jamil sadeghifar

As the EQ-5D questionnaire may miss some dimensions of health and has limitations in utility measurement, adding new dimensions to EQ-5D may improve the validity and sensitivity of the measure. The present study was carried out as a systematic review of studies on adding new dimensions to the EQ-5D questionnaire.

This study was designed as a systematic review. Electronic databases such as Embase, PubMed, ISI/Web of Science and Scopus and two targeted website were mined from inception up to 30st September 2020. General description, version of the EQ-5D, method for valuing, types of bolt-on dimensions, approach for identification of bolt-on dimensions and effect on utilities measurement were extracted. Two authors reviewed the articles independently.

23 studies were included that eight articles studied only cognitive, four studies only vision, three studies only sleep and in two studies, skin problems were added to EQ-5D questionnaire. The majority of studies were conducted with a three-level scale questionnaire (EQ-5D-3L) and VAS Valuation method (n=11).

Adding bolt-on in some dimensions could change the utility measurement specially in cognitive, vision and respiratory dimensions. Comparison of HRQoL showed significant difference in health states for EQ-5D and EQ-5D+Bolt-on dimensions. EQ-VAS has been reduced with the addition of new dimensions. The results of the studies indicate an enhance in the HRQoL by adding the dimension to the EQ-5D, although the inconsistency between some studies can be related to the valuation techniques, the dimension added and the study conditions.

Objective (s):

 Considering the role of self-care in reducing the burden of non-communicable diseases and in order to properly increase the importance of health to society, paying attention to the self-care is a priority. This study was conducted with the aim of investigating the effect of an educational intervention in the context of social messengers on the awareness of the health workers regarding the self-care program.

This semi-experimental study was conducted on 705 employees (doctors, nurses, midwives, health care workers) of health centers in Ilam province, Iran during 2020 and 2021. To collect data, a self-designed questionnaire containing 330 questions related to the 22 educational packages of the national self-care program provided by the Ministry of Health was used. The questionnaire was completed before an educational intervention and 9-months follow-up. The data was analyzed with SPSS version 24 software and through paired t-test and chi-square test.

The results indicated a significant increase in the awareness of health workers in the field of self-care program during a period of nine months after the educational intervention using the virtual educational method. A statistically significant relationship was observed between increasing the level of awareness of health workers with variables such as age (0.01), education level (0.05), gender (0.01) and organizational position (0.01).

Considering the important and fundamental role of health workers in improving the level of health literacy of the society and on the other hand the growing trend of access to social messengers, it is suggested with a cascade approach and based on social accountability, suitable educational programs to improve the awareness of health workers and subsequently health ambassadors at the household level should be prioritized.

Academic Engagement is considered as one of the important factors related to the learners’ academic achievement. It is known as a significant research issue in higher education. The present study aimed to make an instrument for investigating academic engagement among nursing students of Ilam University of Medical Sciences.

The present study is a methodological and cross-sectional research. To localize the academic engagement questionnaire, first, it was translated into Persian using forward-backward method. Then, its content and face validity were evaluated and approved. In order to determine the validity and reliability, the questionnaire was delivered to 120 nursing students and their comments were collected and analyzed. SPSS and AMOS software, statistical tests of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for data analysis.

According to the results, the internal consistency of the questionnaire was confirmed by calculating Cronbach's alpha coefficient (α = 0.906). The EFA and CFA were used to examine the dimensionality of three domains of vigor, dedication, and absorption. Values of Goodness of Fit Index (GFI), Non-Normed Fit Index (NFI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA) indices were 0.89, 0.92, 0.90 and 0.97, respectively

The reliability and validity of the translated academic engagement questionnaire were relatively acceptable in reviewing the academic engagement of medical students, especially nursing students. Future studies should focus on more samples and examine the impact of nurses' background and educational variables on academic engagement.

There is limited evidence about the effect of the corona disease epidemic on the efficiency of hospitals in Iran. This study was conducted with the aim of investigating the effect of the Covid-19 epidemic on the productivity of public hospitals in Ilam province.

