Educational Hospitals In Iran Research Articles

Evaluating the Relationship Between Antiphospholipid Antibodies and COVID-19 Severity.

Coronavirus 2 (COVID-19) has emerged as a new global pandemic, causing severe acute respiratory syndrome. Furthermore, the existence of antiphospholipid (APL) antibodies (Abs) and ultimately patient death may be linked to the occurrence of thrombotic events in patients with COVID-19. We aimed to investigate if there was a link between the presence of APL Abs and the severity of COVID-19 disease in patients at the Vali-Asr Hospital in Zanjan from June to July 2021. Real-time PCR was used to diagnose COVID-19 in 76 hospitalized patients. A total of 38 patients were hospitalized in the internal medicine ward and another 38 people were admitted to the intensive care unit of the Vali-Asr Educational Hospital in Iran's Zanjan region. Lupus anticoagulant (LAC) detection was done using the dilute Russell viper venom time method, and tests for anticardiolipin (ACL) Abs, IgG and IgM, and anti-beta2 glycoprotein 1 Abs, IgG and IgM, were done on blood and plasma samples of linked patients using the enzyme-linked immunosorbent assay technique. SPSS 24 was used to analyze data. Our findings showed that the presence of LAC was associated with disease severity in COVID-19 patients (p = 0.001). However, there was no significant relationship between APL Abs and mortality in patients affected with COVID-19. The evaluation of APL Abs, particularly LAC, in COVID-19 patients appears to be helpful in predicting the severity of the disease.

Attitudes of Emergency Nurses and Patients' Family Members Towards the Presence of Family Members During Cardiopulmonary Resuscitation; a Cross-sectional Study.

Family presence during cardiopulmonary resuscitation (CPR) is one of the elements where family-centered care is practiced. This study aimed to investigate the attitudes of Iranian emergency nurses and patients' family members regarding the presence of family during CPR. In a cross-sectional study, 350 emergency nurses and 254 family members of patients admitted to the emergency department of an educational hospital in Iran were enrolled. Data were collected from May to November 2020 using convenience sampling and using a 27-item questionnaire of participants' attitudes towards family presence during CPR. The mean attitude scores of nurses and family members of patients regarding family presence during CPR were 86.79 ± 7.50 and 92.48 ± 6.77, respectively (p < 0.001). The highest and lowest mean scores of nurses' attitude towards family presence during CPR were related to "CPR performance will be negatively influenced" and "Family members have the right to be present during CPR of their relatives/ Allows relatives to stay with the patient until the end/ Makes the patient less worried ", respectively. The highest and lowest mean scores of family members' attitude towards family presence during CPR were related to "Family members may interfere with CPR" and " May be beneficial to the relatives' grieving process ", respectively. Overall, the results of this study showed that the attitude of emergency nurses and patients' family members towards family presence during CPR was positive. Of course, the mean attitude score of nurses in this regard was significantly lower.

The effects of foot massage on hemodialysis patients' sleep quality and restless leg syndrome: a comparison of lavender and sweet orange essential oil topical application.

Hemodialysis (HD) patients suffer more sleep problems (poor sleep quality and restless leg syndrome [RLS]). Complementary therapy, especially massage with aromatherapy oil is one of the non-pharmacological treatment options with less adverse effects than routine methods. The purpose of this study was to determine the effects of foot massage with of lavender and orange essential oil on HD patients' sleep quality and RLS. This is a double blind randomized controlled trial on 105 HD patients was conducted at a large educational hospital in Iran, Hamadan province between January and September 2017. Patients divided into three groups with random allocation (35 participants per groups in lavender, orange, and control group). Foot massage during HD with lavender and orange essential oil was administered to the patients three times a week for threeweeks, and every massage lasted half an hour. The control group received routine care. Before the intervention, the end of the first, second, and thirdweeks Pittsburgh Sleep Quality Index (PSQI) and RLS questionnaire were completed for all three groups. Data were statistically analyzed with Independent Samples t-test, chi-square test and repeated-measures analysis of variance (ANOVA) by SPSS version 16. The mean score of sleep quality and RLS in the intervention groups were significantly different compare with the control group in all three time of data collecting (p<0 001). Aromatherapy prepared with lavender oil and sweet orange may be recommended to increase sleep quality and RLS level of the HD patients.

Mothers and nurses' perceptions of the family-centered care barriers in pediatric departments of an educational hospital in Iran.

