IntroductionThe successful implementation of health information technologies requires investigating the factors affecting the acceptance and use of them. The aim of this study was to determine the most important factors affecting the adoption of health information technologies by doing a systematic review on the factors affecting the acceptance of health information technology.MethodsThis systematic review was conducted by searching the major databases, such as Google Scholar, Emerald, Science Direct, Web of Science, Pubmed, and Scopus. We used various keywords, such as adoption, use, acceptance of IT in medicine, hospitals, and IT theories in health services, and we also searched on the basis of several important technologies, such as Electronic Health Records (HER), Electronic Patient Records (EPR), Electronic Medical Records (EMR), Computerized Physician Order Entry (CPOE), Hospital Information System (HIS), Picture Archiving and Communication System (PACS), and others in the 2004–2014 period.ResultsThe technology acceptance model (TAM) is the most important model used to identify the factors influencing the adoption of information technologies in the health system; also, the unified theory of acceptance and use of technology (UTAUT) model has had a lot of applications in recent years in the health system. Ease of use, usefulness, social impact, facilitating conditions, attitudes and behavior of users are effective in the adoption of health information technologies.ConclusionBy considering various factors, including ease of use, usefulness, and social impact, the rate of the adoption of health information technology can be increased.

BackgroundLoss of human resources in the health sector through migration has caused many problems in the delivery of healthcare services in developing countries.ObjectiveThe aim of this study was to determine factors influencing intention to migrate in skilled human resources in Iran’s healthcare sector.MethodsThis cross-sectional study was carried out in 2016 in Iran. The study population included health sector human resources at the Tehran and Iran University of Medical Sciences. Using multi-stage cluster sampling, 827 people were selected for participation. Participants included four groups: hospital staff, health workers, medical students, and postgraduate students (Masters and PhD). Data were collected using a valid and reliable questionnaire and analyzed by descriptive parameters, chi-square and logistic regression test using SPSS version 18.ResultsInclination to migrate, in the study population, was 54.77%. There was a significant relationship between inclination to migrate and age, work experience, employment status, marital status, familiarity with a foreign language, foreign language skills, foreign language courses, having relatives or family living abroad, and prior experience of being abroad (p<0.05). The most important factors influencing inclination to migrate were: reaching out for better life (81.92±21.95), interdisciplinary discrimination (80.83±20.75), and experience of living and studying abroad. (80.55±18.12),ConclusionConsidering the high rate of intention to emigrate in the studied population (54.77%), a lot of whom will emigrate if their situation is ready, it can be a serious problem for the health system in the near future in which it will face lack of skilled health workers, and so requires more attention of health sector authorities.

Background Students with complex health care services process face constant challenges with regard to health education. The mobile devices are an important tool that can install various applications for using information such as clinical guidelines, drug resources, clinical calculations, and the latest scientific evidence without any time and place limitations. And this happens only when students accept and use it. Objective The purpose of this article is to identify the factors influencing students in their intention to use mobile health (mHealth) by using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Methods A standard questionnaire was used to collect the data from nearly 302 Lorestan University of medical science students including nutrition and public health, paramedicine, nursing and midwifery, pharmacy, dentistry, and medical schools. The data were processed using LISREL (Scientific Software International, Inc., Lincolnwood, Illinois) and SPSS (IBM Corp., Armonk, New York) softwares and the statistical analysis technique was based on structural equation modeling (SEM). Result A total of 300 questionnaires including valid responses were used in this study. The results showed that mediator of age did not affect the predictors of intention to use mHealth, and the level of education and gender directly affected the intention to use. In addition, effort expectancy, facilitating condition, and behavioral intention directly and indirectly have effect on use, whereas the result revealed no significant relationship between two important processes of performance expectancy and social influence with students' behavioral intention to use the mHealth. Conclusions The present study provides valuable information on mobile health acceptance factors for widespread use of this device among students of universities of medical sciences as a base infrastructure for a variety of information about health services and learning. Review and comparison of results with other studies showed that mHealth acceptance factors were different from other end users (elderly, patients, and health professionals).

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.

