Emotional Transformation, Anxiety, and Expectancy in view ofamong Pregnant Surrogate Mothers: A Qualitative Study

Introduction: Surrogacy is an assisted reproductive technology (ART) in which the surrogate mother accepts to host the baby of another in her uterus. Despite the advantages of surrogacy, it has given rise to certain ethical and legal issues. Thus, the aim of the present study was the evaluation of emotional transformation, anxiety, and expectancy among pregnant surrogate mothers. Method: This qualitative research was conducted based on phenomenological approach. The study population consisted of all pregnant surrogate mothers referring to Isfahan Fertility and Infertility Center, Iran, in 2014. Through purposive sampling method, 5 women were selected. Data were collected using deep and unstructured interviews and analyzed using Colaizzi's method. The reliability and validity of this study was approved based on the 4 elements of dependability, credibility, transferability, and conformability. Results: The mean age of participants was 32.4 years. Through analysis of interviews, 39 primary codes were extracted. The primary codes were categorized into secondary codes. They consisted of 2 themes of emotional transformation in the donor and recipient (emotional transformation) 4 themes of anxiety in the simultaneous motherhood roles, apathy of the receiver, shame and fear of people close to the donor (anxiety), and 3 themes of trust in God, anticipation of the end of the pregnancy, and hope for the resolution of financial problems (expectancy). Thus, the experience of emotional transformation, anxiety, and expectancy by pregnant surrogate mothers was approved. Conclusion: Support systems should be strengthened in Iran so that derelict women have insurance and are not compelled to donate ovum and become surrogates several times. The exploitation of these women and damage to their human dignity should be prevented, and education is the best way to prevent this exploitation. Keywords: Emotional transformation, Anxiety, Expectancy, Surrogacy, Life experiences, Qualitative researc

Opiate Dependents’ Experiences of the Therapeutic Relationship in Methadone Centers; A Qualitative Study

Abstract Background: Methadone maintenance therapy is a treatment of choice for opiate addiction. Understanding opiate dependents’ experiences of patients' treatment is a key to continue the treatment and can provide help to revise the standards of methadone centers and improve the quality of treatment. This study aimed to describe the essence and structure of opiate dependents’ experiences with methadone maintenance therapy. Methods: It was a qualitative phenomenological study, in which participants were selected from opiate dependents referred to methadone centers in Kerman city in 2007. Sampling was purposive and continued until data saturation, which was achieved at 32 participants. Data were collected by in-depth interviews. Colaizzi's method was applied for data analysis. The rigor of the present study was assessed based on the criteria of confirmability and credibility. Findings: A total of 26 themes were extracted and categorized into three main themes including positive therapeutic alliance, negative therapeutic alliance and therapeutic alliance requests. Conclusion: Client–centered therapy in methadone clinics creates a positive therapeutic alliance, and persuades patients to continue their treatment. Establishing a good relationship with patients during their treatment procedure is an effective way to meet the goals. Individual and group counseling sessions and advices on family and career related issues during the treatment should be considered as well. Keywords: Methadone, Experiences, Professional Patient Relationships, Qualitative research, Opiate dependenc

The Experiences of Employed Women Related to their Maternal Role: A Phenomenological Qualitative Research

Introduction: Regarding recent social and economic changes and developments and the increasing presence of working women in society, paying more attention to the importance of maternal role among working women who face multiple roles is necessary. Therefore, this study describes the experiences of working women related to their maternal role. Method: This was a qualitative research, in which the phenomenological approach was used. The participants were selected from women working in one of the units of Islamic Azad University, Iran. Purposive sampling was used to select 9 participants. In-depth interviews were the main data collection method. In addition, data were analyzed through Colaizzi’s method. Reliability and validity of the present study was rooted in the four axes of real value, applicability, continuity, and being based on reality. Results: Data analysis led to the extraction of 414 primary codes, 25 subthemes, and 7 main themes including different pregnancy, supportive umbrella, role alteration, role overlap, role strain, gradual adaptation, and erosion. Conclusion: The acceptance of numerous roles, such as maternal and marital roles, by working women results in various role expectations of them from their children, spouses, family, and the society. This, in turn, forces them to meet both familial and occupational needs and expectations. However, since maternal role is considered as one of the most important roles of women, this obviously, intentionally or unintentionally, can affect the maternal role and cause role conflicts for working mothers. Based on the findings of the current study, this important role of working mothers is accompanied by much hardship and difficulty and it is a completely different process than that experienced by non-working mothers. Since this may affect their physical and mental health, it necessitates more attention. Keywords: Experiences of working women, Maternal role, Phenomenolog

