Integration of Palliative Care into the Primary Health Care of Iran: A Document Analysis

Background: Providing palliative care (PC) is increasing by the increase in the number of people with life-threatening diseases and determined the benefits of these services in the community. Access to palliative care is a patient’s rights and ethical responsibility. Thus it is necessary to integrate into all level of the health system, including the primary health care. This study was conducted to assess the requirements for the integration of PC into the primary health care. Method: It was a document analysis, carried out through conventional content analysis and 10 national documents on PC, released by governmental organizations from 2010. The 4-step Scott method was used for the data validity and the coding process was done utilizing MAXQDA 10 software. Results: Base on the data analysis, we identified the “requirements of the integration of PC into the primary health care”, was of 4 main categories and 12 sub-categories. The categories include “principles and basics”, “legislation and policy-making”, “the establishment of PC system” and “the need for civil support”, which were extracted by reviewing the documents. Conclusion: PC is believed to be in its early stages in the Iranian health system. Therefore, universal access to these services requires their provision at the community level. Thus, it is recommended that the principles and basics of PC in the country be explained and then, the necessary infrastructures of this integration be provided with the cooperation of governmental organizations, NGOs, and charities, through proper policy making

Lifelong learning strategies in nursing: A systematic review

Background: Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood. Objective: The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience. Methods: In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions. Results: In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data. Conclusion: Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient car

The portfolio as a tool for mentoring in nursing students: A scoping review

Background: One of the processes leading to education and evaluation promotion in nursing is mentoring. Moreover, using a portfolio leads to promotion of the mentoring process. Due to the importance of mentoring in nursing, its strengthening by the portfolio, the weakness of mentoring in nursing, and the lack of widespread use of portfolio in nursing education, the aim of this study was to determine portfolio content, which can help the mentoring performance. Materials and Methods: The present scoping review study was conducted in 2017. Articles were searched using the keywords portfolio, mentoring, nursing education, logbook, teaching, learning, nursing, education, and evaluation. The search was conducted in SID, IranMedex, IranDoc, Magiran, PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect databases. Studies published in Persian and English from 1997 to 2017 were reviewed. The studies were extracted based on the inclusion and exclusion criteria. Results: Of the 1070 articles searched, 6 were extracted for the final assessment. The results indicated that a portfolio consists of a title page, content list, introduction, record of experience, mentor's feedback and comments, self-evaluation, and educational activities. Furthermore, nursing process is required to help conduct mentoring among nursing students. Conclusions: Recording experiences, feedback, etc., in the portfolios of nursing students can be helpful in conducting mentoring for student's education. It is suggested that educational managers perform mentoring in educational environments using the contents suggested in this study

The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial

Abstract Background Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity. Methods In this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals. Results Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009). Conclusions The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students. Registration This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016

Effect of Military Training on Soldiers&apos; Emotional Reactions

ABSTRACT A major part of armed forces consists of soldiers and draftees, who are considered the most valuable treasures of the world&apos;s armies. This study aimed to investigate the psychological impacts of military training course on soldiers.This preexperimental study was done on 373 draftees in military training INTRODUCTION Military atmosphere is considered as genuine generator of complex behaviors. The military training aims both adaptation to high uncertainty situations in conflict areas and the specific situations in peacetim