This retrospective descriptive research has investigated the performance of 9 hospitals in Ilam province during a four-year period(1397-1400) based on the Pabon Lasso graphic model. The desired data were extracted from the HIS system of the hospitals and the key performance indicators of BOR, BTR and ALOS were calculated. The Pabon Lasso diagram was drawn with Excel software.

The results showed that the bed occupancy percentage in teaching hospitals is significantly higher than non-teaching hospitals (P<0.05). Based on the results, the percentage of bed occupancy and the rate of bed rotation after the covid 19 pandemic has decreased significantly (P<0.05). The average length of the stay of patients also increased after the pandemic (P<0.05). Overall evaluation of hospital efficiency based on the Pabén Lasso model shows that the frequency of hospitals located in Nakara district has decreased from 4 hospitals before the pandemic to 3 hospitals, although hospitals in Kara district have not changed during this period.

Most of the researched hospitals, especially non-teaching hospitals, have low bed occupancy. Weakness in the service delivery chain, especially diagnostic services and specialized and super-specialized services, is one of the main reasons for this situation. Moving towards a change in the way hospitals are managed and having more flexibility in the structure and implementation in the short term and prioritizing large hospitals with a complete chain of services can lead to a way out of the current inefficient situation.

Disinterest in having children, followed by a decrease in the total fertility rate in recent years, has been the common experience of developed countries and many developing countries, including Iran. Knowing the reasons for disinterest in having children is important for an effective population policy. Therefore, the present study was conducted to identify the causes of disinterest in having children among married women in the Ilam province.

This descriptive and cross-sectional study was conducted in Ilam province in 2022. Families without children who did not want to have children were identified through the Integrated health system (SIB) and included in the study. The data was collected from the mothers using a questionnaire. SPSS software version 22.0 was used to analyze data. Independent t-test was used to compare the means, and chi-square and Fisher's exact tests were used to check the relationship between qualitative variables.

Seven hundred fifty-two households were investigated. The average age in women was 26.6 ± 5.2 years and 31.1 ± 4.8 years in men. The average age of marriage of men and women was 23.3 ± 0.5 years and 27.8 ± 4.6 years, respectively, and the average married life period was 3.2 ± 1.6 years. Worrying about not providing for the child's future with 67.7%, increasing economic problems in life with 60.50%, and not having enough income with 58% were the most important reasons mentioned by mothers for not wanting to have children. A statistically significant relationship was observed between urban and rural residence status with mental and psychological readiness for childbearing (p<0.01) and interference of childbearing with social responsibilities (p<0.01).

The results show that economic issues are one of the most important concerns for making decisions about having children. Along with effective incentive policies, especially in financial terms, modeling the best practices for increasing childbearing in other countries will be an effective strategy.

The widespread outbreak of the COVID-19 virus has resulted in an increase in hospitalizations and mortality in healthcare centers, directly affecting healthcare personnel, especially nurses. Resilience stands for one of the key non-cognitive skills that can ensure nurses’ optimal performance during crises. Hence, the present research was aimed at identifying the status of factors affecting resilience among nurses involved in the COVID-19 crisis at Shohada Hospital in Dehloran (Iran).

This mixed-method study (qualitative-quantitative) was conducted in 2021 (Solar year 1400). Respectively in qualitative and quantitative parts, the research sample consisted of 18 academic members and executive managers in the healthcare sector and 118 nurses at Shahid Dehloran Hospital in Ilam province (Iran). Data collection was performed using semi-structured interviews and questionnaires. Qualitative data analysis was conducted using MAXQDA2020 software, and quantitative data analysis was performed using confirmatory factor analysis, AMOS 26, and SPSS 26.

The factors influencing the resilience of nurses were categorized into three main themes: personal factors (motivation, stress, personal life, Becoming obsessed, balance in personal life, resilience in personal life challenges), organizational factors (mental and psychological health, organizational leaders’ responsiveness), and environmental factors (lack of cooperation, lack of facilities and equipment). According to the results, among personal factors, motivation (R=0.88), among organizational factors, mental and psychological health (R=0.83), and among environmental factors, the lack of facilities has the most significant effect on nurses’ resilience (R=0.75).

