فصلنامه مدیریت پرستاری
سال دهم شماره 1 (پیاپی 35، بهار 1400)

Covid 19 disease is a pandemic disease in the world that has been receiving global attention since March 2020. Due to the high prevalence of this disease and its rapid spread, it is very important to identify various manifestations including respiratory and systemic manifestations.

This is a case-control and retrospective analytical study. The sample size is 180 children who were sampled by two offices selected from pediatricians and pulmonologists in Qom. Study variables in both groups were analyzed by SPSS software and descriptive tests and chi-square test.

The results of this study showed that dry cough (88.9%) and runny nose (36.7%) are the most common complaints in children in case and control groups, respectively; However, bloody sputum was the least common in both groups. Chi-square test showed that there was a significant increase in sputum cough, sore throat, diarrhea, body aches, wheezing, chills, runny nose, short ness of breath, weakness and dry cough in the case group compared to the control group.

The results of this study showed that the type and frequency of clinical symptoms in children who have at least one parent with coronavirus disease are different from children who have healthy parents. It is recommended that parents with corona do not delay in isolating themselves from others.

Job burnout means physical, emotional  and mental fatigue that require prolonged exposure to hard work. This syndrome is a condition in which peoplechr(chr('39')39chr('39'))s strength and ability for work decreases. The purpose of this study was to investigate the impact of individuall characteristics on  job burnout by examining  mediating role of job stress and social capital among nurses In the year 2019.

This research is an applied research and  the method is descriptive-correlation. The statistical population of the study consisted of all nurses working in Imam Reza hospital in Urmia. The sample size was estimated to be 162 according to Morgan table and simple  random sampling method was used. The data collection tools were demographic questionnaire, Maslach burnout questionnaire, Everly- Girdano job Stress questionnaire and Nahapiet & goshale Social Capital questionnaire. Content validity and construct validity were used to determine the validity of the questionnaires. The internal reliability of the questionnaire was calculated by Cronbachchr(chr('39')39chr('39'))s alpha coefficient 0.89, 0.81 and 0.94, respectively. Data were analyzed using descriptive statistics such as mean and standard deviation. Pearson correlation coefficient was used for inferential statistics and structural equation modeling was used to test the hypotheses.

Findings showed that there was a significant relationship between individual characteristics of age with job stress (r=-0.69) and social capital (r=0.79). The relationship between work experience and social capital (r=0.76) was confirmed, but there was no significant relationship with job stress. Also, there was a significant relationship between job stress and social capital with job burnout (r= 0.16 , r=-0.72). Based on the findings of the study (B= 0.30), determining the role of mediation, lower job stress at early age had an impact on job burnout, but the role of mediation in the relationship between work experience and job burnout was not confirmed. Finally, social capital influences the relationship between individual characteristics (age and work experience) and job burnout (B= 0.06 , B= 0.42).

According to the findings, it can be concluded that paying attention to personal characteristics and developing social capital and reducing job stress through holding training classes in hospitals can be of significant importance in reducing burnout among nurses.

The ethical atmosphere in hospitals is one of the factors of moral growth and affects the quality of care. Human resources in todaychr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s world are considered the best competitive advantage of any organization and human beings are more important than ever in the theory of organization. Manpower, as much as it can help organizations compete, can be a serious obstacle to the organization. The purpose of this study is to investigate the effect of the ethical atmosphere of the hospital as an important organization in society on nurseschr (chr(chr (chr('39')39chr('39'))39chr(chr ('39')39chr('39'))) 39chr (chr (chr ('39')39chr ('39'))39chr(chr ('39')39chr('39')))) professional affiliation.
Research

This research is a descriptive-analytical cross-sectional study. The study population consisted of 450 nurses of public hospitals in Khorramabad, which was selected using available sampling in proportion to the volume and based on Morgan table, 210 of them were selected. Data collection tools included the Victor and Cullen Ethical Atmosphere Questionnaire (1987) and the Shaofley et al. (2003) Affiliate Questionnaire with a five-point Likert scale. In this research, 3PLS software was used to test the hypotheses and test the model. Combined reliability, convergent validity, and Cronbachchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s alpha were also used to fit the model.

