Causes of Discharge against Medical Advice in patients of a Number of Selected Hospitals

Introduction: Discharge Against Medical Advice (DAMA) is one of the important concerns of health systems. This could be potentially life-threatening and cause readmission. The purpose of this study was to determine causes of DAMA in patients of some selected hospitals. Methods: This cross-sectional, descriptive-analytic study was performed in winter 2016. The medical files of 261 patients discharged against medical advice were selected by simple random sampling and reviewed. Data were gathered through Hospital Information System and using a self-designed check list. Data were analyzed through SPSS software and using descriptive statistics and Chi-square test. Results: From all, 58.6% were male, 66.3% were married and 22.2% did not have any insurance coverage. The most common reason of DAMA was feeling better (43.3%). Discharge against medical advice showed significant relationship with marital status (P= 0.02), and insurance type (P= 0.05). Conclusion: Since the most common reason of DAMA was feeling better, more attention of authorities and also a stronger patient-physician relationship are recommended in order to aware patients of their clinical conditions and treatment process. Key¬words: Teaching Hospital, Discharge, Discharge Against Medical Advice (DAMA) ¬Citation: Ghorbani R, Moradi Magin M. Causes of Discharge against Medical Advice in patients of a Number of Selected Hospitals. Journal of Health Based Research 2016; 2(4): 319-327

The Relationship of Academic Achievement Motivation with Emotional Intelligence and Quality of Life of University Students

Background & Objectives: Today, studies have shown the impact of emotional intelligence and quality of life on academic achievement motivation. Paying attention to the factors that lead to academic motivation is very important. The aim of this study was to determine the relationship of academic achievement motivation with emotional intelligence and quality of life in students of Bam University of Medical Sciences in 2015. Methods: This cross- sectional, descriptive-analytic study was conducted on 232 students in Bam University of Medical Sciences selected through stratified random sampling. Research instruments were Hermen’s achievement motivation questionnaire, emotional intelligence Bradbry-Graves test and 36-item questionnaire of quality of life. Data analysis was done through SPSS20 and using t-test, ANOVA, Pearson and linear regression analysis. Results: From all, 87% were female, 81% were single, 58.2% were undergraduate students and 71.1% were in the age group of 18-22 years old. Mean scores of academic achievement motivation, emotional intelligence and quality of life showed no significant relationship with demographic features of students. Regression analysis results showed no significant correlation between the motivation of academic achievement and variables of quality of life and emotional intelligence. Conclusion: Although there was no significant relationship between the motivations of academic achievement and variables of emotional intelligence and quality of life, the motivation for advancement can be generalized and thought; so, training courses for motivation development can be very helpful. Key¬words: Motivation of academic achievement, Quality of life, Emotional intelligence, Students Citation: Ghorbani Nia R, Izadi F. The Relationship of Academic Achievement Motivation with Emotional Intelligence and Quality of Life of University Students. Journal of Health Based Research 2017; 3(3): 297-307

The process of requesting clinical tests in a reference university laboratory center

Background: Simultaneous with other countries, utilization of laboratory tests has increased in Iran. Since understanding the requesting behavior of doctors is a crucial matter, this study conducted in a university reference laboratory center, aiming to assess the process of requesting clinical tests.   Materials and Methods: This study was a descriptive cross-sectional study conducted using the census method on 231277 patients of a main referral polyclinic in Kerman. The data regarding the performed tests, the frequency of requesting laboratory tests, and the demographic information about the patients between 2008 and 2012 extracted from the information system of the laboratory. To analyze the data, SPSS 20 and descriptive statistics methods used.   Result:  Most of the patients were women 16 to 50 years old, and had gone to the clinic only once. Most prescriptions had 50 to 100 tests. General physicians and internists had the highest share of orders and prescription costs. In accordance with rising medical expenses, the prices of laboratory services increased in each year.   Conclusion: This study showed that the 80/20 rule applies to prescriptions, since more than 80% of prescriptions made by only 20% of doctors. To change the behavior of requesting laboratory tests, we need to define accurate and tangible criteria for assessing the appropriateness of requesting in clinical guidelines.   &nbsp

Health Village and its place in the Health System

Background & Objectives: Health Village is a residential/healthcare place for natural remedies combined with other medical treatments. Health village can be set in different sizes, depending on the amount of investments and the investors’ strategic objectives. In fact, a complete health village can cover all aspects of health and meet all the health needs of a community. Methods: In this review study, Persian and English articles indexed in valid databases such as Google Scholar, SID, Pubmed, Irandoc Science direct and Scopus were searched using the MESH terms of “ Health village” and “Health resort” without time limitation. Results: Providing health services in natural areas and away from urban pollution can restore the health and well-being and also can cause psychological and physical relaxation not only in patients but also in those who are interested in living in places with services such as water therapy, herbal therapy, gravel treatments, mud therapy, and other services. Conclusion: The effort to create environments such as the health village, due to the potential of such centers in providing high levels of physical and psychological comfort for audiences, can be considered as a beneficial local business. Therefore, the health village is an environment that can contribute to the social and economic development while serving the health of the community. Key­words: Medical Tourism, Health village, Health system Citation: Kochak Yazdi S, Asadi A, Ghorbani Nia R. Health Village and its place in the Health System. Journal of Health Based Research 2019; 5(1): 57 -71 . [In Persian

