Explaining Children Socialization Process Based on Parents’ Experiences

Introduction: Until today, the training of children has long been a major concern for parents. Hence, this study aimed to explain children socialization process based on parents’ experiences. Method: This study was conducted using grounded theory approach. Participants were 30 parents living in Tehran City, Iran, selected via purposeful and theoretical sampling methods. Data were gathered via in-depth and semi-structured interviews during 2013-2014. Data were analyzed using Corbin and Strauss method. Results: Four main processes including “dialogue”, “control”, “creating situation and managing relationships”, and “acquisition readiness” were emerged. While a good quality of dialogue patterns was used in some families, others did not believe on the function of dialogue. In other cases, the dialogue would be transformed to monologue. The control was done in different ways and pursues to protect children from social threats. Creating managed situation was a strategy used by parents to create, maintain, and promote desired behaviors and also to eliminate or alter undesired behaviors. Finally, given that the majority of parents were not prepared enough for parenting, they got readiness in the face of problems in different ways. Conclusion: Generally, based on the findings of this study, the most important emphasize of parents in the process of parenting is protect children from the dangers and at the same time, trying to facilitate their progress by control and management of situation. Keywords: Parenting, Socialization, Grounded theory, Parents, Ira

The Lived Experience of Spouses of People with Implantable Cardioverter Defibrillator: A Phenomenological Hermeneutics Study

Introduction: Implantable cardioverter defibrillator (ICD) is a vital device for the treatment and control of heart dysrhythmia. This study aimed to determine the lived experience of spouses of people with implantable cardioverter defibrillator. Method: This qualitative study with phenomenological hermeneutic approach was performed using van Manen’s method. Participants consisted of 13 spouses of people with implantable cardioverter defibrillator referred to Imam Khomeini hospital, Tehran, Iran, in 2015. All the participants were chosen purposefully. Data were collected with in-depth semi-structured interviews. The duration of interviews was between 30 to 45 minutes. The data were analyzed using van Manen’s six-step method. Results: The three main themes of this research were experiencing the first shock (with subthemes of fear, shock expectation, and unpleasant experience), sense of security (with subthemes of receiving hidden help, gain of control, and dependence to the device), and experience of life limitation with implantable cardioverter defibrillator (with subthemes of interference with the role, the costs, limited mobility, driving, and commuting). Conclusion: People with implantable cardioverter defibrillator had generally the sense of safety and security, despite some unpleasant experiences like electrical shock and some limitations. Healthcare provider especially nurses can provide necessary educations about the device instruction and promote self-care and quality of life in order to help people with implantable cardioverter defibrillator and their family. Keywords: Experience, Implantable cardioverter defibrillator, Spouses, Qualitative researc

Importance of Sex Differences in Impulse Control and Addictions

Background Nursing students are expected to deliver holistic care in their upcoming career. Developing spirituality during nursing training is poorly understood. Objectives The current study aimed to explore the process of developing spirituality among Iranian nursing undergraduates. Patients and Methods The study employed Grounded theory approach and purposive sampling with maximum variation to select the participants among undergraduate nursing students in their fourth-year of study in the nursing school of Tehran University of Medical Sciences. Data were gathered through semi structured interviews with nineteen nursing students and one faculty member (n = 20). Strauss and Corbin approach was selected for data analysis. Results Data analysis revealed that developing spirituality during nursing education is an intuitive development including three stages: early frustration, intuitive development through hardship and seeking meaning and fulfilment. This process is influenced by educational/caring environment as well as role models. Conclusions Upbringing capable nurses to deliver spiritual care require supportive environment and influential role models to encourage students’ spiritual development. Developing spiritually may end in delivering spiritual care and provide nursing students with inner strength for better confrontation with serious situations common in their upcoming career

Post-Divorce Regret among Iranian Women: A Qualitative Study

Background: Post-divorce regret is a context-based phenomenon and in every community it is affected by the personal, social and cultural factors of that community. This study was conducted to investigate the post-divorce regret among Iranian women. Methods: This qualitative content analysis study was conducted from November 2015 to December 2017 in Tehran. 15 divorced women were selected through purposeful and snowball sampling. The data were collected through in-depth individual semi-structured interviews. Interview with participant no. 13 was conducted in two sessions (not having enough time for a long interview). Data were analyzed using Graneheim and Lundman’s proposed method. The MAXQDA 10 software was used for the management of data. Results: Four main categories and 12 subcategories of data were extracted. The main categories and their subcategories were identity threat (stigma, becoming a sex object, discrimination), loss of independence (economic dependence, lack of independence in choosing a place to live, being controlled), vague future (concerns about children’s future, little chance of having an appropriate remarriage, fear of loneliness) and the absence of the husband and his role (emotional and sexual needs, children’s need for their father, need for a supporter and security). Conclusion: The findings of this study showed that many of the participants had got involved in multiple social, economic and support problems after divorce. Most of the participants were not able to adjust to life after their divorce and consequently regretted their decision to divorce. Therefore, it is necessary to provide the appropriate social and economic support for these women based on the culture of the society

Important Coping Strategies Used by Individuals with Spinal Cord Injury: A Qualitative Study

Introduction: Although it is an accepted fact that using coping strategies have an important role in the coping process and quality of life following spinal cord injury (SCI), there is still little information about this issue in the world and especially in Iran. The purpose of this study was to explore important coping strategies used by Iranian patients with spinal cord injuries. Method: 18 patients with SCI from The Brain and Spinal injury Repair Research Center of Tehran University of Medical Sciences, and the Protection Center of the disabled with spinal cord injury were interviewed deeply. Data were collected through recorded interviews, and concurrently analyzed using the conventional content analysis method. Results: Data analysis showed seeking help from religious beliefs (understanding the disease as a divine fate and test, appeal to Imams, and increasing worship), to be an important coping strategy. Conclusion: Understanding strategies that influence the patients’ coping with the SCI will contribute to the nursing body of knowledge. It also helps nurses and other health-care professionals, and the patients’ families in reinforcing the most effective coping strategies and promoting the quality of care. Keywords: Content analysis, Important coping strategy, Qualitative research, Spinal cord injur

Aspects Influencing Access to HIV/AIDS Services among Afghan Immigrants in Iran: A Qualitative Study.

