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Background and purpose: One of the indices that assess the efficacy and progress of health sector is the clients’ satisfaction with hospital services. To promote this index, Honoring the Client project was proposed in Iran. Client-orientation is of great importance in today’s world, so, we have decided to evaluate this project in Sari Imam Khomeini Hospital (hospitalization wards) along with Health Development Program in 2015.

Materials and methods: A cross-sectional study was done in Sari Imam Khomeini Hospital, affiliated with Mazandaran University of Medical Sciences. The study population consisted of 2800 and a sample of 328 subjects were randomly selected. A questionnaire was designed by the University and its validity was verified by researchers using alpha-Cronbach. Data analysis was done by measures of central tendncy in SPSS V.20.

Results: The satisfaction rate from hospital services, nursing services, and medical cares were (p<0.005( 43.83%, 53.46%, and 68.15%, respectively.

Conclusion: Implementation of the Honoring the Client Project was successful in Sari Imam Khomeini Hospital. This project would be more fruitful if performed alongside Health Development Program, the Hoteling Project and regular monitoring of the hospitals.

               

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Background and purpose: Breast cancer is the most common cancer in Iranian women. Two main psychological complaints in cancer patients are depression and anxiety which have negative impacts on their quality of life. Acceptance and commitment therapy provides the involved patients with the skills to respond to these uncontrollable experiences and commitment to personal values. The purpose of this study was to review the clinical trials conducted on the effect of this method on depression, anxiety, and quality of life of these patients in Iran.
Materials and methods: This systematic review and meta-analysis investigated all clinical trials conducted between 2005 and 2017 in Iran. Electronic databases were searched, including Since Direct, Scopus, Pubmed, Google Scholrar, SID, Mag iran, Iran doc, Medex, and Cochrane.
Results: In final investigation, 8 articles were reviewed (three on quality of life and five on depression and anxiety). The studies included people aged 20- 60 years old, all followed pre-test and post-test designs and two studies had performed follow-up interventions.
 Conclusion: Acceptance and commitment therapy could empower breast cancer patients and enhance their ability in accepting the disease, reduce anxiety, and depression and improve their quality of life. Nevertheless, further research consisting of more population and interventions in different stages of the disease are needed. Studies on male cancer patients could be beneficial too. Using more appropriate tools can also provide more reliable results.

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Background and purpose: Research is one of the significant foundations of community development, which requires understanding the capabilities, weaknesses and strengths of programs. This study aimed at investigating the motivations and barri ers to research in clinical faculty members.
Materials and methods: This descriptive-analytical study was conducted in clinical faculty members (surgeon and non-surgeon) in Mazandaran University of Medical Sciences using census sampling. Data were collected via Research Barriers Questionnaire (Sotodeh Asl et al.) and Research Motivation Scale (Salehi). Data analysis was done applying Mann-Whitney test and Kruskal-Wallis test.
Results: One hundred thirty-nine individuals aged 40-50 years participated in this study and the participation rate was high (81%). The motivation for research activities was higher in females
(59.92 ± 6.38) than males (57.24 ±5.47) (P< 0.05). Major obstacles to preparation and compiling a research project, in both surgeon and non-surgeon groups, were lack of clear research needs (3.68 ± 0.67) and priorities (3.11 ± 0.89) in the university. In project implementation, lack of appropriate space
(3.50 ±1.04) was reported as the main problem by both groups. In administrative and management context, little attention to creativity (3.80 ± 0.86) and financial and budget problems (3.27 ± 1.21) were the main barriers according to both surgeon and non-surgeon faculty members, respectively (P> 0.05).
Conclusion: Despite sufficient motivation, organizational and individual barriers affect research activities. These obstacles could be removed by clarifying research priorities, creating a suitable physical space, and solving financial problems.

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Background and purpose: Bone fusion is a dynamic process and availability of calcium and balance of vitamin D can be effective in post spinal cord fusion. There are contradictory results on this issue, so, we decided to compare the effect of administration of vitamin D and alendronate on lumbosacral vertebral fusion in patients undergoing posterior spinal fusion surgery.
Materials and methods: A single-blind clinical trial was carried out in 75 patients. Patients were divided into three groups (n=25 per group) using block randomization: Alendronate group who received 70 mg oral alendronate every two weeks, Vitamin D group to receive vitamin D 50,000 units per month for six months, and control group who received routine treatment after the surgery. After six months, the patients underwent CT scan of the lumbar region for clinical assessment of lumbar fusion. Pain intensity was assessed using Visual Analogue Scale (VAS), one and six months after the surgery. Data analysis was performed in SPSS V16.
Results: Before surgery, pain intensity was higher in vitamin D group (6.36 ± 1.3) than the controls and alendronate group (P <0.0001). The last VAS in this group reached 2.12 ± 0.97 indicating decrease in pain intensity. Overall, there was a significant decrease in pain intensity in all three groups
(P<0.0001). Non-fusion was found to be more frequent in control group (16%) compared to the vitamin D (12%) and alendronate (8%) groups (P=0.900).
Conclusion: In current study, vitamin D and alendronate supplementation slightly improved lumbosacral fusion. Therefore, further studies are needed to investigate the effectiveness of combined treatment with alendronate and vitamin D on pain intensity and lumbosacral fusion in these patients.
 
(Clinical Trials Registry Number: IRCT20180826040869N2)