The Role of Emergency Medicine Specialist on Performance of the Emergency Department of Kerman Shahid Bahonar Hospital: A Qualitative Study

The Role of Emergency Medicine Specialist on Performance of the Emergency Department of Kerman Shahid Bahonar Hospital: A Qualitative Study Ghorbani Nia Rahil1*, Amiresmaeili MohammadReza2, NekoeiMoghadam Mahamod3, Saberi Nia Amin4 1. Lecturer, Department of Health Services Management, School of Public Health, Bam University of Medical Sciences, Bam, Iran. 2. Associate Professor, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 3. Professor, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 4. Assistant Professor, Department of Emergency Medicine, School of Medical, Kerman University of Medical Sciences, Kerman, Iran. *Correspondence: School of Public Health, Bam University of Medical Sciences, Khalij-e-Fars Blvd, Bam. Tel: 09396558571 Email: [email protected] Introduction: Emergency department is the important part of the healthcare system. Today, the need for integrated emergency care services and delivering qualified care services have been felt more than before. The aim of this study was to investigate the role of emergency medicine specialists on performance of the emergency department of Shahid Bahonar hospital, Kerman. Methods: This phenomenological qualitative study was conducted on 16 emergency medicine specialists (EMSs) and nurses of emergency department and Emergency Operations Center (EOC) who were selected using purposeful sampling in 2015. Data were collected through semi-structured interviews and analyzed using framework analysis. Results: The main themes included economics impact, service quality promotion, and emergency management. Some sub-themes included hospitals revenue improvement, tariffs definition for emergency services, effective treatment, improvement of emergency team knowledge, emergency department management, and triage quality improvement. Conclusion: With presence of EMS in healthcare system, the quality of healthcare delivery system has been improved and waiting time for healthcare services has been significantly decreased. By decreasing waiting time, determining of patient statue and determining the ward for patient in the hospital, emergency beds for other possible admissions and emergency preparedness for future admissions will be kept empty. Key¬words: Emergency Medicine Specialist, Emergency Department, Qualitative Study, Framework Analysis, Performance Citation: Ghorbani Nia R, Amiresmaeili MR, NekoeiMoghadam M, Saberi Nia A. The Role of Emergency Medicine Specialist on Performance of the Emergency Department of Kerman Shahid Bahonar Hospital: A Qualitative Study. Journal of Health Based Research 2016; 2(3): 233-248

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

Survey of Under-5-year-old Children Injury and Accident Mortality Causes in the City of Kerman in 2013

Survey of Under-5-year-old Children Injury and Accident Mortality Causes in the City of Kerman in 2013 Nekooee Moghadam Mahmood1, Amiresmaelee MohamaReza2, Ghorbani Rahil*3, Shikhani Hossein4, Navabi Zahra5 Received: 16. 03. 2015 Revised: 18. 04. 2015 Accepted: 01. 07. 2015 Abstract Introduction: One of the most important improvement and health indexes of a country is its under-5-year-old children’s mortality rate. Recently, under-5-year-old children mortality rate has decreased, but it is still more than developing countries. This research aimed to study the causes of accidents and injuries of under-5-year-old children in the city of Kerman. Method: This was a descriptive analytical prospective study in 2013. This project included 1303 under 5-year-old children who had accidents and referred to three training hospitals' emergency departments. Data on accidents were collected from recorded accident and mortality forms of Kerman Medical University for a period of 1 year¬ (2013) with a census method. Data were analyzed by SPSS19 software using t-test, ANOVA, and χ2 tests. Results: Among 159 people died, 69% were girls and 31% were boys. The most kind of accidents occurred to them were injury (39.67%), poisoning (20.56%), and falling (15.11%). Accidents range was higher among girls and among 3-4-year-old children. Age, Sex, and season of death did not have any correlation with the kind of accident however there was a significant correlation between accidents occurred amongunder-5-year-old children and their season of death. Conclusion: Three main causes of accidents were injury, poisoning and falling, so we must provide the affected age group with trainings proportional to their age group and the kind of accidents happened to them. In addition we should try more to train all society members particularly parents who take care of children. Key¬words: Under5-year-old children, Accidents, Mortality, Emergency Department, Training hospital ¬Citation: Nekooee Moghadam M, Amiresmaelee MR, Ghorbani R, Shikhani H, Navabi Z. Survey of Under-5-year-old Children Injury and Accident Mortality Causes in the City of Kerman in 2013. Journal of Health Based Research 2015; 1(1): 1-12. 1. Associate Professor, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2. Assistant Professor, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 3. Lecturer, Department of Health Services Management, Bam University of Medical Sciences, Bam, Iran. 4. BSc Student, Department of Health Services Management, Kerman University of Medical Sciences, Kerman, Iran. 5. BSc, Department of Mother and Child Health, Deputy of Health, Kerman University of Medical Sciences, Kerman, Iran. *Correspondence: School of Public Health, Campus of Bam, Khalij Fars Highway, Bam University of Medical Sciences. Tel: 09396558571 Email: [email protected]

