مجله تصویر سلامت
سال دهم شماره 1 (بهار 1398)

Selection and employment of more competent managers is the most essential decision making for attaining the goals and improvement of organizational performance. Therefore, this study was aimed to identify and rank the competency criteria for selection of the managers in Tehran University of Medical Sciences. This was a mixed method study induced in three phases including literature review using key words in databases, interview with expert panel and utilization of a reseacher-made questionnaire, all criterias of selection and ranking of managers were collected. SPSS software was used for data analysis and presentation of descriptive and analytical results. The results of this research showed that leadership criteria with mean score of 87.71 and personality traits with 87.02 were the most and demographic characteristics was the least important criterias for selection of managers. Establishment of competency-based selection and employment system of the managers need different and various criteria which can be utilized in Tehran University of Medical Sciences and other educational organizations.

The most important strategy for controlling diabetes is self-care. This study aimed to determine self-care ability of people with diabetes who referred to clinics of Tabriz University of Medical Sciences. In this descriptive-analytical study, 350 diabetic patients referred to Clinics of Tabriz University of Medical Sciences were evaluated in 2015. Data were collected using Tubert, et al (2000) questionnaire. Data were analyzed using SPSS v.23 software and chi-square and one-way ANOVA tests. The results showed that 93.1% of the participants in the study were type II diabetes. The self-care capacity mean of the research units was moderate (3.4 of 7). The most commonly used self-care behavior was the timely use of medications (5.79 of 7), with less general physical activity, exercise, and continuous examination of shoes. Variables such as age, gender, history of illness and education showed a significant relationship with self-care capacity of individuals. Also, the highest monitoring of the complications of the disease was related to performing HbA1c test (in 78.6% of samples). Referring to ophthalmology, dentistry and flu vaccine accounted for a smaller percentage. Considering the important role of self-care activities in controlling diabetes, physicians need to plan and implement their patient’s self-care behaviors during interventions by examining their self-care behaviors and determining their self-care needs.

Because of the increased using of herbal medicines, these drugs are becoming vital. By reviewing Iran’s drug supply chain, we find out consumers have less knowledge about the type of drug and its manufacturer, therefore pharmacies are the main clients of pharmaceutical products. This makes the role of pharmacies very important in profitability of the supplier and distributor of herbal medicines. Therefore, the purpose of this study was to identify the distribution problems of herbal medicines from the perspective of pharmacies. This was a qualitative study. The statistical population of this study was pharmacies of Tehran and Qom cities of Iran in 2018; among which 22 pharmacists in charge of drug acquisition were selected through judgmental and snowball sampling method. We used exploratory interviews to collect data and by content analysis method, meaning themes and primary units were done during the data collection and interviews. Finally, by using axial coding, final codes were categorized. The most important problems of pharmacies were recognized as lack of medical sales representative for physicians, lack of product, and difficulty in returning of the expired products, lack of medical sales representative for pharmacies and lack of specialized sales channel of herbal medicine. In addition to distribution problems, the problems of other marketing elements affect the distribution of herbal medicines as well. Also, distribution problems of these drugs are more affected by the elements of the product itself rather than the distribution elements.

Given the complexity of the ruling in organizations, currently knowledge management can be considered as a guide for management practices. Complicated conditions have caused sweeping changes in management of organizations, especially in hospitals, which should be responded to these changes. The knowledge-oriented leadership can be a good answer to these. So, the impact of knowledge-oriented leadership on knowledge management practices in public hospitals was the main objective of this research. This study was a descriptive survey, and an applied research by the objective, and according to the research goals that measure the effects of variables, it is a hypothetical-deductive type. Study population consisted of 631 health sectors of public hospitals in Tabriz. In this research, sampling was done by multi stage cluster method and the views of the managers of 169 health departments were used to collect data. Data analysis was conducted by structural equation modeling. Software outputs indicate a positive and significant impact between knowledge-oriented leadership and knowledge management practices. Also, knowledge-oriented leadership has the greatest impact on knowledge application. The results show that practices of creation, storage, transfer and application of knowledge management has strong relation with knowledge-oriented leadership. In other words, attention to existing knowledge will improve the knowledge of hospitals.