The findings of the study showed that the ethical environment of the hospital (instrumental, attention, independence, organizational rules and regulations, professional ethical rules and regulations) at the level of 95% confidence with a regression coefficient of 0.921 on nurseschr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))) job affiliation. Is a transition (P <0/001). The results also showed that at the level of 95% confidence in the dimensions of the hospital ethical space, which includes instrumental ethical space, attention, independence, organizational rules and regulations, professional ethical rules and regulations, a positive and significant effect on nurseschr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))) job affiliation. Has (P <0/001).

Based on the findings of this study, it can be seen that by strengthening and improving the ethical atmosphere of hospitals, we can have a positive effect on nurseschr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))) job affiliation, and through this group of hospital staff, can improve the performance of this organization. .

A phenomenon called medical tourism is one of the growing sectors of the tourism industry in the world today and it is considered as one of the attractive industries in the fields of economy, job creation, introduction of cultures and even creating political interests for countries. Iran, with its potential and actual capacities in the field of tourism as well as medicine and treatment, can become one of the tourism hubs of Asia with the optimal use of these capacities, but so far this field of business in Iran is coherent and it is not systematized.

 13 hospital managers were interviewed. Based on Thematic Analysis Method, the content of the interviews was analyzed and a proposed model was presented. Based on the obtained model, 7 factors were identified as effective factors. Behavioral quality of medical staff, specialized quality of medical staff, treatment costs, quality of medical centers, perceived image of Iranian medical brand, quality of treatment process and components of treatment destination. Then, according to the obtained model, a questionnaire was designed and distributed among medical tourists in Tehran medical hospitals. Two concepts of validity and reliability were used to validate the questionnaire.

The results showed that all factors identified from the interviews were confirmed and the model was sufficiently valid.

The outbreak of coronavirus has led to both economic and medical problems in many developing countries that has created a conflict between subsistence and health, which suggests the need for models to manage this conflict.

First, the factors affecting the prevalence of corona virus in the community were extracted via literature review.  These factors have different effects on infection, but there isn’t any numeric weight of that effect. Experts who are familiar with this virus and how it is transmitted can verbally compare the effects of these factors in pairs. The hierarchical analysis method can obtain this information and through the help of EXPERTCHOICE software can calculate the weight of each factor. Cardiologists and internal medicine physicians in Ghaem Hospital of Mashhad were selected as experts in 1999 and interviewed in groups. Thus, for the proposed factors, the effect weight was calculated. A number of jobs in Mashhad were selected and they were studied. Prevalence factors in each studied job were evaluated based on Likert scale. To calculate the risk of each job, the sum of factors was calculated by consideration of the weights. So, after getting the weights, for each job based on the work study, the risk of prevalence is calculated for each jobs. But jobs have different importance for reopening. The importance of reopening was explained by the Likert scale based on peoplechr(chr('39')39chr('39'))s dependence on that job. Jobs that are low-risk and high-priority are given priority for reopening. Therefore, by dividing the level of risk into the importance of the job, an index is obtained that explains the priority of job reopening. The lower the index, the earlier the job.

Three factors of social distance, duration of exposure to individuals and population density were weighed according to the hierarchical analysis method. Then 13 jobs were selected and studied. For each job, based on the Likert scale, the importance and values of the three mentioned factors were determined. And these jobs were prioritized. Priorities of the jobs studied in this study are:.: bakery, supermarket, physician, bank employee, nurse, taxi driver, factory worker, public transport providers, education, kindergarten, hairdressing, Sports club and cinema.

In order to develop a health protocol in order to manage the conflict between subsistence and health, it is necessary to use a logical model. Based on this model, it is possible to reopen businesses step by step that overcomes the conflict between subsistence and health with minimum side effects.

Undergraduate education should be able to establish the basic level of clinical competence to care for and maintain patient safety in novice nurses. Examining the clinical competencies of novice nurses from the perspective of nursing managers can identify aspects of the competency of novice nurses that need to be improved.

The present study is a cross-sectional descriptive study that was conducted to evaluate the clinical competence of novice nurses from the perspective of their head nurses in selected teaching hospitals of Mashhad University of Medical Sciences in 2020. 100 novice nurses working in three major teaching hospitals Mashhad participated in this study. Data were collected using a clinical competency evaluation and a demographic information form. The Creighton Competency Evaluation Questionnaire was completed by the head nurses. Stata software version 14.1 and descriptive and robust regression indices were used to analyze the data.

