[Patient education barriers from nurses' opinions]

Introduction: Patient education is one of the important aspects of nursing care and is among nursing key roles in delivery of health services

Objective: This study aimed to determine the barriers to patient education from nurses' viewpoint employed in educational hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd

Methods: This study was a cross-sectional and descriptiveanalytical study in which 162 nursing personnel were selected by stratified-random sampling method. In order to perform the sampling according to the population of each hospital, the numbers of samples were determined. Data were collected with a two-part questionnaire. First part contained personal and demographic information such as age, sex, marital status, education and working experience. The second part included 19 questions on patient education barriers which evaluated four domains of working conditions, management, nursing attitude and training skills. The data were analyzed by descriptive statistics and chi-square statistical test. Answers were designed based on a Likert scale from low to average and high impact with scores of 1-3, respectively. In management domain, the scores ranged from 6 to 18. Scores less than 10 showed "low impact", 10 to 14 "average impact" and more than 14 "high impact". In the domain of working conditions, similar scores were obtained. The findings displayed that nurses' attitude ranged from 2 to 6 scores. Scores less than 3 showed "low impact", 3-4.5 "average impact" and more than 4.5 "high impact". In domain of training skills, scores ranged from 5 to 15. Scores less than 8 indicated "low impact", 8 to 11.5 "average impact" and more than 11.5 "high impact". The data were analyzed with descriptive statistics and chi-square. The study was approved by the Ethics Committee of Health Faculty, Shahid Sadoughi University of Medical Sciences in Yazd

Results: In this study, 149 of the 162 questionnaires were answered indicating92% response rate. The data showed that 45.2% of male nurses and 47.3% of female nurses blamed working condition barriers with highest impact on the implementation of patient education. Moreover, 45.8% of single and 47.5% of married nurses had the same opinion. Chi-square test found no significant relationship between the variables of age, sex, working experience, employment status, marital status, and educational level with patient education barriers [P>/=0.05]. The data showed that 31.5% of nurses believed that barriers related to management had the greatest impact on the implementation of patient education followed by 47.7% barriers to working condition, 2.7% attitude of nurses and 14.1% training skills. Chi-square test showed a significant correlation between the domains of working condition and type of hospital [P=0.048]. Working condition was proved as the most important factor. Management was the second factor followed by training skills as the third. Finally, attitude of nurses was identified as the least important patient education barrier. The results of the present study revealed three factors with highest impact as education barriers in nurses' opinion; high working load [74.5%], insufficient nursing stuff in wards [71.8%] and nursing shifts in a row [70.4%] in working condition domain. The study population reported three factors with lowest impact; training as a specific task assigned for doctors [54.4%], lack of nurses 'self-confidence for training [43.5%] and not delivering the trainings to patients [40.3%]

Conclusion: In attention to that the domain of nurses working conditions had the greatest impact on the education of the patients, it is recommended that official authorities to maintain nursing resource in hospitals and reduce their workload and provide facilities and conditions for educational programs to encourage nurses to consider this important issue

survey on the Yazd pre-hospital emergency medical services' performance assessment, 2009-2010

Pre-hospital care has an important role in the management of critical patients. The more this management is appropriate, accurate and rapid, the less there is mortality and morbidity. It is therefore imperative to assess the current status of Emergency Medical Services [EMS] is to improve its performance. Three measures that can be considered in such assessments are the status of EMS staffing and equipments and more important, the response time of EMS system. This study had a main objective to survey these measures in Yazd pre-hospital EMS stations and to compare them with the existing standards. In a descriptive, analytical and cross- sectional study, we surveyed all 7 EMS stations of Yazd. We extracted the staffing status and the ambulance equipments through checklist and compared them with reference standards. Also, we surveyed 11961 run report forms from all stations that had been submitted to central station during 2008-2009. By using Excell software and descriptive statistics [percent, cumulative distribution and standard deviation],we calculated tractile response times for Yazd EMS and compared it with reference standards of Iran and North America. The results of the study showed that Yazd EMS system has major deficiencies in terms of staffing and access to advanced EMS equipments. Based on the results, only 1 station [14/3%] had sufficient staff. Also, none of the ambulances had the necessary equipments required for critical patients' management. Despite these deficiencies, 81/15% of response time was within 8 minutes, a reference standard for EMS. We concluded that the majority of call services in Yazd EMS have been responded in a suitable time interval compared with reference standards and country's approved EMS response time goal. Although, response time is an important factor in reducing morbidity and mortality in emergencies but deficiencies of personnel and equipments can affect the effectiveness of delivered services. There fore improving in staffing and equipments is an inevitable necessity to reach the goal

