ORIGINAL_ARTICLE
The Effect of Lean Management on Improving Hospital Processes: from 2014 to 2016
Background: The concept of lean management refers to the elimination of waste and creation of value in an organization. The aim of this study was to determine the effect of lean management on improving surgery ward processes in a private hospital in Tehran. Methods: In this case study, the level of patients’ consent and their voluntary discharge both before and after the intervention were investigated. Spaghetti chart methods were used to implement lean management. All clinical, administrative, and paraclinical wards of a private general hospital in Tehran from January 2014 to July 2016 were studied. The data were collected using patients’ consent analysis questionnaires and researcher developed forms, and they were analyzed through descriptive statistics in Excel software. Results: The use of Spaghetti chart reduced the path in the process of discharging male patients was by 55%, 224 meter (from 408 to 184 m), and female patients by 41%, 224 m (from 546 to 321 m). The implemented interventions included the transfer of the Insurance Unit from the third floor to the ground floor and the transfer of the Discharge Unit from the first floor to the ground floor. The implementation of interventions reduced the frequency of voluntary discharge by 0.8% (from 6.8% to 6%), and it increased patients’ overall satisfaction by 8%. Conclusion: Lean management in the hospital leads to the elimination of waste from the process of service delivery and the flow of activities performed. It is necessary to study the hospitals status quo, draw a picture of the forthcoming goals, determine the future status of the lean hospital management, and consequently, draw a map to move towards the lean hospital.
https://smsj.sums.ac.ir/article_43967_912587934119125417372005d46c7f59.pdf
2018-06-22
161
170
Quality Improvement
Management Quality Circles
Hospital Administration
Operating Room
Hossein
Ebrahimipour
ebrahimipourh@mums.ac.ir
1
Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Elahe
Houshmand
2
Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Ali
Vafaei Najar
3
Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Amin
Adel
4
Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Seyed Saeed
Tabatabaei
5
Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Grove AL, Meredith JO, Macintyre M, et al. Lean implementation in primary care health visiting services in National Health Service UK. Qual Saf Health Care 2010; 19:43.
1
Skinner J, Staiger D. Technology diffusion and productivity growth in health care. Review of Economics and Statistics 2015; 97(5):951-64.
2
Abbasi S, ferdousi M. A comparative study of quality management principles and quality management system in Gharazi hospital. Health information management 2006; 3(1): 41-50.
3
Tourani S, Maleki M, Hadian M, Amiresmaili M. A survey on present status of health services priority setting in Iran. Payesh Journal, 2011:10 (2): 217-230
4
Erfannia L, Karimi A, Pooralipour J, noshiravani Y, Salmany F. Total quality management implementation at teaching hospitals affiliated with Zahedan University of Medical Sciences. Journal of Zabol University of Medical Sciences and Health Services (Journal of Rostamineh) 2012; 4(1):9-18.
5
Rezapoor A, Ebadifard Azar F. Situation of resource allocation in Iranians health system. Journal of Hospital. 2013; 11(4):53-64.
6
Farahbakhsh M, Nikniaz A, Tajaddini N, Entezar S, Hasanzade A. Comparing Total Quality Management (TQM) and Management Effectiveness Program (MEP) in Improving of Health Facilities Management. Journal of Health Administration 2011;13(42):35-44.
7
Emiliani M, Stec D. Leaders lost in transformation. Leadership & Organization Development Journal 2005; 26(5):370-87.
8
Ohno T. Toyota production system: beyond large-scale production: CRC Press; 1988.
9
Blackmore CC, Kaplan GS. Lean and the perfect patient experience. BMJ Qual Saf 2017; 26:85-86.
10
Sheykhi S. Design a model of lean hospital and implementation processes of Kashani hospital in ShahreKord. Iranian Health Insurance. Report, 2014. (In Persian), accessible at: http://www.sid.ir/FileServer/PF/8252-01
11
White BA, Chang Y, Grabowski BG, Brown DF. Using lean-based systems engineering to increase capacity in the emergency department. Western Journal of Emergency Medicine. 2014; 15(7):770.
12
Dickson EW, Anguelov Z, Bott P, Nugent A, Walz D, Singh S. The sustainable improvement of patient flow in an emergency treatment centre using Lean. International Journal of Six Sigma and Competitive Advantage 2008; 4(3):289-304.
13
Toussaint JS, Berry LL, editors. The promise of Lean in health care. Mayo Clinic Proceedings; 2013: Elsevier.
14
Curatolo N, Lamouri S, Huet J-C, Rieutord A. A critical analysis of Lean approach structuring in hospitals. Business Process Management Journal. 2014; 20(3):433-54.
15
Skeldon SC, Simmons A, Hersey K, Finelli A, Jewett MA, Zlotta AR, et al. Lean methodology improves efficiency in outpatient academic uro-oncology clinics. Urology. 2014; 83(5):992-8.
