Challenges nursing role on improving quality of life in women with breast cancer undergoing chemotherapy

زمینه و هدف: بروز سرطان پستان و شیمی درمانی توأم با عوارضی است که می تواند منجر به کاهش کیفیت زندگی شود. در این بین از وظایف کلیدی پرستاران انکولوژی پیشگیری و کنترل عوارض ناشی از سرطان و درمان آن می باشد. این پژوهش با هدف بررسی مشکلات ایفای نقش پرستاران در ارتقاء کیفیت زندگی زنان مبتلا به سرطان پستان تحت شیمی درمانی انجام شد. روش بررسی: این مطالعه توصیفی تحلیلی به صورت مقطعی در سال 1392در دو بیمارستان آموزشی از شهرهای شهرکرد و اصفهان انجام شد و 45 نفر پرستار به روش نمونه گیری مبتنی بر هدف وارد مطالعه شدند. با استفاده از پرسشنامه های اطلاعات دموگرافیک و مشکلات ایفای نقش پرستاران در ارتقاء کیفیت زندگی، موانع و مشکلات ایفای نقش این پرستاران در ارتقاء کیفیت زندگی زنان مبتلا به سرطان پستان تحت شیمی درمانی بررسی و تعیین شد. یافته ها: زیاد و سخت بودن روش های رگ گیری، کمبود کارکنان پرستاری، اهمیت ندادن مدیران به مسئله سنجش و ارتقاء کیفیت زندگی و نبود فرم سنجش کیفیت زندگی از عمده ترین موانع گزارش شد. بیشترین مشکل به ترتیب در حیطه های مدیریتی- اجرایی (42)، فردی– پرستار(21)، فردی- بیمار(14)، آموزشی (13) و محیطی– تجهیزاتی(10) مشخص شد. راهکارهای برگزاری دوره های آموزشی برای مدیران، تهیه فرم سنجش کیفیت زندگی و لحاظ نمودن فعالیت آموزش به مددجو در ارزشیابی های پرستاری به عنوان راهکارهایی با امتیاز بالاتر بدست آمد و در نهایت راهکار توانمندسازی مدیران پرستاری به عنوان راهکاری برتر با پوشش دهی تمامی راهکارها پیشنهاد شد. نتیجه گیری: بیشترین مشکل در حیطه مدیریتی- اجرایی گزارش شد؛ لذا پیشنهاد می شود برنامه ریزی هایی در جهت افزایش توانمند سازی مدیران پرستاری در راستای ارتقاءکیفیت زندگی زنان مبتلا به سرطان پستان تحت شیمی صورت پذیرد

Strategies for enhancing nurses' clinical judgment in care for patients with chronic diseases: A grounded theory study in Iran

BACKGROUND: A varying background in situations of chronic diseases affects the selection of strategies in clinical judgments. This study explained the strategies used to enhance the clinical judgment in chronic diseases situations. METHODS: This article was the part of a grounded theory study. Obtained data from open and semi-structured interviews were analyzed simultaneously with data collection and according to the Corbin and Strauss approach. The first experienced nurse was selected with purposive sampling and 25 other participants were selected on the basis of the theoretical sampling from different wards of the clinical and educational care centers of Sanandaj, Iran from 2011 to 2013. RESULTS: As shown in results, the core variable “situation-based efforts for enhancing clinical judgment” represented the main process used by participants in the promotion of clinical judgment in situations of chronic disease. The main categories included a "comprehensive collaboration", "inclusive education", "matching of clinical judgment skills", "maintaining patient's and nurses' autonomy" in a clinical judgment. CONCLUSION: Participants were trying to use strategies appropriate to different situations for clinical judgment in terms of chronic diseases conditions. Applying these processes with regard to the present context, can enhance the clinical judgment in chronic diseases situations

The experiences of nursing students, instructors, and hospital administrators of nursing clerkship

Introduction: Most studies concerning clinical education of nursing students have been performed qualitatively. This study was performed to more deeply investigate the students’ education at nursing clerkship and explore the experiences of nursing students, instructors, and hospital administrators from the clinical education of nursing students. Methods: In a qualitative study a semi-structured interview was done with 8 nursing students at the end of clerkship, four nurses working as ward administrators, an education supervisor, and two supervising instructors. Qualitative content analysis was employed for analyzing the data. Results: Six central variables were realized (emerged) including lack of readiness for entering into clinical learning environment, undesirability of student assessment process, lack of advantageous relationship between the nursing school and the hospital, ideal planning for clerkship shifts, deficiency in clinical education, and the effects of clerkship on hospital and patients' affairs. Conclusion: According to the findings of the study, it is necessary for the nursing administrators to place more effort to resolve the present problems specially the relationship between the nursing school and the hospital, and to renovate hospital into a favorable learning space to meet educational goals of nursing clerkshi

Struggling to create new boundaries: a grounded theory study of collaboration between nurses and parents in the care process in Iran.

