Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 One verse,OneConcept 301 301 FA Goli Arji Samira Alirezaei

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 The Necessity of Implementing Health Promotion Programs in Hospitals 302 305 FA Tahere Soltani Assistant Professor, Health Education and Promotion Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran The epidemiologic transition has caused the hospitals to focus on health promotion strategies in order to improve the health of their patients and staff. It is one of the reasons that justify institutionalizing the concept of prevention and health promotion among all hospital personnel, empowering patients and interacting with society. It is possible to use this high capacity with lowest cost and introduce the concept of improving the health of hospitals into their organizational culture.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 Organizational Insentience in the Red Crescent Population: Model Development with a Mixed Methods Approach 306 321 FA Seyed Ali Salehi Koocheh Baghi Ph.D. student of Public Administration, Chalous Branch, Islamic Azad University, Chalous, Iran Maryam Rahmaty Assistant Professor, Department of Management, Chalous Branch, Islamic Azad University, Chalous, Iran Davood Kia Kojouri Associate Professor, Department of Management, Chalous Branch, Islamic Azad University, Chalous, Iran Background: Considering the high goals of an organization, one of the most important tasks of organizations is to motivate employees as the strategic assets of the organization. The phenomenon of organizational insentience has been one of the main challenges in recent years and refers to a situation in which employees of the organization are not motivated toward their organizational environment. Accordingly, the present study aims to develop the scale of organizational insentience in the Red Crescent Society of the Islamic Republic of Iran. Methods: The present study was conducted through a mixed method in 2022. The qualitative part has been done using the grounded theory approach and based on semi-structured and in-depth interviews with 21 experts selected through purposive and snowball samplings. Furthermore, the quantitative part has been done by the structural equations modeling with partial least squares approach and Smart PLS3 software. The statistical population of the research in the quantitative part included all the executives (110 people) of the Tehran Red Crescent Organization. With a random sampling method based on Cochran formula, 85 people were selected, and for further confidence and reducing the sampling error, 90 individuals were selected for the sample. To collect data in a quantitative part, the researcher-made questionnaire regarding organizational insentience derived from the research model was used. It included 34 items in the form of a 5-point Likert scale. The reliability of the questionnaire was assessed through Cronbach's alpha coefficient, and combined reliability and validity were assessed through the construct validity method, both of which were confirmed based on the results. Results: In the qualitative part, after 3 stages of open, central and selective coding, the research model including 6 main categories (central category; causal, intervening, and background conditions; strategies and consequences of organizational insentience) and 29 sub-categories were presented. The results of the quantitative part showed that causal conditions with a significant value of (0.001) and path coefficient of (0.725) had a significant and positive effect on the central category, and intervening conditions with a significant value of (0.003) and path coefficient of (0.221), background conditions with a significant value of (0.002) and path coefficient of (0.410) and central category with a significant value of (0.023) and path coefficient of (0.334) had a positive and significant effect on strategies. Moreover, strategies with a significant value of (0.001) and path coefficient of (0.347) had a positive and significant effect on the individual and organizational consequences of insentience in Tehran Red Crescent population. Conclusion: The results demonstrated that the model presented in this study was a suitable model for knowledge and awareness of managers in the field of concepts and categories affecting organizational insentience. Therefore, it is recommended that the managers of the Red Crescent Society use the model presented in this study to minimize the phenomenon of organizational insentience and increase employees' productivity.