16
Anne T, Daley M. Using spaghetti diagrams to improve process flow: Tools and knowledge, 2009. Accessible at: https://www.chisolutionsinc.com/wp-content/uploads/2015/01/2009_10_Spaghetti-Diagrams-E-Postcard-Article.pdf
17
Satisfaction questionnaire. Deputy treatment of Iran University of Medical Sciences: Iran University of medical sciences; 2016. Accessible at: http://vct.iums.ac.ir/page/10236/%D9%81%D8%B1%D9%85-%D9%87%D8%A7
18
Buesa RJ. Adapting lean to histology laboratories. Annals of diagnostic pathology. 2009; 13(5):322-33.
19
Tourani S. Lean hospital management, quality improvement and lean thinking in hospital. 1, editor. Tehran, Iran: Ebadi Far Publication; 2012.
20
Warner CJ, Walsh DB, Horvath AJ, Walsh TR, Herrick DP, Prentiss SJ, et al. Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours. Journal of Vascular Surgery. 2013; 58(5):1417-22.
21
Tsai TC, Orav EJ, Jha AK. Patient satisfaction and quality of surgical care in US hospitals. Annals of Surgery. 2015; 261(1):2.
22
Vahdat S, Hesam S, Mehrabiyan F. Effective factors on patient discharge with own agreement. J Holist Nurs Midwifery 2010; 20 (2):47-52
23
Ng D, Vail G, Thomas S, Schmidt N. Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Canadian Journal of Emergency Medicine 2010; 12(1):50-7.
24
ORIGINAL_ARTICLE
The Correspondence between the Curriculum of Public Health Undergraduate Program and Job Requirements: A Cross-sectional Study
Background: The periodic revision of school curriculum in different courses in every scientific discipline is one of the basic principles of the training process and it improves the quality of education. Therefore, this study aimed to investigate the level of correspondence between the basic and specialized courses of Public Health undergraduate program and job requirements. Methods: This cross-sectional study was performed on 66 Public Healthinterns/apprentices at Lorestan University of Medical Sciences in 2016. The Sampling was the census. The data collection instrument was a questionnaire whose validity and reliability have been confirmed in previous studies. The data were analyzed using STATA software and descriptive and analytical statistics. Results: The results showed that the use of specialized and basic courses of Public Health in doing job duties was high and medium respectively. According to the interns, the most practical specialized course was Mother and Child Health and the least practical course was Occupational Health. According to these interns/apprentices, more than 60 % of basic courses and more than 40% of specialized courses offered changed their knowledge and not their attitude and behavior. In both continuous and discontinuous interns/apprentices groups the satisfaction rate of their field of study was average and there was no significant difference between the two groups. Conclusion: According to the interns/apprentices, the correspondence between the curriculum of Public Health undergraduate program and job requirements was average Therefore, it is recommended that the number of active and passive immunization courses be increased. It is also suggested that one internship semester be offered in their education program.
https://smsj.sums.ac.ir/article_43968_14884ce1df1ecacee9f12d035ed1ba97.pdf
2018-06-22
171
184
Curriculum
Public Health Undergraduate Program
Intern/Apprentice
Requirements
Job
Katayon
Bakhtiyar
1
MSc. Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
AUTHOR
Soraya
Nouraei Motlagh
2
PhD, Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
AUTHOR
Mohammad hassan
Imani-Nasab
3
PhD, Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
AUTHOR
Mohammad Javad
Tarahi
4
PhD, Department of Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
AUTHOR
Mohammad Hossein
Gharouni
5
PhD, Department of Food Hygiene, School of Veterinary Medicine, Lorestan University, Khorramabad, Iran
AUTHOR
Heshmatollah
Asadi
heshmat.asadi64@gmail.com
6
PhD, Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
LEAD_AUTHOR
Mehar A. From knowledge creation to economic development: Missing links in Muslim World. Journal of Management & Social Sciences 2000;1(1):24-47.
1
Momeni Mahmuee H. Improvement of high education curriculum a step toward training creative alumni. Education Strategies in Medical Sciences. 2009;2(3):121-6.
2
Tirgar A. The evaluation of occupational medicine education in medical schools of Iran,1998. JBUMS. 1999;1(4):47-52 [persian].
3
Maleki H. Curriculum (guidelines). Tehran: Research and educational planning Organization; 2016.
4
Shirjang A, Alizadeh M, Mortazavi F, Asghari Jafarabadi M, Jeddi A. Relevance of Public Health BSc Curriculum to Job Requirements and Health System Expectations: Views of Graduates on Courses Syllabi and Content. Iranian Journal of Medical Education. 2013;12(10):768-77.
5
Farahani M, Ahmadi F. Doctoral nursing students’ viewpoints about the nursing PhD curriculum. Iranian Journal of Medical Education. 2006;6(1):83-92.