Family-centered care (FCC) is a concept used to describe an approach to caring for children and their families within health services. This study compared mothers and nurses' perceptions of barriers to FCC. This cross-sectional study was conducted in an educational hospital affiliated to Kerman University of Medical Sciences at the southeast of Iran in 2019. Using a researcher-designed questionnaire, we assessed mothers' and nurses' perceptions of barriers to FCC with a census method (60 nurses and 82 mothers). Mothers (49.8 ± 21.1) and nurses' (49.2 ± 16.4) mean scores of the perception of FCC barriers were at a moderate level. No significant difference was found between mothers' and nurses' perceptions of barriers to FCC. A significant relationship was observed between age, child's admission history, and the perception of FCC barriers in the mothers' group. Findings suggest that national and regional policies of educational hospitals should assess factors contributing to the FCC barriers, focus on how to reduce these barriers, and provide appropriate collaborative care by nurses and the family of patients.

Phenotypic and Molecular Characterization of AmpC β-Lactamases among Escherichia coli a Prospective Study in Southeast Iran.

Escherichia coli (E. coli) causes serious health problems due to the high rate of its resistance to common antibiotics. AmpC β-lactamases are important cephalosporinases, encoded by E. coli chromosome, that cause resistance to cefoxitin, cephalothin, most penicillins, cefazolin, and beta-lactamase inhibitor-beta-lactams. This study aimed to detect AmpC β-lactamases among E. coli strains at three educational hospitals in Iran. Two hundred and thirty samples were recovered from the three educational hospitals in Zahedan City in southeast Iran. Sixty E. coli strains were identified by biochemical and differential tests. E. coli strains with extended-spectrum β-lactamases (ESBLs) were selected by disk-diffusion agar method and combined diffuse disc test. Finally, selected isolates were screened by polymerase chain reaction (PCR) for the common AmpC genotypes MOX, FOX, CIT, DHA, EBC, and ACC. Out of 60 E. coli strains, 13 isolates (21.7%) were ESBL positive and 7 strains (11.6%) were phenotypically AmpC beta-lactamase producers. Three isolates had CIT (23.1%), 5 had DHA (38.5%), 4 had EBC (30.8%), and 1 had ACC (7.7%) genotypes. The high prevalence of AmpC-producing E. coli strains in hospital settings is an important challenge for health care systems. Data about beta-lactamase producers that are crucial for controlling bacterial resistance should be upgraded.

Study of clinical features of patients with COVID-19 hospitalized in an educational hospital in Iran

BACKGROUND:The outbreak of new pathogens or the resurgence of pathogens that have already spread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade the human respiratory system in the first place. Coronaviruses form a large family and are so called because of the presence of crown like cristae on their surface.MATERIALS AND METHODS:This is a cross-sectional, descriptive study conducted to assess the status of patients with COVID-19 who were hospitalized in an educational hospital. For this purpose, 142 patients hospitalized in this hospital were followed up 2 weeks after discharge and were inquired about the symptoms they had upon admission to the hospital, the number of hospitalization days, the history of underlying disease, and so on. Descriptive data analysis was done with the SPSS software version 22.RESULTS:The findings of this research showed that overweight or obese people (about 66%) is more likely to contract the disease. It also seems that older people (37.3% older than 60 years old) and those with a history of diseases (69.6%) such as diabetes, high blood pressure, or heart disease are more prone to COVID-19. The most common symptoms of COVID-19 patients included fever (64.5%), shortness of breath (67.4%), and dry cough (50.4%).CONCLUSION:it seems that high risk group (obese people, old people, and people with a history of disease) is more likely to be infect with coronavirus so they should more careful than others. Another important issue is that policy-makers must play an active role in public awareness of dangers of COVID-19 and ways to prevent it.

Anxiety, stress and depression levels among nurses of educational hospitals in Iran: Time of performing nursing care for suspected and confirmed COVID-19 patients.

