فهرست مطالب سمیه حسام

Identifying factors that influence the patient experience are critical to implementing strategies that support patient engagement and ultimately achieve better health outcomes. The present study was conducted with the aim of presenting a model of empowerment of hospitalized patients.

The current research was a qualitative-quantitative study that was cross-sectional by stratified sampling method with proper allocation in hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran, on 230 heads, managers, matrons, supervisors, heads of clinical and paraclinical departments and hospital headquarters units, nurses and doctors were done. The data were collected using the demographic information tool and the questionnaire made by the researcher to design a model of empowering patients admitted to the hospital. Determining the ability of the designed model by fitting the data was done with the confirmatory factor analysis method. Data were analyzed by SPSS version 16 software and Amos.v 24 software.

Questionnaire for designing a model of empowering patients in the hospital has 8 areas and 61 items or components. In the present study, the Chi-square ratio to the degree of freedom was significant (p<0.001), which indicated the appropriate fit of the model. The value of the GFI index was estimated at 0.93, which indicated that the model fits well. The values of GFI and AGFI for the empowerment model of hospitalized patients were higher than 0.8.

Organizations and medical institutions have the opportunity to utilize this model to empower patients. The universities of medical sciences and affiliated hospitals should create an enabling environment for enhancing patient empowerment.

Health tourism is an organized trip from one's living environment to another place, which is done in order to maintain, improve and regain physical and mental health. The purpose of this research was to identify the most important factors affecting medical tourism in Iran.

This was a fundamental study that was conducted in two phases. The first phase consisted of two steps. The first step was to perform a systematic review with the keyword of "MEDICAL TOURISM" on Web of Science and select 434 articles, and the second step was to perform a scientometric analysis on these articles using VOSviewer software. The second phase consisted of three steps. The first step was a systematic review with some keywords, including "MEDICAL TOURISM" and "medical tourism" on foreign and domestic databases and selecting 63 articles. The second step was to perform a content analysis on the selected articles using Nvivo software and identify the components affecting medical tourism in the world. The third step was the implementation of a Delphi method using a Likert scale with the aim of identifying the most important factors affecting medical tourism in Iran from the point of view of academic experts.

The first phase showed that the scope of research on the topic of medical tourism in the world had an upward trend from 1975 to 2020, and the countries of America, Canada, Malaysia, South Korea and Iran were the top 5 countries in this field. In the second phase, 46 factors affecting medical tourism in the world were identified, and after summarizing the opinions of experts, 39 indicators were determined as indicators affecting medical tourism in Iran.

Considering the high number and variety of factors affecting medical tourism in Iran, the development of this industry in the country requires extensive intra- and inter-sectorial coordination.

Medication errors reduce quality of life, immune system function, and cause significant mortality in children with HIV/AIDS. The present study was conducted with the aim of identifying and explaining the factors affecting the management of medication errors in children infected with HIV/AIDS virus in Iran's health system.

The current study was a descriptive one conducted in 2020-2021. At first, by reviewing the research literature and interviewing experts in the field of treating children with HIV/AIDS virus, the main factors affecting the occurrence of medication errors in children with HIV/AIDS virus were extracted and using them, the research questionnaire was designed. Data were collected from 400 experts in the field of treating children with HIV/AIDS virus and analyzed using exploratory factor analysis and through SPSS version 16 and Lisrel software.

Four factors included organizational factors (p < 0.001), individual factors (p < 0.001), educational factors (p < 0.001) and communication factors (p < 0.001), were identified as effective factors in the management of medication errors in children with HIV/AIDS virus. Factors including Individual, communication, organizational and educational with respective factor loadings of 0.84, 0.81, 0.79 and 0.77 had an effect on the management of medication errors in HIV positive children.

For successful management of medication errors in children infected with HIV/AIDS, it is advisable to prioritize individual and communication factors (i.e., behavior-based disease counseling specialists) while attending to all four of the relevant factors.