Pre-hospital emergency medical services in developing countries: a case study about EMS response time in Yazd, Iran

Pre-hospital emergency medical services, a subsystem of Emergency Medical Services [EMS], provides early care to critically ill and injured patients in the field. Time is an important factor in pre-hospital care and the length of time it takes to reach care, has a significant impact on patient outcome. This study aims to calculate the response time in EMS stations of Yazd, Iran. During 2008-2009, 11961 run report forms from all 7 EMS stations in Yazd that had been submitted to central station were surveyed. By using Excell statistical software and descriptive statistics [percent, cumulative distribution and standard deviation], we calculated fractile response times for Yazd EMS. 81.15 percent of response times were within 8 minutes as a referenced standard for EMS. The majority of call services in Yazd EMS have been responded in a suitable time interval comparing with reference standards and country's approved EMS response time goal, but there are still rooms for improvement

comparative survey of organizational commitment based on personal traits: a case study on nurses in Yazd training hospitals

Organizational commitment has been defined as [the relative strength of an individual's identification with and involvement in a particular organization]. Organizational commitment and factors that predict it has emerged as a promising area of research in recent decade for there is a strong evidence of link between high levels of commitment and favorable organizational outcomes. The main objective of this study was to investigate the relationship between the staffs personality traits [introversion - extraversion] and organizational commitment. This comparative - applied study was carried out in 2009-2010. The research population consisted of nurses working at Shahid Sad doghi and Shahid Rahnemoon hospitals. The sample [n=175] was selected by random sampling method. The data were collected by 2 valid questionnaires.organizational diagnosis questionnaire [ODQ] and Eysenck personality questionnaire [EPQ]. Data analysis was performed through SPSS[14] software using descriptive statistics and independent T-Test. The results of research indicated that the introvert and extrovert nurses are different in regards with their organizational commitment [p-v = 0/000]. Also, the organizational commitment was significantly different in both personality groups [introvert, extrovert] in terms of age group [P=0.003, 0.046] and job tenure group [p = 0/002, 0/042]. In the introvert group, organizational commitment was different based on the employment status [p = 0/017] but there was no difference in any group in terms of sex and marital status. The research results indicated that personality traits as a predictor of organizational commitment should be considered in human resources management

Gap analysis between perceptions and expectations of service recipients through servqual approach in Yazd, Afshar hospital

The quality of service is a key ingredient in the success of health care, organizations. Parasuraman, et al [1985] defined service quality as the differences between predicted or expected service [customer expectations] and perceived service [customer perception].Recently, service quality has become an important research topic for of its significant relationship to costs, profitability, customer satisfaction, customer retention and service guarantee. Several tools have therefore been developed to measure service quality but the Parasuraman 22 item servqual questionnaire created based on the gap model remains the most widely used tool in a variety of industries. This study attempts to replicate the servqual measurement of Parasuraman et al in determining the gap between perceptions and expectations of service recipients in Afshar hospital. This descriptive - applied study was carried out cross-sectionally in 2010. The research population consisted of patients admitted to Afshar hospital wards. Totally 84 patients were selected by sample size formula. The data were collected by 22-item servqual questionnaire designed according to gap model. Data analysis was carried out through SPSS and LISREL software using Kolmosrof - Smirnoff and paired sample t -test. The results demonstrated that there was a quality gap in Afshar hospital,that is, there were significant differences between expectations and perceptions of patients in servqual dimensions. Also, the study identified some critical and problematic items that have main roles in constructing observed quality gap. The existing quality gap means patients' expectations exceed their perceptions.Thus improvements are needed to be made across servqual dimensions