AIM: To develop a substantive grounded theory of nurse-mother interaction in the care of chronically ill children in hospital setting. BACKGROUND: Interaction between nurses and parents is critical in paediatric hospital settings. This area of practice in developing countries has been under-researched. METHOD: The qualitative research design of grounded theory methodology was used to develop a theory of nurse-parent interaction within the child care. Registered Nurses (n=17) and mothers of chronically ill children (n=14) from two central paediatric hospital in Iran participated in this study. In-depth interviews with nurses and mothers were conducted using theoretical sampling between July 2007 and August 2008. The data were analysed using constant comparative analysis. FINDINGS: 'Struggling to create new boundaries' as a core variable was a dominant socio-psychological process that was manifesting itself within three stages: facing up to and perceiving the environmental pressures, balancing nurse's duties, and controlling the nurse-parent boundary in the care. CONCLUSION: It is concluded that nurses and parents need a care model, which addresses their collaboration and improved interpersonal relationship and clearly defines the boundary of their roles based on the needs of both sides while allowing parents to choose their role in these defined boundaries and providing parent education with aim to empower them for care at home

The effect of family-centered empowerment model on skill, attitude, and knowledge of multiple sclerosis caregivers

Materials and Methods: This clinical-trial study was done on 70 care givers of multiple sclerotic patients who were divided into case and control groups. Family-centered empowerment model was applied for three months and then the questionnaires regarding skill, attitude, and knowledge of the participants were collected. The obtained data was analyzed by means of SPSS software (version 11.5) and dedicational statistical tests at the significant level of P< 0.05. Results: Independent T-test revealed that there was no ..

The effect of Nurse-parent collaboration Model on mother's satisfaction

زمینه و هدف: علیرغم توافق جهانی در خصوص اهمیت مشارکت خانواده در مراقبت، معنای آن دچار ابهام است. در مطالعه حاضر، محقق به تعیین تأثیر بکارگیری مدل مشارکت پرستار-والد بر میزان رضایت مادران از مراقبت پرداخته است. روش بررسی: مطالعه حاضر از نوع مداخله‌ای با طراحی تحقیق نیمه تجربی دو گروهی بود که در مرکز طبی کودکان تهران انجام گرفت. ابتدا در یک دوره 3 ماهه 30 کودک سن مدرسه مبتلا به بیماری مزمن گوارشی و روماتیسمی بستری در بیمارستان و مادران آنان به عنوان گروه کنترل (دریافت کننده مراقبت روتین) وارد مطالعه شدند. نمونه‌گیری در دو مقطع زمانی 3 ماهه صورت گرفت. در مدت زمان پژوهش تمامی نمونه-هایی که معیارهای ورود به مطالعه را داشتند، وارد مطالعه گردیدند. پس از اتمام نمونه‌گیری مرحله کنترل (تعداد نمونه: 30 نفر)، مشارکت مدیریت شده پرستار- والد در بخش به اجرا گذاشته شد. پس از گذشت دو هفته از شروع اجرای مدل، 25 کودک بستری و مادران آنها به عنوان گروه آزمون وارد مطالعه گردیدند. رضایت مادران هر دو گروه نیز با استفاده از پرسشنامه رضایت از مراقبت تدوین شده توسط پژوهشگر در هنگام ترخیص مورد ارزشیابی قرار گرفت. یافته‌ها: یافته‌های پژوهش نشان داد که میانگین رضایت کلی مادران از مراقبت پرستاری در گروه آزمون (8/10±24/80) به طور معنی داری از گروه کنترل (8 ±7/20) بیشتر است (001/0>P). همچنین میانگین رضایت مادران در پنج حیطه اطلاع رسانی، ارتباطات، مهارتهای بالینی، عاطفی و مشارکت خانواده به تفکیک در گروه آزمون بطور معنی داری بیشتر از گروه کنترل است (001/0>P). نتیجه گیری: یافته های نهایی این پژوهش حاکی از آن است که مشارکت مدیریت شده پرستار- والد می-تواند جهت افزایش رضایت مادران از مراقبت مورد استفاده قرار گیرد

Parental participation and mismanagement: a qualitative study of child care in Iran.