Patient safety in the health care system is a worrying issue and one of the biggest threats in the health system is related to medical errors. Efforts to minimize these problems lead to progress and development in patient safety in hospitals and subsequently lead to prevention, reduction of accidents and injuries caused by providing patient care. From injuries caused by providing patient care, medication errors, surgical complications, incorrect diagnoses, delay in diagnosis, non-diagnosis, failure of devices and equipment leading to wrong diagnosis and other cases such as hospital infections, patient falls, bedsores and others. The cases can be named. It is important to improve the culture of patient safety in organizations according to the model of patient participation. This research was conducted with the aim of designing a model of patient participation in improving the culture of patient safety. The results showed that the designed model has a good fit. In this research, based on the research findings, an attempt was made to provide a comprehensive model for patient participation in promoting patient safety culture. The components and stages of the proposed model were designed using the results of a field review study and findings from semi-structured interviews with experts in this field and after statistical analysis. The presented model is the model of patient participation in promoting patient safety culture, which consists of 3 main factors: organizational factors, environmental and perceptual factors, and decision-making factors. In this model, each of the main factors includes several sub-components. Organizational factors (giving a sense of control and responsibility, heavy tasks and the number of manpower, management and leadership, response to errors) environmental and perceptual factors (communication in the field of safety, patient empowerment, teamwork, evaluation) decision-making in treatment (characteristics patient, patient cooperation and collaboration, raising awareness) were categorized. Finally, each of the sub-components will find objectivity and measureability by one or more items. A total of 58 items were considered for the model.

The current research was a description of structural equations. The statistical population included the employees of educational hospitals of Mashhad and Torbat Heydarieh universities of medical sciences, 536 people were selected as a sample by stratified random sampling method. The researcher-made questionnaire of patients' participation was used in improving the culture of patient safety. A reliability of 0.93 was obtained. LIZREL version 10 software and alpha level of 0.05 were considered for data analysis.

According to the results of this study, in the context of implementing patient participation in improving the patient safety culture in hospitals, first of all, attention should be paid to strengthening the dimension of "being accountable for mistakes", which, from the perspective of hospital staff, has the greatest impact on realizing patient participation. In promoting patient safety culture. After that, strengthening the dimensions of "ethics and ethical leadership", "organization and organizational control", "characteristics of the patient", "giving a sense of control and cooperative activities to the patient", "team work", "management and leadership" ", "manpower planning", "doctor-patient interaction" and then "patient evaluation" are in the next level of importance. The strengths show that the employees and managers of the departments have the necessary potential to promote the safety culture, but it is necessary to modify the procedures and policies at the level of hospitals. Today, examining and strengthening the patient safety culture has been widely considered by healthcare organizations. And the first step of improving patient safety is to evaluate patient safety culture; Team work and interaction between doctor and patient was a positive point, the strength of the patient safety culture. Non-punitive responses to errors were weaknesses of the patient safety culture. The results of this finding were consistent with other studies. This research has faced limitations. The statistical population of the research was limited to the employees of the medical departments of the selected hospitals of Razavi Khorasan province, so caution should be exercised in generalizing the results to other groups and cities. Another limitation of this research was the difficulty in communicating with some of the employees of the treatment department and determining the time required for the interview, and the time-consuming administrative bureaucracies to conduct the research, as well as the low accuracy of some people in studying the questions and answering them. According to the research results, it is suggested to carry out this research in other cities and geographical regions. Also, a model comparison of Iran with other countries is made.

The results showed that the value of t in all paths between the research factors was equal to and greater than 1.96. Also, the results showed that the fit of the general research model is appropriate and strong.

The purpose of this research was to investigate the factors influencing the attraction of medical tourism in selected educational and therapeutic hospitals of Shahid Beheshti University in 1401.

This research was an applied research. 200 managers and employees of these hospitals were included in the study, and 127 of them were selected as samples based on Morgan's table. In this research, the researcher made a questionnaire with 24 questions taken from the background of the research and by confirming the validity and reliability to the amount of 0/711 and 0/802 Used. Exploratory factor analysis test, sample t-test and confirmatory factor analysis with SPSS and PLS software were used.

In total, all factors with eigenvalues higher than one were able to explain 91.371 of the variance of 24 items related to the questionnaire. Considering that all values are higher than 0.7, therefore Cornbrash’s alpha of the research variables is confirmed. According to the AVE table, all structures are greater than 5. And as a result, the convergent validity of the model and the appropriateness of the fit of the measurement models are confirmed.

