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BackgroundBreast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC.MethodsA comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.ResultsBased on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment.ConclusionThe present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL.PROSPERO registration number CRD42022309791.

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Background and Objective: Health promotion standards are designed to meet the physical, mental and social needs of patients, staff and the community. So, this study aim was investigated the preparedness to implementation of health promotion hospital(HPH) standards from nurses' perspective in the military hospitals. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted in 2019. 400 nursing staff of three selected military hospitals in Tehran selected by quota and simple random sampling. The data collection tool was a valid and reliable questionnaire of the WHO regarding HPH standards in 5 dimensions. The data were analyzed by SPSS 22 using ANOVA test at 95% CI. Results: The mean and standard deviation score for the management policy,

Introduction : Risk management is a frequent and step-by-step process that helps system managers improve decision-making in times of risk. During this process, the risk of errors is reduced, and Opportunities for improvement are increased. Given the increasing importance of patient safety and the role of risk management in reducing medical errors and treatment costs, this study was conducted to identify the executive framework of active risk management in the operating room of hospitals from the perspective of experts and administrative staff. Method This qualitative phenomenological study was conducted with a targeted sampling method and included 20 experts and executive staff as the study sample. Data were collected using a researcher-developed semi-structured interview and were analyzed using the framework analysis method. Results The results showed that active risk management consists of four components, including types of risks, principles, processes, and risk management framework in the operating room with 27 main themes based on the standard classification for types of risks (the Eight Risk Domains of Enterprise), principles, processes, and framework) principles, framework, and risk management process from ISO 3100( and 115 sub-themes. Conclusion By identifying different types of risks, analyzing and reporting them continuously, implementing the principles and framework of clinical risk management, creating an open and fair safety culture to achieve patient safety, creating programs and policies for error reporting, continuous training, skill development, institutionalizing methods to prevent errors, and requiring employees to implement the risk management process fully, a suitable model of clinical risk management can be implemented in hospitals’ operating rooms.

Background: Environmental characteristics, as well as the quality of health care services provided to older adults group, are among significant determinants of elderly quality of life. The present study was done to assess the quality of services delivered to elderly residents in nursing homes located in Tabriz, Iran in 2019. Materials & Methods: This cross-sectional study was conducted on the elderly living in nursing homes in Tabriz, Iran, of whom 74 residents met the inclusion criteria and were included. The researchers referred to the nursing homes and recruited the participants with regard to the inclusion and exclusion criteria. Results: Out of the 74 older adults, 35 and 39 cases were respectively male and female. The largest age group (43.2%) was related to those between 60 and 69 years old. Also, 71.6% of the elderly had been residing in nursing homes for 6-20 months. The rate of service quality in terms of the medical, psychological, welfare, and social domains was 66%, 48%, 68%, and 65%, respectively. Besides, no significant relationship was observed between demographic variables and total scores of service quality (P>0.05). Conclusion: Paying attention to psychological services, including providing counseling and social work services, adapting the centers, and creating recreational departments can lead to an increase in psychological quality and ultimately, overall service quality.

Background: Providing financial resources for health services is the responsibility of the government, insurers and direct payments of individuals. Considering that health services are one of the most essential people's needsand impose a high cost on individuals, and may create catastrophic health costs for poor people. Therefore, the present study was conducted with the aim of analyzing the effect of health system evolution (HSE) program on out-of-pocket (OOP) payment in hospitals affiliated to Mashhad University of Medical Sciences. Methods: This descriptive-analytic study was conducted in 24 hospitals of Mashhad University of Medical Sciences from 2013 to 2017 in order to survey the effect of HSE Program. The sample of this study included all patients with basic insurance referring to hospitals. Data were collected based on a researcher-made checklist for urban and rural patients. The statistical analysis software SPSS19 was used to analyze the data. Results: According to the research findings, the total OOP payment percentage fell from about 20 % to 8 % at the end of the year. The percentage of the patient's spending on consumer use declined from 60 % to 6 %, for drugs from 30 % to 5.5 %, for services from 12 % to 4 %. Conclusion: Increasing people's financial access to health care will improve the health of the community, which is expected to improve community health indicators by lowering their OOP payments. The continuation of OOP payments reduces the need for macroeconomic policies and sustainable budgets.

Background: Pre-hospital care plays an important role in managing patients who require emergency services and preserving human life. The aim of this study was to evaluate the cost of completed public pre-hospital emergency missions according to the activity-based costing model and to compare it with the cost of private pre-hospital emergency services in Mashhad in 2016. Methods: In this applied and descriptive cross-sectional study, the data were collected using a researcher-made form 4 major groups of costs were identified to estimate the total costs: 1- Personnel salaries, 2- Current expenses 3- Medical consumables 4- Depreciation. The cost of providing pre-hospital services was calculated based on the activity-based costing. Eventually, the cost of pre-hospital emergency services was compared between the public and private sectors. To investigate the cost-effective factors for missions, multiple regression analysis, Breusch-Pagan, Ramsey RESET, Swilk, and Linktest diagnostic tests were used by  Stata 11.0 software. Results: The average cost of each mission was equal to 2114337 ± 217786 thousand Rials in 58 emergency medical centers of Mashhad in 2016. Of this cost, 78.51 %, (1660129 ± 1578445 Rials) was related to employees' salaries, 19.24 % (406842 ± 375083 Rials) was related to the current costs of each center, 0.23 % (4796 ± 4476 Rials) was related to depreciation, and 2/02 % (42761 ± 42822 Rials) was related to medical consumables in each pre-hospital emergency mission. The value of contract with an emergency pre-hospital emergency was 1104000 Rials for each mission in 2016, which is almost half of the cost related to the public pre-hospital. Results of the regression model estimation also showed that among the variables of the model, the fuel cost variable was identified as an effective variable on the cost of each mission (p = 0.0001). Conclusion: The private sector provides pre-hospital emergency services at a lower cost. Moreover, before establishing a pre-hospital pre-service center, the cost-effectiveness of establishing a center in each region should be checked.