Perceptions of Organizational Justice Among Nurses Working in University Hospitals of Shiraz: A Comparison Between General and Specialty Settings

Background: Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. Objectives: The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. Materials and Methods: In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Results: Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Conclusions: Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions

Estimating willingness to pay for an improved service delivery to patients referring namazi hospital chemical therapy ward in Iran using contingent valuation

Objective: The aim of this study was to estimate patients' willingness to pay (WTP) for improving the quality of non-medical aspect in Namazi hospital patients chemotherapy an assessment using the contingent valuation method (CVM). Patients and Methods: This was an applied, cross-sectional and analytical-descriptive study carried out in Iran, Shiraz in 2013. A sample of 185 patients was determined using random sampling. Multiple choice questions and follow-up open-ended questions were employed to elicit patients' WTP. The question asked patients would have to pay for this improving their own pocket. linear regression were used to Econometrically estimate the maximum WTP using STATA 11 software. Results: The results of this study indicated that 31 were male and 69 were female and the adjusted mean WTP was PPPUS15 for pat maximum amount of willing to pay was for to get the same quality service in own city respondents (PPPUS16) and minimum amount of willing to pay was to get advice of experienced nurse(PPPUS10) Patients were willing to pay more if their satisfaction with two attributes of care were increased. The cancer type and income taking care of you are significant factors influencing a patient's WTP. Conclusions: In the worst socio-economic conditions of the people were willing to pay to improve the reducing wait times in receiving a drug and get the same quality service in own city respondents. In Future efforts Health policymakers should consider the ability to pay when making their decision. © 2018 Asian Pacific Organization for Cancer Prevention

Organizational Pathology in Staff Department of Shiraz University of Medical Sciences based on Three-branch Model

Introduction: Pathology of organizations is one of the most key actions that make the university officials aware of the strengths, weaknesses, opportunities and challenges of an organization and allows these officials to take the right actions accordingly. Therefore, this study examined the pathology of human resources in staff departments of Shiraz University of Medical Sciences. Methods: This was a cross-sectional study. Two hundred employees participated in this study. Random sampling was used and the data were collected by an organizational pathology questionnaire based on the three branch model. Data analyzed by SPSS software. Results: The results showed that behavioral factors (mean = 2.73) and contextual factors (mean= 3.34) had the highest and the lowest impacts on human resources malfunction in Shiraz University of Medical Sciences. Among subsets of structural factors, the payment system (average rank of 2.5, mean=2.21±0.72 and p-value ≤0.001), behavioral factors, and job security (mean rank = 2.03, mean=2.28±0.93 and p-value ≤0.001) and among subsets of contextual factors, customer-orientation (mean rank= 1.31, mean=3.07±0.70 and p-value 0.19) had the most impact on organizational pathology in this university. Conclusion: Considering that the behavioral factors had the greatest impact to the damages, it seems that the university has to adopt programs and policies in terms of creating appropriate organizational culture, increasing motivation and job satisfaction, adopting effective leadership, providing opportunities for training and development of employees and improving job security for the staff. Indeed, it is worth mentioning that solving some of these issues is beyond the powers of the executive organs, so solving these types of problems at macro-organizational level in the country is of vital importance

The inappropriateness of brain MRI prescriptions: a study from Iran

Background: Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating the rate of inappropriate brain Magnetic Resonance Imaging (MRI) prescriptions and their financial burden in Iran. Methods: Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. Results: About 21 percentage of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P < 0.01) had significant relationships with prescription appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99,988 US dollar in 2017. Conclusions: More than one-fifth of brains MRIs were inappropriate (i.e. prescriptions without medical indications). It caused 99,988 United States Dollar (USD) financial burden which is 17 times that of Iran's Gross Domestic Product (GDP) per capita. To better allocate resources for the provision of MRI services to health system, rationing policies for controlling moral hazard and reducing provider induced demand can be helpful

Estimation of the demand for health for urban households using Grossman's model in Shiraz, Iran