The findings highlight the considerable and significant impact of personal, organizational, and environmental factors on enhancing nurses’ resilience. Based on the research results, the proposed conceptual model can serve as a suitable mechanism for hospital managers to enhance the healthcare staff’s resilience.

Health literacy is recognized as a key determinant of health and is a central focus of public health policy strategies. The present study aimed to assess the health literacy level and identify the factors influencing it among the clients of comprehensive health service centers in Ilam city.

In 2022, a descriptive-analytical study was conducted to examine 429 clients aged 18-65 years who visited comprehensive selected health service centers in Ilam city. For adults the data collection tool used was the Helia health literacy questionnaire. Sampling was conducted in nine clusters, with each cluster consisting of 50 samples. The data was analyzed using SPSS software, which included descriptive statistical tests, Pearson’s correlation coefficient, and one-way analysis of variance, with a significance level set at 0.05.

Based on the results, the average health literacy score was 80.16 ± 16.50. In terms of health literacy, 18.97% of people had inadequate or not very adequate health literacy, while 44.39% of the participants had excellent health literacy. The average health literacy scores across different dimensions are as follows: access to health information 65.74, comprehension of information 81/81, reading information skills 12.74, evaluation of information 05.75, and decision making and behavior based on information 61.92. A significant relationship was observed between job, education, and income variables and various dimensions of average health literacy (p-value≤0.001). However, there was no significant relationship between general health literacy and age, gender, and place of residence (P≤0.05).

The results of the present study demonstrate that vulnerable groups have significantly lower literacy levels. Furthermore, given the impact of education on enhancing people’s health literacy, it is advisable to leverage mass media, social networks, and educational centers to enhance literacy levels as a potential factor in community health.

Suicide is a tragic and complex public health problem that affects individuals, families, and communities. The current study aimed to predict suicidal ideation based on cognitive emotion regulation strategies, perceived social support, self-efficacy, perfectionism, and spiritual health in students at Ilam universities, Ilam, Iran.

The current study was a cross-sectional study conducted in 2021. A total of 463 working students studying in Ilam universities were selected and included in the study through the available sampling method. A questionnaire was used for data collection. To determine the relationship between the variables and suicidal thoughts, the Pearson correlation test was used, and to investigate the predictors associated with suicidal thoughts, stepwise regression analysis was performed.

The research results showed a significant negative relationship between the variables of perceived social support, self-efficacy, spiritual health, and positive emotion regulation strategies (i.e., acceptance, positive reorientation, planning, positive appraisal, and underestimation) and a significant positive relationship between perfectionism variables and negative emotion regulation strategies (i.e., self-blame, rumination, catastrophizing, and blaming others) with suicidal thoughts. The highest correlation coefficient was related to perceived social support, which was the most important predictive variable in this study (r=-0.71). Perceived social support, existential health, rumination, perfectionism, self-efficacy, self-blame, and acceptance variables were able to become significant as predictive variables in the regression equation. In total, these factors explained 66% of the variance of suicidal thoughts.

Based on the research findings, the variables of cognitive emotion regulation strategies, perceived social support, self-efficacy, perfectionism, and spiritual health may be important components and predictors of suicidal thoughts. Therefore, it is important to pay attention to these components in suicide prevention programs and treatment and counseling methods

Sharps injuries are a threat to the nursing community during the COVID-19 pandemic. This study was conducted to evaluate the knowledge, attitude and practice of nurses working in Shahid Mostafa Khomeini Hospital in Ilam towards the prevention of injuries caused by sharp and sharp objects in 2020.

This descriptive-analytical study was conducted among 157 nurses working in Shahid Mostafa Khomeini Hospital in Ilam. The study sample were included by census method. Data collection tool was a researcher-made questionnaire consisting of 54 questions. The validity of the questionnaire was assessed by experts' opinions and approved (CVR > 0.54). The reliability of questionnaire was confirmed by using Cronbach's alpha method (0.74, 0.78 and 0.78 for knowledge, attitude and practice alternatively). Data analysis was performed using SPSS software by independent t-test, one-way analysis of variance and linear regression. Ethical considerations were taken into account throughout the study.

