The Factors Contributing to Domestic Violence from the Perspective of Iranian Couples: A Qualitative Study

Introduction: Domestic violence is the most common form of violence against women. Negative health outcomes caused by domestic violence have been recognized as a public health problem with extensive effects on society. The main objective of this study was to explore Iranian couples’ experiences of domestic violence. Methods: This study was carried out through a qualitative approach and a conventional content analysis method in 2015 in Mashhad, Iran. Fifteen couples (15 women and 15 men) were selected from five health centers in Mashhad using purposive sampling. Data were collected through individual in-depth semi-structured interviews with the participants about their perceptions and experiences of factors underlying domestic violence. The interviews were transcribed verbatim and analyzed using Graneheim and Lundman's content analysis approach with MAXQDA software. Results: The results of this study revealed three main themes including social factors affecting violence (the family’s economic position, culture and values, and social support), interpersonal relations (the type of marriage and life skills), and personal factors (intrinsic factors and acquired factors). Conclusion: Given that social, interpersonal, and personal factors such as economic problems, social culture, low social support, low education levels, addiction, and the absence of life skills can lead to the outbreak of domestic violence among couples, there is a need to train couples to adopt effective strategies to reduce domestic violence in the family and seek help from support centers

The Relationship between Social Capital and Nurses’ Performance in Hospitals of Mashhad City, Iran

Introduction: One of the most important issues that managers are facing is the improvement of their staffs’ performance that could improve and increase the productivity of the organization. This study was performed with the purpose of determining the relation between social capital and the nurses’ performance in the Hospitals of Mashhad University of Medical Sciences. Methods: This is an applied and Cross-sectional study performed in 2012. The statistical population included 320 employed nurses of the hospitals of Mashhad University of Medical Sciences. Data were collected using social capital measuring questionnaires designed by the author. The questionnaires were scientifically confirmed and had the Reliability of 84% using Cronbach’s Alpha Test. Data were analyzed using the Spearman test. Results: A significant and direct relationship was found between social capital and 5 of its components (social participation, mutual trust and reciprocity, social networks and perception of the environment) and nurses performance in the mentioned hospitals (p<0.001). Conclusion: managers can improve their staff’s performance and their motivations by recognizing and developing the social capital. Therefore it is suggested that efforts should be made in improving the components of social capital in hospitals, which are one of the most important organizations in providing services

Proactive risk assessment of the laboratory management process inGhaem Hospital, Mashhad (2013)

Laboratory errors may occur in every stage of laboratory management process and lead to a considerable harm to inpatients. This study was aim to investigate the Proactive risk assessment of the laboratory management process in Ghaem Hospital, Mashhad (2013). This was a descriptive research that quantitatively and qualitatively analyzed some failure modes and effects. In order to classify the modes of failure and effective causes of them and also determining the improvement strategies, we have used "nursing error management association", "Eindhoven" and "theory of inventive problem solving" models respectively. In 5 steps of laboratory management process which is conducted on17 listed sub-processes, on average 59 error modes in each ward was identified. 18.7% of error modes were identified as high risk errors (hazard score ≥ 8). Most of error causes were related to human factors (42.7%).In addition, 31.6% of preventive measures were assigned in human resources management strategy group and 16.9% in team work group. The Healthcare Failure Mode and Effect Analysis method was very efficient in identifying failure modes, determining causes which impact each failure mode, and proposing improvement strategies for laboratory management processes of Ghaem Department.

The Quality of Maternity Services in Mashhad Educational Hospitals, Using SERVUSE Model

Introduction: Reducing maternal and neonatal mortality requires improved care quality; the aim of this study was to determine various dimensions of the quality of services in maternity wards in Iran from the patient’s perspective. Methods: In this cross-sectional study which was conducted from April to October 2017, 363 patients were selected from maternity wards of five hospitals affiliated to Mashhad University of Medical Sciences by convenience sampling method. Data collection tools consisted of the SERVUSE (Service Usability questionnaire), including 51 items in 6 dimensions of services quality; its validity and reliability were determined in previous studies. Data analysis was performed using SPSS, version 20. The analysis was performed using descriptive and inferential statistical methods including Wilcoxon, Kruskal Wallis and Mann-Whitney tests. The significance level in all the tests was considered 5%. Results: The total mean scores of the patients’ expectation and perception were 19.10±2.14 and 15.11±4.25, respectively. The highest expectation and perception were related to the usability dimension, and the lowest expectation and perception were related to reliability dimension. The differences between the median score of perception and expectation for all dimensions and total median score of perceptions and expectations were statistically significant (P<0.05, using Wilcoxon test). There were no statistically significant differences in the median score of the gap between the patient’s expectations and perceptions at the levels of demographic variables (P>0.05, using Mann-Whitney and Kruskal Wallis tests). Conclusion: It seems that the service quality of maternity ward of hospitals was approximately unsatisfactory from the patients’ perspective, and they had high expectations in maternity wards of hospitals. Since maternity service quality is critically important, improvement of quality requires management, concordant participation, and efforts of the hospital and staff at all levels of the medical facilities and convenience

Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model

Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods: The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results: The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients’ non-medical needs, complaints and patients’ participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients’ non-medical needs, patients’ participation in the treatment process and research and development. Conclusion: The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safet

Awareness of Evidence-Based Medicine among Interns of Mashhad University of Medical Sciences, Iran

Background & Objective: Interns are one of the most important groups among medical student, and thus, must learn to use evidence-based medicine (EBM). The present study was performed with the aim of evaluating the knowledge of medical interns of Mashhad University of Medical Sciences (MUMS), Iran, on evidence-based medicine in 2013 Methods: In this descriptive cross-sectional study, 70 medical interns were selected using convenience sampling method. Data were gathered using a standard questionnaire and analyzed by descriptive statistics and SPSS software. Results: The information source for clinical decision making in 65.7% of interns were their textbooks among which 62.9% used textbooks because of their accessibility. In addition, 95.7% of interns believed EBM to be useful in improving patient care. However, only 37.1% of them knew the meaning of EBM and 95.7% were not familiar with EBM internet sites. Conclusion: Integrated planning is necessary in order to include EBM courses in medical curriculum and to teach the use of internet and correct forms of searching. Keywords Knowledge Medical interns Evidence-based medicin

Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Background: Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients’ dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients’ complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). Methods: This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients’ complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. Results: A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. Conclusion: The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients’ needs and expectations may reduce complaints from public health facilities

Original Article Customers&apos; Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Background: Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients&apos; dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients&apos; complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). Methods: This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients&apos; complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. Results: A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. Conclusion: The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients&apos; needs and expectations may reduce complaints from public health facilities

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 quality assessment of family physician service in rural regions, Northeast of Iran in 2012

Background: Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients’ expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. Methods: This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. Results: The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference ( P ≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services ( P ≤ 0.05 ). Conclusion: There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients’ expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employee