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 Challenges of Safety Culture in Educational and Medical Hospitals: A Qualitative Study in Tehran 322 333 FA Mahdi Hasani Ph.D. of Health Services Management, Research Center for Cognitive & Behavioral Sciences in Police, Directorate of Health, Rescue & Treatment, Police Force, Tehran, Iran Hasan Abolghasem Gorji Associate Professor, Department of Health Services Management, Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran Asaad Ranaei Ph.D. of Health Services Management, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Srva Rezaee Ph.D. student of Nursing, Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Noureddin Niknam Assistant Professor, Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran Background: Safety culture is the basis and dominant part of patient's safety, and is considered as the main axis of safety promotion programs and service quality. The purpose of this study was to explain the challenges of safety culture in Iranian educational centers with a qualitative approach. Methods: This study was a contractual qualitative content analysis which conducted in 1400. The study population consisted of people who had 5 years of experience in taking care patient or working in the patient's safety and quality control unit in teaching and medical centers affiliated to Tehran University of Medical Sciences. Study data were saturated by purposeful snowball sampling and in-depth and semi-structured interviews with 25 participants. “Granheim and Landman approaches” and “Goba and Lincoln criteria” were used to analyze the data and solidify the research. The process of coding and analyzing research data was performed simultaneously; Finally, the extracted categories and subcategories were confirmed by the interviewees. MaxQDA 10 was used to analyze data. Results: By analyzing the interviews, 331 codes, 7 categories and 20 subcategories were extracted. Lack of reporting errors, poor culture regarding no-blame, staffing issues, low understanding of patient safety, poor management support for patient safety, poor teamwork between units, and lack of open organizational communication were the main categories found and the most important challenges of safety culture in teaching and medical hospitals. Conclusion: According to the findings of the research, developing codified and continuous educational programs, strengthening teamwork and communication, adopting a comprehensive approach to increase the presence of all members of the treatment team in the process of reporting, and analyzing and implementing error prevention programs are among the requirements for improving and promoting the safety culture and quality of service to patients.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 Analysis of Promoting and Hindering Factors for Implementation of Medical Tourism Policies: Case Study in Golestan Province 334 346 FA Hossein Livani Ph.D student of Public Administration, Department of Public Administration, Gorgan Branch, Islamic Azad University, Gorgan, Iran Ali Farhadi Mahalli Assistant Professor, Department of Public Administration, Gorgan Branch, Islamic Azad University, Gorgan, Iran Alireza Matoufi Associate Professor, Department of Public Administration, Gorgan Branch, Islamic Azad University, Gorgan, Iran Background: Medical tourism as a money-making industry in the world has led to the increasing competition of countries to attract the maximum number of tourists. Considering the growing international competition in this field, in order to properly utilize the capabilities of Golestan province, this research was conducted with the aim of analysis and explaining the dimensions and components that promote and hinder the implementation of medical tourism policies in Golestan province. Methods: This research was conducted using the qualitative method based on the Grounded theory in 2020. Data collection was conducted through in-depth and semi-structured interviews. The research population included experts such as managers and faculty members of the university of medical sciences and public and private hospitals, managers and officials of the General Office of Cultural Heritage and Tourism, and travel agencies, doctors and nurses with at least 5 years of relevant work experience and expertise in the field of medical tourism. Purposive sampling was done and continued until data saturation. Finally, 13 people were interviewed. Data analysis was done simultaneously with data collection through Open, Axial and Selective coding and MaxQDA 2020 software. Results: The findings of the present study showed that the promoting and hindering factors for the implementation of medical tourism policies in Golestan province were categorized in the form of 263 codes, 65 concepts, 9 subcategories and 5 main categories. They consisted of climatic and environmental attractions, organizational architecture, policymaking system, capacity development and service quality and strategic management. Conclusion: Using the results of this study, the policymakers of medical tourism in Golestan province can predict the appropriate implementation instrument regarding the policy-making process to develop medical tourism, income and business in Golestan province.