Studying the Status of Job Burnout and its Relationship with Demographic Characteristics of Nurses in Shiraz Nemazee Hospital

Background: Today, in order to provide desirable health care services, too much emphasis is placed on the physical and mental health of nurses, and job burnout among nurses is introduced as harmful elements to the health of nurses. Objective: This study was performed to evaluate job burnout in Shiraz Nemazee Hospital in relation to demographic characteristics. Methods: This research is a cross-sectional and descriptive-analytic study. The research community included all nurses in the whole sections of Nemazee Hospital out of which 245 were selected by classified random sampling as the study sample. A questionnaire was used to collect the data. After collection, data were entered in statistical package for social sciences SPSS software (version 18) and T-test, and analysis of variance (ANOVA) and Kruskal-Wallis tests were used to analyze the variables. Results: The mean score of emotional exhaustion, lack of personal accomplishment and job burnout were at an average level, and depersonalization was at a low level. As regards the intensity of burnout, most nurses were moderate. Between components of depersonalization of job burnout with marital status and age, there was a significant relationship (PConclusion: According to the findings of this study and in terms of the stressful nature of nursing profession, it is necessary that hospital managers and healthcare authorities pay attention to job burnout in nurses, its level, as well as provide and implement strategies for its prevention, thereby decreasing its effects and risks

Factors affecting the choice of treatment center by infertile couples: A cross-sectional study in Yazd Reproductive Sciences Institute

Background: Infertility is one of the critical health issues in Iran. There are more than 70 specialized infertility treatment centers in Iran, of which the Yazd Reproductive Sciences Institute, is one of the most important ones. Objective: This study aimed to determine the factors influencing infertile couples’ choice of Yazd Reproductive Sciences Institute. Materials and Methods: This cross-sectional study was conducted on 275 infertile couples aged 18 and older, referring to Yazd Reproductive Sciences Institute, Yazd, Iran from September 2021 to March 2022. Data were gathered using a 2-part questionnaire. Data analysis was done through SPSS software. We used descriptive statistics, Kruskal- Wallis, Mann-Whitney, and t test for data analysis. Results: Most participants were individuals who came from other provinces of Iran (74.9%) and were referred to the Yazd Reproductive Sciences Institute. Among the 4 categories that influenced couples’ decision to choose this center, factors related to the personnel and treatment staff received the highest score (75.83), while personal factors received the lowest score (65.76). The average score for factors related to doctors was 72.90, and for factors related to the center, it was 73.65. The satisfaction with personnel and treatment staff varied based on participants’ education levels, with those who had lower levels of education reporting higher levels of satisfaction (p < 0.001). Conclusion: The primary factors contributing to the success of the Yazd Reproductive Sciences Institute in attracting clients were the dedication and expertise of the staff, as well as the esteemed reputation of the doctors at the center. Key words: Infertility, Fertility clinics, Yazd, Iran

Explaining the Challenges of the Iranian Health System in Fighting the Covid-19 Pandemic: a qualitative study

Introduction: The covid-19 pandemic has become a global threat for the general public and health care workers and it has created major challenges for all healthcare sectors. The challenges created by this disease can vary in different countries depending on cultural, social, and economic factors. To explain the challenges of the Iranian health system in fighting the covid-19 pandemic from the managers’ and executive authorities’ viewpoints. Methods The present study is a basic-applied research performed using a qualitative approach. It has studied 30 managers of the hospitals and medical centers’ managers, and deputies of the Ministry of Health, and the universities of medical sciences which were selected by purposive and snowball sampling with the maximum variety in March-September 2020. Data collection was done through semi-structured interviews and content analysis was used to explain the challenges of the Iranian health system in fighting the covid-19 pandemic (2020). Results Most of the interviewees (87%) had a Ph.D. degree (34%), and 40% of the participants were graduated in management and health economy and policymaking fields. Analysis and synthesis of the data collected from the interviews led to the creation of 19 sub-themes and 12 main themes classified into four general scopes including the organizational factors, resources, management factors, and other factors. Conclusion Identifying the mentioned challenges can provide useful information for the managers and policymakers to develop appropriate plans and take the necessary measures for resolving the challenges and using the available resources to provide the most effective services

Using Ergometer and Timing Activities in Determining the Manpower Required in Chosen Units of Laboratory in the Shiraz Faghihi Hospital

Background: The quantity and quality of manpower, especially in health systems, are major factors affecting speed of service delivery, cost, and accuracy, or, in other words, the quality of service. Objective: This study purposed to investigate the manpower required in various units of the laboratory at Shiraz Faghihi Hospital. Methods: This is a cross-sectional and descriptive-analytical research conducted on all testing processes in the fields of parasitology, hormone biology, microbiology, and urinalysis performed at the studied hospital. The Westinghouse ergometer and timing method was used to estimate manpower requirements, and SPSS18 software was used to analyze data. Results: The average standard time of every duty cycle in parasitology units, hormone biology, microbiology, and urinalysis are 12, 5, 9, and 5 minutes, respectively. The numbers of human resources required in said units were estimated to be 2.6, 3, 4, and 3.7 respectively. In parasitology unit there is lack of 1 manpower. In hormone unit there are two manpower surpluses. In biology unit there is one manpower surplus and urinalysis unit is estimated to be proportional to the number of troops. Conclusion: It is suggested that new, scientific tools be used to evaluate the status of department staff and make improvements to avoid the high costs and difficulties that manpower shortages and surpluses cause for the organization

