Psychological Problems of Family Members of Brain-Dead Organ Donors: A Qualitative Study

Introduction: Organ donation is a very difficult decision for families. Families of brain-dead patients simultaneously face the difficult and damaging stages of experiencing and understanding brain death and the crisis of decision-making about organ donation. The understanding of individuals’ mentality and experiences is not possible with common quantitative approach; however, due to the importance this issue in nursing, understanding this concept seems necessary in order to provide appropriate care. Thus, in the present study, the qualitative study method was used for a deeper understanding of the psychological problems of brain dead patients’ family members. Method: This qualitative study was conducted through content analysis approach. The study participants were 13 relatives of 8 brain dead patients and were selected through purposive sampling method. Data were collected through in-depth, semi-structured interviews. Data collection was continued until data saturation, when no new codes and categories were found. All interviews were recorded and transcribed verbatim. Data were analyzed through the qualitative content analysis methods of Granheim and Lundman. Results: Through data analysis, 16 sub-categories were obtained and were categorized into the 4 themes of ambiguities, fear and doubt, dependency, and growth and development. Each of these concepts was divided into smaller indices. Conclusion: Results of the qualitative evaluation of the psychological problems of families of brain-dead organ donors showed that, because of families’ different experiences, lack of awareness, and harmful levels of anxiety and depression, it is necessary to appropriately support families in this crisis. The extracted concepts showed that all of the families required the medical team’s sympathy and that they must be assisted in understanding any ambiguities and better understanding these conditions. Moreover, the incidence of inappropriate thoughts and confounding factors in the acceptance of this crisis must be reduced by strengthening the humanitarian morale of individuals. Keywords: Brain death, Organ donation, Family experience, Qualitative researc

Nursing students perception of clinical learning environments:A qualitative study

Introduction: Nursing students’ perception of clinical learning environments is effective on decision making and selection of learning approach. Due to the importance of perception toward clinical learning environments, nursing students’ perception of this environment was examined in this qualitative study. Method: This qualitative study was performed using grounded theory. For data analysis, the glazer approach was used. Using purposeful sampling, 35 deep interviews were conducted and 1 focused group interview was conducted with 5 subjects. Continuous comparative analysis was performed simultaneously to data gathering using OneNote software. Results: It was found that a range of stimuli affect nursing students’ perception of clinical learning environments in the form of a 4-step process. These 4 steps consist of experiencing and processing primary expectations, experiencing and processing the programmed environment, experiencing and processing the clinical learning environment, and nurturing personal and professional talents and capabilities. Conclusion: The results of this study can help instructors and curriculum programmers in understanding the process of nursing students’ perception of clinical learning environments. An understanding of these perceptions can improve students’ perception of these environments and help to nurture their talents and personal capabilities. Keywords: Perception, Clinical learning environment, Nursing student

Moral intelligence in nursing: a cross-sectional study in East of Iran

Abstract Moral intelligence is one of the dimensions of intelligence that can provide a framework for the proper function of man, and be used as a predictor for people’s conduct. Nurses’ performance is of great importance because of the moral and human nature of their profession, and their adherence to ethical principles improves the nursing care quality as well as organizational performance. Therefore, the present study aimed to assess moral intelligence in nurses. This cross-sectional study was conducted on 400 nurses from teaching hospitals in South Khorasan. Participants were selected through census method. Data were collected by Lennik & Kiel’s moral intelligence questionnaire, and data analysis was performed using SPSS 16 software and descriptive and analytical statistics tests. The results suggest that the nurses’ moral intelligence score was 4.35 ± 0.56 (range: 1-5). There was a direct and meaningful relationship between moral intelligence and age and years of practice (P < 0.05). Optimal levels of moral intelligence suggest the importance that nurses attribute to moral values, and can also be an indirect manifestation of their moral conduct in healthcare environments