The investigations showed that the physical space of the hospital, the supporting infrastructure for foreign patients, the strengthening of the transportation system, the strengthening of marketing, the role of experienced medical staff, the quality of providing medical services, and the respect for the opinions of tourists are important in attracting tourists. Medical tourism has an impact.

Hospitals use natural resources; All of which have a negative impact on the environment. But they spread the concept of green hospital in the world by intelligent and sustainable use of natural resources. The purpose of this research is to investigate the factors affecting the implementation of the green hospital standards in the hospitals of the Social Security Organization in 1401 in GGHH model.

research was applied, quantitative and descriptive with targeted sampling (manager, quality improvement, environmental/professional health) in social security hospitals (sample: 210). The questionnaire was researcher made and the statistical method is Shapiro-Wilks, Wilcoxon and Friedman test in SPSS (0.001: p-values).

Components with more than average (CI: 95%) are of sufficient importance. The effectiveness of components in the energy sector has the highest rating (20.27) related to the use of energy efficient devices and the lowest rating (7.09) related to the minimum use of artificial heating. The effectiveness of the components in the food sector is the highest rating (10.83) related to the use of reusable food containers and the lowest rating (4.79) related to the supply of food inside the hospital. The effectiveness of the components in the water sector has the highest rank (8.35) related to the use of wastewater recycling and the lowest rank (3.42) related to the use of "water curtain".

According to the findings of the current research, with optimal planning and provision of resources to the standards of the Green Hospital, the GGHH model was implemented in hospitals.

Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication non-adherence in HIV-positive Iranian patients.

The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication non-adherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and   SPSS23 and LISREL software.

Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients.

To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease).

Smartening hospitals can be effective in improving the quality and providing faster and better services and increasing the possibility of tracking and security of the equipment in the hospital. The current research aims to identifying effective factors in making hospitals smarter.

The present research is a qualitative method of content analysis. The statistical population includes managers, doctors, experts in the field of hospital intelligence, hospital information and communication technology experts, and hospital medical equipment experts in 2019-2019. Sampling method was done in a purposeful way and by snowball method. Data collection was done through semi-structured interviews with 12 experts who are familiar with hospital smart issues. The data was analyzed by content analysis and using coding method.

The number of 135 primary codes, 22 sub-categories, and after combining the codes, 4 categories including information and communication platforms, advanced medical equipment and facilities, trained human resources and management in hospitals were identified as effective factors for making the hospital smarter.

In the present study, 4 categories including information and communication platforms, advanced medical equipment and facilities, trained human resources and management in hospitals were identified as effective factors for making the hospital smarter. It is suggested to use the findings of the present study for better performance in hospitals.

Patient participation in treatment decisions has been associated with improved treatment results. By checking the level of knowledge of patients and informing patients about the risks and benefits of treatment methods, the level of participation of patients in treatment can be checked. This study was conducted with the aim of determining the participation rate in the treatment of breast cancer patients. The current cross-sectional study was conducted in descriptive and analytical form in 2019. The statistical population includes 15 doctors who worked in the field of breast diseases and 300 patients with breast cancer who visited clinics and doctor's offices in the cities of Shiraz, Kerman, Rasht and Tabriz, who were selected by cluster random sampling. In order to measure the level of participation, a researcher-made questionnaire was used after validity and reliability. The data were analyzed using SPSS 20 software with the help of descriptive statistics and chi-square inferential tests. The findings of the research showed that patients' participation in treatment has a significant and direct relationship with age, education, duration of illness and income of patients (P value < 0.05). Based on the findings of this study, patient participation was reported in three areas (decision-making process (53%), doctor's practical behavior (67.6) and patient preferences (66.2)) and in general, the level of participation in the treatment of patients with Breast cancer was estimated at 52%. Empowering patients by increasing awareness about diagnosis and treatment, as well as covering breast cancer as a special disease and receiving treatment allowances, can help increase patient participation.

Providing health services to middle-aged people is of special importance due to the large population, productivity, and the impact of health behaviors of this age group on various aspects of family health. The purpose of this study is to evaluate the provision of middle-aged health services.