BACKGROUND:Following the global emergency of coronavirus disease 2019 (COVID-19), health-care workers, especially nurses were encountered with an increasing workload. Therefore, due to the importance of this issue, the present study aimed to examine stress, anxiety, and depression levels among nurses during the COVID-19 pandemic in Iran.MATERIALS AND METHODS:This cross-sectional study was conducted in four educational hospitals affiliated to Kerman University of Medical Sciences in 2020. The standard Depression, Anxiety and Stress Scale-21 questionnaire was applied to assess the levels of stress, anxiety, and depression in nurse personnel with a census method (n = 403). Data were analyzed using descriptive statistics and analytic statistics such as Kolmogorov–Smirnov, Mann–Whitney, Kruskal–Wallis, and multiple linear regression tests through the version 20, SPSS Inc., Chicago, IL, USA, Software at the level of P < 0.05.RESULTS:The results of the study showed that the mean scores of depressions (9.18 ± 4.45), stress (9.62 ± 4.94), and anxiety (10.32 ± 4.85) in nurses were at moderate level. A significant relationship was observed between stressed, anxious, and depressed participants in the gender, marital status, level of education, and working hours per month. No statistically significant relationship was found between other demographic variables including age, work experience, and employment status with anxiety, depression, and stress categories.CONCLUSION:The results of this study can increase the awareness of health system managers, especially hospitals, about the level of stress, anxiety, and depression and can help in order to provide psychological support programs for improving the mental health of nurses during the COVID-19 pandemic.

Validation of the 30-item nurses' observation scale for inpatient evaluation and mental health-care promotion.

CONTEXT:The 30-item nurses' observation scale for inpatient evaluation (NOSIE-30) developed for the behavioral and observational rating of psychiatric inpatients.AIMS:The purpose of this study was to evaluate the validation of the NOSIE-30 and mental health-care promotion.MATERIALS AND METHODS:The participants with psychiatric disorders were selected from 310 inpatients referred to the military educational hospital in Iran. This study was carried out in two phases: First, translation of the NOSIE-30 into Persian followed the stepwise, iterative procedures developed by the International Quality of Life Assessment project approach. Second, face validity, criterion-related validity and construct validity, and reliability of the Persian version were determined. The concurrent validity was assessed by using the global assessment of functioning (GAF) instrument. Data were analyzed with the SPSS software of version 22. Exploratory factor analysis, the Cronbach's alpha coefficient, and interrater agreement with intraclass correlation coefficient and Pearson's correlation coefficient were used to data analysis.RESULTS:Pearson's correlation coefficient between the NOSIE and GAF was 0.75. The interrater reliability for subscale scores and structure of the NOSIE were ranging from 0.70 to 0.94 and Cohen's kappa = 0.74. Furthermore, the internal consistency of the scale's total scores was estimated by Cronbach's alpha = 0.85.CONCLUSIONS:The finding indicated that NOSIE-30 Persian version scale has the desirable validity and reliability for evaluating the nursing care of inpatients. Thus, nurses can promote mental health care by applying this scale in the psychiatric setting.

Psychosocial Needs of the Families With Hospitalized Organ Transplant Patients in an Educational Hospital in Iran.

Nurses are required to understand and meet the physiological needs of the family members of the patients hospitalized in transplant wards of the hospitals. Considering the importance of this issue, this study aimed to investigate the psychosocial needs of the families with an organ transplant patient. The study employed a cross-sectional design and was conducted in Afzalipour Educational Hospital affiliated to the Kerman University of Medical Sciences in 2018. The 45-item questionnaire of the psychosocial needs was applied to assess the psychosocial needs of the families with an organ transplant patient, including kidney, liver, and bone marrow. The quota sampling method was used and 230 participants completed the survey. Data were analyzed using descriptive mean and SD and analytical statistics independent t-test, anova, and Pearson's correlation coefficient tests by SPSS 22 (version 22, SPSS, Chicago Inc., IL). The results indicated that the mean scores of psychological needs of families with transplanted patients hospitalized in three wards of bone marrow, kidney, and liver were at a high level (143/16 ± 12/29). The mean scores of psychosocial needs in the bone marrow transplantation ward (148/60 ± 8/18) were significantly higher than those of the patients hospitalized in the liver (141/24 ± 16/41) and kidney (141/25 ± 11/30) wards. A significant difference was observed among the three wards of the liver, kidney, and bone marrow transplantation with regard to the provided support, information, and proximity. To improve the psychological needs of the family members with patients hospitalized in transplant wards and reduce their mental reactions, they should be provided with more precise information about the patient's treatment procedure.