The results showed that the mean age of participants was 24.23±1.72 and their mean clinical competence from the perspective of head nurses was 59.55 ± 16.26 equal to 65% of total score. Using robust regression, the relationship between competence and the studied variables was investigated and there was no significant relationship with any of the variables (p>0/05).

 Improving the competence of nurses to increase the quality of pateint care is one of the main program of nursing managers.The clinical competence of novice nurses in the dimensions of patient assessment and clinical judgment from the perspective of head nurses had the lowest score that should be planned to improve it. Considering that there was no significant relationship between contextual variables and variables such as interest in the profession, the duration of work experience with clinical competence, it needs further study on the validity of competency assessment from the perspective of head nurses.

The main purpose of this study was to identify and determine moral virtue indicators in clinical centers and to examine their impact on quality and treatment care, as well as the to rank identified moral virtue indicators.

The research method is analytical descriptive. The statistical population was 200 experts and medical specialists. The sample size was 131 people. Moral virtue dimensions were determined by Delphi method using the experiences of experts. Using SPSS and LISREL software, two types of descriptive and inferential statistics were applied to analyze the data. Path analysis method was used to investigate the impacts of the moral virtue dimensions on the performance of medical centers and ANP network analysis process and Super Decision software were used also to determine the coefficients of importance of each of the indicators and dimensions of moral virtue.

The criteria were identified from the literature of previous research and studies and interviews with experts. In order to optimize the data analysis process and to select the most important criteria to enter the analysis process, the factors in each category were reviewed and the most relevant factors were specified. Considering the fact that the t-statistic between the variables of health and treatment services and all indicators of employee ethics is greater than the value (1.96), the relationship between the quality of health services and all indicators of employee ethics became significant at 99%. The findings showed that the moral virtues of the staff at medical centers affected the quality of services. According to the analysis, the criteria of the patient honor group (C3) had the highest role and in terms of importance, they held the most important category of criteria in the  moral virtue indicators in clinical centers.

The spiritual and responsible behavior of nurses with patients has been found to have an effective role in improving and restoring their health, so the nursing profession is based on ethics. Therefore, observing ethical virtues in nursing practices is more sensitive and important than other cases of care, which can also affect the quality of medical services.

The prevalence of COVID-19 has caused concern and anxiety in the community. Due to direct contact with patients, nurses have an important role in preventing the spread of COVID-19 and this causes psychological problems in them. Therefore, this study aimed to investigate the turnover intention (TI) of nurses in the outbreak of COVID-19: the role of compassion fatigue (CF), compassion satisfaction (CS), and burnout (BO).

The research method was descriptive-correlation. In this study, 312 nurses in Malayer public hospitals participated in the study by census method. TI scale (Cammann et al, 1979) and The Professional Quality of Life Scale (Stamm, 2005) were used to collect the data. The validity and reliability of measuring instruments have been confirmed. Multivariate analysis of variance (MANOVA), Pearson correlation, and multivariate regression with enter method were used to analyze the data.

The rate of TI, CS, BO and CF in nurses in the outbreak of COVID-19 were 56.41%, 29.81%, 86.54%, and 85.89%, respectively. Female nurses compared to males had higher levels of BO and CF, TI, married nurses compared to single had higher levels of BO and CF, nurses with bachelorchr('39')s degree compared to nurses with masterchr('39')s degree had low levels of CS and high level of BO (p<0.05). ICU and CCU nurses had higher levels of TI, BO, and CF and lower levels of CS than nurses in other wards (p <0.05). There was a significant relationship between CS (r = -0.34), BO (r = 0.36) and CF (r = 0.19) with TI of nurses in the outbreak of COVID-19. Based on the results of multivariate regression, Cs, BO and CF have explained 0.20 of the TI (p = 3.1; f = 25.01). Based on the beta value, CS and CF and BO had a significant role in explaining the TI, respectively (p <0.05). (p <0.05).

According to the findings, psychological program based on the components of quality of work life, such as CS, BO and CF in the outbreak of COVID-19 can be effective in reducing the TI of nurses.

