Academic journal article Iranian Journal of Public Health

Health Promoting Hospitals Model in Iran

Academic journal article Iranian Journal of Public Health

Health Promoting Hospitals Model in Iran

Article excerpt

Introduction

The hospitals' duty is beyond providing clinical and specialized services, and making plans for delivering health care services and promoting health is one of their important duties (1). In each country, from 40% to 70% of health budget is absorbed by and spent in the hospitals and usually one to three percent of working population is employed in them (2). On the other hand, the employees in hospitals suffer from high levels of job stress (3). Therefore, the plan of "Health Promoting Hospitals" (HPH) was launched more than a decade ago (4-5). This plan refers to the fact that the hospital activities should be aimed not only at therapeutic and diagnostic activities (6) but also at disease prevention and health promotion, and the hospital services should be targeted to the needs of the people (7). Hence, developing a new strategy for hospital services and paying attention to the health promotion programs in the hospitals are essential in the present century, today, the hospitals are required which consider health promotion programs as a key service (8-9). The issue of HPH is paid more attention due to the increasing prevalence of lifestyle-related diseases and also chronic diseases, the changes in public expectations, the increasing number of chronic patients who need continuous support, and the number of hospital staff who daily exposure to psychological pressures and health risks (10).

On the other hand, health promotion is a concept that should be considered as a behavioral challenge (11). In this context, and given the current problems in hospitals, 20 hospitals were selected officially by WHO from 11 European countries for a pilot project of EPHP (European Pilot Hospital Project of HPH) in Warsaw in April 1993 (12) and the International Network of Health Promotion Hospital was established (13). These hospitals not only provide comprehensive and high quality medical and nursing services but also develop an organizational structure and culture assuming an active role for patients and staff in health promotion programs and actively cooperate with the community in health activities (2). Hospitals with the health promotion plan should take several measures to implement health promotion programs such as using organizational development processes, forming a joint committee of health promotion projects, providing regular reports by subgroups of the health promotion project, providing feedback, using public relations techniques, reporting and documentation systems (14).

In the model of HPH, provided by the Research and Development center of HPH in Taiwan (11), at first, the preliminary measures, including formation of a project implementation team and a health promoting hospital committee were taken and, then, the project planning and implementation were made. In many health promotion programs implemented in hospitals, the community needs assessment is one of the preparatory measures (16). Other health promotion projects for implementing health promotion programs in the hospitals focus on managerial methods, sharing and using resources (17), and collaboration with society organizations (18). Finally, many hospitals in the world have implemented the WHO HPH program and have achieved costeffectiveness and quality assurance of health services (19-20).

However, only the peripheral levels of the health network system in Iran play the role of prevention and hospitals are responsible for performing the traditional role of diagnosis and treatment and there is no clear plan to deliver health promotion services in the hospitals. Although some of these services such as nutritional counseling are provided sporadically in some hospitals in Iran, there has not been any defined structure for becoming a HPH and very few studies (18, 21) have been conducted in this field. Therefore, this study aimed to determine factors affecting the establishment of a health promoting hospital in Iran using factor analysis method. …

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