Effect of massage on behavioural responses of preterm infants in an educational hospital in Iran

ABSTRACTObjective: The aim of this study was to assess the effect of providing massage (tactile and kinesthetic stimulation) on behavioural responses for preterm infants.Background: These infants have immature central nervous systems. Sleep–wake states during infancy have been shown to reflect severity of disease developments, and the nervous system and brain maturation.Methods: This study is a quasi-experimental study with before and after design conducted on 45 preterm infants who were admitted in neonatal intensive care unit (NICU). The subjects received massage 15 min per day for 5 days using field massage technique. Behavioural responses were measured by behavioural state, motor activity and behavioural distress. Data were obtained 10 min before and 10 min after the providing massage period.Results: An increase was observed in sleep state score after providing massage. And also, the awake, fidgeting and motor activity scores reduced after providing massage. No significant change was seen in the total behavioural distress.Conclusion: The findings suggest that providing field massage had soothing and calming effect on preterm infants and could be beneficial in nursing intervention. Nurses working in neonatal intensive care unit need to be educated on how to performing the massage on preterm infants.Abbreviation: NICU: Neonatal Intensive Care Unit

Attitudes of Iranian Nurses Toward Spirituality and Spiritual Care.

Spirituality and spiritual care play a crucial role in providing more effective treatment for patients. The purpose of this study was to determine nurses' attitudes toward spirituality and spiritual care in an educational hospital in Iran. A significant association was found between nurses' spirituality/spiritual care attitudes and age, education level, and type of hospital ward employment (noncritical vs. critical care). Nurses' scores on attitudes toward spirituality and spiritual care suggest the need for more education in this area.

Barriers to adopt the Health Promoting Hospitals (HPH) initiative in Iran: The Q method derived perspectives of front line practitioners

ObjectiveThis study aimed to investigate prospects of a sample of Iranian front line health care professionals about their perceived barriers to implement the HPH initiative. MethodsThe six stages Q methodology was applied to systematically envisage divergent perspectives of the 33 health professionals (7 physicians, 2 managerial and 24 nurses) working in the 10 educational hospitals in Iran. ResultsAnalysis of the study participants’ viewpoints (the Q-sorts) resulted in a five factor solution (accounted for 48% of the total variance) to endorse main barriers of the HPH implementation in the typical Iranian hospitals. The health professionals’ dominant biomedical approach and their deficit commitment to health promotion programs, inappropriate decision-making mechanisms and insufficiency of the organizational infrastructure in the Iranian national health system (INHS) were among the important emanated factors to sustainably maintain the HPH program. ConclusionThe identified barriers reflect the spheres that need to be focused in interventions to facilitate the successful implementation of the HPH initiative in Iran and other developing countries. Practice implicationsDespite the existent consensus about overall merits of the HPH to fulfill best interests of hospitalized patients, major challenges deems to exist for operability of this beneficial undertaking in Iran.

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial.

Coronary angiography can be stressful for patients and anxiety-caused physiological responses during the procedure increase the risk of dysrhythmia, coronary artery spasms and rupture. This study therefore aimed to investigate the effects of peer, video and combined peer-and-video training on anxiety among patients undergoing coronary angiography. This single-blinded randomised controlled clinical trial was conducted at two large educational hospitals in Iran between April and July 2016. A total of 120 adult patients undergoing coronary angiography were recruited. Using a block randomisation method, participants were assigned to one of four groups, with those in the control group receiving no training and those in the three intervention groups receiving either peer-facilitated training, video-based training or a combination of both. A Persian-language validated version of the State-Trait Anxiety Inventory was used to measure pre- and post-intervention anxiety. There were no statistically significant differences in mean pre-intervention anxiety scores between the four groups (F = 0.31; P = 0.81). In contrast, there was a significant reduction in post-intervention anxiety among all three intervention groups compared to the control group (F = 27.71; P <0.01); however, there was no significant difference in anxiety level in terms of the type of intervention used. Peer, video and combined peer-and-video education were equally effective in reducing angiography-related patient anxiety. Such techniques are recommended to reduce anxiety amongst patients undergoing coronary angiography in hospitals in Iran.

Health information technology and health care activists: Where is the place of Iranians?