Purpose: To study the effects of socioeconomic variables on health stock using Grossman model in Shiraz, Iran. Materials and Methods: This was an applied, cross-sectional and analytical-descriptive study conducted in Iran, Shiraz in 2012. A sample of 1538 individuals from 769 households was determined using stratified sampling proportional to size and systematic random sampling methods. Health stock was measured using Quality of Life SF36 questionnaire, and an ordered probit model was used to econometrically estimate the demand for health equation. Results: The results showed that being male and having high school and university degrees had positive and significant effects on health stock (p<0.05). Also, ages over 44 years and being unemployed had negative, and significant effects on health stock (p <0.05). However, the estimated effects of monthly income level, public health insurance coverage status and supplementary health insurance coverage status were positive, but not significant. Conclusions: According to the results, the following suggestions can be made for improving individuals' health status: providing education opportunities and facilities for all, increasing health and wellness education programs at different education levels, providing health education for all people through the media at the appropriate time, implementing health subsidies and exemption from payment policies for the elderly, increasing recreational, and sports facilities for women, etc

Influential factors of out of pocket payments for health care in Iran: A foresight approach using the cross impact analysis

OBJECTIVE: To identify and explain the interactions and network of the relationship between influential factors of out-ofpocket payments for health services. METHODS: This futures study was conducted in 2015 in Iran, and comprised experts of various sectors. At first, key factors and driven forces of out-of-pocket payments were detected; then, the factors were collected in the form of a square-matrix questionnaire; and completed based on impact of each factor on the occurrence probability of others, with collective agreement, so the role of any factor in forecasting out-of-pocket status in future was identified by cross-impact analysis. MicMac software was used for data analysis. RESULTS: As many as 35 factors were identified which affected out-of pocket payments. The factors were categorised in four main roles, i.e. influencing, two-sided, dependent and independent. Some economic factors which had a higher impact on other system factors were influencing factors; they were the most critical components because the system changes were dependent on them. In contrast, some factors related to organising the health system were depending factors and were affected by the least changes in other factors. There are 10 factors in this group. These factors were mainly related to the utilisation of health services by a special look to the part of delivery (public or private). CONCLUSIONS: Policymakers should consider interactions and influencing network of out-of-pocket payment factors and should understand how a change in one factor can have a series of changes

Increased induction of apoptosis in ESCC (Esophageal squamous-cell carcinoma) by betula pendula roth stem cell extract containing triterpenoids compared to doxorubicin

Background: Esophageal Squamous-Cell Carcinoma (ESCC) is one of the most life-threatening malignancies worldwide, with a growing incidence in Iran higher than the global average. Objective: The present study, for the first time under patent number (97668), introduces a method using in vitro production of activated-Birch stem cells using biotechnological techniques of tissue culture and plant stem cell culture from Betula pendula Roth (Birch) bark. Methods: In the first step, Birch stem cells were produced in large amounts using tissue culture, and then the amount of triterpenoids of its extract was measured by the HPLC method. In the second step, the cytotoxicity was evaluated by MTT, and the IC50 was calculated. The cellular apoptosis in response to the extract compared to doxorubicin was measured using the Annexin V kit and the flow cytometry method. Results: The optimized method introduced in the current study efficiently produced plant stem cells containing triterpenoids in large quantities over a period of 2-4 months. Our findings indicated that the growth of ESCC cells decreased by induction treatment 3 times (24, 36, 48 hours). IC50 values were obtained in 24 hours for the natural bark extract, Birch stem cell extract, doxorubicin and interactions of two extracts with doxorubicin at 300µg/mL, 1700µg/mL, 0.5µM, 150µg/mL, 1800µg/mL, respectively. In the flow cytometric test, the Birch stem cell extract showed the highest percentage of apoptosis, with 92.5 for total apoptosis. The percentage of total apoptosis in doxorubicin treatment was 85.33, and the combination of doxorubicin with Birch stem cell extract was 88.33. Natural bark extract and its combination with a lower percentage (69.33 and 70.33, respectively) caused apoptosis of esophageal cancer cells. Conclusion: Owing to the extinction of Birch in Iran and its inaccessibility and exploitation, Birch stem cells can be cultured as an appropriate alternative source to produce valuable triterpenoids for pharmaceutical purposes. Additionally, according to the results of this study, stem cells can be used to enhance the treatment of esophageal cancer and supplementation with chemotherapy. © 2021 Bentham Science Publishers