Physical Effects of Methadone Maintenance Treatment from the Standpoint of Clients

Background: Studies have shown that methadone maintenance treatment (MMT) is effective in improving the client’s quality of life and physical health. This study aimed to describe the nature and structure of drug dependents' experiences and the physical effects of MMT Methods: The present study is a qualitative and a phenomenology study on 32 clients referred to methadone clinics in the city of Kerman in 2008. Colaizzi’s method was used for data analysis and to evaluate the data, validity and reliability criteria were used. Findings: Encoded concepts were categorized in general groups of effectiveness on general health, sleep, appetite and weight, sexual desire, appearance and other effects. These six categories showed the main structure of experience and physical effects of MMT. Conclusion: The clients' viewpoints towards this treatment had a role in their experience expression and feelings, but MMT had an overall positive physical effect on the clients Keywords: Methadone maintenance treatment, Physical effects

How can the results of a qualitative process evaluation be applied in management, improvement and modification of a preventive community trial? The IHHP Study

BACKGROUND: This study reports the results of the qualitative process evaluation (PE) of the Isfahan Healthy Heart Program (IHHP), an integrated community-based trial for prevention and control of non-communicable diseases in Iran. METHODS: The study explored the overall quality of program implementation. The participants, including designers of IHHP, stakeholders and community members (n = 60) were purposefully recruited from the intervention areas. Data collected from semi-structured interviews and field notes were analyzed using a modified thematic analysis. RESULTS: Four main themes were identified. Our findings highlighted the key role of the resources as both facilitating and hindering factors. IHHP directors faced incompatibilities arising from negative perceptions/attitudes which resulted in decreased adherence to the program. Hence various strategies were used to motivate, strengthen and organize the human workforce implementing the program. CONCLUSION: Recommendations arising from evaluation of the program were used in subsequent stages of implementation. Qualitative research is an important component of community trials which can improve their implementation

Emotional and Psychological Experiences of Transplanted Patients in Communicating with Families of Brain-dead Donors

Introduction: Transplanted patients’ communication with the families of brain-dead donors is a new experience, which provokes different reactions in both sides due to its different dimensions. The aim of this study was to clarify emotional and psychological experiences of transplanted patients in communicating with brain-dead donors’ families. Method: This study was a qualitative research conducted using the phenomenology approach. The experiences of transplanted patients were studied using unstructured and in-depth interviews. Data saturation was reached by interviewing 8 transplanted patients who communicated with the brain-dead patients’ families. Data were analyzed using qualitative content analysis based on Colaizzi’s method. Results: The findings of this survey can be classified into two general concepts of anxiety, and psychological and mental disturbances after receiving the organ. These two concepts consist of smaller concepts. Anxiety consists of concepts such as complicated therapy, regret due to relationship problems, stress and worry, and stress after the incident. Mental and psychological disturbances after receiving the organ consist of the recipient’s mental challenges with her/himself, and increase in blood pressure due to stress. Conclusion: Transplantation is an important event occurring in the life of these patients. The anxiety of the possible failure of transplantation is a problem that these patients are exposed to after transplantation. Communication and familiarity with the donor’s family also increase this anxiety. If the brain-dead donor’s family wishes to communicate with the organ recipient, it is better to start this relationship under special conditions and the supervision of a psychologist. Keywords: Emotional experience, Psychological experience, Organ transplantation, Communication, Family, Brain deat

Psychological and emotional outcomes in patients with systemic lupus erythematosous

Introduction: Systemic lupus erythematosus is a chronic autoimmune disease that affects different body organs and causes extensive and serious damage to the connective tissues، blood vessels and membranes. In addition to numerous Clinical complications، psychosocial، social، and economical disabilities also follow. The present study describes psychological and emotional outcomes in patients with systemic lupus erythematosus. Method: This study has a qualitative (phenomenological) approach. A purposive Sampling of 10 Patients who had been diagnosed with systemic lupus erythematosus and who had referred to rheumatology clinic in Bandar Abbas and been approved for research Were conducted through in- depth interview by open- ended unstructured questions and collyzi utilized for data analyses. Results: The extracted interviews were analyzed for the conceptual codes and codes then were transformed to the original concept of "mental emotional consequences" which include subcategories concepts such as mood and emotional reactions، cognitive disorders، incorrect diagnosis and subjective image impairment. Conclusion: This study indicates that these patients have a wide range of problems in different aspects of mental and emotional life، so the study results can provide suggestions for treatment and care of patients with lupus and other diseases that bring forth disabling، chronic and non-curable problems by providing nurses، doctors and all those who somehow are associated with this disease. So that each patient's care requires a unique opinion and since most clients are young women، in addition to maturity and physical needs of patients، mental and emotional problems must also be taken into consideration. And، if necessary، consultations from psychologists and psychiatrics can be used to facilitate the healing process. Keywords: Systemic Lupus Erythematosus, Psychological and Emotional Outcomes, Chronic Illnes