This was a qualitative   study performed in 2017 in   comprehensive health centers of Yazd city. Central part of Iran. Sixty two individuals (specialists, general practitioners and experts) providing health services in comprehensive health centers were selected through targeted sampling . Interviews were done with a semi-structured individualized method. Questions were asked in the following domains: weaknesses and strengths and recommendations about the method of providing services and its content.

According to the results, 15 weak points and 5 strong points in the method of providing services, and 8 strong points and 7 weak points about the content of health service packages and 17 recommended mechanisms about the improvement of the providing services and 11 recommended mechanisms about improvement of the content of packages were extracted. The main weak points in providing services were such as not observing referring system, lack of insurance coverage for some services, problems in Integrated Health Record System. The weak points of the packages of health services for middle-aged people were as lack of predicting the service packages for levels 2 and 3, repetition of the questions in evaluation, and low attention to social health and traditional medicine.

Concentrating on the improvement of the service providing and the contents of the packages of new health services by utilizing presented recommendations according to professional viewpoints of health service providers helps improve health level in this age group and increase the efficiency in the middle-aged people.

Basic and supplementary insurances play an important role in achieving universal health coverage. In developing countries, complementary insurances have many structural and organizational problems and inadequacies. The present study was conducted with the aim of investigating the factors affecting the service packages of supplementary medical insurance.

The current research is of a qualitative type with a framework analysis method that was carried out in 1400. 11 experts of the insurance organization and experts in the health system were selected as the research samples by the purposeful sampling method. MAXQDA software was used for data analysis.

The dimensions of the complementary insurance model of treatment in Iran based on the analysis of the opinions of experts and experts in Iran include five main dimensions: "laws and regulations, coverage of services, strengthening and creating a competitive market, developing standards for the use of services and treatment guidelines; Development of complementary insurances.

Based on the findings, efforts to develop a comprehensive package of complementary treatment services in the country in order to increase people's access should be considered by policy makers and the financial capacity to manage and finance universal health coverage should be increased. It is expected that with the scientific development of supplementary medical insurance, it will contribute greatly to universal health coverage in the country.

Patient participation in treatment decision-making has become a political necessity in many countries and health systems around the world. At the global level, how to deal with cancer patients has found a different approach. Considering that cancer affects a person's physical, mental and social health, patient-centered care can be one of the proper approaches for cancer patients. The purpose of the present study was to determine and investigate the barriers to participation in the treatment of breast cancer patients in Iran.

The present qualitative study was conducted in 2021.The data were collected using semi-structured interviews with the cooperation of 15 breast surgeons and 300 breast cancer patients who visited doctors' offices and clinics at Shiraz University of Medical Sciences, Tabriz, Gilan, and Kerman. Sampling of patients was done by cluster random method, 20 patients for each doctor. The validity and reliability of the questions were verified using the opinions of 15 experts. To end with, coding and classification of data was done using the paradigm model in the grand theory way. The data were analyzed using SPSS24 software and qualitative methods in Grand Theory.

The result of the present research indicated that the fear and anxiety of patients is the most important factor in non-cooperation and weak participation of patients during treatment. Patients’ lack of awareness and insufficient information was the second obstacle in poor participation in treatment decision making. Moreover, the findings indicated that the treatment costs had no effect on the continuation of the treatment process and the type of treatment chosen despite the occurrence of many problems for the patients.

The results of the present study indicated that fear and anxiety, not having enough information about the disease and financial problems are among the most important factors affecting patients' participation in treatment.

Patient participation is among the essential factors in providing high-quality and safe services in health care centers and a primary concernfor health system managers and policymakers.

The scientific model of this research was based on qualitative interviews with hospital experts (faculty members of universities), and the sampling method was both purposive and snowball. A total of 16 qualitative interviews were conducted with the hospital experts,and the grounded theory technique was adopted to identify the components of patient participation in improving the patient safety culture. The necessity of each component extracted fromthe patient participation model was examined. The research data were analyzed using the coding method in three stages: open, axial, and selective.