In this study, the mean and standard deviation of nurses’ knowledge, attitude and practice were 6.41(± 1.94), 31.76 (± 6.09) and 18.85 (± 6.50), respectively. There were significant differences in nurses’ knowledge according to the age, duration of employment, employment status, vaccination history, previous training and place of work. Also, there were significant differences in attitude according to place of work; and practice according to duration of employment, place of work, and degree of education (P<0.05).

Due to the poor knowledge, attitude and practice of nurses of Ilam Shahid Mostafa Khomeini Hospital towards injuries caused by sharp objects, it is necessary to plan and implement an intervention in order to improve nurse’s knowledge, attitude and practice. Designing and continuous presentation a set of appropriate trainings for nurses, requiring nurses to be vaccinated against hepatitis B, establish an accurate and credible reporting system, and as well as principles of ergonomics in the workplace can be used as the necessary solutions in this area.

The most well-known classification of the cost of diseases is direct medical cost. The aim of this study is to investigate and analyze direct treatment costs of patients with Covid-19 by hospitals affiliated with Ilam University of Medical Sciences.

This was a descriptive-analytical, cross-sectional study performed retrospectively. The hospital expenditure information in Ilam province from March to October 2020 was used. Cost information related to all patients was collected and classified and reviewed using Excel 2016 software. The average direct treatment costs of hospitalized patients were also determined.

The direct costs of treatment in hospitalized patients in Ilam were estimated at $ 2349272.094 (98669427959 billion Rials). The per capita direct medical costs were calculated to be $ 1228.056 (51578373 million Rials(. The largest share of the cost related to pharmaceutical services and the share of basic insurance was equal to $ 934.570 (39,252,109 million Rials).

Results of the study indicated that the treatment costs of patients entering Ilam province are high, and the highest cost concerns pharmaceutical services. Taking necessary measures to prevent and control the spread of coronary artery, using the most cost-effective drug interventions and reducing unnecessary hospital stays of patients can increase the efficiency of financial resources and reduce direct medical costs in Ilam province.

Utilizing the successful experiences of countries and local regions can be useful in the management and control of coronavirus disease‑2019 (COVID‑19), so the research team aims to determine and extract the strengths, weaknesses, opportunities, and threats of the health system in the risk management of COVID‑19 using strengths, weaknesses, opportunities, threats (SWOT) analytical approach.

This study was performed by a qualitative multimethod approach. In addition to reviewing the minutes of meetings and approvals of the Provincial Anti‑Corona Headquarters, focused group meetings and in‑depth semi‑structured individual interviews were conducted. The results were extracted based on the SWOT analytical approach in the form of strengths, weaknesses, opportunities, and threats of the health system and then based on the SWOT matrix, the necessary strategies were identified.

In the necessary strategies, based on SWOT matrix in SO strategies: SO1, formation of regional health assessment teams; SO2, promotion of preparedness, resilience, and effective response; SO3, activation of research and training centers; SO4, integrated management, supervision, and coordination; in WO strategies: WO1, analysis and COVID‑19 risk monitoring; WO2, communication and risk information management; WO3, people‑based management; and WO4, activation of local economic institutions and manufacturing centers; in ST: ST1, comprehensive care system strategies; and ST2, enhancing social trust with a transparency approach; and finally in WT strategies; WT1, stress management; and WT2, specific financial system design for disaster management were identified.

Now, for the prevention and control of this disease, the need of empathy and participation of all human societies is felt more than anything else. These experience and analysis are based on the SWOT approach for the health system to be able to provide solutions and practical points that can be used by stakeholders.

One of the most important requirements for developing a strategic plan is the effective participation of various stakeholders in plan formulation. The aim of present study was the evaluation of stakeholder participation in the strategic plan developing process in selected hospitals in Tehran.

This is a cross-sectional study. This study was conducted in selected hospitals at Tehran in 2015. The data collection tool was a researcher made questionnaire consisting of 3 parts: demographic data, stakeholder participation, and attention to the strategic planchr('39')s components. The validity of questionnaire was confirmed by experts, and its reliability was confirmed by Cronbachchr('39')s Alpha test (α = 0.8). The SPSS18 software was used for data analysis. Descriptive statistics (means, standard deviations, and percentages) were calculated.