6
Yazdani S, Hosseini F, Homayouni zand R. Reform in general medical degree curriculum. edition f, editor. Tehran: Shahid Beheshti University of Medical Sciences; 2007.
7
Mohammadpour A, Matlabi M. The survey of the Gonabad medical sciences students views on their educational needs and improving theoritical and clinical education program (2001-2002). Iranian Journal of Medical Education. 2002;2:41-[persian].
8
Ehsanpour S. Achieving Minimum Learning Requirements from the Viewpoints of Midwifery Students in Isfahan School of Nursing and Midwifery. Iranian Journal of Medical Education. 2006;6(2):17-25.
9
Shahidi S, Changiz T, Salmanzadeh H, Yousefy A. Factors Affecting the Needs Assessment in Continuing Medical Education: Presenting a Practical Guideline for Selecting Models and Techniques. Iranian Journal of Medical Education. 2010;9(4):321-30.
10
Gerzina TM, McLean T, Fairley J. Dental clinical teaching: perceptions of students and teachers. Journal of Dental Education. 2005;69(12):1377-84.
11
Victoroff KZ, Hogan S. Students’ perceptions of effective learning experiences in dental school: a qualitative study using a critical incident technique. Journal of Dental Education. 2006;70(2):124-32.
12
Salehi S, Abedi H A, Alipour L, Najafipour S, Fatehi N. Learning activities and clinical nursing services gap and the related factors: a comparative study. Iranian Journal of Medical Education. 2001;1(3):43-9[persian].
13
Babaee N, Jahanian I, Bijani A, Ardebili Haghighi MR. Viewpoints of Dental Students about Practical Value of Educational Contents in Oral Medicine Department. Biannual Journal of Medical Education Education Development Center (edc) Babol University of Medical Sciences. 2014;2(1):35-40.
14
Samadi MT, Taghizadeh J, Kashitarash Esfahani Z, Mohammadi M. Evaluating environmental health students' attitudes toward their discipline and future career in Hamedan university of medical sciences in 2008. Iranian Journal of Medical Education. 2010;9(4):331-6 [persian].
15
Hoseinpour M, Samiei H, Behdad. Assessment of medical interns opinion about education in surgery courses in Isfahan University of Medical Sciences. Iranian Journal of Medical Education. 2002; 3:1-35.
16
Mortazavi SAA, Razmara A. Medical Student Satisfaction in Different Educational Locations. Iranian Journal of Medical Education. 2001;1(3):51-4 [persian].
17
ORIGINAL_ARTICLE
An Epidemiological Survey of Traffic Accident Victims Who Referred to Khatam Al Anbia Hospital in Zahedan
Background: The increase in morbidity and mortality rates owing to traffic accidents has become a major global concern. The use of epidemiological information pertinent to traffic accidents has a key role in prevention programs; therefore, the current study was done to determine the epidemiological characteristics of victims of traffic accidents who referred to Khatam Al Anbia Hospital in Zahedan. Methods: In this descriptive cross-sectional study, out of 466 traffic accident victims who referred to Khatam Al Anbia Hospital in Zahedan, a sample of 210 people were selected randomly. Data were collected with a checklist that included 4 sections: demographic information, accident, clinical features, and discharge information of injured patients. Data extraction and checklist completion were done by going to the hospital and studying the patients’ records. SPSS software version 16 was used for data analysis. Results: According to results of the research, 82.9% of victims were male, 61% single, and 35.2% were in the age group of 16-25 years old. 35.2% were motorcyclists and most of the injuries (34.8%) were fractures. The body organs mostly affected by injury were head and neck (40.5%). Surgical procedures were performed for most victims (42.4%). 3.5% of victims died. Conclusion: The findings showed that male, single, and young people were more involved in traffic accidents than other groups. Therefore, the adoption of community-based prevention programs is one of the important recommendations of this study. In this regard, the use of media and schools to institutionalize the culture of driving and traffic can be highlighted.
https://smsj.sums.ac.ir/article_43969_f3481017f5e58cc3291ce0e45a24f489.pdf
2018-06-22
185
194
Accidents
Traffic
Epidemiology
Afsaneh
Karimi
1
Medical Records lecturer, Health Information Technology Dept., Paramedical school, Zahedan University of Medical Sciences, Zahedan, Iran
AUTHOR
Yousef
Mehdipour
2
Medical Informatics (PhD), Health Information Technology Dept., Paramedical school, Zahedan University Of Medical Sciences, Zahedan, Iran
AUTHOR
Ali
Mohammadpour
mohammadpur2000@gmail.com
3
Health Information Management (PhD), Health Information Technology Dept., School Of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
LEAD_AUTHOR
Asma
Heidari Dalir
4
Medical Records (BSc), Baharan Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
AUTHOR
Hamid
Bouraghi
5
Health Information Management (PhD), Health Information Technology Dept., School Of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
AUTHOR
Gunjan B. Ganveer, Rajnarayan R. Tiwari. Injury Pattern among Non-Fatal Road Traffic Accident Cases: A Cross-Sectional Study in Central India. Indian J Med Sci. 2005; 59(1):9-12.