BackgroundThe level of knowledge and using health information technology by clinicians, students and staff has always been one of the essential issues in the field of health.ObjectiveThe objective of the present study was to evaluate HIT knowledge, attitude, and practice habits among health care professionals and students in educational hospitals in Iran.MethodsThis case study was carried out in 2016 on 539 personnel of 65 educational hospitals in Iran entailing three subgroups of physicians (n=128), medical students (n=97), and health record staff (n=314). A pretested self-administered questionnaire was designed to evaluate the knowledge, attitude and practice of health information technology. It was comprised of three parts of “baseline general characteristics”, “knowledge categories”, and “attitude and practice”.ResultsIn total, 28.8% of participants had a good level of knowledge about computer science, whereas 37.7% had a poor level of knowledge. A total of 40% showed good attitude and practice, while 25.6% had poor attitude and practice. Furthermore, 16.4% of physicians, 32% of students and 33.1% of health record staff had good knowledge, while poor knowledge was reported in 45.3% of physicians, 25.8% of students, and 37.6% of staff (p=0.304). The trend of good attitude and practice habits were respectively 28.9%, 50.5%, and 40.8% in physicians, students, and staff, whereas these trends were respectively 30.5%, 4.1%, and 29.9% for poor attitude and practice (p=0.163). Generally, the knowledge level of participants was positively related to the rate of attitude and practice (r=0.847, p<0.001), so the higher knowledge level brought about the higher score in attitude and practice.ConclusionThe level of knowledge and practice of HIT was low among the physicians, students, and staff. Our university can provide a plenary program to promote the level of knowledge and information on practice of HIT.

Domestic Violence Against Women Working in Four Educational Hospitals in Iran.

Domestic violence is a serious threat to the health of women in the world and derives from several factors. Therefore, due to the importance of this issue, this study aimed to determine domestic violence against women in four educational hospitals in Iran as a Muslim country. The study employed a cross-sectional design and was conducted in four educational hospitals supervised by the Kerman University of Medical Sciences in 2016. Using a researcher-made questionnaire, we assessed factors associated with domestic violence in female employees using a census method (N = 400). Data were analyzed using descriptive statistics including mean and SD and analytic statistics such as Kolmogorov-Smirnov, ANOVA, t test, and Pearson and multivariate regression tests using SPSS 16 and p ≤ .05. This study showed that most common types of violence against women are psychological/verbal (58%), physical (29.25%), and sexual (10%), respectively. There was a significant relationship between couples' age gap, forced marriage, husband addiction, income, and history of violence experienced by the husband with domestic violence against women. This study examines the basic prevalence of partner violence victimization among Iranian women who work in hospitals in southeast Iran. Findings suggest that national and local policies in Iran may need to examine factors that contribute to violence against women as well as focusing on how to reduce partner violence.

Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study.

Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED). In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016. The discriminatory power and calibration of the models were calculated and compared using STATA 11. 2148 patients with the mean age of 39.50±17.27 years were studied (75.56% males). The area under the curve of REMS and RAPS in predicting in-hospital mortality were calculated to be 0.93 (95% CI: 0.92-0.95) and 0.899 (95% CI: 0.86-0.93), respectively (p=0.02). These measures were 0.92 (95% CI: 0.90-0.94) and 0.86 (95% CI: 0.83-0.90), respectively, regarding poor outcome (p=0.001). The optimum cut-off point in predicting outcome was found to be 3 for REMS model and 2 for RAPS model. The sensitivity and specificity of REMS and RAPS in the mentioned cut offs were 95.93 vs. 85.37 and 77.63 vs. 83.51, respectively, in predicting mortality. Calibration and overall performance of the two models were acceptable. The present study showed that adding age and level of arterial oxygen saturation to the variables included in RAPS model can increase its predictive value. Therefore, it seems that REMS could be used for predicting mortality and poor outcome of trauma patients in emergency settings.

User Acceptance of Picture Archiving and Communication System in the Emergency Department.

BackgroundPicture archiving and communication system (PACS) has allowed the medical images to be transmitted, stored, retrieved, and displayed in different locations of a hospital or health system. Using PACS in the emergency department will eventually result in improved efficiency and patient care. In spite of the abundant benefits of employing PACS, there are some challenges in implementing this technology like users’ resistance to accept the technology, which has a critical role in PACS success.ObjectivesIn this study, we will assess and compare user acceptance of PACS in the emergency departments of three different hospitals and investigate the effect of socio-demographic factors on this acceptance.Materials and MethodsA variant of technology acceptance model (TAM) has been used in order to measure the acceptance level of PACS in the emergency department of three educational hospitals in Iran. A previously used questionnaire was validated and utilized to collect the study data. A stepwise multiple regression model was used to predict factors influencing acceptance score as the dependent variable.ResultsMean age of participants was 32.9 years (standard deviation [SD] = 6.08). Participants with the specialty degree got a higher acceptance score than the three other groups (Mean ± SD = 4.17 ± 0.20). Age, gender, degree of PACS usage and participant’s occupation (profession) did not influence the acceptance score. In our multiple regression model, all three variables of perceived usefulness (PU), perceived ease of use (PEU) and the effect of PACS (change) had a significant effect in the prediction of acceptance. The most influencing factor was change with the beta of 0.22 (P value < 0.001).ConclusionPACS is highly accepted in all three emergency departments especially among specialists. PU, PEU and change are factors influencing PACS acceptance. Our study can be used as an evidence of PACS acceptance in emergency wards.

