDS (319.5%). Conclusion: It seems that in the following decades, BOD will have a sharp increase in Iran, mainly due to DemBOD. It seems that communicable diseases (except HIV/AIDS) will have less contribution, and especially non-communicable diseases will play a more significant role

Does a socially well integrated university have anything to do with faculty retention? A study on Kerman University of Medical Sciences-2011

Purpose – The purpose of this paper is to measure the relationship between organizational social capital and retention of faculty members in Kerman University of Medical Sciences in 2011. Design/methodology/approach – Using a stratified multistage sampling, 120 faculty members were recruited to fill the questionnaire. Findings – There were a direct and positive bilateral (r¼0.65) relationship between social capital and retention of faculty members. Originality/value – The university officials and policy makers need to pay closer attention to some issues such as providing welfare facilities, salary and wages, benefits, interests and appreciation for faculty members

Research Priorities of Kerman Medical Sciences University: A Documentary Study

Background: Setting research priorities is an important process in management of health researches. If this process is carried out based on the goals and values ​​of the health system, the actual needs will be properly met. This study is aimed to determine research priorities of Kerman Medical Sciences University. Methods: In this documentary study, content analysis method was used. The study was base on upstream documents, which were selected purposefully. Data collection tools were checklist and a researcher-made questionnaire. Results: Research priorities were identified in two categories of structural - organizational studies and environmental researches. The first category of research priorities included human resources, budget management, research management, organizational structure, facilities and physical space, knowledge management, information technology, business processes and organizational culture and the second group of research priorities included health supporting environments, community empowerment, equity in health, the quality of services, and health culture. Conclusion: Setting research priorities based on upstream documents review is a favorable method to determine priorities consistent with actual needs. In this method, priorities will be determined based on goals and values of the system and the existing needs and problems. Using the integrative approach of documents review and utilizing beneficiaries' involvement is also recommended to obtain better results. Keywords: Needs assessment, Research prioritization, Upstream document