1
Jha N, Srinivasa D.K., Roy G, Jagdish S. Epidemiological Study of Road Traffic Accident Cases: A Study from South India. Indian Journal of Community Medicine 2004; 29(1): 20-24.
2
Singh Y N, Bairagi KK, Das KC. An Epidemiological Study of Road Traffic Accident Victims in Medicolegal Autopsies. JIAFM 2005; 27(3):166-69.
3
Chandran A, Hyder AA, Peek-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev. 2010; 32(1):110-120.
4
Ansari-Moghaddam A, Martiniuk AL, Mohammadi M, Rad M, Sargazi F, Sheykhzadeh K, et al. The pattern of injury and poisoning in South East Iran. BMC International Health and Human Rights. 2012; 12(1):17. (Persian)
5
Global status report on road safety. Geneva: World Health Organization; 2015.p.1-271
6
Leonard Evans, DPhil. Traffic Fatality Reductions: United States Compared With 25 Other Countries. American Journal of Public Health. 2014; 104(8):1501-1507.
7
Salehi M, Mehmandar M, Mobaderi T. Application of growth mixture model to analysis of road traffic death rate in the world, 2007 -2013.Razi Journal of Medical Sciences 2017; 24(161): 1-12. (Persian)
8
Sadeghian F, Khosravi A, Emamiyan M, Younesian R. The pattern of traffic accident damage and related factors in Shahrud. Payesh 2008; 7(3): 33-225. (Persian)
9
Khazaie S, Mohammadian Hafshejani A, Mohammadian M, Salehiniya H, Afshari M. An epidemiologic study of traffic accidents on Iran drivers in 2013. Journal of Rescue & Relief 2015; 7(1): 51-60. (Persian)
10
Abdolvand M, Bahadori Monfared A, Khodakarim S, Farsar AR, Golmohammadi A, Safaei A. Evaluation of Accidents and Incidents at Injury Registered in Medical Centers Affiliated to Shahid Beheshti University of Medical Sciences (2012-2013). Journal of Safety Promotion and Injury Prevention 2014; 2(1): 65-72. (Persian)
11
TaravatManesh S, Hashemi Nazari S, Ghadir Zadeh M, Tarvot Manesh L. Epidemiologic study of accidents and traffic accidents that resulted in death in Sistan and Baluchistan province in 2012. Journal of Safety Promotion and Prevention of Injuries 2015; 3(3):161-168. (Persian)
12
Salimi J, Nisa Jay Zwar M, Khaji A. Epidemiological Survey of Trauma-Related Deaths: Six Tehran University Hospitals. Journal of Tehran University of Medical Sciences 2007; 65 (2): 25-22. (Persian)
13
Shojaei Baghini H, Nakhai N. The profile of the injured patients referring to emergency rooms in Kerman, 2002 and 2003. South Medical Journal 2005; 8(2): 77-172. (Persian)
14
Bakhtiyari M, Soori H. Epidemiology of traffic crashes outcomes and related factors in Iran 2010. Journal of Safety Promotion and Injury Prevention 2013; 1(3):150-159. (Persian)
15
Taravatmanesh S, Hashemi-Nazari S, Ghadirzadeh M, Taravatmanesh L. Epidemiology of fatal traffic injuries in the Sistan and Baluchistan province in 2011. Journal of Safety Promotion and Injury Prevention 2015; 3(3):160-168. (Persian)
16
Suri H. Epidemiology of accidents in children referred to emergency department of Ahvaz hospitals. Journal of Ahwaz University of Medical Sciences 2002; 3(32): 1-11. (Persian)
17
WHO. International classification of diseases and health related health problems. (ICD-10). Available at: http://www.who.int/classifications/icd/en/
18
Mohammad Hussain Khan, Iftikhar Ahmed, Niamatullah Zia, et al. Road Traffic Accidents: Studyof Risk Factors. Professional Med J 2007; 14(2): 323-27.
19
Nilambar J, Chandra Shekhar A. Epidemiological Study of Road Traffic Accident Cases: A Study from Eastern Nepal. Regional Forum WHO South-East Asia Region 2004; 8(1):1-7.
20
Suriyawongpaisal P, Kanchanasut S. Road Traffic Injuries in Thailand: Trends, Selected Underlying Determinants and Status of Intervention. Injury control and Safety Promotion 2003; 10:95-104.