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 The Effect of Social Support on the Motivation of Health Workers of Yazd with the Mediating Role of Job Stress 347 355 FA Mehdi Kabiri Naeini Assistant Professor, Department of Industrial Engineering, School of Technical Engineering, Payam Noor University, Tehran, Iran Mohtaramsadat Hosseini MSc student in Human Resources Management, School of Management, Payam Noor University, Tehran, Iran Zeynab Elahi MSc in Industrial Engineering, Department of Industrial Engineering, School of Technical Engineering, Payam Noor University, Tehran, Iran Background: Considering the impact of employees' motivation on the quantity and quality of their performance, it is necessary that managers pay attention to the variables which strengthen and weaken motivation. Social support means being accepted by society and appreciating the employees' services by people, which can be effective in reducing job stress and tensions and improving employees' motivation. Occupational stress is a phenomenon in which employees are caught when facing expectations beyond their known capacity. It manifests itself in the form of physiological, psychological and behavioral effects. The aim of this article is to examine the effect of social support on the motivation of health sector employees with the mediating role of job stress in the health and treatment sector of Yazd. Methods: The present cross-sectional study was conducted on the employees of the health and treatment in Yazd in 2021. Using Cronbach's alpha formula, 346 employees were selected by simple random method. The required data were collected by 3 standard questionnaires: Haynes et al, Perry and Karnavaq et al. The convergent, divergent, and content validity and the composite reliability coefficient of the questionnaire were confirmed by the opinion of management professors and experts of Yazd health and treatment department. Using Cronbach's alpha test, its internal consistency was confirmed. In order to analyze data, descriptive statistics and structural equation model and SPSS 20 and AMOS 18 software were used. Results: 3 research hypotheses were confirmed through the path test and structural equation model. The findings showed that social support with the critical value of (3.163) and path coefficient of (0.85) had a positive and significant effect on employees' motivation (p = 0.002). Social support had a negative and significant effect (p = 0/042) on job stress with the critical value of (- 2.996) and path coefficient of (- 0.17). Job stress also had a negative and significant effect (p = 0.001) on employees' motivation with a critical value of (- 2.308) and the path coefficient of (- 0.28). Finally, job stress played a mediating role regarding the test statistic (2.12) in the path of these 2 variables. Conclusion:  As the coverage of social support increases, mental health and occupational motivation of each individual improve, and finally, stress-related factors will be reduced.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 Investigating the Communication Apprehension Model of Physicians in Public Hospitals of Yazd City 356 368 FA Rohollah Mirjalili Ph.D. student of Public Administration, Department of Management, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Hossein Kazemi Assistant Professor, Department of Management, School of Administrative Sciences and Economics, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran Malike Beheshti Far Associate Professor, Department of Management, Rafsanjan Branch, Islamic Azad University, Rafsanjan, Iran Background: A good and healthy communication between the physician and patient and the therapeutic staff is the basis of good medical care, and communication skills play an important role in patient's satisfaction and their treatment. The aim of this study was to explore the physicians' communication in public hospitals of Yazd city using phenomenological methods. Methods: This qualitative research was conducted using the phenomenology method from January 2021 to August 2022. The location of the study was 2 hospitals affiliated to Shahid Sadoughi University of Yazd. The statistical population included general practitioners and specialists from the government hospitals of Yazd city. Among these doctors, 12 people who had a working experience of more than 11 years and were willing to cooperate with the researcher were selected as the sample using a selective and purposive method. Data were collected through interviews. Lincoln and Guba criteria were used to assess validity and reliability of the research, and these data were analyzed by NVIVO 11 software. Results: Results demonstrated that physicians' communication pattern consisted of 11 sub-themes: psychological factors; family factors; lack of skills; information disorders; challenges related to patients, colleagues, and medical profession; hospital environment; social harm; and religious factors. These sub-themes were categorized into five main themes: environmental, individual, communicative, cultural, and professional aspects. Conclusion: Establishing a proper relationship between the patient and physician is the essential component of a high quality medical care. Improving this relationship will cause patient's more commitment to the treatment, more satisfaction with the medical team, and less medical errors and complaints.

