فهرست مطالب امیرعباس کشاورز اخلاقی

Considering the benefits that a welcoming environment can have for the patients and their families, and specifically for people with mental disorders, this study aims to launch a welcoming program in the Iran psychiatric Hospital and assess its effectiveness in improving the quality of and satisfaction with the services for patients with mental disorders.

The welcoming unit of the hospital was officially launched and began to operate since September 2017. In the welcoming program, the nurse first introduced herself to the patients and their families, and if needed, made them familiar with the hospital and its goals and environment, how to reach psychiatrists, and regulations during hospitalization. This program continued by acquainting patients with their rights, the hospital's rules, treatment team, welfare amenities, inpatient wards, electroconvulsive therapy unit, clinics, support center, and by handling complaints and criticisms. For internal evaluation, a survey form with 5 open-ended questions was designed without including demographic characteristics and distributed among the hospital departments. The responses were collected and analyzed using the content analysis method.

The results of internal evaluation showed that 92% of the patients and their families were satisfied with the welcoming program and perceived it as very good and excellent. Half of the patients and their families (50%) believed that some nurses were caring and some were careless and did not take care of problems well. They perceived that psychiatrists and psychologists did not spend much time with the patient, and their visits were done very late.

Based on the perceptions of the patients and their families about the welcoming program, it seems that they are satisfied with the program in overall. The result can motivate other psychiatric and non-psychiatric centers in Iran for the implementation of a welcoming program.

Mental health in Iran was approved in 1988. However, and then this program was integrated into the primary care system in our country and was implemented within the villagerschr('39') family physician program with great success. In urban areas, there is no structured health network. However, regarding the demographic changes in the countrychr('39')s population, huge sprawling of cities, and the changes in urban-rural population proportion, demands for a coherent plan to provide mental health services to the urban population are felt more than ever. This study aimed to investigate the feasibility and establishment of a model of urban mental health network for severe psychiatric patients.

This plan is based on resource reviews, Use the experiences of other countries, Model World Health Organization, The services available in the country currently run by the beneficiary organizations, Description of the responsibilities of the responsible organizations, Collaboration between the Ministry of Health and various organizations responsible for mental health, Having the views of national expert and international constant in this field from other countries cooperated with the aim of examining how to compile a coherent and integrated urban health service plan. This model is estimated by community-based services for 100,000 people.

 The proposed model for providing immediate psychiatric services with greater cohesion and increasing training and skills capacity among staff 110, 115, 1480, and 123 services, as well as a space for hospitalization of 3 to 5 emergency patients next to the public hospital, is recommended. Depending on the number of patients in a population of 100,000, we will need community-based services, including 2 to 3 home visit teams to cover 80 patients per team, and 3 daily centers to provide services to 40 patients. If community-based services are provided, we will need 12 acute psychiatric beds and 5 beds for mid-term rehabilitation to provide inpatient services. In terms of employment and accommodation, 50 patients will need supported employment, respectively, and two apartments with an area of about 60 meters will be needed to accommodate about eight people. The provision of the above services requires the equal participation of the interested organizations. The family physician will play an essential role in continuing medical care for severe and mild psychiatric patients under the constant supervision of specialists

To achieve a better model of mental health services in cities that can cover a wide range of people in urban areas and at various levels from prevention and care to treatment and rehabilitation, we need the coordination between the organizations providing these services for the accurate planning of the interests of each organization, elimination of duplicate services, and saving human capital and resources of the country.

Many psychiatric studies increasingly have focused on the spirituality and the concepts related to it are educated by many universities around the world. In spite of the activities for removing the available defects in this field in Iran, but there is not any clear picture about what subjects of spirituality should be read by medical residents. The aim of the present study is responding to this question in the field of psychiatriy.
In this study, the Educational resources of psychiatry residency were analyzed by using of the analyzing the inductive qualitative content method. The considered resources were final board exam psychiatric reference textbooks in 2014, the published articles in the Iranian journals in the field of education over the past 10 years as well as the articles from the foreign journals which have been used in the this field over the past 20 years.
A total of 153 paragraphs and 9 tables in the reference textbooks and 37 articles in the journals were available for spirituality and its related issues. In the qualitative analysis of the texts, results were classified into the 5 groups and 20 subgroups. The themes were: fundamental perspective to spirituality, to need spirituality in the difficulties, spirituality in the treatment, spirituality as mediator, and negative spirituality.
The subject of spirituality in psychiatric has been considered in the relatively high volume of the resources of the psychiatric board exam in Iran. Therefore, it shows the importance of this issue; however, the volume is small in comparison with the total volume of the references. In addition, due to its dispersal and concealment among the other learning subjects, its education and functionality faces to difficulties.