Iranian infertile couples' strategies to manage social interactions after unsuccessful treatments with assisted reproductive technologies

Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances

Investigating the Knowledge Management Infrastructures of SBMU-Affiliated Libraries

Introduction: Increasing productivity in academic libraries can be due to knowledge management. The successful implementation of knowledge management requires appropriate infrastructures. In this study, to determine the level of readiness of SBMU-affiliated libraries and to implement knowledge management, the infrastructure of the management approach, organizational culture, human resources, organizational structure, and information technology has been examined.   Methods: The descriptive-survey research method was used to determine the status of the infrastructures studied to obtain the opinions of 58 librarians working in the libraries of Shahid Beheshti University of Medical Sciences. The data collection tool was a researcher-made questionnaire. The opinions of 10 experts obtained to analyze the qualitative validity. Content validity‏ ratio (CVR) was calculated to analyze the quantitative content validity, content validity index (CVI), and the validity of each item, which was considered 62% and 79%, respectively. Cronbach's alpha was also used to measure reliability, which was 0.92, indicating that reliability is appropriate. A 5-point Likert scale was used to weigh a 50- item questionnaire.   Results: The mean obtained for the infrastructures of the management approach was 2.72, organizational structure 2.66, organizational culture 3.13, human resources 3.26, and technology 3.21, respectively.   Conclusion: The status of the two infrastructures of management approach and organizational structure was undesirable, and the three infrastructures of organizational culture, human resources, and technology were at a moderate level. Consequently, these infrastructures need investment and exceptional attention to provide a suitable platform for the implementation of knowledge management in the SBMU-affiliated libraries

Nurses� perception of nursing services documentation barriers: A qualitative approach

Background: Researches has shown that the quality of nursing documentation services in the world, including Iran, is far from existing standards. Understanding the barriers to improving the documentation of nursing services is essential for the first step. The aim of this study was to identify barriers to improving the nursing documentation services using the experience of nurses in the emergency department of one of the Iranian hospitals. Materials and Methods: This study is based on content analysis in accordance with the style of Graneheim in 2017 in the emergency department of one of the Iranian hospitals. This qualitative study was performed on 20 participant from different nursing grades including 17 nurses, 1 head nurse, and 2 members of the accreditation committee. The data were collected through semi-structured interviews and using interview guide and field note. Results: Research data have been explained in four main themes of qualification of documentation including sub-categories of the need for effective training, the need for training in the standards of documentation, and the necessity of skills in reporting; job burnout including sub-categories of job stress and work pressure; perceived control including sub-categories of planned control and effective monitoring and control; intra-organizational coordination including sub-categories of improving health information system and documentation management time, legal barrier for documentation including sub-categories of escaping from the law and legal liabilities. Conclusion: In this study, 599 primary codes were extracted and the main themes documentation competency, job burnout, perceived control, intraorganizational coordination, and legal barrier extracted. © 2018 by the authors; licensee Modestum Ltd., UK

Nurses� perception of nursing services documentation barriers: A qualitative approach

Background: Researches has shown that the quality of nursing documentation services in the world, including Iran, is far from existing standards. Understanding the barriers to improving the documentation of nursing services is essential for the first step. The aim of this study was to identify barriers to improving the nursing documentation services using the experience of nurses in the emergency department of one of the Iranian hospitals. Materials and Methods: This study is based on content analysis in accordance with the style of Graneheim in 2017 in the emergency department of one of the Iranian hospitals. This qualitative study was performed on 20 participant from different nursing grades including 17 nurses, 1 head nurse, and 2 members of the accreditation committee. The data were collected through semi-structured interviews and using interview guide and field note. Results: Research data have been explained in four main themes of qualification of documentation including sub-categories of the need for effective training, the need for training in the standards of documentation, and the necessity of skills in reporting; job burnout including sub-categories of job stress and work pressure; perceived control including sub-categories of planned control and effective monitoring and control; intra-organizational coordination including sub-categories of improving health information system and documentation management time, legal barrier for documentation including sub-categories of escaping from the law and legal liabilities. Conclusion: In this study, 599 primary codes were extracted and the main themes documentation competency, job burnout, perceived control, intraorganizational coordination, and legal barrier extracted. © 2018 by the authors; licensee Modestum Ltd., UK

Developing and psychometric of an instrument for reproductive health need assessment related to HIV/Aids in Iranian adult men