The results revealed100 unreplicated nodes (codes) extracted based on the conceptual similarities of the composition and 58 common codes.Based on the researchers’ intuition and understanding of the subject, the main components and sub-components of organizational factors (giving a sense of control and responsibility, heavy tasks and the number of manpower, management and leadership, and response to errors), environmental and perceptual factors (safety communication, patient empowerment, teamwork, and evaluation), and treatment decision-making (patient’s characteristics, patient’s collaboration, and raising awareness) were categorized as tree nodes.

According to the results of this study, Patient participation is an important issue in healthcare systems. Patients can play an important role in improving immunity by actively participating in health care. Patient participation is effective in improving the quality and safety of care.

The aim of the current research is to design a model to identify factors affecting the productivity of non-medical hospital employees. Today, all the countries of the world are trying to achieve a suitable position in the global competition scene and increase the welfare of people's lives by consuming fewer resources and producing more. Meanwhile, human resources, as one of the main factors and institutions of any organization, plays a significant role in the quality of the headquarters of that organization.

The research is applied and descriptive correlation and the data collection method is a questionnaire. The statistical sample of the research includes 135 non-medical employees of Maryam Hospital in Alborz province. Also, in order to test the research hypotheses, the Kolmogorov test, t-test, confirmatory factor analysis, structural equation analysis, and SPSS and Smart PLS software were used.

The research results indicate that research and development variables, organizational capacity, government laws, equipment life, energy costs, workforce composition, work ethics, and management have a significant impact on productivity. On the other hand, the stability and job security variable have no significant effect on productivity.

The results of the research show that research and development variables, organizational capacity, government laws, equipment life, energy costs, workforce composition, work ethics, and management can affect the productivity of non-medical hospital employees.

The present study was an attempt to use a scenario model to recognize the effect of the Covid-19 epidemic on the working capital. The researchers used the data of 98 companies of Iran Stock Exchange during the period 2016-2021 canonical co-integration regression estimation method. The results indicated the partial role of Stock ownership in normal conditions was caused growth in working capital, which the effect of Stock ownership was more appeared in the Covid-19 crisis. This means, that the growth rate is higher than usual in the face of crisis. In deed the Covid-19 epidemic caused damage the economy, through a decrease in investment rate and then this will caused to decrease in Decreased production and economic growth. If, with the increase of investment process and efficient management of working capital, the production process has increased so that the new infrastructures meet the production volume. Therefore, it is recommend to use support of government for short and medium term, especially for in responses to in Quick return support of investments government from the damaged parts is necessary due a pandemic. According to the results of the study, it is suggested that more attention be paid to the impact of unpredictable crises on the growth of the capital market.

The Ministry of Health influences the executive organizations through the high councils and the decision-making system. It is necessary to adopt an inter-sectoral cooperation approach, seek appropriate support for interacting with these councils, focus on the health taken decisions, and analyze their current situation. This study aimed to investigate the challenges and barriers to the interaction of high councils of health with the Iran Ministry of Health.

The present study is a field-based qualitative study that was conducted to analyze the current situation of the High Councils. Data were collected through interviews, group discussion sessions, and document analysis. To collect the data, 23 interviews and 2 focus group sessions were conducted using purposive sampling. The obtained data were then analyzed using MAXQDA software (version 10).
(Ethic code: 162432750)

The results of the study showed that in terms of activity, the elected high councils are divided into three categories of active, semi-active, and inactive. Challenges facing these councils include lack of financial and human resources, inadequate structure and organization, non-transparent rules and regulations, lack of executive guarantees, poor planning and cross-sectoral coordination, lack of monitoring and evaluation system, low level of awareness and attitude of policy makers and managers about health, poor leadership of the Ministry of Health, and finally the lack of a health appendix in approvals. The improvement of the performance of high councils in applying the health appendix to approvals can be achieved through such interventions as 1. Policy interventions, 2. Executive structure interventions, and 3. Culture building and advocacy.

According to the results of the study, it is necessary for the health system to develop inter-sectoral cooperation and seek appropriate support from high councils in order to fairly improve community health indicators, take action to reduce barriers to interaction through policy, executive, culture-building, and advocacy interventions.