The Relationship of Academic Achievement Motivation with Emotional Intelligence and Quality of Life of University Students

Background & Objectives: Today, studies have shown the impact of emotional intelligence and quality of life on academic achievement motivation. Paying attention to the factors that lead to academic motivation is very important. The aim of this study was to determine the relationship of academic achievement motivation with emotional intelligence and quality of life in students of Bam University of Medical Sciences in 2015. Methods: This cross- sectional, descriptive-analytic study was conducted on 232 students in Bam University of Medical Sciences selected through stratified random sampling. Research instruments were Hermen’s achievement motivation questionnaire, emotional intelligence Bradbry-Graves test and 36-item questionnaire of quality of life. Data analysis was done through SPSS20 and using t-test, ANOVA, Pearson and linear regression analysis. Results: From all, 87% were female, 81% were single, 58.2% were undergraduate students and 71.1% were in the age group of 18-22 years old. Mean scores of academic achievement motivation, emotional intelligence and quality of life showed no significant relationship with demographic features of students. Regression analysis results showed no significant correlation between the motivation of academic achievement and variables of quality of life and emotional intelligence. Conclusion: Although there was no significant relationship between the motivations of academic achievement and variables of emotional intelligence and quality of life, the motivation for advancement can be generalized and thought; so, training courses for motivation development can be very helpful. Keywords: Motivation of academic achievement, Quality of life, Emotional intelligence, Students Citation: Ghorbani Nia R, Izadi F. The Relationship of Academic Achievement Motivation with Emotional Intelligence and Quality of Life of University Students. Journal of Health Based Research 2017; 3(3): 297-307

The Rate of Occupational Hazards and the Effective Factors in Nurses of Selected Hospitals of Kerman in 2011

Background: Occupational hazards are one of the most important issues in developing countries. Meanwhile, hospitals are the most risky health provision centers, and nursing is one of the stressful jobs. Therefore, the present study aimed to study occupational hazards and their influential factors among nurses. Methods: This cross-sectional study was carried out in Sirjan and Baft hospitals in 2011. Two hundred nurses were included in this study using stratified random sampling. A questionnaire was used for data collection. Data analysis was conducted through SPSS 19 software and using chi-square test, Fisher’s Exact test and descriptive statistics. Results: The frequency of awareness and observing safety measures were respectively 98.5% and 86.0%. The Staff perception of safety was 99.5%. The rates of incurred physical and mental injuries to nurses were respectively 95.0% and 88.6%. The rate of physical invasion to the personnel was zero. There was a significant relationship between somatic injuries and variables of gender, education, working years and hospital. Also, a significant relationship was observed between the rate of awareness and type of employment. The awareness of nurses in emergency wards was less than others and the most mental injuries were seen among nurses working in CCU (100%) and emergency wards (94.1%). Conclusion: The results of the present study indicate psychosomatic injuries in a high number of the personnel. Therefore, it is recommended to spend a proper budget to provide the required equipment, in order to decrease occupational hazards to nurses. Keywords: Occupational hazards, Hospital, Nurs

Survey of under 5 year's children injury and accident’s mortality causes in Kerman state-2013

Introduction: One of the most important improvement and health indexes is under 5-year children’s mortality. Recently under 5-year children decreased but it is still more than developing countries. This research aimed to study accidents and injuries of under 5-year children in province of Kerman. Method: This was a descriptive analytical prospective study in2013. This project included 1303 under 5 years children who could refer to three training hospitals 'emergencies which data on accidents for a period of 1 year (2013) were collected from record accident and mortality of health military forms of Kerman Medical University (‌. The study was conducted in 1303 under 5-year children. Data were analyzed by spss19 software and using t-test, ANOVA, 2&chitests. Results: Among 1303 under 5-year children were studied, 159 people died. 69% were girls and 31% were boys. The most accidents that occurred for them were injury, poisoning and falling. Accidents range were higher among girls and most of them occurred in 3-4 years old children. Age, Sex and season of death did not have correlation with kind of accident however there was a significant correlation between accidents occurred in under 5-year children and season of death. Conclusion: Three main causes of accidents occurring were injury, poisoning and falling so we must choose proportional trainings with age group and accidents that happened for them, and in addition we should try more to train all society particularly parents that care children. Key words: under 5-year children, accidents, Mortality, Emergency Department, Teaching hospital Citation: Nekooee Moghadam M, Amiresmaili MR, Ghorbani R, Shikhani H, Navabi Z. Survey of under 5 year's children injury and accident’s mortality causes in Kerman state-2013. Journal of Health Based Research 2015 1(1