Moral distress and attitude to euthanasia: A correlation study in nurses

Moral distress is one of the major health issues that can affect the quality of nursing work life and fails to achieve health goals. One of the major issues affecting the development of moral distress phenomenon is euthanasia. Although the occurrence of the phenomenon according to religious and legal structures in Iran is impossible; But it also could underlie attitude to events; among the causes of moral distress in nursing is discussed. Cross - sectional study aimed to investigate the relationship between the phenomenon of moral distress and euthanasia is performed. A quota sample of subjects selected from hospitals in Kerman and data were collected to Corly moral distress and attitudes toward euthanasia questionnaire. The results indicate that the intensity and frequency of moral distress among nurses attitudes towards euthanasia is not significant relation (P>0/05). Average of moral distress in nurses (2/7±0/57) and the average attitude towards euthanasia (0/9± 1/5) were reported. According to this issue euthanasia is one of the reasons which produce moral distress in nurses but maybe Low nurse’s attitudes prevent it. Levels of moral distress planning and attention needed to understand this phenomenon and to increase nurses' coping mechanisms they to require and as a result come that this phenomenon cannot have an important role in creation of moral distress in Iranian nurses, nonetheless, levels of moral distress necessitate planning and attention for introducing this phenomenon to the nurses and increasing coping mechanisms in them

Determination of the Content of Communication between the Care Team and Family Members of Patients in the Intensive Care Unit: The Experience of Nurses and Patients’ Families

Introduction: Establishing an effective communication with patients is an essential aspect of nursing care. However, most studies have described the nurse-patients’ family relationship as weak. Recognition of the content of effective care team-patient’s family communication will facilitate a more affective relationship between the care team and family members of patients in intensive care units. The present study aimed to determine the content of effective communication between the care team and family members of patients in the intensive care unit from the perspective of nurses and patients’ families. Method: This study was performed with a qualitative approach and content analysis method. Participants included 8 Iranian registered nurses and 4 physicians working in intensive care units (ICU) of hospitals affiliated to Kerman University of Medical Sciences, Iran, and 10 first-degree relatives of patients. Data were collected using interviews and observations. Unstructured interviews were used in the present study. We used observation in order to gain a deeper understanding and verify data from interviews. The observations focused on the interactions between the care team and patients’ families during mutual communications. Results: The data analysis of the handwritten account of the communication of the participants resulted in five categories of spiritual care (subcategories: giving hope, considering Allah, and performing religious practices) emotional reaction (subcategories: empathy, mutual understanding, promoting comfort, and trust), encouraging participation (subcategories: participation in decision making, and participation in physical care), interactive learning (subcategories: identification of the information requirements of the family, responding to the needs of the patient’s family, and training the patients), and consultation and guidance (subcategories: consultation in selecting treatment, and selecting the best care method). Conclusion: The findings resulted in the recognition of important aspects in communication between the ICU team and the family of the patients. By identification of the content of communication, establishing new rules, and application of creative methods in educating the care team on establishing communication, implementation of rules, and application of the patient-based approach in clinical environments we can communicate more effectively. Keywords: Content of care, Team-patient’s, Family communication, Intensive care unit, Qualitative content analysi

Correlation between workplace culture, learning and medication errors

The occurrence of medication errors in intensivecare units can bring about irreparable damageand even lead to death in hospitalized patients.In this respect, numerous investigations have suggestedthat many factors including workplace culture and learningfrom error can affect the incidence rates of such errorsin these units. Accordingly, the present study was to shedlight on the correlation between workplace culture, learningfrom error, and reporting rate of medication errorsamong nurses in intensive care units affiliated to teachinghospitals of Shahid Beheshti University of Medical Sciencesin Iran.Methods: A descriptive-analytical study was conductedamong 120 nurses working in intensive care units in fourteaching hospitals in the city of Tehran. Then, the questionnairesdeveloped by Gulley et al., Rybowiak et al., andWakefield et al. were used to collect the data related toworkplace culture, learning climate, and medication errors.Results: The findings of this study indicated that increasedlearning from error in nurses working in intensivecare units could lower reporting rate of medication errors(r=-0.312, p-value=0.001); there was also a significantrelationship between workplace culture and reportingrate of medication errors, so that enhancing workplaceculture could reduce reporting rate of medication errors(r=-0.239, p-value=0.012).Conclusion: Improving workplace culture via supportingemployee creativity and innovation as well as promotinglearning environment through an employee reward systemalong with avoidance of punishments and reprimands fornurses during the occurrence of errors could be effective inmitigating the incidence rates of medication errors

Transformation and personality development: the outcomes of client’s violence in the professional relationship of social workers