The present study aimed to determine the causes of patients' readmission in hospitals affiliated to Bam University of Medical Sciences in 2019.

The current study was a descriptive-analytic study and the study population included patients readmitted in Pasteur Hospital in Bam, Javad Al-Aimeh Hospital in Narmashir, and Ayatollah Hashemi Rafsanjani Hospital in Regan in 2019. The samples consisted of 312 patient records which were chosen randomly. Data were collected by a checklist and were analyzed using SPSS software version 23 and descriptive and analytical tests (Chi-square and one-way analysis of variance).

The results showed that the internal medicine department received 34% of readmissions. The average readmission cost was 17,265,353 Rials. The most common reasons for readmissions were having a new disease (46.2 percent) and recurrence of the former disease (39.8 percent). Findings of inferential statistics revealed no significant relationship between the causes of readmissions and gender (P = 0.566), age (P = 0.065), or costs (P = 0.625), but there was a significant relationship between the causes of readmissions and marital status (P = 0.049) and married people had more readmissions than single people.

It is necessary to pay more attention to readmissions caused by disease recurrence. It is also possible to prevent such readmissions and improve the quality of medical services by standardizing hospital processes and tools, standardizing staff training, and employing new diagnostic and treatment methods.

Background and Objectives :

Public-private partnerships can lead to increased efficiency, equity, accountability, quality and access to services in the health system. The aim of this study was to explore the opinion of health system managers about the advantages, disadvantages and barriers of public-private partnership in the provision of primary health care services.

Material and Methods: 

We used both quantitative and qualitative methods to explore the opinion of experts about the objectives of the study. First of all a literature reviewe was done to identify the problems and challenges of public-private partnership in the health sector in the year 2020. Based on the literature review and interviews conducted with experts, a two-part questionnaire was developed to collect data. The sample for the interviews was selected by snowball method until saturation was reached. After the validity and reliability of the questionnaire were established, the questionnaire was completed by 100 health managers. The collected data were analyzed using Stata software version 14.

Results:

The most important benefits of public-private partnership in providing primary health care services from the point of view of health managers include providing financial resources for health services plans with an average of 4.02 (SD 1.00) , as well as the high technical and managerial efficiency in the private sector with an average of 3.90 (SD 0.60). Lack of full coverage of primary health care services and incomitment to social justice with an average score of 3.99 (SD 0.92) as well as the inadequate job security of human resources in the private sector with an average score of 3.97 (SD 0.9) were found as the most important disadvantages of partnership of public-private. It was revealed that the major barriers hindering public-private partnership in service delivery include "legal, and monitoring shortcomings alongside hampering rules and regulations in partnership with the private sector" with a mean score of 4.06(SD 0.60), "reluctance of health managers for risk-taking when in partnership with the pivate sector "with a mean score of 4.05 (SD 0.61) and" Insufficient expertise of government managers regarding knowledge of partnership with the private sector "with a mean score of 4.04 a(SDf 0.53).

Conclusion: 

It seems that managers' attention to the disadvantages of partnership, such as lack of full coverage of services and withdrawal from social justice, etc., can pave the way for developing much clearer and smoother public-private sectors’ partnerships.

Increasing pressure on available capitals in health care section, especially hospitals, underlines the need for analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and healthcare centers is using components of the marketing mix. This study endeavored to determine the related factors on patients' preference in choosing a hospital based on the mixed marketing model.

This study was conducted in Farhikhtegan Hospital in Tehran, Iran, in 2020. Simple random sampling was employed to select the sample from among 243 inpatients, outpatients, and clients of the hospital. A bi-part researcher-made questionnaire was used to gather the data (demographics and seven aspects of marketing mix); whose validity and reliability were deemed appropriate. Regarding the data analysis, one-sample t-test and Friedman test were used to rank dimensions and components and the analysis of variance (ANOVA) was used to compare the views of different classes of society.

All seven dimensions of the mixed marketing had a significant and different effect on the preference of the patients in choosing the Farhikhtegan Hospital. Manpower and promotion dimensions were the most and the least important dimensions, respectively. Among the mixed marketing components, sufficient expertise, family income, hospital’s reputation, physicians’ attitude, pacing of services’ provision, doctors' advice and degree of diversity, novelty, and advanced equipment came out to be the most effective components of each dimension of mixed marketing.

