Facilitators and barriers to the privacy of Iranian hospitalized patients in government hospitals

BackgroundPrivacy is one of the essential needs of humans, and is therefore crucial in effective healthcare systems. There is limited research clearly addressing the facilitators and barriers underpinning privacy for hospitalized patients.AimsThis study aimed to explore Iranian patients' perceptions of and experiences with the facilitators and barriers of privacy of in government hospital in-patients.Methods This qualitative study was conducted on 22 patients admitted to the in-patient departments of government hospitals in Tehran, Iran, in 2016. The study population was selected through purposive sampling technique. The data were collected using individualized semi- structured interviews, which were recorded and transcribed. Data analysis was performed by means of an inductive content analysis approach.Results The analysis of the experiences of the hospitalized patient's extraction of six themes. These themes included the ethical and legal backgrounds of privacy, multi-dimensional design of privacy, perceived vulnerability, patriarchal care, conflict between privacy and care, individual backgrounds, nature of disease, and informed consent.ConclusionThe privacy of the hospitalized patient is affected by complicated factors. These factors are facilitators and barriers and should be considered in the design of care

Collaborative Learning Experiences of Nursing Students in the Clinical Learning Setting: A Qualitative Study

Introduction: Collaborative learning encourages students to work with peers and leads to the development of problem-solving and communication skills, and the transfer of knowledge learned in the classroom to be used in the clinical setting. This study aims to explain the role of collaborative learning experiences of nursing students in the field of clinical training. Methods: In this qualitative study, 20 nursing students who experienced specialist clinical training were selected using object-based sampling. The data were collected using semi-structured and focus group interviews. The interviews were transcribed verbatim and the relevant themes were extracted and categorized using content analysis. Results: The results revealed that group interactions lead to useful experiences in clinical works. It was also shown that collaborative learning affects the clinical success of nursing students. The participants stated that group work in clinical settings is the most important learning experience in the training course. While contributing to learning development, group participation helps the students to deal with the assigned tasks more efficiently and support each other by sharing their knowledge and establishing friendly relations. The themes derived from the data included 1) peer support, 2) clinical reasoning, and 3) group capabilities. Conclusion: Collaborative learning is an important factor in improving clinical work. The results of the present study underlined the weakness of educational programs in terms of collaborative learning. Therefore, educators and education professionals are recommended to support the development of a suitable context for active and collaborative education and learning

Barriers of Pre-Hospital Services in Road Traffic Injuries in Tehran: The Viewpoint of Service Providers

Abstract Background: Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents.The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. Methods: A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Results: Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure,Barriers related to the profession and Barriers related to managerial issues. Conclusion: Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries

Factors behind moral distress among Iranian emergency medical services staff: A qualitative study into their experiences

Background: The unique characteristics of each emergency situation and the necessity to make prompt decisions cause emergency medical services (EMS) staff's ethical conflicts and moral distress. Objectives:This study aimed to explore EMS staff's experiences of the factors behind their moral distress. Methods: This qualitative study was conducted on 14 EMS staff using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Each interview was started using general questions about moral issues at workplace and barriers to professional practice. The five-step content analysis approach proposed by Graneheim and Lundman was used for data analysis. Results: The factors behind EMS staff's moral distress were categorized into 13 subcategories and 5 main categories. The main categories were staff's lack of knowledge and competence, inability to adhere to EMS protocols, restraints on care provision, ineffective interprofessional communications, and conflicts in value systems. The subcategories were, respectively, inadequate knowledge and experience, working with incompetent colleagues, artificial services, working in unpredictable situations, lay people's interference in care provision, resource and equipment shortages, barriers to early arrival at the scene, obligatory obedience to the system, poor interprofessional interactions, inadequate interprofessional trust, refusal of care, challenges in obtaining consent, and challenges in telling the truth. Conclusion: EMS staff experience moral distress at work due to a wide range of factors. Given the negative effects of moral distress on EMS staff's physical and mental health and the quality of their care services, strategies are needed to prevent or reduce it through managing its contributing factors

The effect of education of self care behaviors based on family-centered empowerment model in type II diabetes