The findings showed that the highest (42.9) and lowest (34.7) mean score of stakeholder participation in the strategic planning formulation was related to "provision required information for planning" and" presentation of gathering and documentation of the plan, "respectively. Hospital managers (91 percent) had the highest involvement, and external stakeholders had the least participation (1.7 percent) in the strategic planning formulation. The least attention is devoted to evaluating the proposed strategieschr('39') feasibility, identifying competitive and strategic differentiation, and identifying stakeholderschr('39') concerns and needs, respectively.

Stakeholderschr('39') involvement in the formulation of the hospitalschr('39') strategic plan was not favorable, and hospitals were unable or unwilling to benefit from their participation in the program.

Employees spend most of their time at work, and hence, it is important to pay attention to health‑promoting behaviors. The purpose of the present study was to investigate the status of health‑promoting behaviors of employees in the Medical University of Ilam‑Iran.

This cross‑sectional, descriptive study has been conducted by the participation of 208 employees, whom selected through the simple random sampling method. In the present study, participants completed Walker’s Health Promoting Life Style Profile II in the self‑report form. The gathered data were analyzed using software at the significant level of 0.05. Data were analyzed by the independent samples t‑test, one‑way analysis of variance, and Pearson correlation coefficients.

The highest correlation of health‑promoting behaviors was related to spiritual growth (r = 0.785), stress management (r = 0.777), interpersonal relationships (r = 0.767), health responsibility (r = 0.730), nutrition behaviors (r = 0.641), and physical activity (r = 0.611) were in the next places (P < 0.001), respectively. Among sub‑scales, the highest correlation was observed between spiritual growth and stress management (r = 0.676, P < 0.001) and the lowest correlation between physical activity and interpersonal relationships (r = 0.253, P < 0.001).

The score of physical activity was lower compared to other dimensions of health promoting behaviors. Therefore, it is necessary to make more effective interventional measures for improving physical activity status.

One of the important requirements of health care systems in providing quality and safe services is developing appropriate strategies, effective implementation of these strategies, and controlling the results of the implementation. The design and implementation of a strategic control system ensures that the organization's performance in relation to the strategic management steps is correct. The purpose of this study was to identify and explore factors related to strategic control in the hospital systems.

This analytical study was conducted in 2016 on 425 experts from the Strategic Planning Committee of educational hospitals affiliated to Tehran and Iran University of Medical Sciences and experts in the field of strategic planning. Data were collected using a researcher-made questionnaire. Data analysis was performed based on exploratory factor analysis with SPSS 21 software. Data were collected using a researcher-made questionnaire. Data analysis was conducted based on exploratory factor analysis using the SPSS software version 21.

Results of the exploratory factor analysis showed that factors related to strategic control in the hospital system were five independent factors including infrastructure and external support (variance percentage 13.3), vision clarification and strategy and conversion to action (variance percentage 12.2), sharing and establishing data and knowledge flow (variance percentage 10.3), planning and setting goals (variance percentage 9.2), and strategic learning and feedback (variance percentage 7.5).

The results of the study showed that the strategic control questionnaire used in this study could be useful as a tool for assessing the accuracy of designing, implementation, monitoring, and evaluation of strategies in the hospital systems.

Academic engagement is one of the key factors related to the academic achievement of students, which is considered as a significant research issue in higher education. Academic engagement focuses on the internal commitment and active involvement of students in access to learning. This study endeavored to explore the relationship between academic engagement and achievement among nursing students of Ilam University of Medical Sciences.

This cross-sectional descriptive was conducted in school of nursing in Ilam University of Medical Sciences. The population was all nursing students in 2018 (140 students) who completed and returned 116 questionnaires. The data collection instrument was a questionnaire taken from an external questionnaire including 14 questions in three dimensions of Vigor, Dedication, and Absorption. Besides, a researcher-made questionnaire was developed to measure studentschr('39') academic achievement. Data was analyzed using descriptive statistics and correlation tests of Spearman, Manwitney and Kroskalwalis.