Background: Due to the socio-cultural characteristics of Iranian adult men and lack of standardized questionnaires to assess their reproductive health associated with sexually transmitted diseases and HIV / AIDS, this study is done with the goal of development and psychometrics of a valid relevant instrument.Method: A mixed method was used in this study. The reproductive health needs of men were investigated using qualitative content analysis according to the views of 40 people who participated in the study and were chosen via purposive sampling. Accordingly, a psychometric questionnaire was designed and features of the questionnaire were determined using formal, content, and construct validity as well as internal consistency reliability and stability.Findings: The validity index (0.92) and construct validity was analyzed by exploratory factor analysis, which resulted in five factors. Its reliability was estimated using internal consistency, ndCronbach's alpha was 0.88. The analysis ofthe instrument consistency revealed that intraclass correlation index in two phases within two weeks was 0.98.Finally, a questionnaire with 43 items and 5 factors (required) consisting of "gender-based education and services", "overcoming the challenges of educational services", "adequate support", "correction of cultural beliefs" and "empowerment of women" was prepared.Conclusion: The designed instrument is valid and reliable. It is culturally appropriate. It is suggested to be used to assess reproductive health needs of adult men in relation to HIV / AIDS and sexually transmitted diseases.Keywords: men, needs assessments, psychometric tools, AIDS, sexually transmitted disease

Understanding the impact of COVID-19 pandemic on health-related quality of life amongst Iranian patients with beta thalassemia major: a grounded theory

Background:The coronavirus disease 2019 (COVID-19) pandemic and the resulting measures can impact daily life and healthcare management amongst patients with beta thalassemia major.Methods:The Corbin and Strauss method of grounded theory was used to explore the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) amongst Iranian patients with beta thalassemia major. Semi-structured interviews with 16 patients with thalassemia major in the eastern of Iran were performed. Data collection was conducted from 19 September through 18 November 2020. Collected data were recorded, transcribed, and coded to develop themes and subthemes. Paradigm components were sought to find out what happened to these patients and explore the process and events.Results:Insights from these interviews led to five major themes: ‘changing physical health’, ‘emotional and psychological reactions’, ‘changing the nature of relationships and the scope of social support’, ‘metamorphosis of ongoing healthcare, and ‘functionality and adaptation to new realities.’ The emerging core concept was labelled: ‘maintaining well-being balance.’ The COVID-19 pandemic disturbed the balance of life and health of the patients. Multiple strategies to maintain balance and reduce the negative effects of the COVID-19 pandemic on HRQoL were used by the patients, the healthcare team, and support systems.Conclusions:Due to the fear of COVID-19, the patients with beta thalassemia were less likely to contact healthcare professionals. They considered postponing blood transfusion and abandoned evaluating disease complications. Reduced access to the healthcare system and shifting resources from existing programmes to COVID-19 by the healthcare system were incompatible policies. These policies and strategies had strong and negative effects on the physical domain of HRQoL. The patients experienced a deterioration of emotional functioning. They reported a strong reduction in social functioning and felt lonely. Online interventions supporting mental health and social interactions and telemedicine can help during the times of social distancing and lockdowns

Analysis of vaginal delivery promotion package in the National Health System Reform Plan in Iran: a qualitative study

Background: The Vaginal Delivery Promotion Package was a part of the National Health System Reform Plan in Iran, which was implemented to reduce the rate of cesarean sections. The aim of the present study was to examine the views of the beneficiaries on the implementation of the promotion of natural vaginal delivery in the hospitals affiliated to Tehran University of Medical Sciences.  Methods: A qualitative study conducted in 2016 using semi-structured interviews for data collection. The sampling method was purposeful with maximum variation of the beneficiaries. After doing 35 interviews, the data reached a saturation point. Data analysis was done through content analysis method using MAXQDA 10 software.   Results: The package beneficiaries believed that it was successful in achieving its goal to reduce cesarean sections. Their perspectives were classified into two categories (strengths and weaknesses), eight themes (package design, achieving the goals, education and persuasion, package comprehensiveness, monitoring, infrastructures, plan implementation, and service quality), and 24 sub-themes. The most important weaknesses of this package were the payments and supervisions.  Conclusion: Officials and policymakers can improve the package by continuous monitoring, providing necessary feedback to the staff, and modifying the payments. Besides, paying attention to midwives and health workers, the first contact point for pregnant mothers with service providers, can increase the effectiveness of this package

Exploration of the Experiences and Viewpoints of Faculty Members on Continuing Education Webinars: A Qualitative Study

