manal etemadi

Since primary healthcare is a significant link in promoting and maintaining the health of the elderly, evaluating age-friendliness of service provision system is of great importance in ensuring the health of the elderly. The purpose of this study is to evaluate the state of primary healthcare centers’ compliance with the standards of age-friendliness in Saveh city.

This was a cross-sectional and descriptive study conducted on May and June 2022, in Saveh city, Markazi Province in Iran. The statistical population of the research included 33 primary healthcare centers selected by the census method and based on World Health Organization’s checklist regarding age-friendly primary healthcare centers (2008); they were examined by observation. After translating the checklist, its face validity, content validity, and reliability were reviewed and approved by 13 experts in the fields of health policy, health education and promotion, the elderly's health, occupational health engineering, and healthcare. Data analysis was done using descriptive statistical tests, one-way analysis of variance, Kolmogorov-Smirnov test, Tukey's post hoc test, and SPSS 16 software.

Regarding the psychometric analysis of checklist, based on the experts' opinions, the content validity ratio and content validity index were calculated and except for 8 items, all items scored higher than 0.54 and 0.79. In order to check the reliability, the research tool was provided to 2 observers. By calculating the Kappa coefficient, the agreement between the 2 observers was above 0.6, which indicates the validity of the checklist. This study showed that comprehensive health centers and their affiliated units had a 57.6 % access to public transportation and 72.7 % access to stairs at the front entrance. The entry was 100 % free from obstacles, access to parking was 42.4 %, access to public telephones, 18.2 %, to a reception counter near the entrance restrooms, 42.4 %, to waiting room, 78.8 %, to a dining area, 42.4 %, to stairs, 9.1 %, to corridor, 87.9 %, compliance with guiding signs, 66/7 %, visibility of the signs, 72.7 %, and personnel identification was 42.4 %. Also, based on the analysis of variance, a statistically significant difference was obtained between the type of centers (urban and rural) and friendliness towards the elderly (p < 0.05).

Primary healthcare centers of Saveh city did not have an acceptable compliance with the standards of age-friendly centers. The main issues are the number of stairs and the lack of alternatives (ramps and elevators) for people with mobility problems, the lack of facilities such as public telephones, and the inadequacy of guiding signs and personnel identification to identify employees. The government should strengthen and improve primary healthcare centers for the elderly and facilitate geographical access to these centers, considering the important role of these centers in the health of the elderly.

The Resource-Based Relative Value Scale (RBRVS) payment basis, combined with the unorganized increase in the payment rate with the Fee-For-Service (FFS) payment method that stimulates service supply and leads to an increase in induced demand, creates a crisis for the health system, which wastes the limited resources. The present study looked briefly at the challenges caused by the health service pricing system in Iran and has provided policy recommendations to improve it. The national payment system based on the RBRVS in Iran lacks important cost control tools of the main model, including the Sustainable Growth Rate, Budget Neutralization Factor, and forecasting the growth rate of Rial value of the relative value conversion factor in the annual budget laws. A number of technical challenges exist in the national model of the RBRVS include changing the ratio of Physician Work to the Practice Expense, removing the Geographic Practice Cost Indices, removing the budget neutralization factor, the lack of an allowable payment to determine the Rial value of the conversion factor. There are also policy challenges, the most important of which is the disassociation of the Supreme Council of Health Insurance and the Supreme Council of Welfare and Social Security as a part of comprehensive welfare and social security system structure. All of the challenges are the root of the malpractice of the health service pricing system in Iran. Dissociation between health financing policies and macroeconomic policies of the country necessitates the adoption of policies to strengthen the governance of the payment system, including reforming the existing pricing system by returning to the principles governing the original model, changing the payment method to improve behavior on two supply and demand sides and institutional reform to strengthen the regulatory function for health services pricing.

Given the high expenditure of universal long-term care for elderly and the challenge of financing it for most countries, this article intends to examine leading countries to provide solutions for Iran.

The present study is a comparative study using domain review and examines the evidence related to the insurance for long-term care in the selected countries in six dimensions: type of insurance, type of membership, contribution rate / premium, inclusion criteria for coverage, the scope of services covered, and ultimately cost sharing through studies reviewed in the electronic databases.