Background: A successful response to the risk of human immunodefficiency virus (HIV) infection among immigrants requires improved access to HIV prevention, diagnosis, and treatment services. However, most immigrants face significant challenges in accessing HIV/AIDS services. The aim of this study was to explore the aspects influencing access to HIV/AIDS services among Afghan immigrants in Iran. Methods: This was a qualitative study using conventional content analysis that was conducted from June 2018 to April 2020 in Tehran, Iran. Purposeful sampling method was performed. We conducted 25 semi-structured interviews with three groups of stakeholders including Afghan immigrants infected with or at risk of HIV (n=8), service providers (n=8), and policymakers/managers/experts (n=9). Inductive qualitative content analysis was applied according to the Granheim and Lundman method. Data were analyzed using Open Code software version 4.03. Results: Aspects influencing access to HIV/AIDS health services were categorized into 3 themes (that were extracted from 9 categories): 1. Cultural aspects (cultural similarities and differences, values and beliefs); 2. Psychosocial aspects (social support, stigma and discrimination); and 3. Service delivery related aspects (awareness, health services coverage and integrity, health services financing, accessibility, and continuity of care). Conclusion: The findings suggest that efforts to improve Afghan immigrants’ access to HIV/AIDS health services in Iran need to consider the cultural aspects, increasing HIV awareness, providing support, reducing stigma and discrimination, and improving health services coverage, integrity, financing, and continuity of accessible services

Applying Intersectionality in designing and implementing health interventions: a scoping review

BACKGROUND: Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions. METHODS: The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist. RESULTS: Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were "intersecting categories" and "power", particularly at the stages of 'problem identification' as well as 'design & implementation'. The results showed that "multilevel analysis" principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as "reflexivity" as well as "social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies. CONCLUSIONS: Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality

Preparation and In-Vitro Evaluation of Ketoconazole-Loaded Niosome (Ketosome) for Drug Delivery to Cutaneous Candidiasis

Background: Recently, niosomes are becoming popular in drug delivery. The current work aimed to investigate the characteristics, cellular safety, and antifungal activity of ketoconazole-loaded niosome (ketosome). Methods: Ultrasonic approach was employed to prepare ketosome including cholesterol, nonionic surfactant and ketoconazole. The size characteristics and morphological features of ketosome and physicochemical properties of ketoconazole in ketosomes were evaluated using dynamic light scattering (DLS), differential scanning calorimetry (DSC), powder x-ray diffractometer (PXRD), scanning electron microscopy (SEM), and attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy. Also, the dissolution rate, cellular safety test and antimycotic properties of ketosome were examined. Results: According to the results, the particle size of the ketosome decreased from 491.400±10.622 to 121.300±7.274 nm by the increment of cholesterol. According to further research, changes in the cholesterol:surfactants ratio can modulate the zeta potential from -27.866±1.069 to -12.500±1.153 mV. The highest entrapment of ketoconazole was about 87% when the cholesterol concentration in the ketosome was high. Ketosome with the maximum cholesterol:surfactants ratio showed the fastest drug release. Furthermore, the cell viability assay revealed that the ketosome had lower cytotoxicity in comparison with pure drug. The cell viability of the ketosome was estimated to be about 90% (HGF cell line). The ketosome had a lower MIC than the pure drug when tested against Candida albicans. Conclusion: The results of this study revealed that the optimized ketoconazole-loaded niosome could be used as a possible nanovesicle for ketoconazole drug delivery, potentially opening up new ways for the management of cutaneous candidiasis complaints

Patient advocacy: barriers and facilitators

BACKGROUND: During the two recent decades, advocacy has been a topic of much debate in the nursing profession. Although advocacy has embraced a crucial role for nurses, its extent is often limited in practice. While a variety of studies have been generated all over the world, barriers and facilitators in the patient advocacy have not been completely identified. This article presents the findings of a study exploring the barriers and facilitators influencing the role of advocacy among Iranian nurses. METHOD: This study was conducted by grounded theory method. Participants were 24 Iranian registered nurses working in a large university hospital in Tehran, Iran. Semi-structured interviews were used for data collection. All interviews were transcribed verbatim and simultaneously Constant comparative analysis was used according to the Strauss and Corbin method. RESULTS: Through data analysis, several main themes emerged to describe the factors that hindered or facilitated patient advocacy. Nurses in this study identified powerlessness, lack of support, law, code of ethics and motivation, limited communication, physicians leading, risk of advocacy, royalty to peers, and insufficient time to interact with patients and families as barriers to advocacy. As for factors that facilitated nurses to act as a patient advocate, it was found that the nature of nurse-patient relationship, recognizing patients' needs, nurses' responsibility, physician as a colleague, and nurses' knowledge and skills could be influential in adopting the advocacy role. CONCLUSION: Participants believed that in this context taking an advocacy role is difficult for nurses due to the barriers mentioned. Therefore, they make decisions and act as a patient's advocate in any situation concerning patient needs and status of barriers and facilitators. In most cases, they can not act at an optimal level; instead they accept only what they can do, which we called 'limited advocacy' in this study. It is concluded that advocacy is contextually complex, and is a controversial and risky component of the nursing practice. Further research is needed to determine the possibility of a correlation between identified barriers/ facilitators and the use of advocacy