Among the dimensions of academic engagement, the dimension of Dedication (2.32±0.88) and Vigor (2.22±0.87) had the highest and lowest mean and standard deviation, respectively. There was no significant correlation between academic engagement and studentschr('39') academic achievement (r=0.096). There was a significant relationship between gender with academic achievement and engagement and the years spent studying with studentschr('39') academic involvement P <0.05).

There was no significant correlation between the dimensions of academic engagement and Grad Point Average and the rate of academic engagement in female students was higher and decreased with age and increased the length (years) of study. It is suggested that interesting and varied methods need to be used for teaching and learning students. Similarly, holding training courses for professors to gain more skills in motivational management of students and learning attractive and effective teaching methods seems to be needed to promote studentschr('39') academic engagement.

Patient preparation process for surgery is one of the strategic control points in hospitals, which can improve the patient satisfaction and increase the quality of provided services. This study aimed to determine the impact of pre-surgery consultation unit startup on waiting time before surgery and cancellation of surgery.

This cross-sectional and analytical study was conducted in an Eye Hospital in Tehran. The study population included patients hospitalized for cataract surgery at Farabi Hospital in Tehran City, Iran. Data were collected using a researcher-made questionnaire containing information about the participants' gender, age, waiting time, cancellation of surgery, and length of stay. Data were analyzed by SPSS18 using Mann-Whitney and Chi-Square tests.

Pre-surgery consultation unit startup was able to significantly reduce the patient waiting time before surgery (P-value < 0.001). No significant change was observed in cancellation rate and length of stay after the pre-surgery consultation unit startup (P-value > 0.05).

Considering the reduction of patients' waiting time as one of the key indicators in eye surgery, preoperative consultation process and other effective processes should be improved to maximize benefits of establishing a preoperative consultation unit at Farabi Hospital.

  Femoral fracture surgery is one of the most common and expensive surgical procedures and forearm fracture surgery is common performed by Ilam Imam Khomeini Therapeutic Center. This study conducted to analyze the difference in actual cost and global surgery tariffs in this hospital.Also, the related factors acutal cost of mentioned surgery were identified.

This cross-sectional and descriptive study was conducted on factors related to the actual costs of femoral and forearm fractures. The Activity-Based Costing approach identifies the related cost associated with these surgeries in through six steps. Data analysis was performed using Excel 2016 software.

The avarage actual cost of the femur fracturs , the code 2 forearm and the code 1 forearm were 953 thousand and 700 tomans, 444 thousand and 400 tomans and 337 thousand and 800 tomans , respectively. The actual cost of surgery for femoral fracture per unit surgery was 406,000 and 400 tomans lower than the Ministry of Health's tariff. But ,the real cost of the code 2 forearm was 33 thousand tomans higher, as well as the code 1 forearm 20 thousand tomans higher than the global tariff.

Overall, there are significant differences between hospital costs and the Ministry of Health's global tariff. That can be corrected by improving the hospital's performance, as well as carefully examining the cost of global surgical procedures for amending the system of tariff regulation and make the actual amount closer to the tariff level.

Birth weight is a reliable indication of intrauterine growth and determines the child's future physical and intellectual development. The purpose of this study was to use data mining technique in identifying accurate predictors of (low birth weight) LBW.

This study used secondary data from 450 medical records of newborns in the educational Hospitals affiliated to Ilam University of Medical Sciences. The birth records were reviewed from April 2015 to April 2016.  The checklist used to collect data comprised of two parts: demographic and effective factors (13 factors of medical and neonatal, 4 factors of mother's lifestyle and 8 about mother factors). Data were analyzed by SPSS version 21 and WEKA software.

Our findings showed that mean weight of infants was 2289 ± 864 gr. The mean gestational age was 35.2 ± 4.63 weeks. 14.9% of mothers suffer from placenta previa and 14.4% suffer from preeclampsia. The results of ANOVA showed that neonatal weight was significantly higher among mothers with weight range of 84-110 Kg. The random forest algorithm showed that gestational age less than 36 weeks is main predictor and number of fetuses, preeclampsia, and premature rupture of membrane, placenta previa, the number of pregnancies and the degree of mother education were other predictors of low birth weight.