The results in the six countries showed that long-term care insurance requires public sector support in full or partly in combination with the private sector. This insurance’ being consistent with basic insurance coverage, its mandatory nature, the combination of government and individual financing (deduction from salaries or taxes) and the existence of a limited user fee to receive services, have saw in all these countries. The type of coverage is defined either universally or only for the elderly, and finally the scope of services in these insurances is graded based on the degree of dependence, the time required and the place of receiving the service.

In all studied countries, compulsory insurance coverage for long-term care was designed to allow for cross-subsidization. Consolidation and reduction of fragmentation of resources and expansion of integrated risk sharing is an important prerequisite for designing long-term care insurance in Iran. It is necessary to implement of the law requiring supplementary insurance to only cover services outside the basic insurance package and redesign both the basic and complementary insurance packages to determine what can be defined in the form of long-term care insurance package.

Protection against financial risks is one of the important goals of the health system. The present study aims to determine the rate of exposure to catastrophic expenditures in the insured inpatients.

The present study was cross-sectional one which is conducted in 2016. The statistical population comprised all the insured patients presenting to a private hospital in Qom who presented to the hospital within 4 months from December 2015 to March 2016. Random convenience sampling method was used, and the sample size was estimated at 267 people using Cochran formula. A questionnaire was employed for data gathering. Data were analyzed using Chi-square test and logistic regression using SPSS software version 20.

RESULS:

Patients exposed to catastrophic expenditures of treatment accounted for the 54.8% of the cases. The highest rate of being exposed to the catastrophic expenditures was related to the insured patients of the Universal Health Insurance Fund (UHIF). People with rural insurance, on average, paid the highest cost of treatment in the hospital. The surgical ward and critical care unit accounted for the biggest percentage of the patients who incurred catastrophic expenditures. Being rural, longer length of stay, lower education of the head of the household, lack of supplementary insurance coverage, and being in UHIF coverage have a substantial relationship with being exposed to catastrophic expenditures.

The socioeconomic status of the insured people in the UHIF and the Rural Insurance Fund was worse than other funds in terms of less utilization and higher rate of exposure to catastrophic expenditures, and this issue requires the adoption of specific targeted policies for these groups in respect with reducing out-of-pocket payments through mechanism such as stepwise copayments, maximum out-of-pocket limit, fee exemptions or waiver and providing supplementary insurance to reduce the exposure to catastrophic expenditures.

Increase of healthcare costs has become a major challenge worldwide. In order to ensure the security of treatment for all people, resiliency is necessary for the country’s health economy and must promote in the country. The aim of this article is to introduce the macro-axes and specific issues of each axis.

In this study, concurrent-nested mixed method was used. After discussing in focus group meeting and qualitative content analysis, the macro- axes priority of the resistance economy and specific issues were extracted. Studies in the field of health and resistance economics were identified as the complementary role by searching the databases of sid, magiran and Google scholar and with the keywords health, resistance economy, health system and Iran and the final list was obtained.

Twelve macro-priority areas and specific issues of each axis were identified. The macro-axes are: "Conceptualism", "Basis, Principles, Values, Goals", "Policies and Strategies”, “Pathologic barriers and Challenges of the Health Economics", "Indices", " Intersectoral dimensions of the Health Economics and the Resistance Economics", "Requirements", Examples/Objective Examples in Contemporary History”, “Culture and Culture-Building”, “Dimensions of Health Economics Management”,  and “Implementation Strategies" in each macro-axis, a number of specific issues were introduced.

Strengthening the countrychr('39')s health system in normal conditions, crisis and disaster, war and bioterrorism, and economic sanctions, requires the implementation of health resistance economy. An excellent, efficient and responsive health system is possible with comprehensive implementation of the general health policies, related clauses of the resistance economy general policies, and other upstream documents in the field of health. Monitoring, evaluating and macro observation of health are also necessary for dynamism and prosperity of health economy and the achievement of affect and defense capabilities.

An economic crisis is any decrease in economic activity in the whole economy of a country that lasts more than a few months and is visible in GDP, income, employment, industrial production and major and minor sales. The poorare more susceptible to irreparable damage to health due to economic crises. Inability to finance health services may force them to neglect essential services. The purpose of this study was to identify the effects of economic crises on health spending, and utilization of services among thepoor.