BackgroundThe migration of healthcare specialists from developing countries has increased in recent years. This has caused a rapid reduction in the access to and quality of healthcare services in such countries. The aim of this study is to evaluate the factors affecting the migration of specialist human resources in Iran’s healthcare system.MethodsThis is a qualitative study, which was carried out through semi-structured interviews between 2015 and 2016. For sampling, purposive sampling method with maximum variation sampling was used. Further, data saturation was observed by conducting 21 interviews, and data analysis was performed using the MAXQDA10 content analysis software.ResultsFactors affecting the migration of specialists were classified into five key themes, including structural, occupational, personal, socio-political and economic factors. These themes consisted of 12 categories and 50 subcategories. The most important factors affecting the migration of our study population were structural issues, occupational problems, and personal concerns.ConclusionIdentification of factors influencing migration is the first step to prevent the migration of specialist human resources. Implementing the recommendations proposed in this study would assist to prevent migration of medical professionals.

Purpose The purpose of this paper is to determine the second victims’ experience and its related factors among medical staff. Design/methodology/approach This research is a cross-sectional study that was conducted in public hospitals of Sanandaj, west of Iran, in 2017. The sample consisted of 338 medical staff including physicians, nurses and mid-wives. A self-report questionnaire was used for data collection. Descriptive statistics, cross-tabs and χ2 test were used for data analysis using SPSS20. Findings A total of 51.5 percent (n=174) of the medical staff had experienced medical error in the past year, of which 90.2 percent (n=157) had at least one of the symptoms of “second victims.” Tachycardia and sleep disturbances were the most commonly referred physical symptoms with 73 and 51.7 percent, respectively. Also, repetitive/intrusive memories and fear of reputation damage were the most commonly referred psychosocial symptoms with 68.3 and 51.7 percent, respectively. The experience of physical and psychosocial symptoms was different according to the occupational category. In addition, there was a significant association between the experience of physical symptoms with the hospital administrators’ awareness of medical errors and the consequences of medical errors for patients. Practical implications Adoption of coping strategies, including learning from medical errors as well as hospital administrators’ support from second victims, is recommended. It is also suggested that medical staff be informed about the consequences of medical errors as well as physical and psychological symptoms of second victims so that they can ask for help from managers and colleagues when the symptoms occur. Originality/value This study outlines the prevalence, the most psychological and physical symptoms, and the demographic and occupational factors associated with the second victim phenomenon in medical staff. Also, the most important strategies for coping with this phenomenon are prioritized from the perspective of medical staff.

One of the newest and most effective strategies to empower staff is building the infrastructure and platform for strengthening organizational learning. This study has conducted about the relationship between organizational learning and staff empowerment. This correlational study was conducted among the staff of a Children's Hospital affiliated to Tehran University of Medical Sciences, Iran in 2012. Numbers of 145 staff in this hospital has selected and enrolled by simple random sampling. The data collection tools were tow questionnaires for organizational learning and staff empowerment which approved their validities and reliabilities. Finally, collected data were analyzed by Spearman correlation test. Among the dimensions of organizational learning, knowledge transfer and integration with 3.47 and system perspective with 3.16 obtained highest and lowest scores respectively. Generally, overall rating of organizational learning and the staff empowerment variables were determined 3.25±0.71 and 3.74±0.59 respectively. Between the four dimensions of organizational learning (managerial commitment, system perspective, openness and experimentation, knowledge transfer and integration) and staff empowerment, was observed a significant correlation. According to the findings, the current situation of organizational learning and staff empowerment in studied hospital is relatively acceptable. It recommended that hospital systems can improve staff empowerment by developing organizational learning environment, creating experience and knowledge exchange platforms, using material incentives and specially focusing on the intrinsic motivation.

Background: Health policymakers need to use prioritization for resource allocation in the health system because of limitations to financial resources. Objectives: This study aimed to explore the criteria affecting the appropriate allocation of health system resources to different diseases. Methods: A qualitative study was carried out in 2017 using semi-structured interviews. Participants were chosen using purposeful and snowball sampling methods. Totally, 25 experts in the health care system were interviewed. The present study employed conventional content analysis and data were analyzed using MAXQDA10 software. Results: The findings were categorized into four main categories and 21 sub-categories. The main categories included criteria related to "type of disease", "patients' characteristics", "type of treatment", and "ethical and responsiveness issues". Furthermore, the most effective factors on resource allocation included the emergency or non-emergency aspects of the disease, disease severity, disease onset, treatment effectiveness, and disease prevention. Conclusions: Health policymakers should direct resources toward emergency and severe diseases that significantly affect people's quality of life. According to the findings of the present study, the "type of disease" was one of the most important criteria in health resources allocation. Therefore, similar to DRG, we can categorize diseases and health system problems based on their priority and use such grouping for health resources allocation.