Medical tourism is one of the important sub-branches of the tourism industry. One of the factors influencing the choice of hospital by the tourist is the way of providing hotel services in hospitals.

The research was a descriptive correlational study conducted in 2009 in selected private hospitals in Tehran. A researcher-made questionnaire was used to collect information about the components of hoteling and a Shahroudi questionnaire was used to examine the observance of the components affecting the attraction of health tourists. The samples included 78 employees of the international department of two private hospitals in Tehran. To measure normality, Kolmogorov-Smirnov tests and multivariate regression and Pearson correlation coefficient were used to measure and determine the relationship between variables by SPSS 21.

This study showed that there is a significant relationship between the six pillars of hospital hotels with the attraction of medical tourists. Pillars of "buildings and installations" (p <0.05), (r = 0.231), "equipment and facilities" (p <0.05), (r = 0.263), "welfare services" (P <0.05), (r = 0.357), "cleaning and hygiene services" (p <0.05) and (r = 0.234), "nutrition" (p <0.01), (r = 0.393), and "administrative affairs and workflow" (p <0.01), (r = 0.332), are directly correlated with the attraction of medical tourists. It was also found that "human resources" is not correlated with the attraction of medical tourists.

In order to attract more medical tourists, it’s necessary that hospital managers and health policy makers pay more attention to the hoteling pillars, especially "nutrition" and "administrative affairs and workflow", which have the most correlation with attracting medical tourists.

The maintenance of specialized physicians in deprived and less developed areas is of great importance so that if their maintenance is not considered, it will cause problems in the health of the community.

The present study was a qualitative study. Participants in the study included 20 experts, physicians and health managers in less developed provinces and disadvantaged areas who were selected by snowball sampling and invited for interviews. Grounded theory method was used to analyze the data and all data including the results of theoretical foundations, upstream documents and interviews were coded and classified.

The final model consisted of three organizational, environmental and individual factors of retention of specialist physicians in disadvantaged and underdeveloped areas. After analyzing the upstream documents, interviews and open coding and selective coding in the upstream documents section, the two main categories include physicianschr('39') welfare and social and psychological support of physicians, and in the interview section, the eight main categories include; Facilities needed by specialized physicians in deprived areas (10 concepts), problems in maintaining specialized physicians in deprived areas (18 concepts), positive results in maintaining specialized physicians in deprived areas (11 concepts), negative results, lack of specialized physicians in deprived areas (12 concepts) , Motivational conditions for keeping specialized physicians in deprived areas (13 concepts), strategies for keeping specialized physicians in deprived areas (12 concepts), factors of reluctance of specialized physicians in deprived areas (15 concepts) and the current situation of specialized physicians in deprived areas (9 concepts) Extracted and placed in the model.

Three organizational, environmental and individual factors are effective in retaining specialist physicians in deprived and less developed areas. Accordingly, decision-makers can plan according to the identified factors in order to improve the maintenance conditions and provide the required manpower in deprived areas.

 The aim of this study was to investigate the various aspects of the implementation of the health system transformation plan after seven years of its implementation in Iran.

 The present study was conducted in two phases in 2021. In the first phase, a comparative study of health system reforms and developments in selected countries of Turkey, Malaysia, South Korea, Mexico and Brazil was reviewed. In the second phase of the research, using the narrative review method, the published studies on the impact of the Iranian health system transformation plan were searched and summarized, and information about the researchers, the province where the study was conducted, and their most important findings were extracted. Data analysis was performed as a comprehensive review of articles, qualitative summary and final conclusions.

The effect of health transformation plan on the performance of services in the dimensions of natural childbirth and cesarean section, stakeholder satisfaction, performance evaluation of providers and the volume and amount of services used and the effect of health transformation plan on the function of financing in the dimensions of household financial participation, payment Out of pocket, the financial performance of departments and units, health and insurance expenses, and informal payments were identified and reviewed.

 The findings of the present study showed that the health system transformation plan in Iran after seven years and with the implementation of various steps and packages, in the areas of reducing out-of-pocket payments, cesarean section rates without indication, non-payments Formalism and access to health services have to some extent been able to achieve predetermined goals.