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 The Impact of Internal and External Integration on Hospital Performance in Context with Supply Chain Value Addition 369 379 FA Mehdi Haddadzade Assistant professor, Department of Business Management, Payame Noor University,Tehran,Iran Alie Sadat Motevalian Bafghi MSc student in Public Management, Department of Public Management, Payame Noor University, Tehran, Iran Background: The performance of an organization is affected by activities of other supply chain members. The key issue in a supply chain is the coordinated management and control of all these activities, which is achieved through proper integration of the supply chain. Therefore, this study was conducted with the aim of investigating the effect of internal and external integration on the performance of hospital with the mediating role of added value of the supply chain in Hazrat Valiasr Bafaq Hospital. Methods: The current cross-sectional research was conducted with the structural equation approach in 1400. The statistical population included all the employees (250 people) of Hazrat Waliasr Bafaq Hospital, 163 of whom were randomly selected based on Cochran's formula. Data collection tools included value added questionnaires of supply chain, internal integration, external integration and performance. The validity of the instruments was investigated and confirmed using convergent and divergent validity, and reliability was studied using Cronbach's alpha and composite reliability. The structural equations model and SPSS 24 and LISREL 8 software were used to analyze the data. Results: Findings showed that internal integration with a significant value of 1.925 and path coefficient = 0.177 does not affect performance, and external integration with a significant value of 5.670 and path coefficient = 0.446 had a positive and significant effect on performance. Moreover, internal integration with a significant value of 2.281 and path coefficient = 0.265, and external integration with a significant value of 5.586 and path coefficient = 0.495 had a significant positive effect on the added value of the supply chain. The added value of the supply chain had a positive and significant effect on performance with a significant value of 2.315 and path coefficient = 0.231. In addition, the added value of the supply chain explains the mediating role between integration and performance. The quality of the final model of the research had a good fit with the overall model fit index (0.38). Conclusion: The findings of this study showed that External integration has a significant effect on both the performance and supply chain value addition. But internal integration only affects supply chain value addition. It was also found that interdepartmental coordination is one of the important parameters for improving hospital performance. According to the results of this research, it is suggested that all the internal activities of the hospital be carried out based on a written program. Moreover, a special focus on the added value of the supply chain should be included as one of the hospital's strategies.  

Shahid Sadoughi University of Medical Sciences Management Strategies in Health System 2476-6879 7 4 2023 3 1 The Effectiveness of Acceptance and Commitment Therapy on Emotional Regulation and Psychological Distress in Patients with Chronic Low Back Pain and COVID-19 Anxiety 380 391 FA Farzin Bagheri Sheykhangafshe Ph.D. Student of Psychology, School of Humanities, Tarbiat Modares University, Tehran, Iran Hojjatollah Farahani Assistant Professor, Department of Psychology, School of Humanities, Tarbiat Modares University, Tehran, Iran Ali Fathi-Ashtiani Professor, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Background: The COVID-19 pandemic brought many psychological consequences for patients with chronic low back pain. The present study aimed to assess the effectiveness of acceptance and commitment therapy on emotional regulation and psychological distress in patients with chronic low back pain and COVID-19 anxiety. Methods: This was a semi-experimental study with a pre-test-post-test design and a control group. The statistical population included patients with chronic low back pain in Tehran in 2021. The study sample included 30 patients with chronic low back pain who were selected using the convenience sampling method and were randomly assigned in to two experimental and control groups. The collection tools included COVID-19 anxiety (Alipour et al (2020)), emotional regulation (Gross and John (2003)), and psychological distress (Lovibond and Lovibond (1995)) questionnaires. The experimental group received 8 ninety-minute sessions of therapy based on acceptance and commitment, but the control group did not receive any intervention. Research data were analyzed using descriptive statistics (mean and standard deviation), normality (Shapiro-Wilk test), multivariate covariance analysis, univariate covariance analysis test in Mancova text, and Levene's, Box's and Bartlett's chi-square tests at a significance level of 0.05 through SPSS 24 software. Results: The results of the present study showed that acceptance and commitment therapy has significantly increased emotion regulation (reevaluation and suppression) and reduced psychological distress (depression, anxiety, and stress) in patients suffering from chronic low back pain and COVID-19 anxiety (p > 0.05). Conclusion: Based on the findings, it can be concluded that acceptance and commitment therapy has been able to reduce the psychological problems of patients with chronic low back pain and COVID-19 anxiety. For this purpose, it is suggested to hold workshops and develop programs by psychologists and pain specialists for patients with chronic low back pain.