Background: Violent behaviors in professional relationships of social workers have become a growing concern for the international society. The outcomes of violence are effective in professional relationships. The purpose of this study was to better understand the consequences of violence in the professional relationships of Iranian social workers in order to improve their performance and coping skills. &nbsp; Methods: The study was carried out through qualitative content analysis and 20 semi-structured interviews were conducted with 17 social workers. The participants were selected through purposeful method and data gathering was stopped after data saturation. &nbsp; Results: Two main categories including “distress” and “development opportunity” and four subcategories including “distress and social worker’s reactions,” “distress and client’s reactions,” “personality development,” and “reinforcement of professionalism” were identified. &nbsp; Conclusion: The cognition of violence consequences and learning coping skills in professional communication in social work can improve professional performance. Paying special attention to distress and violence repercussions and making appropriate decisions by putting in practice scientific and practical training in workplaces and educational settings can help social workers in preventing and reducing violence. As experiences in social work settings are not enough, it is suggested to look at the objective of this research from a macro-social and organizational perspective and plan both at the micro and macro levels to reduce violence

Quality of life in thalassemic school aged children of Kerman special diseases center in 2010

Introduction: Thalassemia syndrome is a hereditary hemoglobinopathy that is transferred to individual of mutations in the genes alpha or beta goblin chain manufacturer. In beta thalassemia, there is impaired in manufacturer beta chain gene. If both beta genes are defective, a person will catch thalassemia and severe anemia. Thalassemia is one of the most common human chronic diseases in the world and it provides many problems for patients, families and health care system. The prevalence of thalassemia in Iran is about 4-3 percent of the total population. Statistics over of this disease and a variety of physical, mental and social disorders in patients were showed high rate of disorder in the normal routine of life in patients and increasing the psychological pressure and stress in their family. Objective: This study aimed to assess the quality of life in school-aged children with Thalassemia disease. Method: This cross-sectional study was done to evaluate the quality of life in school-age children that came to thalassemia center for receiving blood. The research tool included: the questionnaires of demographic information and general quality of life questionnaire for children (peds qol) version 4. They were used after determination of content validity and estimation of reliability by internal correlation method. After collecting data, the statistical software SPSS Version 15 and descriptive and analytical statistical tests appropriate for research purposes of data analysis were used. Results: The findings from research were indicated quality of life of patients in various aspects of thalassemia disease. According to the obtained results, aspects of physical and emotional functions of quality of life in these patients had lower scores. Mean of physical aspect was: 7.83 ±2.68 and for emotional was 4.87 ±2.26. Aspect of school function had highest level and its’ mean was 8.02 ± 2.68. Conclusion: Thalassemia patients had severe psychological and social problems. Medical therapy with emotional, psychological and social support should be combined for improve the quality of life in these patients that could be prevented to create irreversible effects in these people.. Keywords: Children, Thalassemia, Quality Of Life, School-Age

Knowledge and attitudes in mothers with school age thalassemia children of Kerman special diseases

Introduction: Thalassemia is one of the most common inherited diseases in the world that is providing many problems for patients, families and health care system. High prevalence of the disease and a variety of problems in these patients and their families cause disturbance in their normal life process and it is necessary awareness and knowledge of mothers regarding their children's illness and its complications shows. The present study has been conducted to aim to assess knowledge and attitude of mothers with school age children have the thalassemia disease. Methods and materials: This cross-sectional study was done to assess the knowledge and attitudes in mothers of in school-age children with thalassemia major that came to Kerman thalassemia center for receiving blood. The research tool included: the questionnaires of demographic information and researcher Made knowledge and attitude questionnaire They were used after determination of content validity and estimation of reliability by internal correlation method.. After collecting data, the statistical software SPSS Version 15 and descriptive and analytical statistical tests appropriate for research purposes of data analysis were used. Results: The findings from research were indicated maternal knowledge and attitudes in various aspects of thalassemia disease Average obtained from the different dimensions of knowledge were: awareness of the disease 5.90(±1.91), symptoms 1.81(±0.80), treatment 4.21(±1.86), diagnosis 1.00(±0.98), transport means 0.67(±0.91) Total awareness 13.59(±4.94) and average obtained from the attitude was 13.03(±12.88). Conclusion: According to concessions mean that the subjects earned of answering questions. Mothers only in awareness of disease domain had moderate knowledge about the disease, but in other aspects had poor awareness and attitude. Therefore, to determined maternal knowledge of child illness and their attitudes towards the disease must be considered. Keywords: thalassemia, knowledge, attitudes, mothers, school age childre