مجله علوم پزشکی صدرا
سال ششم شماره 1 (زمستان 1396)

Patients with diabetes may have many mental and psychological problems. These problems may lead them to spirituality. The aim of this study was to determine the prevalence of stress, anxiety, and depression in patients with diabetes and their associations with spiritual health.
This cross-sectional study was performed on 200 adults with diabetes. Convenience sampling was used. Data were collected by stress, anxiety and depression scales (DASS-21) and spiritual well-being scale. The results were analyzed using SPSS software and ANOVA and linear regression tests.
The prevalence of stress was 44.1% (15.5% mild, 20.2% moderate, 8.3 severe, and 1% extremely severe). Anxiety comprised 62.8% (24.5% mild, 22.9% moderate, 12.2 severe, and 3.2% extremely severe). Moreover, the prevalence of depression was 31.3 (12.8% mild, 18.4% moderate, and 6.1 severe). The mean score of spiritual well-being was 92.28 (SD=12.53). There was an association between spiritual well-being and anxiety (F=5.64, P The results of this study showed that more than one third of patients with diabetes suffered from stress and depression. More than half of the participants experienced anxiety. There was an association between spiritual well-being and anxiety and depression. Therefore, screening patients with diabetes in order to identify their mental and psychological problems and provide spiritual health interventions in order to reduce the probability of these problems is suggested.

Occupational success is closely related to individual, family, social, political, and cultural aspects of hemophiliac patients. Therefore, this study was conducted with the aim of developing a career exploration model of hemophilia patients’ occupational success based on personal, occupational, and social variables
The present research is descriptive of correlation type and the study population (participants) were all the hemophilia patients of Isfahan in 2016 two hundred of whom were selected randomly. The data collection instrument was a researcher-developed questionnaire to measure the communication/networking skills, interpersonal trust, individual skill development, psychological capital, citizenship behavior, work ethic, job involvement, updating knowledge, updating knowledge, career planning, vision and identity, intrinsic motivation and creativity and career success. Data were analyzed through path analysis using SPSS software.
The results of path analysis showed that in a multilevel model there was a chain relationship between individual variables, employment and social and occupational success in hemophilia patients. There was a significant relationship between creativity, job involvement, vision and identity, communication/networking skills /, interpersonal trust, intrinsic motivation, career planning and career success. Also, there was a significant relationship between work ethic, updating knowledge, career planning, intrinsic motivation and creativity. On the other hand, there was a significant relationship between work ethic, communication/networking skills, career planning, job motivation, job involvement, interpersonal trust, individual skill development, work ethic skills and communication/networking skills.
The findings of this study indicated that we can strengthen hemophilia patients’ career success through a multi-level set of individual, social, and occupational variables, especially through creativity, job involvement, vision and identity, communication/ networking skills, interpersonal trust, intrinsic motivation and career planning

Organizational justice is especially important because of its significant effects on employee's attitudes and behaviors in health care organizations. Responsiveness of the healthcare system is also an important issue and it is something that is very important for policy-makers and health managers. This paper aimed to study the relationship between organizational justice and its components and social responsiveness in the hospitals of Tehran University of Medical Sciences in 2016.
This cross-sectional descriptive study was conducted in 5 teaching hospitals at Tehran University of Medical Sciences. In this study, 245 hospital staff were selected in order to review their responsiveness toward 228 inpatients to measure organizational justice. The data-collection instruments were Bioger and World Health Organization questionnaires for organizational justice and responsiveness measurement, respectively. The data were analyzed using descriptive statistics and tests, ANOVA, and Pearson correlation. The level of significance was determined at 0.05 using SPSS software and the statistical test employed was Pearson correlation.
The mean of organizational justice and social responsiveness were 58.10 ± 11.56 and 77.9 ± 11.62, respectively. There was a significant correlation between organizational justice and social responsiveness (r = 0.5, p = 0.03).
According to the results, the status of organizational justice and responsiveness were assessed at a moderate and good level, respectively. Therefore, in order to improve perceived justice, adopting policies such as modifying payment mechanisms, reviewing decision-making processes, and improving the communication between supervisors and employees that will increase the level of responsiveness are recommended.