This study confirmed that low birth weight is a multifactorial condition requiring a systematic and accurate program to reduce LBW. Individual and group education through mass media, repeated monitoring of pregnant mothers, activation of the referral system and pursuit of a family health care technician may reduce prevalence of LBW.

Challenges of service provision systems necessitate the presence of staff with higher motivation to work more efficiently; therefore, paying close attention to job satisfaction of such staffs to enhance organizational efficiency sounds essential. This study aimed to prioritize factors affecting personnel satisfaction in hospitals of TUMS using AHP Model.
This was a cross-sectional study conducted in 5 hospitals affiliated to Tehran University of Medical Sciences in 2015. The data collection tool was a questionnaire containing demographic questions as well as nine questions on personnel satisfaction. The validity and reliability of the questionnaire were assessed, and the data was analyzed using analytic hierarchy process and Expert Choice V. 11 software.
Findings: According to the AHP model, rewards and compensations were the most important factors (0.262), and monitoring and supervision were of the lowest importance (0.030). Factors of Job security (0.182), job improvement (0.177), job positions (0.091), working conditions (0.075), communications among colleagues (0.063), associated with personal life (0.060), and policy management (0.035) obtained next priority. Also, rank of items in unmarried female employees were higher than that of married male employees.
Discussion & The conclusions for our investigation demonstrate that correction mechanisms in hospitals and use of leverage by offering incentives such as performance-based management can enhance motivation as well as the employees’ performances. In addition, efforts to strengthen social relationships among colleagues would lead to more satisfaction as a significant component.

Equitable distribution of health care services is prerequisite of success to the national development programs. This study was conducted to assess the townships of Ilam province in terms of enjoyment of health care services.
This cross-sectional study was carried out in Ilam province using 14 health care services indices. Data were collected by a data collection form made by the researcher using statistical yearbook of Statistical Center of Iran (SCI) in 2011. Ilam townships were assessed with 5 methods using Microsoft Excel 2010 (disharmonious index of Morris; standardized score; Scalogram; Numerical Taxonomy; TOPSIS) and given the different methods did not reach a general consensus, Copeland's method was used.
Findings: The findings indicated that there existed unequal distribution of health care services across the townships of Ilam province. According to the Copeland method, Ilam and Malekshahi townships have been ranked the first and last regarding the enjoyment of health care services, respectively.
Discussion & As a result, health care services have been settled in the provincial center (Ilam Township). The policies leading to the development of health care services in large cities are the major important factors in the unequal distribution of health care services. The results of this study can provide illustration of current situation of enjoyment of the health care services and promote the evidence-informed decision making (in national and local levels) for policymakers.

Kidney disease is one of the most common diseases in people that leads to emotional problems such as stress, anxiety and depression. The purpose of this study was to predict of the amount of depression, anxiety and stress based on spiritual components in hemodialysis patients in Ilam province.
In this research, which was carried out with the correlation method, 150 hemodialysis patients were selected and then subjected to the study by means of available sampling. Three questionnaires regarding depression, anxiety, stress, prayer and spiritual health were used as a means of data collection. In this research, dimensions of prayer and spiritual health were considered as a predictors and emotional components were considered as a dependent variable. The data were analyzed by R Pearson correlation coefficient and multiple regressions analyzes.
The results of the study revealed that there are significant negative relationships between all dimensions of prayer and depression and stress, while there are also significant negative relationships between a dimensions of prayer except pray frequency and anxiety (P Spiritual components are correlative with patient's emotional component. Thus, religious beliefs can be used to improve hemodialysis patients’ health.