Brucellosis is one of the common zoonosis. This study aimed to map out epidemiological aspects of the disease in the city of Divandarreh, Kurdistan province, Iran between 2013 and October 2016. This study was a descriptive cross-sectional, in which the population under the study were census-based and all cases were included in the study between 2013 and 2016. The research method was referring to patients' files in the city health center and collecting information as followed in the checklist designed based on the variables of the research. During the study period, 790 cases were diagnosed with brucellosis. The highest prevalence was among men (52.55 per 10,000), in the summer season (34 per 10,000), among ranchers (51.46 per 10,000) and in the age group of 20-35 years old. Divandarreh is one of the areas with high prevalence of brucellosis in Kurdistan province. Due to the high economic costs of this disease, more effort is needed to educate the people of the region about not keeping the livestock in their place of residence and not to drink raw milk. it is also suggested that the level of cooperation between the Department of Veterinary Medicine and the City Health Center should increase.

Disaster incidence rate is very high in Iran and hospitals as the most important settings for treatment of wounded and injured people need to be prepared to accomplish their mission at crisis time. This study aimed to determine preparedness of Ahvaz educational hospitals for confronting disasters. This descriptive and cross-sectional study was conducted in educational hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. Data gathering instrument was a checklist which included 220 questions. Its validity was confirmed by content analysis. Kappa reliability test approved checklist with 0.8. Due to small study population, all the training hospitals were included in the study. Data were analyzed by SPSS 17. First, the total score of each hospital was calculated from the checklist in each component, and then the percentage of each hospital was determined in all components. Preparedness level was considered as poor for the average scores less than 50%, relatively prepared for average scores between 50% to 80%, and perfect for the average scores over 80%. The mean score calculated for the studied hospitals was 58%; so the studied hospitals can be estimated relatively prepared in case of disasters. The traffic component with 70% and the evacuation and transferring component with 29% were the highest and lowest dimensions, respectively. The overall preparedness in each hospital was calculated between 51- 63 percent. Studied hospitals were estimated relatively prepared in all preparedness components except for the evacuation and transfer; and overall preparedness estimated as relatively well. It seems necessary for these hospitals to revise and update their disaster plans, in order to improve different components of preparedness; especially the evacuation and transferring.

Having clear picture about how information is used in hospitals can be effective in stabilization or correction of information flow cycle, decision making, planning and supervision of hospitals. This study tried to evaluate the use of information in hospitals. This study was conducted in all hospitals in Tabriz (20 hospitals) using qualitative method. Participants (40 participants) included hospital managers and senior experts appointed by managers. Data were collected through semi-structured interview with participants by using an interview guideline about how hospitals use services information, information about beds, medicines, medical errors, information about customers and financial data. Thematic analysis was used for analyzing data. Overall, 12 main indicators about use of information were extracted. Coordination, quality management, human resources management and education were the most frequent outcomes of using information in hospitals. Convening meeting and managing personnel were the most frequent action that authorities had taken in reaction to received information. Huge amount of information is produced and distributed among authorities in hospitals every day. Results indicate that the use of information is limited and in most cases results in convening meeting or coordination. Part of information, despite collection, is not reported to anyone. It can be concluded that information production and distribution cycle in hospitals needs revision.

The goal of continuing medical education is improving the skills, performance and updating the knowledge of health care professions. To achieve this goal, need assessment should be performed prior designing programs. The purpose of this study was to systematically review the variety of the need assessment methods and extracting need assessment gaps in continuing medical education. This systematic review was performed by searching the Medline/PubMed, Web of Science, Scopus, Eric, ProQest, Google Scholar, Magiran, Iran Medex, and SID databases by both Persian and English keywords. We included studies from 1987 to 2018. The results of all studies were reviewed by two researchers using CASP checklists. Among 631 articles, 27 articles were included in the study. The results showed that 41% of need assessments were based on felt need by the learners. Need assessment based on patients need and overlapping service delivery by several professions has been less performed. Need assessments were focused more on medicine, dentistry and nursing. Some of the studies had used several approaches to extract needs. So, the patients and overlap services need assessment could be expressed as a missing link in the continuing medical education need assessments, which it will eventually cause damage to the community. For achievement comprehensive needs assessment, we can be used several need assessment approaches. Since medical service is a team work, those in charge of continuing medical education need to perform educational need assessment to promote education and treatment by empowering the members of treatment team.