محمد صباحی بیدگلی

Nurses are the professionals who are doing important work in the hospital and always are exposed to occupational injuries. Safety climate that is important factor is measured by using quantity questionnaire and show a snapshot of organization safety Status. To assess safety climate, a valid and reliable tool is needed. The aim of this study was developing and psychometric questionnaire to assess safety climate among the nurses. This psychometric study was conducted among the 480 nurses in five hospitals in Iran. Using nurse's safety literature and other nurse's safety climate questionnaire, a 25 items questionnaire was developed. Face validity, content validity by using quality and quantity methods, construct validity by using exploratory and confirmatory factor analyses was examined. To evaluate the questionnaire reliability the internal consistency and test-retest reliability method was used. The data was analyses by spssv16 and lisrelv8.5. The content validity index of questionnaire was estimated. Exploratory factor analyses extracted 6 factors with 60.69 percent of total variance. RMSEA, GFI and AGFI indexes were estimated 0.050, 0.92 and 0.89. Cronbach's alpha was calculated 0.79 and Pierson coefficient showed significant correlation between test and retest results (p<0.001). The 22 items questionnaire that measures the 6 safety climate factors has appropriate validity and reliability to assess nurse's safety climate.

Using personal time management skills is one of the most important factors in academic achievement. Students can use it to plan and organize their time schedule. This study was performed to investigate using personal time management skills and its relationship with time spending satisfaction. This cross-sectional descriptive-analytic research was performed in 2010 with 332 students of Zahedan University of Medical Sciences. Samples were selected through stratified sampling and in each category by systematic sampling. A questionnaire was used to measure students’ time management skills in four aspects. Validity and reliability of the questionnaire was assessed. Data were analyzed by SPSS software. Students’ personal time management skills was from moderate to low. Students’ performance was better in time planning aspect and poorer in commitment to implementing aspect. Students’ were relatively satisfied with time management. There was a significant relationship between students’ personal time management skills and students’ time satisfaction. Students of School of Rehabilitation Sciences were the best and students of Health School were the poorest in time management. Female students'' scores were higher than those of males. Students’ personal time management skills were less than average. Thus، it seems necessary to plan for improving students'' time management skills in order to enhance their satisfaction.

Oxidative stress due to free radicals formation plays an important role in noise-induced hearing loss (NIHL). Many hypotheses have been proposed regarding the biochemical prevention of this complication. This study was performed with the purpose of determining the preventive effect of N-acetylcysteine (NAC) administration, as an antioxidant agent, on NIHL in Rabbit. In an experimental study, 24 adult white male rabbits were divided into four groups, including: 1) control, 2) noise exposure (100dB octave band noise centered at 4000Hz for 40h), 3) noise exposure plus NAC administration (325mg/kg, daily ip injection), and 4) no exposure and NAC administration. Audiometric test of rabbits was assessed by auditory brainstem response (ABR) technique in three stages. The Kruskal-Wallis and Mann-Whitney tests were used to compare the groups, and a p<0.05 was considered significant. The mean ABR threshold shift for the noise exposure plus NAC administration group, 1 hour after exposure at 1, 2, 4 and 8kHz frequencies were, respectively, 16.66±1.63, 21.66±1.75, 33.5±2.34, and 39.33±2.25dB. These values were significantly less than the same values in the noise exposure group. The results of this study showed that NAC can provide a proper protective effect against hearing loss resulting from noise exposure.

The present case study aims to investigate the impact of service quality on patient's loyalty to the services rendered in outpatient clinics of the studied hospitals throughout Tehran.

This is a descriptive-analytical survey in which 242 outpatients referring to the studied hospital clinics in Tehran. For data collection purposes, the standardized SERVQUAL questionnaire(1988) and for the measurement of loyalty for service quality, the standard questionnaire for customer's behavioral tendencies(Zitamel and Berry, 1996) were used. Regarding the validity of the questionnaire, its content validity was confirmed; and its reliability was approved through test-retest method and Cronbach's alpha coefficient. For data analysis, Pearson correlation test was employed.

The results revealed that there was a positive and meaningful relationship between the quality of services and the patient's loyalty in Tehran clinics. The most important aspect of loyalty was complaining behavior.

Hospital managers should enhance their understanding and awareness to maintain, and even improve, the patient's loyalty to their services and should do their best in this regard. Hospital employees should be aware of the patient's expectations and act beyond it. Finally, they should know that rendering services to patients is teamwork and that the key to providing patients with good services lies in their satisfaction with the quality of services they receive.