In this qualitative study first, the major financial crises of the health system, budget shortages and financial protection policies in crises with focus on the poor over the past fourteen years were sought and identified through semi-systematic searches of valid databases. Then, a questionnaire based on the findings of a review of studies including the main topics of health system financial crises, the effects of crises on the health system and the health system response to them, designed by experts and Health system specialists selected by convenience and purposeful sampling were completed.

A clear policy response to protect the poor has not been formulated in the health system to deal with financial crises, and laws and documents relate to conditions of economic stability. A review of the financial crises of the last four decades has shown that in crises with a foreign origin (war and sanctions), often reduce access to services and diminish the services having the most important effects on the health system and the austerity policies were the main policy response. Costs shifting has also been the most important policy response in domestic financial crises (caused by rising costs and lack of budget due to economic policies).

Governments that place greater focus on social safety net programs, justice and health financing, are more resilient to financial crises. Efficacy, cost reduction, and income support mechanisms can help governments maintain critical services for the poor and vulnerable. The countrychr('39')s health system must focus on ensuring the access of the poor to health services in times of crises.

Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair service access is not set as the top priority in the rationing choices, the poor will experience service limitation and scarcity. This study aims at investigating the effects of rationing policies on the poor covered by Iran Health Insurance System.

This article is based on a qualitative study conducted in 2017. In total, 32 experts of health system financing participated in the study. A purposeful sampling method was applied till reaching knowledge saturation. Data were collected using semi-structured interviews. Afterwards, data was analyzed by framework analysis based on Bennet and Gilson pro-poor health financing system framework using MAXQDA10 software.

The main challenge of rationing through the insurance system in Iran is the rationing only for the poor. As a result of rationing decisions, the poor are mostly the first group affected by service limitation only because they exempted from paying the premium. The current implicit or explicit health services rationing policies in each dimension has jeopardized the access of the poor to the services.

Every resource allocation and negotiation of service purchaser on the budgets should be aligned with the focus on vulnerable groups and their needs. The access of deprived groups should not be reduced for limited budgets or income prioritization. Every decision about the constraints on the usage of the services should be accompanied by the analysis of potential effects on the poor and preventive policies should be implemented so that the burden of service rationing could not be imposed on the poor

CONTEXT:

Health system reform plan refers to conducting some fundamental, systematic, and sustainable changes.

The aim of the present study was to evaluate different required inputs of Iran Health Transformation Plan from experts' viewpoints.
SETTINGS AND DESIGN: The data of this qualitative study were collected using semi-structured interviews.

SUBJECTS AND METHODS:

The purposive sampling method led to 18 participant selection and then they were interviewed. Interviewees were assured about confidentiality of information.
STATISTICAL ANALYSIS USED: The thematic analysis method and MAXQDA software were employed for analyzing the data.

There were 4 main themes and 35 subthemes extracted including management requirements for health development plan, human resources, information resources, and financial resources. Each theme had subthemes such as “resource allocation,” “development of required standards for human resources,” “human resources' motivation,” “failures in IT infrastructures,” “hospital information management software,” “guidelines and instructions,” “costs controlling,” and “financing the plan”.

Results of the present study put significant emphasis on the path of improving the effectiveness and efficacy of applying the discussed inputs, which can be a light for revising past policies and taking better future steps, it also can be a resource guide for policy-makers and managers of the health-care system.

The fourth industrial revolution that is currently taking place requires policy decisions and responses. Political will, as one of the important variables studied in public policy, is the subject of this paper. The management will requires that policymakers first become familiar with the knowledge, appropriate to the various dimensions of this revolution and have policy concern about it; Secondly, They should have the ability to formulate this policy discourse in the country’s managerial body and thirdly, they must develop the ability to spread this discourse in the community level. This paper, analyzing upstream documents and health policy-makers discourse, shows that such three conditions have not been yet met.