21
Almasi A, Hashemian A. The status of road accidents in Kermanshah in 2002. Journal of Improvement 2002; 69(12): 54-47. (Persian)
22
Banthia P, Koirala B, Rauniyar A, Chaudhary D, Kharel T, Khadka SB. An Epidemiological Study of Road Traffic Accident Cases Attending Emergency Department of Teaching Hospital. JNMA J Nepal Med Assoc 2006; 45(162):238-43.
23
Mablaghi J, Moulanaei N. The survey of mortality and injuries caused by traffic accidents in hospitalized patients in the accident ward of Besat Hospital in Sanandaj in 2001. Scientific Journal of Kurdistan University of Medical Sciences 2002; 6(24): 33-28. (Persian)
24
Karbakhsh M, Rostami G, Zargar M. Factors related to the severity of traffic accidents lead to occupants of four-wheelers. Payesh Quarterly Journal 2004; 3(4): 78-273. (Persian)
25
Singh Y N, Bairagi K K, Das K Ch. An Epidemiological Study of Road Traffic Accident Victims in Medicolegal Autopsies. JIAFM 2005; 27(3):166-69.
26
Anjos K C, Evangelista M R B, Silva J S, Zumiotti A V. A Patient Victim of Car Traffic Violence: a Social Services Intervention in the emergency room. Acta Ortopédica Brasileira 2004; 15(3): 262-66.
27
Sadeghian F, Khosravi A, Emamiyan M, Younesian R. The pattern of traffic accident damage and related factors in Shahrud. Payesh Quarterly Journal 2008; 3: 33-225. (Persian)
28
ORIGINAL_ARTICLE
The Effect of Organizational Changes on Occupational Stress of Nurses Considering the Moderator Role of Trust in Head Nurses
Background: One of the major problems that human societies are struggling with in the past few decades due to the gradual growth of modern life is the stress phenomenon. This phenomenon has become especially important and, by being globalized, it has increasingly affected the health of the workforce. Therefore, the purpose of this study was to analyze the effect of organizational changes on occupational stress among nurses considering the moderator role of trust in head nurses. Methods: With regard to the aim of the study, this study is practical and regarding data collection it is a preliminary study and a branch of field studies which was done cross-sectional at eight Tehran University teaching hospitals in 2017. The statistical population of the study was all the nurses working in the teaching hospitals of Tehran University of Medical Sciences (16 hospitals). 215 out of 230 nurses were selected by multi-stage cluster sampling method. The data collection tool was March Organizational Change Questionnaire (1981), Helicel and Slackome Job Stress Questionnaire (2010), and McCaffrey's Surveillance Trust Questionnaire (2010) whose validity and reliability were confirmed. In data analysis, Pearson Correlation test was used to examine the relationship between variables, structural equation modeling and Bootstrap test were used to measure the fit of the research model and hypotheses test using SPSS 22 and Amos22 software was used. Results: The results showed that the research model has a good fit. If the trust in the head nurse is low, an organizational change with a coefficient of -0.60 at a 95% confidence level affects the nurses’ job stress, and if the trust in the head nurse is high, the effect of organizational change on nurses' job stress in the 95% confidence level is 0.77. Conclusion: Stress can, to a certain extent, have a positive impact on the performance of the individual in an organization, and if it exceeds a certain limit, it has a negative effect on the individual's performance in an organization. Therefore, in general, stress through trust leads to an organizational change.
https://smsj.sums.ac.ir/article_43970_7dd9955e719c641f215e8f07b3f0cb10.pdf
2018-06-22
195
204
Organizational change
Nursing job stress
Trust in head nurses
Alireza
Fathiizadeh
a_fathii@yahoo.com
1
Department of Public Management, Payame Noor University, Tehran, Iran
AUTHOR
Reza
Zare
rezazare@pnu.ac.ir
2
Department of Public Management, Payame Noor University, Tehran, Iran
LEAD_AUTHOR
Mohammad
Khammarnia
m_khammar1985@yahoo.com
3
Assistant Professor, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
AUTHOR
Seyed Kousha
Mirmasoudi
koshamirmasoudi@yahoo.com
4
Master of Business Administration (MBA), Payame Noor University of Karaj, Alborz, Iran
AUTHOR
Steege LM, Rainbow JG. Fatigue in hospital nurses- Super nurse’ culture is a barrier to addressing problems: A qualitative interview study. International Journal of Nursing Studies 2017; 67: 20-8.
1
Labrague LJ, McEnroe‐Petitte DM, Gloe D, Tsaras K, Arteche DL, Maldia F. Organizational politics, nurses' stress, burnout levels, turnover intention and job satisfaction. International Nursing Review 2017; 64(1): 109-16.