Validation of thoracic injury rule out criteria as a decision instrument for screening of chest radiography in blunt thoracic trauma

Thoracic injury rule out criteria (TIRC) were first introduced as a decision instrument for selective chest radiography in blunt thoracic trauma in 2014. However, the validity of this model has not been assessed in other studies. In this regard, the present survey evaluates the validity of TIRC model in a multi-center setting. In this cross-sectional study, clinical presentations and chest radiograms of multiple trauma patients referring to 6 educational hospitals in Iran were evaluated. Data were gathered prospectively during 2015. In each center, data collection and interpretation of radiograms were conducted by two different emergency medicine specialists. Measures were then taken for assessment of discriminatory power and calibration of the model. Data from 2905 patients were gathered (73.17% were male; the mean age was 33.53±15.42 years). Area under the receiver operating characteristics curve of the TIRC model for detection of thoracic traumatic injuries was 0.93 (95%CI: 0.93-0.94). Sensitivity and specificity of the model were 100 (98.91-100) and 67.65 (65.76-69.45), respectively. The intercept of TIRC calibration plot was 0.08 (95%CI: 0.07-0.09), and its slope was 1.19 (95%CI: 1.15-1.24), which are indicative of the model being perfect in detecting presence or absence of lesions in chest radiograms. The findings are corroborative of external validation, good discrimination, and proper calibration of TIRC model in screening of multiple trauma patients for obtaining chest radiograms.

Learning Organization Profile of Educational Hospitals in Iran: Practice of Organizational Interlocking Systems.

Background:Organizational learning has been identified as necessary for different organizations to improve their performance in the changing and competitive environment.Purpose:The main purpose of this research was to specify the learning organization profile of educational and health centers of Tehran and Qazvin Universities of Medical Sciences in Iran.Methodology:The present research was conducted using a cross-sectional method in the academic year of 2013-2014. A staff of 530 from educational hospitals subordinated to Tehran and Qazvin universities of medical sciences participated in the research. The participants were selected using stratified random sampling. That is to say, a random sample of a proportionate size was selected from each hospital. The instrument for data collection was a Likert-scale questionnaire involving 50 items. The statistical techniques of ANOVA, t-test, Chi-square, correlation coefficients (Pearson and Spearman), and regression were utilized to analyze the data. All of them were performed using the Statistical Package for Social Sciences (SPSS) 16.0 for windows.Result:The results indicated that 449 of participants (84.7%) had a B.S. degree and 78 of them (14.7%) had an M.S. or a Ph.D. degree. Among the fivefold dimensions of “Learning Organization” model (Learning, Organization, People, Knowledge, and Technology) in comparison of the two universities, the “people” dimension was the highest-rated dimension with the mean rating of 25.71±8.36 and the “learning” dimension was the lowest-rated dimension with the mean of 25.35±8.04. Comparison between the two universities yielded the result that educational hospitals in Tehran University of medical sciences with the rating of 126.56 had a more complete profile than that of educational hospitals in Qazvin university of medical sciences with the rating of 122.23.Conclusion:The hospitals of the two above-mentioned universities were, to a great extent, far from the characteristics of Learning Organization. In light of the massive mission of these centers to maintain and improve the community health and to train the skilled labor force, the centers should embark on updating the data and institutionalizing learning. Furthermore, to modify staff’s behavior and performance and to achieve their goals, they should accentuate the importance of acquiring, creating, and transferring knowledge.

Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

Today, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients' dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients' complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS). This descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty) training hospital. All the recorded patients' complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. A total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%), communication failures (20.17%) and dissatisfaction with the provided care (14.59%). Thirty one (13.31%) cases were solved at first place, 194 (83.26%) referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. The findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients' needs and expectations may reduce complaints from public health facilities.