Considering the changes in the needs of the audiences in the health field, hospital managers can identify the patients' needs in accordance with the principles of marketing mix. Regarding the importance of manpower in the findings of this study, managers can attract the attention of patients with culture making and preparing practical guidance in appropriate treatment of employees.

Centers of long-term care and their caregivers are the most important resources. The aim of this study is to identify factors affecting the professional ethics of official caregivers in old age centers.

The type of qualitative research and its method is theoretical. The statistical population included experts familiar with the management of geriatric human resources and formal caregivers working in nursing homes and the research environment of nursing homes. Fifteen caregivers and 20 experts were selected from the target population by theoretical sampling method. The extraction of variables done with the Strauss and Corbin technique and the analysis method was a constant comparison with the opinion of the experts (Delphi technique).

The codes derived from the analysis of interviews in 6 subcategories: knowledge of care, caring and elderly personality traits, workload experience, effective communication between caregiver and elderly, support system of colleagues and management, each of which facilitated or prevented by nature In the process of care. Subclasses were categorized into the main threefold of individual factors and working factors and factors related to the elderly.

Based on the findings of the participantschr('39') experiences, facilitators and inhibitors factors, based on their nature, by facilitating or enhancing the care of the elderly, can be effective in respecting the observance of professional ethics by caregivers. Strengthening the facilitators through advancement of caregiverschr('39') knowledge by educating how to care, providing facilities, equipping them with care and designing older age care systems will lead caregivers to fulfill their duties.

Macro policies in the field of health tourism should be designed and implemented taking into account the facilities and environmental resources in order to provide a good opportunity to provide quality medical services to foreign patients referring to the country and create their satisfaction. The purpose of the present study was to identify and prioritize the factors affecting the management of health tourism development in Fars province.

The present qualitative-exploratory study was conducted in 2019. 20 experts active in the field of health tourism were selected by purposive sampling method with maximum diversity. After obtaining informed consent from the participants, the research data were collected by semi-structured in-depth interview method and then recorded in Maxqda-10 software and analyzed using directional and summary composite content analysis. In this method, the units of analysis in each step were the paragraphs recorded by the researcher in the process of interviewing the participants. During the content analysis process, different codes were first reviewed, then grouped into subcategories, and finally 70 subcategories and 23 main categories. The five themes of structural, behavioral, environmental, conservation and development were integrated. The collected data were analyzed using paired comparison matrix test with hierarchical analysis process.

The results of the present study revealed that the factors affecting the management of health tourism development in Fars province consist of 5 main categories including: structural factors, development and optimization, environmental, behavioral, and protective. The relative weights identified for each of these factors were 0.512, 0.276, 0.128, 0.053 and 0.032, respectively.

Structural, developmental and optimization, environmental, behavioral, and conservation factors had relative weight and significant incompatibility rates for health tourism development management. Therefore, the results of the present study inform high-level decision makers where and how to focus their efforts and resources to have the maximum impact on the management of health tourism development at the local and national levels.

The participation of people in legislative processes takes place via different methods. In the last two decades, Information and Communication Technology has vastly progressed and provided a greater capacity to support the participation of citizens in democratic processes. This technology is employed in various ways in different countries. Digital tools can transform parliaments, and so new media platforms and more transparent data help parliaments to communicate better with their citizens.The present study is a comparative study and the research environment included legislative meetings in a number of selected countries, such as Finland, Turkey and Iran. These were then compared and carefully analyzed based on the criteria of the legal systems of America, England, Malaysia, Brazil, France, Germany and South Africa, and the efficiencies of these countries and the successes in their legislation. These countries were selected by carrying out targeted searches.Based on the findings, in all the countries studied, parliaments had legislative power in various forms and benefited from traditional or electronic participation of their citizens. As a result, the information collected varied.In Iran, there is a great deal of potential for people to participate in legislation and parliamentarians can easily interact with the relevant stakeholders. These circumstances provide a suitable platform for professional and expert participation in the field of legislation.