2
Okita S, Daitoku S, Abe M, Arimura E, Setoyama H, Koriyama C, Ushikai M, Kawaguchi H, Horiuchi M. Potential predictors of susceptibility to occupational stress in Japanese novice nurses-a pilot study. Environmental Health and Preventive Medicine 2017; 22(1): 20.
3
Alvani M. The Relationship between Management Styles and Organizational Health and Job Stress of Employees. Quarterly Journal of New Approach in Educational Management2013; 5(2). (Persian)
4
Soparnot RD. The concept of organizational change capacity. Journal of Organizational Change Management 2011; 24(5): 640-661.
5
DavenportJ. Leadership Style and Organizational Commitment: The moderating role of locusof control. ASBBS Annual Conference: Las Vegas 2010; 1(1): 1-10.
6
Lee H. The role of competence-based trust and organizational identification in continuous improvement. Journal of Management Psychoiogy 2015: 19(6): 623-639.
7
Ahmadi MS. Predicting Job Stress and Burnout based on Personality Characteristics of Nurses 2016; 17 (2):98-107. (Persian)
8
Samad Pour Amlashi T, Kianmehr J. Nurse’s occupational stressors at medical wards of teaching hospitals in Zanjan. Faculty of Nursing of Midwifery Quarterly 2007; 16(55):37-45 (Persian).
9
Navidian A, Masoudi G, Mousavi SS. Workrelated stress and the general health of nursing staffs in Zahedan hospitals emergency wards (2014). Behbood 2015; 9(3):17-26 (Persian).
10
Darvishpour Kakhaki A, Ebrahimi H, Alavi majd H. Health statues of nurses of hospitals to dependent to Shahroud medical university. Iran Journal of Nursing 2010; 22(60):19-27 (Persian).
11
Hebrani P, Behdani F, Mobtaker M. Evaluation of stress factors in nurses’ different hospital wards. The Quarterly Journal of Fundamentals of Mental Health 2010; 10(3):231-7 (Persian).
12
Rouhi GH, Molaei EA, Mahmoudi GR. Management approach to nurse administrators and its relationship with occupational burnout among nurses’ staff of Golestan university hospitals. Jahrom Medical Journal 2009; 6(2):38-55 (Persian).
13
Azar A, Gholamzadeh R, Ghanavati M. Modeling structural path Management, Tehran: Negahe Danesh, The First Edition; 2012. (Persian)
14
ORIGINAL_ARTICLE
Prevalence of Depression, Anxiety, and Stress among Caregivers’ of Patients with Stroke
Background: Caregivers of stroke patients may be at risk of psychological problems. The aim of this study was to determine the prevalence of depression, anxiety, and stress among caregivers of patients with stroke. Methods: This was a descriptive and cross-sectional study. One hundred and twenty two caregivers of stroke patients who referred to Payambar Aazam Hospital in Bandar Abbas participated in this study. Convenience sampling was used. The Depression, Anxiety and Stress Scales (DASS-21) were used for data collection. The data were analyzed using Chi-square and ANOVA tests. Results: Sixty eight percent of stroke patients’ caregivers suffered from mild to extremely severe depression. Approximately, two-third and half of the stroke patients’ caregivers experienced mild to extremely severe anxiety and stress, respectively. The results of the study showed that there was a significant statistical relationship between depression level and caregivers’ gender (c2=11.15, p=0.01) and caregivers’ age (F=3.30, p=0.02). In addition, an association was observed between the caregivers’ level of anxiety and the patients’ gender (c2=12.04, p=0.007) and age (F=5.93, p=0.001). Conclusion: The findings of this study indicated that there was a high percentage of depression and anxiety among the caregivers of stroke patients. In addition, half of the caregivers experienced stress. Since, male and younger caregivers experienced more depression, attention to this group is crucial. Moreover, the intensity of anxiety was higher in younger caregivers and those who were caring for male patients, so making interventions for this group is recommended.
https://smsj.sums.ac.ir/article_43971_e130cb7a2ce58f840185720f66dc5463.pdf
2018-06-22
205
214
Caregivers
Stroke
depression
Anxiety
Simin
Soudagar
1
MS, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
AUTHOR
Masoumeh
Rambod
ghodsbin93@gmail.com
2
PhD, Community Based Psychiatric Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Mozaffarian. Heart disease and stroke statistics-2015 update: a report from the American Heart Association (vol 131, pg e29, 2015). Circulation. 2015; 131(24):E535-E.
1
Zhang Y, Chapman A-M, Plested M, Jackson D, Purroy F. The incidence, prevalence, and mortality of stroke in France, Germany, Italy, Spain, the UK, and the US: a literature review. Stroke research and treatment. 2012; 436125. doi: 10.1155/2012/436125.
2
Bakas T, Austin JK, Okonkwo KF, Lewis RR, Chadwick L. Needs, concerns, strategies, and advice of stroke caregivers the first 6 months after discharge. Journal of Neuroscience Nursing. 2002; 34(5):242.