One of the main challenges of healthcare systems is to protect people from consequences of health expenditures. Such expenditures may lead to catastrophic financial loss in families so that many people deny demanding necessary healthcare services, which results in harms to their health status. The aim of this systematic review was to investigate the catastrophic health expenditures trend and its related factors in Iran.
This systematic review and meta-analysis was conducted on studies conducted between 1984 and 2014. Data were collected through searching electronic databases and searching engines of PubMed, Scopus, EconLit, Google Scholar, Science Direct, MagIran, and Scientific Information Database (SID). The random effects were used with 95% confidence interval for the meta-analysis.
Out of 561 initially retrieved articles, finally 42 were included in the final analysis. The studies were conducted between 1984 and 2014. The overall proportion of exposure to catastrophic health expenditure in Iran was 7.5% (95% CI, 6.2 – 9.1). In the urban and rural areas, the proportion was 2.3% (95% CI, 1.8 – 2.9) and 3.4% (95% CI, 2.8 – 4.1) respectively. The overall proportion of exposure to the catastrophic health expenditure in hospitals was 35.9% (95% CI, 23.5 – 54.3).
The catastrophic expenditures proportion of healthcare is relatively high in Iran and the government is expected to adopt effective measures in this regard, especially for the inpatient care. There are needs for special supporting policies for the financial protection of specific patients, the poor and villagers.

One approach to improve efficiency in health care is to identify patients with high risks of readmission so that resources should be distributed in a way they would benefit targeted care. A model named LACE (length of stay, acuity of admission, Charlson comorbidity index (CCI(, and number of emergency department visits in preceding 6 months) has been proposed to predict patient readmission which is widely used due to its simplicity to rank factors’ risks. The aim of this study is to determine if LACE Index could be used to predict Iranian hospital readmission.
This was a prospective cohort study in which the prediction of readmission for patients admitted to the cardiac intensive care of Shahid Beheshti Hospital of Qom during April to June 2012 within one month after the discharge was evaluated based on 4 items of LACE index. Following-up readmission states by making calls within a month after discharge. Purposive sampling was used to select the sample, patients having four most prevalent chronic heart diseases in the CCU of the hospital were selected and at last sample size was 109 patients. We used logistic regression, the phi and Spearman correlation coefficient to analyze data using SPSS18. the significance level was considered as 5% in all tests.
Among the items of LACE model, 48.6% of patients stayed at the hospital for 4 to 6 days. Only 11 patients (10.09%) referred to the hospital after a month. None of the components of the LACE index could enter the stepwise logistic regression model.
Considering that LACE model with its four items is a weak in predicting readmission, in order to improve the model in predicting the readmission of cardiac patients, it is recommended that individual variables and factors associated with the service providers be added to it.

Moral hazards are the result of an expansive range of factors mostly originating in the patients’ roles. The objective of the present study was to investigate patient incentives for moral hazards using the experiences of experts of basic Iranian insurance organizations.
This was a qualitative research. Data were collected through semi-structured interviews. The study population included all experts of basic healthcare insurance agencies in the City of Isfahan, Iran, who were familiar with the topic of moral hazards. A total of 18 individuals were selected through purposive sampling and interviewed and some criteria such as data reliability and stability were considered. The anonymity of the interviewees was preserved. The data were transcribed, categorized, and then, analyzed through thematic analysis method.
Through thematic analysis, 2 main themes and 11 subthemes were extracted. The main themes included economic causes and moral-cultural causes affecting the phenomenon of moral hazards resulted from patients’ roles. Each of these themes has some sub-themes.
False expectations from insurance companies are rooted in the moral and cultural values of individuals. People with the insurance coverage make no sense if using another person insurance identification or requesting physicians for prescribing the medicines. These expectations will lead them to moral hazards. Individuals with any insurance coverage should consider the rights of insurance agencies as third party payers and supportive organizations which disburden them from economical loads in the time of sickness.

