Background: The health system reform plan (HSRP) is one of the recent reforms adopted in the health system of Iran. Objectives: This study aimed to investigate the effect of implementing of the HSRP on the performance indicators of teaching hospitals in Iran.

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Background and Purpose: Currently, the high prevalence of COVID-19 and increased workload in hospitals has posed a threat to the physical, mental, and emotional health of nurses. The present study was an attempt to investigate the workload and its relationship with job stress of nurses in COVID-19 reference hospitals in southern Iran. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted in 2021 on 431 nurses from COVID-19 reference hospitals in southern Iran. Data collection tools included the NASA workload and OSIPOW job stress standard questionnaires. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficient in SPSS23 Software and at a significance level of 0.05 Results: The mean age and work experience of the nurses participating in the study were 31.03±5.23 and 6.42±4.61, respectively. The mean scores of the workload and job stresses were 83.64 ± 17.24 (of 100) and 236.68 ± 16.54 (of 300), respectively. Mental load dimension (85.81 ±19.31, of 100) among workload dimensions and role workload dimension (43.62 ± 19.14, of 50) among job stress dimensions had the highest mean score. Thus, there was found a statistically significant relationship between workload and job stress of nurses (P= 0.04, r= 0.19). Conclusion: Workload and job stress of the studied nurses were estimated at a high level. There was a significant positive correlation between these two variables, and increasing workload resulted in an increase in job stress.

Background and Purpose: COVID-19 could be a threat to healthcare workers' mental health. This study was conducted to investigate job burnout and its relationship with the resilience level of the personnel in the COVID-19 treatment hospital in southern Iran. Methods: This descriptive-analytical cross-sectional study was conducted in 2021 on 496 personnel of Hazrat Ali Asghar (AS) Hospital selected as the center of COVID-19 in southern Iran. The participants of the study were selected using the census. Data collection tools were the standard Maslach Burnout Inventory (MBI) and Connor-Davidson Resilience Scale (CD-RISC). Data analysis was performed using t-test, ANOVA, Pearson correlation coefficient, and multiple linear regression in SPSS23 at a significance level of 0.05. Results: The mean scores of job burnout and resilience were 76.95 ± 14.36 (of 132) and 71.21 ± 8.24 (of 125), respectively which indicated the moderate level of these two variables. There was a significant inverse correlation between job burnout and resilience (P<0.001, r= - 0.514). Spiritual influences (P<0.001), perception of competence (P=0.001), positive acceptance of change and secure relationships (P= 0.001), trust in individual instincts (P= 0.02), and control (P= 0.03) of resilience aspects were identified as predictors of job burnout. Additionally, there was a statistically significant relationship between job burnout and gender (P=0.001) and occupational group (P= 0.04); and between resilience and gender (P= 0.02) and with marital status (P= 0.03). Conclusion: Job burnout status and personnel resilience were at a moderate level. It was recommended to train employees with resilience-enhancing skills employees according to each of their dimensions.

Introduction Communication skills and acceptable levels of spiritual intelligence (SI) are the prerequisites of the nursing profession, which can significantly impact the individual and organizational performance of nurses. This study aimed to investigate the competency and self-efficacy of communication and its relationship with the SI of nurses. Methods This cross-sectional study was conducted in 2021 and included 312 nurses working in a COVID-19 hospital in the south of Iran. The data collection instruments were the Standard Communication Competence Scale, Communication Self-Efficacy, and SI Questionnaires. Data were analyzed with SPSS software version 23 using descriptive and inferential statistics, and t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression were performed at 5% significance level. Results The mean scores of nurses’ communication competence, communication self-efficacy, and SI were 89.11 ± 7.32 out of 180, 64.45 ± 5.61 out of 120, and 147.13 ± 11.26 out of 210, respectively. A direct and significant correlation was observed between competence (r = 0.527, p<0.001) and communication self-efficacy (r = 0.556, p<0.001) with spiritual intelligence. The dimensions of spiritual intelligence, including the ability to deal with and interact with problems, self-awareness, love and affection, general thinking and doctrinal dimension, and dealing with moral issues, were identified as predictors of nurses’ communicative competence and self-efficacy (p<0.05). There was a positive and significant correlation between nurses’ competence and self-efficacy with their age (p<0.05). The nurses’ mean communication competence and self-efficacy score were different regarding their level of education and the number of shifts (p<0.05). The mean scores of self-efficacy revealed a statistically significant difference between the participants’ gender and the number of patients under observation (p<0.05). Moreover, the nurses’ SI significantly correlated with age, and the mean scores of this intelligence had statistically significant differences regarding gender (p<0.05). Conclusion The nurses’ communication competence and self-efficacy were at a moderate level. Considering the correlation and predictive role of SI and its dimensions, it is recommended to promote problem-solving skills, improve self-awareness, and pay attention to moral standards to nurture communication competence and self-efficacy among nurses.

Background:The ever-increasing development of information and communication technologies has created new opportunities in the domains of curriculum planning and teaching. In this study, an exercise therapy course was held using both lecture-based and virtual teaching methods. Then, the students' opinions were investigated and their overall levels of satisfaction were measured. Methods: This cross-sectional study was conducted among all physiotherapy students who had enrolled in the fourth semester of 2014 academic year and had selected the course of principles of exercise therapy. This study was conducted during one semester. We evaluated the effect of lecture-based and virtual (multimedia-based) methods of education according to the learning management system (LMS) among 20 students. A researcher-made questionnaire was designed regarding satisfaction with virtual versus lecturebased teaching methods; the questionnaire was scored based on a five-point Likert-type scale.Results: Of 20 students, one individual was single and 19 were married. Moreover, the mean test score was 12.38 ± 3.23 for the virtual teaching method, while it was 14.21 ± 1.88 for the lecture-based one, showing a significant difference (P = 0.03). Generally, 50% of the students preferred the virtual teaching method over the lecture-based one. In total, 75% of the students were satisfied or totally satisfied with the virtual teaching method for the exercise therapy course. Conclusions: In terms of scores, the lecture-based method was better than the virtual one. However, the level of student's satisfaction in the virtual method was higher than the lecture-based one.

Objective Health insurance is based on people’s significant risks in receiving health services that they cannot afford alone. Since the outbreak of the corona epidemic, the health insurance system has suffered many economic problems. Designing a model of a health insurance system based on the requirements of a resilient economy can improve the functions of this system in the corona crisis. Results In this research 12, structural components were obtained in the form of 4 conceptual components. The 4 main conceptual components are Knowledge-based economy, Economic stability, Economic resilience, and justice. The knowledge-based economy is the basis for the formation of economic resilience in the health insurance systems. Health insurance systems will achieve two crucial intermediate results, namely economic resilience, and economic stability, by building the basic infrastructure of a knowledge-based economy. In the long run, maintaining such intermediate results is the foundation of justice in the health insurance system.

A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing. There was not any myomectomy scar.