3
Balhara YPS, Verma R, Sharma S, Mathur S. A study of predictors of anxiety and depression among stroke patient–caregivers. Journal of Mid-life Health. 2012; 3(1):31.
4
Menon B, Salini P, Habeeba K, Conjeevaram J, Munisusmitha K. Female caregivers and stroke severity determines caregiver stress in stroke patients. Annals of Indian Academy of Neurology. 2017; 20(4):418.
5
Chen P, Fyffe DC, Hreha K. Informal caregivers’ burden and stress in caring for stroke survivors with spatial neglect: an exploratory mixed-method study. Topics in Stroke Rehabilitation. 2017; 24(1):24-33.
6
Farhadi A, Foroughan M, Mohammadi F, Rassouli M, Sadegh Moghadam L, Nazari S, et al. Caregiving appraisal in family caregivers of older adults. Iranian Journal of Ageing. 2016; 11(1):8-19.
7
Wan-Fei K, Hassan STS, Sann LM, Ismail SIF, Raman RA, Ibrahim F. Depression, anxiety and quality of life in stroke survivors and their family caregivers: A pilot study using an actor/partner interdependence model. Electronic Physician. 2017; 9(8):4924.
8
Ain QU, Dar NZ, Ahmad A, Munzar S, Yousafzai AW. Caregiver stress in stroke survivor: data from a tertiary care hospital-a cross sectional survey. BMC Psychology. 2014; 2(1):49.
9
Lovibond S, Lovibond P. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation Australia; 1995.
10
Szabo M. The short version of the Depression Anxiety Stress Scales (DASS-21): Factor structure in a young adolescent sample. Journal of Adolescence. 2010; 33(1):1-8.
11
Sinclair SJ, Siefert CJ, Slavin-Mulford JM, Stein MB, Renna M, Blais MA. Psychometric evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of US adults. Evaluation & the Health Professions. 2012; 35(3):259-79.
12
Edraki M, Rambod M. Psychological Predictors of Resilience in Parents of Insulin-Dependent Children and Adolescents. International Journal of Community Based Nursing and Midwifery. 2018; 6(3):239-49.
13
Das S, Hazra A, Ray BK, Ghosal M, Banerjee TK, Roy T, et al. Burden among stroke caregivers: results of a community-based study from Kolkata, India. Stroke. 2010;41(12):2965-8.
14
Alfakhri AS, Alshudukhi AW, Alqahtani AA, Alhumaid AM, Alhathlol OA, Almojali AI, et al. Depression Among Caregivers of Patients With Dementia. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2018;55:0046958017750432.
15
Pucciarelli G, Ausili D, Galbussera AA, Rebora P, Savini S, Simeone S, et al. Quality of Life, Anxiety, Depression and Burden among Stroke Caregivers: a longitudinal, observational multicentre study. Journal of Advanced Nursing. 2018. Article in press.
16
Byun E, Riegel B, Sommers M, Tkacs N, Evans L. Caregiving immediately after stroke: A study of uncertainty in caregivers of older adults. The Journal of neuroscience nursing: journal of the American Association of Neuroscience Nurses. 2016;48(6):343.
17
Välimäki TH1, Vehviläinen-Julkunen KM, Pietilä AM, Pirttilä TA. Caregiver depression is associated with a low sense of coherence and health-related quality of life. Aging and Mental Health. 2009; 13(6):799-807.
18
Alexander T, Wilz G. Family caregivers: Gender differences in adjustment to stroke survivors' mental changes. Rehabilitation Psychology. 2010; 55(2):159.
19
Keir ST, Guill AB, Carter KE, Boole LC, Gonzales L, Friedman HS. Differential levels of stress in caregivers of brain tumor patients—observations from a pilot study. Supportive Care in Cancer. 2006; 14 (12):1258-1261.
20
ORIGINAL_ARTICLE
Analysis of Factors Affecting the Tobacco Use in Iran: a Household Budget Survey
Introduction: Recently, one of the biggest achievements of public health programs around the world has been the decline in tobacco use. The purpose of this study was to determine the impact of economic, social and demographic factors affecting smoking in Iran. Methods: The current research was applied-descriptive. This study was conducted for 114826 Iranian households from 2007 to 2015, and the statistical information required by Stata13 software was extracted from raw data of household expenses and income in the Iranian Statistics Center. In this study, the double hurdle approach was used to distinguish between unwillingness to consume and the corner solution, and the coefficients were computed with Stata13 software. Results: The marginal effects obtained for the dual hurdle model were: income (1.8), price (2.6), employment status (1.7), age (-0.5), house ownership status (-2.9), marital status (6.08), educational status (-1.4), presence of children under the age of 14 in the household (1.9), and gender (12.6). The marginal effects of the participation equation for consumption were: employment status (0.28), age (-0.1), house ownership status (0.15), marital status (-0.16), educational status (0.07), presence of children under the age of 14 (0.07), and gender (1.8).All coefficients were significant at the 5% level. Conclusion: The results showed that considering the marginal effects calculated for consumption equation, the effect of demographic factors on smoking was more than economic factors. Therefore, policymakers' attention to employment, marriage and housing of community members can be turned to reducing tobacco use and improving the general health.
