ABSTRACT
Clinical governance is a framework in which the organizations providing clinical services are responsible in exchange for the permanent improvement of quality and preserving the service's high standard. It relies on the responsibility to maintain current levels of care and on clinical governance pillars to improve the quality of future care. Also, it is a concept that attempts to integrate the previous methods and tools in measuring and improving quality of care. This descriptive-analytic-interventional study was conducted to evaluate the hospitals of Mashhad before and after the establishment of clinical governance in 2011. Data were collected by both questionnaires and observation. Comparing the range of clinical governance's pillars obtained, from the selected hospitals, showed a significant improvement in all studied axes following the establishment of clinical governance. The highest effectiveness was related to clinical audit, staff management and training axes, whereas the least effective part was the interaction with patients, their relatives and the community. Regarding the significant difference in the obtained results after the establishment of clinical governance in this study, it could be concluded that the establishment of clinical governance and its performance could remarkably improve the quality of health services.
Subject(s)
Health Services , HospitalsABSTRACT
The aim of this research was to determine the relationship between perceived childhood attachment and adolescent attachment with identity status. This was a descriptive-analytic, cross sectional study. The sample was consisted of 106 females and 104 males' high school students [15-17 years] in Torbat-e-Jam city, north east of Iran, which was selected through randomized and multistage sampling in 2008-2009. Attachment to parents measured by Attachment to Each Parents Scale and attachment in adolescents measured by Revised Adult Attachment Scale and identity status measured by Extended Objective Measure of Ego Identity Status-2 Version Scale [EOM-EIS-2]. Data were analyzed through chi square and liner regression analysis. Findings show that secure, non secure-ambivalence and non secure-avoidance attachment styles had the most effect on the achieved identity, respectively. Non secure-avoidance, non secure-ambivalence and secure attachment styles had the most effect on the foreclosure identity, respectively too. Moreover non secure-ambivalence and avoidance attachment styles [positive relationship] and secure attachment style [negative relationship] had the most effect on the moratorium identity respectively and Non secure-avoidance and secure attachment styles [negative relationship] and ambivalence attachment style [positive relationship] had the most effect on the diffused identity respectively. Findings indicated that there are meaningful relationships between perceived childhood attachment style and identity status and between different attachment styles and identity status in high school students
ABSTRACT
Anxiety disorder is one of the prevalent disorders among children which could be the cause of many dysfunctions. As many researches have shown the family structure for anxiety disorders, this study is aimed at investigating the frequency of anxiety and depressive disorders in the parents of children with anxiety and comparing it with the control group. In this case-control study, the parents of 30 children which had been diagnosed as an anxiety case by child psychiatrist in Dr. Sheikh Hospital and 30 children without any psychiatric disorder with the age range of 3 to 12 were tested employing Beck Depression Inventory and Spielberger state trait anxiety inventory to evaluate the severity and frequency of depressive and anxiety disorders. The frequency of depression in patients' mothers was significantly higher than the control group [P=0.002] whereas the results among fathers showed no meaningful difference. The frequency of trait anxiety was significantly higher [P=0.004] in patients' mothers in comparison to the control group; however, this revealed no meaningful difference among fathers of the two groups. Although, the frequency of state anxiety in both fathers and mothers of the control group was a little higher than the patient's parents, this showed no significant difference. The results of this study showed that the frequency of depressive and anxiety disorder in patient's mothers was higher than the control group. Also, the findings indicated that the mentioned disorders in patients' fathers did not show any significant difference