How Baloch Women Make Decisions About the Risks Associated With Different Childbirth Settings in Southeast Iran

Background: In Zahedan City in Southeast Iran, some women prefer to give birth at home despite the availability of the equipped hospitals and expert advice that hospital births are safer. Objectives: This study explains how Baloch women make decisions regarding the risks associated with childbirth at home versus a hospital. This study identifies and defines the factors that influence the choice of the place of delivery by Baloch women. Materials and Methods: The article draws on data from a grounded theory. In particular, on in-depth interviews with 25 Baloch women, 21 of whom had planned home births and 4 planned hospital births in their most recent childbirth. Results: Six categories emerged from the data as follows: 1) deliberation and risk assessment; 2) obstacles to hospital births; 3) preference for hospital births; 4) obstacles to homebirth; 5) preference for homebirth; and 6) risk management. The core category was deliberation and risk assessment. Our interviews showed that Baloch woman weighed the negative and positive aspects of each option when deciding on a childbirth setting. In this process, their assessment of risk included physical wellbeing and social-cultural values. Furthermore, their assessment of risk can, in some circumstances, result in delays or avoidance of having hospital childbirth. Conclusions: Managers and service providers need to know an ordinary woman’s perception of risk to address the gap between current and desired childbirth services and encourage women to use current hospital services

Nursing Care Aesthetic in Iran: A Phenomenological Study

Background: Despite the emphasis of contemporary nursing theories on the belief that nursing is a science and an art in care, published studies show that only the nursing science has developed. Many experts believe that by recognizing and perceiving this concept, the clinical field can develop aesthetic knowledge in nursing and education of students. Objectives: The purpose of this study was to explain clients and nurses perspective of nursing care aesthetics. Patients and Methods: Using an interpretive phenomenology, 12 clients and 14 nurses were interviewed. Participants in this study were purposefully selected and their experiences were analyzed using Van Manen’s hermeneutic phenomenological framework. Results: Emerged themes were as follows: subjective description, overt spirituality, opening desperate impasse, sense of unity, continue to shine, and painful pass and pleasing. According the participants experiences, nursing care aesthetics includes subjective description of spiritual and desirable caring behaviors combined with sense of unity and sympathy between the nurse and the patients, which leads to opening in desperate impasse with creating the feeling of satisfaction and peace in the patient. It is a shining of clinical capabilities and an action beyond what should be combined with a decorating care that leads to a pleasant ending against the pain and suffering of the others for the nurse. Conclusions: Many caring behaviors associate with aesthetic experience for both patients and nurses and despite two different views, findings of this study showed that these experiences were similar in most cases. The aesthetics of nursing care was defined as what reflects the holistic nature of nursing with an emphasis on spirituality and skill. Results of this study are effective in identification of the values existed in nurse caring behaviors and developing of profession by instruction, implementation, and evaluation them

Proposing indicators for the development of nursing care quality in Iran

Background: Nursing has come a long way in developing frameworks for the delivery of high-quality care; however, it is still grappling with identifying key performance indicators and defining the patient outcomes that are directly or indirectly affected by nurses. Objective: The study aimed to determine performance quality indicators in nursing care based on the healthcare system in Iran. Methods: A descriptive exploratory study was conducted and 220 nurses from seven provinces in Iran were selected by quota sampling. A questionnaire including 97 indicators in seven categories was developed to collect data and respondents were asked to rate each indicator for importance, scientific acceptability and feasibility of implementation. Results: Of the initial 220 distributed questionnaires, 74% (n = 119) nurse managers and 26% (n = 42) expert nurses (total: n = 161) returned questionnaires (73% response rate). The mean scores for all categories showed that the most of the indicators were important and scientifically acceptable (mean > 2.40), but difficult to implement in hospitals (mean < 2.15). An analysis using ANOVA showed that there were no significant differences between seven categories for the ‘importance’ aspect, but there were significant differences between ‘time and quality of care’ and ‘job satisfaction’, for ‘scientific acceptability’ (P = 0.004) and significant differences between most of categories for ‘feasibility of implication’(P = 0.000). Conclusion: The researchers have proposed the most significant nursing quality indicators for the clinical setting in Iran. These indicators would be useful for nurse managers as a first step to assess the quality of nursing care in hospitals