AbstractBackground and aim:  Type II diabetes, can be controlled by medical treatment and self care behaviors, however the patients often fail to comply with self care behaviors. Concerning the role of family in supporting patients’ self care behaviors, the aim of this study is to determine the effect of a family –centered education of self care behaviors based on family- centered empowerment model on patients with type II diabetes.Methods and materials:  The quasi-experimental design carried out on 40 patients with type II diabeteswho were randomly assigned to intervention and control groups. The education of self care behaviors in four domains (nutrition, physical activity and exercise, medications, complications and foot care) for intervention group and their families was performed. Data were collected by a valid and reliable questionnaire. The scores of self care behaviors before and after the education were measured. Data were analyzed by the SPSS16 software. Findings:  Prior to education, there was no significant difference between self-care behaviors scores in both intervention and control groups (p>0/05). After education, self-care behaviors of the intervention group in total scores and also in all domains were increased and statistically were significant (p <0/05), while there was no significant change in the control group.Conclusion:  The findings showed that this education method improved self -care behaviors among patients with type II diabetes. These results can be used in the other chronic diseases and different levels of nursing care.Keywords: Education, family-centered empowerment model, diabetes, self-care REFERENCES Alhany F (2004). [ Design and evaluation of family- centered empowerment model for prevention of iron   deficiency], Ph. D Thesis in Nursing. Univercity of Tarbiat Modares, 2004. (Persian). American Diabetes Association(2004). 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Development of a Community-Based Care System Model for Senior Citizens in Tehran

In recent years a variety of system models for providing community based health care services for the elderly has been envisioned and implemented in the developed countries which meet the special care needs of different groups of elders. In Iran as a developing country, a considerable percentage of old people live in the society need to receive specialized care and health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as: existing and available resources and facilities (financial and human resources); social and cultural issues and characteristics of each groups of elders(healthy elders, frails,home bounds, …)  seem to be necessary. At the development phase of the care model in this study Ellowing methodological triangulation must be considered: 1) Comprehensive review of current and related literature, 2) Conduction of an ethnographic study on a number of Tehranian elders and their families, 3) Seeking opinions of a group of experts on this issue using nominal group technique, and analysis as well as synthesis of the collected data were employed to develop a community based care system for elders. The preliminary results of employing this care system and examination of expected outcomes such as promoting quality of life and expectancy in elders reflects the efficiency of this system, although further complementary studies and particularly cost benefit analysis are strongly recommended

Instability of emotional relationships and suicide among youth: a qualitative study

Abstract Background Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults. Method This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis. Results The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide. Conclusion The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support

Post Stroke Llife in Iranian People: Used and Recommended Strategies

Objectives: Stroke survivors develop their own strategies to combat disabilities, developing strategies to maintain or reestablish a sense of continuity after the disruptive life event that stroke represents, using strategies to foster hope during the process of adjusting to life after stroke and drawing on spiritual practices. The aim of this study is to identify the used and recommended strategies of life after stroke among Iranian people. Methods: A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors, 12 family caregivers and 6 formal care givers. Results: Five main concepts emerged describing as the used and recommended strategies of the participants including, improving functional performance, re-learning life skills and educational support, accessing to rehabilitative services, socio-economical support and well-suited coping strategies. Discussion: Participants valued better knowledge and skills regarding the adaptive strategies for stroke survivors and their family care givers are essential in accomplishing with activities of daily living and doing social roles for improving life after stroke. Also developing the socio- economic supports is crucial for assuring a more supportive approach to achieve rehabilitation services and design better educational program for them

Loneliness From the Perspectives of Elderly People: A Phenomenological Study

Objectives: The purpose of this study was to explore the perspectives of elderly people on loneliness. Methods & Materials: Hermeneutic interpretive phenomenology was selected as the research methodology, and a sample of thirteen elders undertook in-depth interview. Participants were asked for descriptions of their day-to-day lived experiences of loneliness. The data were analyzed using van Mannen's thematic analysis. Results: The text revealed three common themes: feelings of pain and suffering, losses and deprivation and, compensation mechanisms. Conclusion: This study provides explicit knowledge about how older persons experience the phenomenon of loneliness. The lived experience of the older adults showed that loneliness is a feeling of pain and suffering which is related to the losses. Relationship with God, starting new relationships and reminiscences of the past were stressed as ways of coping or dealing with the loneliness experience. These findings can help the healthcare providers to define the sense of loneliness, the factors contributing to, and the mechanisms used by the adults to cope with it and perhaps the ways which may prevent it