Diabetes mellitus is a metabolic disorder and is considered as the sixth most common cause of mortality. Hospital readmission in patients with diabetes is important and can impose great costs on the health system. Therefore, this study investigated factors affecting the readmission of patients with type II diabetes to selected hospitals in Kermanshah, Iran, in 2012.
This was a descriptive-analytical and cross-sectional study on 140 patients with diabetes. The participants were selected through convenient sampling from Imam Khomeini, Taleghani, and Imam Reza Hospitals. The validity of the questionnaire used was confirmed through content validity method and its reliability through Cronbach's alpha (86%). Data were analyzed using chi-square test in SPSS software.
Findings: The results of chi-square test showed that hospital readmission had a significant relationship with the variables of sex, educational level, and occupation, number of children, present smoking status, smoking history, substance abuse, and history of disease.
This study provides a clear picture of the causes of hospital readmission for patients with diabetes. Previous studies have evaluated this phenomenon in general. However, this study presents a specific approach to patients with diabetes, thus allowing policy-makers to better plan for this group of patients in order to prevent much of the costs resulting from readmission.

Nowadays self-medication is one of the most common public health issues in many countries, as well as in Iran. According to need to epidemiological information about self-medication, the aim of this study was to systematic review and meta-analysis of prevalence and cause of self-medication in community setting of Iran. Required data were collected searching following key words: medication, self-medication, over-the-counter, non-prescription, prevalence, epidemiology, etiology, occurrence and Iran in Google Scholar, PubMed, Scopus, Magiran, SID and IranMedex (from 2000 to 2015). To estimate the overall self-medication prevalence, computer software CMA: 2 applied. In order to report the results, forest plot was employed. Out of 1256 articles, 25 articles entered to study. The overall prevalence of self-medication based on the random effect model was estimated to be 53% (95% CI, lowest= 42%, highest=67%). The prevalence of self-medication in students was 67% (95% CI, lowest=55%, highest=81%), in the household 36% (95% CI, lowest=17%, highest= 77%) and in the elderly people 68% (95% CI, lowest=54%, highest=84%).The most important cause of self-medication was mild symptoms of disease. The most important group of disease in which patients self-medicated was respiratory diseases and the most important group of medication was analgesics. The results show a relatively higher prevalence of self-medication among the Iranian community setting as compared to other countries. Raising public awareness, culture building and control of physicians and pharmacies’ performance can have beneficial effects in reduce of prevalence of self-medication.

Diabetes is the fourth leading cause of death in societies. Diabetes is not only considered just a disease but also is an interwoven network of environmental and genetic risk factors with different pathophysiology which is very costly. The aim of the present study is to investigate the utilization pattern of patients with diabetes in the centers of the City of Isfahan. The present study is a cross-sectional study which employs a descriptive method. In this study, the medical records of patients with diabetes referring to five diabetic care centers (a private center, a state-run center, a charity services center, a sub-specialized eye care center, and a subspecialized center for diabetic foot treatment) in the first half of 2013 were investigated. The data analysis was conducted using Microsoft Excel. Most of the admitted patients were referred ones and the least of them were introduced by other centers. In the second level, visits to specialists and visits to ophthalmologists had the highest frequency. In the charity center, visits to internists had the highest frequency. In the state center, visits to ophthalmologists had the highest frequency. Regarding the favorability of the degree of diabetic patient's access to services in the City of Isfahan, policy making for public screening for identifying latent cases of diabetes and including patients in treatment cyclesin order for preventing the incidence of side effects and diabetes in the members of patient's families seem necessary.

Induced demand in healthcare is referred to as provision of unnecessary services or the patient by health services providers, while the patient is not aware of their unnecessity. Apart from being unethical, this practice can potentially disturb the supply and demand balance in the health market, pose financial load on the patient, thread the patient’s health by imposing possible side-effects, and lead to waste of the limited national health resources. This study, thus, was aimed at investigating the nature of the phenomenon in Iran, as perceived by the healthcare experts. A qualitative research design was adopted. Data was collected using semi-structure interview. Participations were selected by purposive sampling method. Thematic analysis was used for extracting and categorizing the major domains of induced demand. Four major categories of health services in which induced demand occurs were extracted from the interview data, including para-clinical services, medical services, surgical services, and pharmaceutical services. These health services domains account for nineteen specific health services with the potential of induced demand. The study identified the health services domains in which induced demand frequently takes place. This information can help policy-makers to devise strategies for alleviating the problem.