https://smsj.sums.ac.ir/article_43972_cc399c33a685d94ce651a81e32eade26.pdf
2018-06-22
215
226
Public Health
Economics
Tobacco Use
Income
Nima
Mohamadnejad
1
Department of Management and Economics, Tarbiat Modares University, Tehran, Iran
AUTHOR
Mohammadreza
Masoumi
mohamadmasoumi_119@yahoo.com
2
Department of Health Economics, School of Health Management and Information Sciences, University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Javad
Javan-Noughabi
3
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Haenle MM, Brockmann OS, Kron M, Bertling U, Mason AR, Steinbach.Overweight, physical activity, tobacco and alcohol consumption in a cross sectional random sample of German adults. BMC Public Health 2013; 91(1): 233.
1
Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, Wollum A, Sanman E, Wulf S, Lopez AD, Murray CJ. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. Jama. 2014 Jan 8; 311(2):183-92.
2
Castiglione C, Infante D. Rational addiction and cultural goods: the case of the Italian theatregoer. Journal of Cultural Economics. 2016; 40(2):163-90.
3
Gordon BR, Sun B. A dynamic model of rational addiction: Evaluating cigarette taxes. Marketing Science. 2015; 34(3):452-70.
4
Martinez E, Mejia R, Pérez-Stable EJ. An empirical analysis of cigarette demand in Argentina. Tobacco control. 2015; 24(1):89-93.
5
Bask M, Melkersson M. Rationally addicted to drinking and smoking. Applied Economics 2004; 36(1): 373 – 381.
6
Jones AM. A double-hurdle model of cigarette consumption. Journal of Applied Econometrics 1989; 41(7): 23-39.
7
Jones AM. A note on computation of the double-hurdle model with dependence with an application to tobacco expenditure. Bulletin of Economic Research 1992; 44(9): 67-74.
8
Blaylock JR, Blisard WN. U.S. Cigarette consumption: The Case of Low- Income Women. American Journal of Agricultural Economics 1992; 7(4): 698-705.
9
Yen, S.T. A Multivariate Sample-Selection Model: Estimating Cigarette and Alcohol Demands with Zero Observations, American Journal of Agricultural Economics, 2005: 87, 453-466.
10
Aristei D, Perali F, Pieroni L. Cohort Analysis of Alcohol Consumption: A Double-Hurdle Approach. American Journal of Agricultural Economics 2015: 91: 450-481.
11
Atkinson, A.B., J. Gomulka, and N.H. Stern. Household expenditure on tobacco 2000-2015: evidence from the Family Expenditure Survey. London School of Economics 2016: 51: 102-121.
12
Yen, S.T. Working wives and food away from home: The Box-Cox double hurdle model, American Journal of Agricultural Economics. 2014; 75: 884-895.
13
Yen S T. Zero observations and gender differences in cigarette consumption, Applied Economics. 2015: 37: 1839–1849
14
Newman C, Henchion M, Matthews A. A double-hurdle model of Irish household expenditure on prepared meals, Applied Economics. 2016: 35: 1053-1061.
15
Su S-J B. and S.T. Yen. A censored system of cigarette and alcohol consumption, Applied Economics 2016: 32: 729-737.
16
Casetta B, Videla AJ, Bardach A, Morello P, Soto N, Lee K, Camacho PA, Hermoza Moquillaza RV, Ciapponi A. Association between cigarette smoking prevalence and income level: a systematic review and meta-analysis. Nicotine & Tobacco Research. 2016; 19(12):1401-7.
17
Lim GC, Zeng Q. Consumption, income, and wealth: Evidence from age, cohort, and period elasticities. Review of Income and Wealth. 2016; 62(3):489-508.
18
Basaza R, Otieno E, Musinguzi A, Mugyenyi P, Haddock CK. Factors influencing cigarette smoking among soldiers and costs of soldier smoking in the work place at Kakiri Barracks, Uganda. Tobacco control. 2017; 26(3):330-3.
19
Bromet E, Andrade LH, Hwang I, Sampson N, Alonso J, Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine 2011; 90(9): 1-16.
20
Bailey JA, Epstein M, Steeger CM, Hill KG. Concurrent and prospective associations between substance-specific parenting practices and child cigarette, alcohol, and marijuana use. Journal of Adolescent Health. 2018; 62(6):681-7.
21