The Capabilities of Iranian Hospitals in Attracting Medical Tourists; Based on Joint Commission International: A Case Study of Shiraz Hospitals

Introduction: Medical tourism is one of the competitive and income industries in world and has the ability to attract tourists in the health sector and international markets are totally dependent on international accreditation. This study has been done to evaluate the capabilities of active public and private hospitals in Shiraz regarding attraction of tourists’ base on accreditation standards. Methods: This is a descriptive-analytic and cross-sectional study which performed on four hospitals which were active in medical tourism in 2012. A checklist of international accreditation standards based on Joint Commission International (JCI) was applied for collecting data. Data were analyzed using descriptive analytic statistical tests. In descriptive statistics, frequency tables and standard deviation were used for scoring the hospitals. Independent student (T-test) was used to compare the mean of public and private hospitals in attracting medical tourists. Results: Hospital No.3 in the Patient-Centered Standards and Health Care Organization Management Standards was in the best position whilst hospital No.2 in the Patient-Centered Standards was in the worst state and hospital no.1 in Health Care Organization Management was in the worst position. Also there was a significant difference between public and private hospitals in attracting medical tourists according to Joint Commission International (sig=0.01). Conclusion: Shiraz hospitals have good ability to attract medical tourists; these abilities are very good in most cases and in some cases there is a need to improve. Having recognized the strengths and weaknesses of these hospitals can use SWOT analysis model, which is used in medical tourism program of some countries, for improving their abilities in attracting medical tourists

Preparation and Designing a Checklist for Health Care Marketing Mix, with Medical Tourism Approach

Introduction: Increasing pressure on available funds in health care section especially hospitals, enhances the need of analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and health care centers is using elements of the marketing mix. In this way we could make the best use of the resources and cause a return on investment and also generate income.    Methods: This is a cross-sectional and qualitative study. To prepare checklists, author used previous studies in marketing by referring to relevant web sites and designed the first draft. In next step, Delphi’s technique was used for validity check; the checklist was sent to health care management specialists who had studied in medical tourist fields or those who lived in cities active in this field. Results: the final checklist included 8 aspects (mixes) and 79 indexes in which Product Mix had 11 indexes, Place Mix had 3 indexes, Promotion Mix had 13 indexes, Price Mix had 9 indexes, Personnel Mix had 12 indexes, Promotion Mix had 6 indexes, Physical attraction Mix had 19 indexes and Physician Mix had 6 indexes. Conclusion: this instrument could be used in various studies that could help asses' health care units state specially hospitals so that alternatives could be considered for improvable points and make maximum use of the potentials

Shiraz Medical Tourism Industry: Development Strategies

Background: Medical tourism industry with global revenue of around 20 billion dollars in 2005 is one of the largest industries in the world. Absorbing a percentage of this amount can have a significant impact on medical tourism economy of Asian countries, including Iran. The aim of this study was to provide solutions for attracting medical tourists in Shiraz. Methods: This qualitative study was carried out on health care management specialists, hospital administrators, statistics and medical records' specialists, as well as medical tourism officials in Shiraz University of medical sciences. The participants were selected using targeted sampling method. Focused-group discussion and personal interview techniques were used to obtain the participants' viewpoints.  Results: Interviews with experts about the strategies for improving medical tourists’ attraction led to determination of 44 different solutions represented as varied marketing strategies. Conclusion: Applying the offered solutions in different marketing strategies by the relevant managers and authorities of medical tourism can lead to increase of medical tourists' attraction on public and private hospitals in Shiraz city. &nbsp

Occupational Stress and How to Confront It: A Case Study of a Hospital in Shiraz

Background: Although all jobs can be stressful, occupational stress is an important issue in jobs that deal with human health. Evidence indicates that nursing is a stressful occupation. Objective: This research evaluated factors affecting occupational stress and strategies for coping with it. Methods: This cross-sectional descriptive-analytic study was conducted in 2015. The study population comprised all nurses at Shahid Rajaee hospital, from whom 190 nurses were selected by random sampling. Data was collected by questionnaire and analyzed using SPSS software (version 19), Pearson correlation coefficient tests, Mann-Whitney tests, and t tests. Results: Occupational stress was rated as moderate among the studied nurses. Significant positive correlations were found between occupational stress level and less effective coping method, occupational stress level and work experience level, and ineffective coping methods and age. Moreover, a significant difference was seen between men and women in terms of emotion-focused coping. Conclusion: According to the research findings, occupational stress was at a moderate level among the studied hospital nurses, indicating that the authorities need to focus on efforts to reduce occupational stress for nurses

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding: Bill & Melinda Gates Foundation