Nowadays, disaster prevention and crisis management are the main and sensitive issues in countries. Organizations, as one of the main components of todaychr('39')s society, are no exception. . The main problem of organizations is coordination in the event of a crisis to control it. In this regard, in this study, we are looking for influential components in the cooperation between disaster management organizations in the earthquake-stricken areas of Kermanshah.

This is a descriptive-correlational study with an applied aim that the statistical population consisted of 120 managers, experts and experts of 20 crisis management agencies in Kermanshah province who had the least executive experience in the last two earthquakes. A sample of 92 people was selected. A researcher-made questionnaire was used to collect data.

There was a semantic relationship between the components of organizational, structural, communication, informational, resources and equipment, educational, cultural and coordination between disaster management organizations in the earthquake-stricken areas of Kermanshah. A total of 54 effective components in coordination were identified that "communication components" with a rank mean of 5.04 were the most effective and "information components" with an average of 3.90 were the least effective components.

In order to create fruitful and efficient coordination between the organizations responsible for disaster management, it is necessary to identify precisely the implementation, practice and re-implementation of the experimental maneuvers in order to create effective coordination between organizations in the field of action.

 This study aims to identify the challenges for public participation in health legislation in Iran.

This is an exploratory and qualitative study. The study data were collected by using semi-structured interviews. The participants were experts in the field of health law with at least ten years of work experience. They had both experience and enough knowledge about the country’s health system. All interviews were transcribed verbatim after recording and then analyzed using thematic analysis.

 We identified five main categories (themes) and 26 subcategories related to challenges. The main themes included legal barriers, infrastructure barriers, sociocultural barriers, people’s barriers, and legislators’ barriers. The legal barriers had three subcategories of parliament’s structure, legal requirements for participation, and facilitating laws. The infrastructure barriers had seven subcategories of the existence of mass media and communication networks, informing, ability to access to/meet the legislators, ability to categorize opinions, the possibility of electronic participation, financial resources, and structural facilities. The sociocultural barriers had three subcategories of people’s desire to participate, belief in teamwork, and social capital. Barriers related to people included eight subcategories of access to information, access to legislators, getting answers or feedback from legislators, feeling safe after participation, people’s awareness of their rights, education, ability to exchange views, and the existence of a highly-skilled expert team. Barriers related to legislators had nine subcategories of the desire to use others’ opinions, capacity to accept different opinions, party-related factors, regional factors, administrative health, education, opportunity, priorities, and motivational factors.

 Iranian citizens have several challenges to participate in health legislation. Regarding legal challenges, it is necessary to determine the participation right of citizens in the legal system. Besides, members of parliament should be educated to use the capacity of public participation. On the other hand, people should speak freely with the legislators and gain health knowledge as well.

Evaluation in hospitals is a necessity in the way of promoting the health of the community and requires valid and reliability instruments. Therefore, the present study was conducted with the aim of developing and psychometrics "Evaluation Criteria for Health Promoting Hospitals Scale".

The present research is methodological. Initially, a comprehensive review of the research topics included documents, service providers at hospital management levels, all published library documents, and national strategic documents in the field of hospital health promotion and Social Security documents. The " Evaluation Criteria for Health Promoting Hospitals Scale" was then developed with 72 items. Face validity, content validity ratio, and content validity index were measured by a survey of 10 experts. Construct validity (factor analysis) was determined by distributing the scale between 272 samples. Reliability was measured by internal consistency method by calculating Cronbachchr('39')s alpha coefficient with 15 participants and composite reliability. Data were analyzed in SPSS. 21 and LISREL.

The " Evaluation Criteria for Health Promoting Hospitals Scale" was developed with 68 items, 11 components (in 3 structural, process and consequential dimensions). The ratio of content validity, content validity index and construct validity was confirmed. Reliability was performed by internal consistency method by calculating Cronbachchr('39')s alpha coefficient and its value was 0.758 for structural dimension, 0.895 for process dimension and 0.924 for consequential dimension. 

The "Evaluation Criteria for Health Promoting Hospitals Scale” with 68 items, 11 components (in 3 structural, process and consequential dimensions), has a high validity and reliability. It is recommended to use the above scale to evaluate health promotion hospitals.