Reflection on the Experiences of Disabled People: The Society as a Cause of Growth or Barrier

Introduction: In recent years, based on evidence from several communities, positive psychology researchers have constructed a new conceptualization called “post-traumatic growth”. Based on the theory of symbolic interaction, members of the society, especially family members, play an important role in meaning making of events, quality of life after the accident and its consequences, and whether they experience growth or not. The aim of the present study was decoding experiences of successful disabled people of causing factors (facilitator) or barriers of growth by qualitative method. Method: A qualitative design, based on the content analysis approach, was used to collect and analyze the experiences of 12 disabled people with national and international achievements. Participants were selected by purposeful and snowball sampling method. Semi-structured interviews were used for data collection. The data were analyzed based on the Granheim content analysis approach. Results: The findings showed two main themes: 1) intelligent and noble family with 3 subcategories of initial acceptance and support, interaction with other groups and successful disabled people, and timely attraction and repulsion 2) family as obstacle with 3 subcategories of pity and clumsy support, entertaining instead of being goal-oriented, and ignoring them. Conclusion: Attitudes and family functions have wanted and unwanted effects. They may act as facilitators or obstacles of growth. Understanding these factors based on experiences of disabled people could cause effective changes in the attitudes and beliefs of people. Keywords: People with spinal cord disability, Growth, Content analysi

Development of Clinical Teaching Process of the Fundamentals of Nursing with Participatory Approach: an Action Research

Introduction: Consistent with health care changes, nursing schools also require revising of clinical education programs, especially, the nursing student’s first clinical experience. The first clinical experience is considered the cornerstone in professional nursing education. The present study was conducted with the aim to identify challenges of clinical training of the fundamentals of nursing to undergraduate students and develop them with a collaborative approach in the School of Nursing and Midwifery in Ahwaz Jundishapur University of Medical Sciences, Iran. Method: The presents study reports the two operating cycles of an action research with a collaborative approach and focus group discussion, and with the participation of 84 stakeholders. Content analysis approach was used to analyze the data obtained in focus discussion interviews. In addition, reflective evaluation was performed during the operation and final evaluation at the end of each cycle with the participation of all members, including students. Results: The findings of this qualitative study detected a lack of consistency in planning and implementation of curriculum, inadequate intra- and extra-organizational communication management, inadequate student understanding of situation, and improper control of restrictors and improper use of facilitators in teaching and practice. After classification of problems, educational decision-making authorities of the School developed an operational program within the national curriculum framework through participation in clinical skills and principles training program. Overall, the evaluation results in the two operating cycles confirm that the general success of the action plan is based on professional collaboration of faculty trainers and administrators, and clinical nurses involved in the process. Conclusion: Planning fundamentals of nursing training in partnership with all those involved in practice and education, together with students can be effective in reducing educational failures, gap between theory and practice, and result in the satisfaction of all stakeholders. Keywords: Fundamentals of nursing, First clinical experience, Undergraduate nursing student, Clinical training partnership, Action research stud

Medication Errors Experiences of Nurses who Working in Hospitals of Isfahan at 1391

Introduction: Patient safety has long been a major concern for healthcare professionals. Today, hospitals should provide patient safety in order to gain accreditation. Among patient safety issues, medication error rate has been considered as a major indicator of healthcare quality. The different aspects of medication error are not clearly known and the nurses are the main source of knowledge in this field. Therefore, the researcher decided to study the experiences of nurses who have been faced with a medication error in order to clarify the various aspects of this phenomenon. It is through the exact identification of this phenomenon that it can be managed. Method: In the present study, a phenomenological qualitative approach was used. Participants in this study were nurses working in hospitals of Isfahan and had experienced medication error. Purposive sampling was adopted in the study and sample size was dependent on the data saturation. A total of 10 participants were chosen. Data collection was carried out through unstructured interviews and analysis through Colaizzi’s Method. Results: From the findings of this study, six main themes expressing participants’ experiences emerged. The six main themes include: The context of error, the error range, negligence, the consequence of error, concealment of error, and reporting of error. Conclusion: Nurses report their errors when they feel safe and do not see harmful results for them. Therefore, hospitals should review their policies on error reporting to ensure they actively encourage nurses to report medication errors, and to support a blame-free culture in the organization and a systembased approach to deal with the error. Keywords: Nurses’ medication errors, Nurses’ experiences, Patient safety, Qualitative researc