One of the most important principles of counseling is proper use of communication skills; nonverbal communication is one of the most effective ways of available communications. This research has been performed to study student's viewpoints on advisors’ nonverbal communication skills in schools of health and allied health sciences of Kashan University of Medical Sciences. In a descriptive cross-sectional study, 202 students of schools of health and allied health sciences of Kashan University of Medical Sciences were asked about their viewpoints toward advisors’ nonverbal communication skills. Students were selected through stratified random sampling. A self-made questionnaire was used to assess nonverbal communication skills considering five dimensions through 39 statements. Student's satisfactions with advisors were evaluated by a separate question. Validity of the questionnaire was confirmed via content validity, and its reliability was confirmed using Cronbach’s Alpha (α=0.96). Data was analyzed using descriptive statistic and nonparametric inferential tests (Mann Whitney, Kruskal-Wallis, Friedman, and Spearman correlation test). The total score of nonverbal communication skills of thesis supervisors was 3.39±0.71 (out of 5). The highest means belonged to “advisors’ appearance” (3.76±1.10) and “their facial expression during consulting” (3.54±1.07). The score of students’ satisfaction with advisors was 3.36±1.28 accordingly. Spearman test showed a significant correlation between student's satisfaction with advisors performance and the five dimensions of nonverbal communication skills (α>0.05). According to the results, the level of nonverbal communication skills and student's satisfaction with advisors were moderate. It seems necessary for faculties under investigation to develop effective strategies to promote their communication skills. This could increase the level of satisfaction among students and improve the quality of counseling sessions.

Inappropriate feeding grounds for many common diseases such as diabetes, cancer and cardiovascular diseases. This study was conducted to determine knowledge, attitude and nutrition and its relationship with body mass index (BMI) was to allow students using data and recognize the status quo and in order to increase awareness, attitude and nutrition of students and strengthen The indicators and to plan for medical university students.Methods and Materials: This was a cross sectional study which included 250 subjects (148 female and 102 male) (125 of them where in first year and 125 in fourth) randomly selected among 1500 studens. Individuals with specific diseases affecting BMI were excluded. Height and weight were measured, and the students body mass indexes were obtained and BMI percentiles were compared with America Center Disease Control and Prevention (CDC). The data was collected and analized by software11.5SPSS. In this review the knowledge and attitude there was a significant realationship between the knowledge of first fourth year students (p 0/05). In the BMI= 9/24-5/18 group in the first year and fourth year knowledge, attitude and performance was significantly related to nutrition. In 5 / 18> BMI and BMI = 9/29- 25 groups only significant relationship of awareness was found. Due to inadequate performance of nutrition in students and the significant relationship of BMI with students knowledge and attitudes, it is necessary to provide the proper nutritional program and lifestyle modification and nutritional topics for students was are continuing their education.

The issue of patient safety is today of much importance for the medical community and the World Health Organization in the developing and developed countries. Medical errors are serious threats to the public health and patient safety. The aim of this study was to determine nursing staff’s viewpoints about patient safety climate in medical centers of Kashan. Methods and Materials:In this descriptive study 218 nurses working in the medical centers of Kashan were participated. Data were collected by questionnaire included two parts, demographic and ‘Safety Climate QuestionnairePatient’ with seven dimensions that covered by the questionnaire were: educational opportunities, reporting, refreshment, head nurses’ viewpoints, nursing condition, relation with physician, and nurses’ inter-relations. Content validity method and Cronbach’s alpha coefficient (0.89) were used for confirming validity and reliability of the questionnaire, respectively. Data were evaluated using the SPSS (v.11). The results showed that mean age of the nurses participated in the study was 32.63±6.85 years, of them 85.8% were female. The mean of patient safety climate score in all seven aspects were significantly different. Except for the refreshment aspect, other aspects had different mean scores in different centers (p=0.001). Highest and lowest mean scores were related to the nurses’ inter-relations (3.24±0.67) and head nurses’ attitudes (2.47±0.71), respectively. Patient safety climate in the centers under the current study was not in a good condition. This does motivate the managers of the health sector in the city to adopt an appropriate approach to patient safety climate in health care centers.

Today studies have shown that communication between the physician/or the nurse with the patient treated as a clinical skill and considered as one of the main effective factors in improving both client’s satisfaction and health care outcomes. The aim of this study was to determine the correlation between nurse's communication skills and inpatient service quality in the hospitals of Kashan University of Medical Sciences, 2011. Methods and Materials:In this correlation study using a stratified sampling, 384 patientsfrom hospitals of Kashan University of Medical Sciences were selected. A three-section questionnaire for assessing respectively demographic characteristics, nurse’s communication skill, and inpatient service quality was used to collect the data. For communication skills, instrument validity and reliability were tested by content validity method and Cronbach’s alpha coefficient of 0.92, respectively on 20 patients in the hospitals under study. In measuring the service quality, SERVQUAL Scale was used. With regard to analyzing the data, Freedman’s statistical test was applied to study the service quality dimensions versus inpatient service quality. Also Spearman’s rank correlation coefficient was applied to detect the type and level of relationship among the nurses’ communication skills. Results showed that there was a significant correlation between communication skills and inpatient service quality in the hospitals (P-value=0.001 and R=0.782). The patients noticed a positive and significant correlation between communication skills and service quality dimensions. The intensity of the relationship between the two variables from the highest to the lowest is 0.708, 0.689, 0.637, 0.552, and 0.514, respectively for the assurance, reliability, responsiveness, empathy, and tangibles. Consequently, improving the communication skills for the hospital personnel can improve the service quality contribution of hospitals.