One of the most important and useful models for assessing hospital performance is the Pabon Lasso Model, a graphical model that determines the relative performance of hospitals using three indicators: 1. Bed Occupancy Rate (BOR); 2. Bed turnover (BTO); 3 Average Length of Stay (ALS). The aim of this research is to investigate the performance of the hospitals affiliated with Tehran University of Medical Sciences in Iran during the year 2011 based on the Pabon Lasso Model.
This descriptive and cross-sectional study conducted in 2011. All the 16 hospitals affiliated to Tehran University of Medical Sciences formed the study population. Data was analyzed by Excel software and Pabon lasso model.
The following average results for each performance indicator were obtained: Average Length of Stay (ALS) = 6.55 days. Bed Occupancy Rate (BOR) = 74.151% and Bed Turnover (BTO) = 70.24 times per year18.75% hospitals were located in the Pabon Lasso Model zone 1.25% hospitals in zone 2.25% of hospitals in zone 3, and 31.25% hospitals in zone 4 of the model.
The study showed that 75% of the studied hospitals were inefficient. Applying Pabon Lasso model compared hospital's performance. Thus, using one of the active ways of problem recognition in hospitals and perceiving the relation of performance indicators will be helpful in establishing new policy and reviewing current policy in order to maximize performance capacity.

One of the key factors affecting on job performance, is compensation mechanisms. The study aimed to determine the relationship between compensation mechanisms and job performance among nurses working in hospital.
This cross-sectional and correlational study was conducted in 2014. The number of 221 nurses at two hospitals (Valiasr and Lolagar) base on simple randomized sampling enrolled. Data gathered by two questionnaires for Compensation mechanisms and job performance. Data analysis was done by descriptive statistics and Spearman test.
Findings: The results showed that the job performance of nurses is moderate (2.76±0.50). Among the compensation mechanisms, persuasive years, higher education grants, job promotions and performance based pay had a high priority, respectively. Spearman test showed significant relationship between job performance and non-cash payment (P= 0.0001), performance based pay (P= 0.004), persuasive years (P= 0.0001), decreasing the working hours (P= 0.0001), increase in services tariff (P= 0.0001), and monthly fixed amount (P= 0.02).
According to our results, it seems that Services compensation variable is a good predictive for job performance. There were fewer tendencies for receiving cash benefits than non-cash payments for the nurses working in studied hospitals, proposed to be carried out as a pilot reform of compensation mechanisms and examine the impact of these reforms on variables such as job performance.

Challenges of service provision systems necessitate the presence of staff with higher motivation to work more efficiently, so paying close attention to job satisfaction of these staffs to enhance organizational efficiency sounds essential. The aim of this study was to investigate and among those staffs working in a Shohadaye Tajrish educational Hospital in Tehran. This was a cross-sectional correlative study on a 200-staff sample in a teaching hospital in Tehran which was selected by a simple accidental sampling in 2013. The research instrument was a questionnaire with 25 questions that was considered suitable for face and construct validity and reliability. Data analysis was done by parametric statistics and Pearson correlation on statistical level of 0.05 applying SPSS version 18. Results indicated that the highest average of the participants was related to satisfaction of coworker's dimension 4.05±¬0.87, and the least average belonged to satisfaction of salary 1.54±0.74. Furthermore, there was positive and statisticant relation between the whole satisfaction and all other five dimensions of the model. Finally the analysis among two variables (sex and age) and whole job satisfaction had significant relationship. It seems that correcting reward mechanisms in hospitals and applying managerial tools like performance-based-management can improve the staffs` performance and motivation. In addition, reinforcing the social relationships among coworkers may lead to incremental changes in one of the most important dimensions of the model and finally affect the whole satisfaction.

Health care section as an important social part of a community plays a determining role in people’s health and therefore all people must equally and purposefully enjoy health services and facilities; failure in this regard may lead to unpleasant consequences. The research is both applied and analytical which ranks the counties of Sistan and Baluchestan province in terms of entitlement to health structural indicators in 2011. Thus, 15 health structural indicators were selected and data were collected from Statistical Center of Iran. Experts’ opinions and FAHP technique were used to weight the indicators. Finally the counties ranked by TOPSIS technique. Data were analyzed using Excel, Expert Choice, and LINGO. FAHP’s results showed that indicator of health house workers (Behvarz) in health centers was more important and dentist indicator less important than other indicators. Besides, TOPSIS technique showed that Zahedan, Zabol, and Iranshahr were the highest and Delgan, Zaboli, and Sib and Suran were the least entitled counties, respectively. Based on our findings, there seems to be a huge gap between the counties of the province in terms of their entitlement to health structural indicators. It is therefore suggested that authorities of the health section set the priorities according to the counties’ entitlement to the indicators to remove inequalities in the province.