To develop a clear criteria for classifying the patients in triage unit of a tertiary healthcare center according to five-level triage system. This study is a qualitative study being conducted in five stages at Vali-Asr Hospital of Qom in 2013. After two survey, the experts were interviewed using focus group discussion (FDG) and study was continue with. Data were analyzed through studying the opinions of the specialized teams'' members, summarizing and classifying the data in qualitative phase. Changes proposed in the triage form communicated by Iran''s emergency department according to the participants'' opinions include informing all the patients in the emergency department of some necessary information. Therefore, three parts of medical and medicinal history, vital signs and level of consciousness were added to the first part of the form and necessary emergency facilities were also added to the third level of triage. Measuring each item added to the general part of the triage form provides more precise diagnosis and more scientific classification, since the level to which the patient belongs should be identified based on medical history, clinical signs and level of consciousness.

Social loafing is the phenomenon of people deliberately exerting less effort to achieve a goal when they work in a group as compared to when they work alone. People who feel they are being treated unfair in an organization would be more likely to show this phenomenon. This study investigated the social loafing among nurses and its relationship with organizational justice in Tohid Hospital in Sanandaj, Iran. This was a correlational descriptive-analytical study conducted in 2012. The study population was all nurses working in Tohid Hospital in Sanandaj, Iran. Data were collected using a valid questionnaire. For data analysis SPSS-20 software was used, the descriptive statistics being frequency distribution, mean, standard deviation, and the Spearman, Mann-Whitney, and Kruskal-Wallis tests. The highest organizational justice component was found to be organizational justice (0.086 ± 3.39), and the mean of social loafing was higher in comparison with organizational justice. According to the Spearman test, all organizational justice components had inverse relations with social loafing. Only distributive organizational justice was significantly related to social loafing (p<0.05). It can be concluded that the personnel are highly sensitive to distributive justice and managers need to create the feeling that the organization has a fair distribution of resources. Hospitals should try to minimize the negative effects associated with loafing by creating an environment that discourages social loafing. One way to achieve this goal is to try to impress the personnel by telling them that their functions are important, such that they feel their job is important and that the role of nurses in connection with the patients is of value and significant.

Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them.

This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test.

Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029).

The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement

Purpose and meaning of life is most important issues of religious، administrative، philosophical and psychological. Having meaning and purpose in life indicate mental health and cause to increase ability to do things. This research aimed to study relationship between the purpose in life and general health in Veterans and ordinary people. Method & Materials: This descriptive correlation study was conducted from March until June 2012. Two groups of population including veterans (154 people) and ordinary people (145 people) that all the veterans were randomly selected in the city area and Gilangharb and Seryal Zahab in Kermanshah province. Research tools were two questionnaires of Krambaf purpose in life (PIL) and General Health Questionnaire (GHQ) Goldberg. date were analyzed using SPSS software، descriptive statistics and spearman correlation and variance analyze test. In this study، the mean score of purpose in life of veterans (81 ± 11. 85) was higher than the ordinary people (8. 45 ± 76)، But the mean score of general health in ordinary people (47. 47 ± 9. 87) was higher than the veterans (40. 12 ± 7. 57). The relationship between the score of purpose in life and general health was statistically significant that this relationship was higher in ordinary people (r = 0. 61، p <0. 001). In this study، life expectancy and general health status in veterans is higher than ordinary people. General health status in both groups is higher than the cut-off point so we require the serious attention of policy makers to improve public health.

Spiritual health is the only force that makes up the physical، mental and social dimensions of human. Social anxiety can be negative this reaction with the action. The aim of this study was to investigate relationship between spiritual health and social anxiety in chemical veterans. This descriptive correlation study used a questionnaire that included demographic، health spiritual and Liebowitz social anxiety. 109 veterans were selected by easy sampling in Kermanshah. Data analysis was performed by descriptive statistics and Spearman and Mann-Whitney test. In this study، there was an inverse relationship between spiritual health and social anxiety (p = 0/01، r = -0/363)، but between spiritual health and social anxiety associated with demographic characteristics was not statistically significant. Several studies have confirmed the existence of anxiety in veterans. Strengthening of spiritual health as a strong force on the physical، mental and social health can control social anxiety. Because the veterans need to promote physical and psychological condition in their activities. Thus reinforcing the spiritual health programs is obvious in accordance with the new social conditions.