Background and Objectives; Autoclaving is one of the methods which sterilizes infectious solid wastes. Since variety of parameters such as temperature, time, and pressure influence autoclave performance, this study was carried out to evaluate the parameters and set optimum condition for the autoclave apparatus applied in Shahid Beheshti Hospital in Kashan. In this descriptive-analytical study, the performance of subjected autoclave was surveyed based on biological index and through setting 144 tests. Variables were packaging type in two groups (open and wrapped), loading type in three groups (light, medium and heavy), and four temperature-time features in fixed pressure equal to 101 kpa. Biological index was ATCC 7953 which contained Stearotermophilus Geobacillus spores. Finally obtained results were analyzed by Chi-Square test. The results of statistical test showed that there isnt any meaningful relation between packaging type of waste, system loading, and efficiency of sterilization(P>0.05),while meaningful relation was found between system performance and variety states of temperature-time feature(P<0.05), illustrating temperature and time effects in fixed pressure on sterilization of solid waste. Based on the results, the best autoclave operational condition for sterilizing infectious solid wastes are: temperature-time equal to 10 min-140°C and 15 min-134°C in fixed pressure of 101 kpa, respectively. It was also revealed that temperature-time condition suggested by manufactory, i.e. 20min-121°C, is not sufficient for complete sterilization of solid waste.

Postpartum depression is a serious problem that may have negative effects on mother and family mental health. Considering that several theories have been proposed to explain the epidemiologic and demographic factors associated with the postpartum depression, the aim of this study was to identify the factors related to postpartum depression in Kashan. In this cross-sectional study, 50% of all health centers in Kashan were randomly selected during 2007-8. All of 204 mothers referred during 2-3 months of postpartum with minimum literacy (primary education) showed willingness to complete the questionnaire which included two parts: demographic and psychosocial questions and BDI (Beck Depression Inventory). Data were analyzed using Chi-square test, CI, OR, and logistic regression. Seventy-seven (37.7%) out of 204 mothers referred to Kashan health centers experienced postpartum depression (0.31-0.44). There was a statistically significant relationship between seven demographic and psychosocial factors and postpartum depression, in logistic regression (P<0.001), three factors (husband's appropriate behavior, intimate relationship with family, and no prior history of depression) were remained in the model. The findings indicated that the mentioned factors can reduce the incidence of postpartum depression. According to the results, factors including husband's appropriate behavior, intimate relationship with family and no prior history of depression may reduce the incidence of postpartum depression.

The main mission of any hospital in a health care system is to promote care quality for patients and to meet their needs and expectations. The aim of this study was to evaluate the quality of hospital services from the viewpoint of patients admitted to Kashan educational hospitals. In this cross-sectional study, 390 patients admitted to Kashan educational hospitals were selected based on the stratified sampling and their points of view were evaluated using SERVQUAL questionnaire during 2008-9. The quality attributes of the questionnaire consisted of seven dimensions (e.g. physician's empathy, physician's availability, the reliability of physician performance, nurse's responsibility, nurse's empathy, drugs management and tangibility of services). Validity and reliability of the questionnaire were confirmed using content validity and Cronbach's alpha coefficient (0.93), respectively. The data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. The mean age of the respondents was 45.72±18.36 years and 54.1% of subjects were men. There was a significant difference among the mean of seven dimension scores and the total quality dimension. Moreover, a significant difference was observed in the quality score mean of different dimensions among hospitals. The highest and lowest means of quality score were for physician's empathy (3.97±0.75) and tangibility of the services (3.76±0.58), respectively. From the patient's viewpoint, educational hospitals have made good progress in providing hospital services; however, different quality scores among quality dimensions in any hospital signify that the health care administrators should pay more attention on the quality improvement programs to improve patient's satisfaction.

Common belief is that water quality evaluation must be based on its appearance, not only the apparent characteristics but also the microbial and chemical characteristics should be considered. This study was conducted to examine the relationship between turbidity, residual chlorine concentration and microbial quality of water used for drinking in rural areas of Kashan. This cross-sectional descriptive study was carried out on drinking water samples taken from 57 villages of Kashan during 2008-9. Among the total samples taken during three stages, only one sample was selected and analyzed for water quality parameters of turbidity, residual chlorine concentration and heterotrophic plate count (HPC). HPC, residual chlorine concentration and turbidity of water samples desirable in three stages and undesirable in another three stages were 86%, 22.8% and 75.4%; 12.3%, 29.8% and 0%, respectively. Furthermore, HPC in 95% of samples under the supervision of rural water and wastewater company (RWWC) and in 64.7% of samples that were not under the supervision of RWWC, were in the range of standard drinking water. The results of the study show that correlation between residual chlorine concentration and HPC level of drinking water in Kashan rural areas was significant, while there is no significant correlation between residual chlorine concentration and turbidity; HPC and turbidity. Hence, RWWC supervision has a prominent role in supplying safe drinking water for such areas.