Continuing education is necessary to improve the professional knowledge and skills of graduates of medical sciences, which may be implemented via e-learning. This qualitative study aimed to explore the experiences and viewpoints of faculty members participating in continuing education webinars. The participants consisted of 15 faculty members selected purposefully and with maximal variation regarding their sex, age, the field of specialization, academic rank, and work experience. Data were collected through semi-structured individual face-to-face interviews. Data analysis of these transcripts using a qualitative content analysis approach revealed 3 themes and 9 sub-themes. The main themes included “Moving across the boundaries of knowledge,” Virtual education challenges,” and “Motivators and facilitators.” These data suggest that the main prerequisites for holding successful and effective continuing education webinars are the existence of the necessary software and hardware infrastructures, high-speed and accessible Internet, purposeful educational design, as well as empowering, motivating, and encouraging faculty members to participate in such educational programs. The technical infrastructures and human elements remain critical in effective implementation of continuing education webinars

Humanism in clinical education: a mixed methods study on the experiences of clinical instructors in Iran

BACKGROUND: Medical education is currently more considerate about the human dimension. The present qualitative study aimed to explain the experiences of clinical professors with regard to humanism in clinical education in Iran. METHODS: This mixed methods study had two phases, a quanitative phase of scientometrics and a qualitative phase of a content analysis. In the scientometrics phase, Ravar PreMap and VOSviewer software programs were utilized for plotting the conceptual networks. The networks were analyzed at the micro-level based on centrality indices (closeness, degree, and betweenness). The conceptual network was plotted and the prominent topics in clinical education were identified using co-word analysis. In the second qualitative phase on the topic, based on the scientometrics phase, semi-structured interviews were conducted with clinical professors. The interviews were transcribed verbatim and analyzed. RESULTS: On the basis of the analysis of titles, abstracts, and keywords of the retrieved articles on clinical education from ISI Web of Science, Scopus, and PubMed, 1412 keywords were extracted. After the refining process, 356 keywords with 6741 relations remained. Upon plotting the conceptual network, 19 conceptual clusters related to clinical education were obtained. Then, micro-level network analysis (centrality criteria) indicated that the keyword humanism with the frequency of 137 had the highest rate (97.753), closeness (97.802), and betweenness (13.407). Moreover, from the interview data analysis, two themes of "intertwined nature of the human spirit in clinical education" and "humanistic behavior of professors in clinical education" were extracted. CONCLUSION: As a part of the educational culture, humanistic values must be intertwined with the medical education curriculum. In this regard, humanism and clinical reasoning are the two major clusters of clinical teaching; moreover, altruism and adherence to humanistic values, and scientific qualification are other main pillars that should be considered as the criteria for the selection of clinical professors and medical students

Modelling the Role of University-Industry Collaboration in the Iranian National System of Innovation: Generating Transition Policy Scenarios

In a knowledge-based economy the collaboration between university, industry and government is vital for growth and innovation (Etzkowitz, 2008). A conceptual model of the relevant macro and micro environment was developed using the theoretical constructs from the literature on systems of innovation theories including, National Systems of Innovation, Porter’s ‘Cluster’ or ‘Diamond’ model, and the ‘Triple-Helix Model’ of university–industry-government interactions. The role of culture and trust in different systems of innovation theories was examined, and the role these elements play in UIC activities was found to be particularly important, though vague on the processes. A generic model of university-industry-government interrelations was developed to aid a systemic understanding of the mechanisms (primary barriers and drivers) for productive collaboration. This systems model was used in the formation of policy instruments designed to improve university-industry collaboration (UIC), and thereby the means of regional economic development. These policy experiments are applied to the case of Iran. However, since the future of Iran in this context is highly uncertain due to cultural, political and economic factors there are few assumptions which can be relied upon as a basis for traditional innovation management practice. Instead, it is intended to use the systems model in a series of scenario-based analyses of the effectiveness of policy instruments on the UIC associated with two Iranian cluster industries. A questionnaire survey and a series of semi-structured stakeholder interview methodology were used to build a basis for these scenario techniques. The method of systems modelling to generate policy change scenarios for UIC is a novel feature of this research. Analysis of the causal relationships of UIC activities in Iran found many were biased to create an established behaviour pattern (culture) which is overwhelmingly negative. This negative behaviour is manifest as a significant lack of trust at all interfaces between the primary actors in the system. According to the results of this research, trust is influenced by many factors including government activities, institutional structure, institutional culture, and also national culture of the country. The systems model is a complex interaction of reinforcing loops that emphasizes the scale of challenge policy-makers face in creating effective innovation systems, and may explain why few developing countries have been successful in achieving economic transition. This research shows how a policy development framework was formed using the UIC systems model to understand the structural problems facing Iran. A set of evolved states (exploratory and future-backward scenarios) served to illustrate the effect of these policy choices, and therefore to inform an improvement agenda for UIC activities in Iran