Considering the importance of sense of belonging in the formation of professional identity and clinical experiences of nursing students, in this study, the factors involved in the sense of belonging from nursing students’ perspective were studied to promote and form this phenomenon in nursing students explaining the factors involved.
A Qualitative research design was adopted and data were collected through 15 semistructured interviews with nursing students. The recorded interviews were analyzed using content analysis. The validity of the data was evaluated using the criteria of credibility, dependability, and conformability.
The data were extracted in 2 main categories: 1- Perceived consequences which included a subset of the community acceptance, internal perspective, feedback from the instructors, viewing the results, interaction with peers, family acceptance, and learning experiences, 2- Professional relationships which included a subset of health communications, staff interpersonal communication, interpersonal communication of the students with their instructors, and student acceptance in the ward.
Considering the importance of perceived consequences and professional communications, creating a situation in which students feel they are part of the care team is of high importance. To this end, preparation and training of personnel to accept students as their future colleagues should be considered by education planners. The introduction of professional nursing in the community can play a supporting role in providing a sense of belonging in nursing students.

Studies show that the most important limiting factor for fertility and a healthy reproduction with an older couple is women’s age. But the question is that to what extent will the father's age affect pregnancy and infant health? The aim of this study was to determine the relationship between paternal ages with reproductive outcomes.
This retrospective cohort study was conducted in Zahedan in 2017. The study population included 3,000 children under one year of age who were selected from urban health centers of Zahedan. Data were collected using a standard checklist. SPSS software, descriptive statistics, chi-square test, and logistic regression were used for data analysis.
Most fathers were 20 to 40 years old. The majority of the studied families had one child and most children examined were the first child. The results showed an association between paternal age and the sex of the baby (P=0.017), birth weight (P 0.031P =), type of delivery (P= 0.001) and delivery time (P=0.013).
With increasing paternal age, there is the possibility of developing risk factors such as early delivery and cesarean section. Childbearing at a young age increases the likelihood of having a healthy baby. In order to reduce early and high risk pregnancies and household costs, and health systems, it is suggested that the childbearing of family take place when parents are younger.

Resilience is defined as a successful acclimatization process with injurious experiences. The concept of the source of control refers to human's ability in controlling conditions and environmental events. In some surveys, resilience and locus of control are known as factors affecting academic progress of students. Therefore, this study aimed to investigate the relationship between students’ resilience and their source of control with their academic performance conducted at Paramedical School, Alborz University of Medical Sciences.
This cross-sectional study was performed with180 students at Alborz University of Medical Sciences with simple stratified random sampling. Data collection tools included a demographic questionnaire, student's total average, Connor-Davidson standardized resilience questionnaires, and Rotter's locus of control. In order to analyze the data, SPSS 23 software and descriptive statistics (mean and standard deviation) and analytical statistics (Pearson and Spearman correlation coefficient, independent t-test, multiple linear regression) were used.
The results showed that there was a significant relationship between resilience and locus of control, i.e. the resilient individuals had internal locus of control (r=-0.418, P The results showed that off campus students were more resilient and had a better academic performance than on-campus students.

Elderly population constitute a significant share of demand for health services and thus the cost of services provided to this population is important from health economic perspective. Therefore, this study aimed to estimate the medical and non-medical direct and indirect costs among elderly population who referred to selected hospitals of Iran University of Medical Sciences.
This cross-sectional study was conducted on 400 elderly patients admitted to Firouzgar and Rasoul Akram hospitals in 2015. Medical and non-medical direct and indirect costs were collected using a checklist and the data were analyzed with an SPSS statistical software.
In this study, the mean cost of elderly patients was 3,801,081 Rials for one month. Direct medical costs had the highest share and the indirect costs had the lowest share of the total cost for elderly patients (2,992,276 and 217,088 Rials, respectively).
Discussion and Although direct medical costs had the highest financial burden on older patients, the non-medical direct and indirect costs also constituted more than 20% of the total cost for elderly patients. Therefore, all components of costs should be considered in the planning and policy-making in the health system.