The purpose of this study was to explore parents' and nurses' experiences of parental participation in child care in hospitals in Iran. Using thematic analysis, the data were collected through interviewing 14 parents and 11 nurses from two pediatric hospitals. The results showed that four major themes emerged, including the necessity of a parent's presence, the unplanned and informal delegation of care to the parents (which itself had five subthemes: the parents as nurses, the delegation of care without sufficient and planned parental training, informal parent-to-parent support, the continuum of parents' willingness to participate, and the neglect of parents' needs), the inconsistency of care, and the parents as informal evaluators of care. Based on the study's findings, effective communication by nurses with parents is required. Nurses need to make an ongoing assessment of parents' wishes for involvement and negotiate care accordingly, with enough support and supervision to warrant quality of care

Iranian Nursing Instructors’ Perceived Experiences of Challenges of Effective Education: A Qualitative Content Analysis

Introduction: Any shortcoming and deficiency in training has direct impacts on clinical knowledge and skills of nurses. Such impacts will eventually affect community health. The purpose of the present study was to explore nursing instructors’ perceptions about challenges of effective education in Iranian nursing. Method: A qualitative content analysis approach in-depth Semi-structured interviews and purposeful sampling were conducted in 2011 with 15 participants to better understand their perceptions of the effectiveness education In Ahvaz and Tehran University of Medical Sciences. Results: The data analysis resulted in three main themes achieved: ‘Non-care-centered education, inadequate technical competence ‘Evaluation not conducted, were considered as important challenges of in effectiveness education in Iranian nursing. Conclusion: The findings can be helpful for international nurse instructors and educational planners to be exposed to the unheard perspectives of nursing faculties and reconsider the weakness of effective education in nursing planning and evaluation process conducted by them. We suggested that educational goals in nursing are designed base on “care”. If the weaknesses have improved, it can lead to achieve technical competency of nurses and community health will promote. Keywords: Effectiveness education, Qualitative content analysis, Nursing instructor\'s experiences, Educational base car

Strategies for enhancing nurses' clinical judgment in care for patients with chronic diseases: A grounded theory study in Iran

BACKGROUND: A varying background in situations of chronic diseases affects the selection of strategies in clinical judgments. This study explained the strategies used to enhance the clinical judgment in chronic diseases situations. METHODS: This article was the part of a grounded theory study. Obtained data from open and semi-structured interviews were analyzed simultaneously with data collection and according to the Corbin and Strauss approach. The first experienced nurse was selected with purposive sampling and 25 other participants were selected on the basis of the theoretical sampling from different wards of the clinical and educational care centers of Sanandaj, Iran from 2011 to 2013. RESULTS: As shown in results, the core variable “situation-based efforts for enhancing clinical judgment” represented the main process used by participants in the promotion of clinical judgment in situations of chronic disease. The main categories included a "comprehensive collaboration", "inclusive education", "matching of clinical judgment skills", "maintaining patient's and nurses' autonomy" in a clinical judgment. CONCLUSION: Participants were trying to use strategies appropriate to different situations for clinical judgment in terms of chronic diseases conditions. Applying these processes with regard to the present context, can enhance the clinical judgment in chronic diseases situations

Exploration of structure of clinical judgment of nurses: A grounded theory study

Introduction: Clinical judgement as a tool for professionals allows the nurses to play their roles and explore their opinion. This necessitates clarification of the structure of clinical judgment. It is difficult to give a unanimous definition for clinical judgement therefore, exploration of the structure of the concept is necessary to understanding clinical judgment. The aim of this study is to explore the structure of clinical judgment of nurses. Method: This qualitative research was a grounded theory study based on purposed sampling. 18 clinical nurses from Kurdistan University of Medical Sciences were interviewed. The interviews were transcribed in Microsoft Word Office, and then the data were analyzed in MAXQDA2007. Constant comparison analyses were used simultaneously with data collection. Results: The participants in study include 9 men and 9 women, with at least 3 years of experience of nursing in variable clinical settings. Final research findings could be discussed in five categories including: complexity of definition of clinical judgment, context of clinical judgment, continuum of clinical judgment, skills of nurse in clinical judgment, and achieve to professional criteria. Conclusion: Despite the complexity of the concept in the literatures and the field of research, this study could explore the structure of clinical judgment of nurses in the clinical arena. The results of this study would be used to explore nurses' clinical judgment model, based on grounded theory. Keywords: Clinical judgment, Nurses, Grounded theory, Qualitative stud