Development, implementation and evaluation of the ‘BELIEVE’ program for improving physical activity among women: a mixed method action research study

Abstract Background There is insufficient physical activity among women. Yet the implementation of effective, multilevel, and evidence-based interventions may address this. Since the lifestyle of individuals is formed in many different social, physical and cultural contexts, it will be necessary in designing such interventions to involve many stakeholders. Consequently, the present study took a mixed method action research approach in developing, implementing and evaluating a bespoke program to improve physical activity among women. Methods This study was conducted within the Khoramroudi neighborhood of Tehran between 2013 and 2015 utilizing the four main phases of action research. The Mobilizing for Action through Planning and Partnerships (MAPP) process was used to design the study. During the initial phase, participants were organized into three groups; a core support committee, a steering committee, and a study population. Qualitative and quantitative data were also collected during this first phase. During the second phase, interventions were developed and implemented. In the third phase, an evaluation was carried out using both quantitative (Designing a quasi-experimental study) and qualitative methods. During the fourth phase, an exploration of the structure and process of action research was completed with the aim of providing a conceptual model and descriptions of the context. Results Three strategic interventions were effective in improving physical activity among women: (1) utilization of sports assistants; (2) Local health promotion and the dissemination of an informational, motivational and culturally competent booklet entitled “Educational content for sport assistants" (3) Group-based cognitive behavioral therapy. Quantitative results [Significant difference between the total score of PA before the intervention, and 1 and 3 months after the intervention (P < 0.001)] and the results of qualitative evaluations were shown to improve physical activity among participants. The newly co-created “adjusted MAPP model” was offered within three action cycles. The structure of this was described to capture the impacts of interactions among a variety of stakeholders. Conclusion The comprehensive identification of problems led to the development of collaborative strategies. Strategies of action research can positively affect physical activity among women. To improve physical activity outcomes more generally, the use of MAPP principles and strategies is suggested to meet the specific needs and strengths of all community members

Validation of Objective Structured Clinical Examination (OSCE) based on the Occupational Therapy Practice Framework (OTPF): A pilot study

Fieldwork education is an integral part of the educational process in occupational therapy and assessing student competency at the end of fieldwork is important. The aim of this study was to design and conduct an Objective Structured Clinical Examination (OSCE) based on the Occupational Therapy Practice Framework (OTPF) for occupational therapy students on Level II fieldwork in Iran. A seven-station OSCE was designed and conducted with 13 students. Face and content validity of the exam scenarios and grading checklists was assessed via faculty review. The correlation between scores from each station and total OSCE scores were obtained to assess construct validity. Inter-rater reliability between two independent examiners at each OSCE station was determined. The participants’ (including both students and examiners) reactions to and learning from the exam was assessed using a self-report questionnaire that included participants\u27 attitudes, satisfaction, and emotional response to the OSCE. Finally, a focus group of 12 examiners was conducted to examine the strengths and weaknesses of the exam. It was ascertained that the OSCE had good and acceptable face, content, and construct validity as well as inter-examiner reliability. All students reported that the exam was stressful, and most students (n=8, 61%) and examiners (n=5, 42%) reported there was not enough time for each station. Strength and weaknesses of the exam as related to the exam condition, exam content, students, and examiners were reported. Based on the qualitative and quantitative analysis of the results, in order to use OSCE as a method of evaluating occupational therapy students, some changes should be applied

A qualitative study on adolescence, health and family

Family is important to both health and adolescence. Adolescence is a time of peak health, but there are some important family based risk factors. The aim of this study was to explore the perspective of adolescent Iranians on issues of family and their health. We used descriptive, qualitative methodology and purposeful sampling and interviews for collecting the data. Forty‐one participants explained their perspectives on health and family. Data were analysed using qualitative content analysis. Analysis revealed three categories of risk factors: a widening generation gap, effective parenting and family financial situation. To have healthy adolescents, both children and parents need more knowledge and better skills about adolescent health and development and about social trends. To understand adolescents in a more realistic way, parents should develop healthy communication to avoid family health problems

Nursing Challenges in Motivating Nursing Students through Clinical Education: A Grounded Theory Study

Nurses are the first role models for students in clinical settings. They can have a significant role on students’ motivation. The purpose of this study was to explore the understanding of nursing students and instructors concerning the role of nurses in motivating nursing students through clinical education. The sampling was first started purposefully and continued with theoretical sampling. The study collected qualitative data through semistructured and interactive interviews with 16 nursing students and 4 nursing instructors. All interviews were recorded, transcribed, and analyzed using grounded theory approach. One important pattern emerged in this study was the “concerns of becoming a nurse,” which itself consisted of three categories: “nurses clinical competency,” “nurses as full-scale mirror of the future,” and “Monitoring and modeling through clinical education” (as the core variable). The findings showed that the nurses’ manners of performance as well as the profession’s prospect have a fundamental role in the process of formation of motivation through clinical education. Students find an insight into the nursing profession by substituting themselves in the place of a nurse, and as result, are or are not motivated towards the clinical education

Supportive Counseling for the Students with Low Academic Achievement َ: An interventional study

Introduction: Low academic achievement and educational failure are yet considered as the most usual reason for students' drop out. Performing supportive interventions seem essential for these students. This study has tried to determine the effect of a supportive counseling program on nursing students' academic achievement in Iran University of Medical Sciences. Methods: Forty two BS nursing students with low academic achievement were selected with simple random sampling in this quasi-experimental study in 2007. Intervention included a supportive counseling program which was conducted for one semester in from of individual and group counseling sessions. The data were collected by researcher made forms inquiring students' demographic data and scores record to check their academic status. The data were analyzed by statistical tests of X2, , independent T-test and Man Whitney Test through SPSS software. Result: The findings showed that mean score increments of subjects in experimental group were more than the control, but the difference was not statistically significant. Mean scores difference in experimental group among boys was significantly more than those of girls. Conclusion: Although the effect of supportive counseling programs on nursing students' academic achievement was not proved in this study, reinforcement of teachers' supportive and conductive role and facilities for supportive interventions for these students and promotion of better dormitory life is recommended

Job satisfaction and related factors among Iranian intensive care unit nurses

Abstract Objectives The aim of this study is to determine the levels of job satisfaction and to collect information about the factors affecting job satisfaction of Iranian ICU hospital nurses. Results The participants included 124 nurses working in the ICU section of hospitals in the city of Amol in Iran, who were selected by census method. The instruments for gathering the information included Demographic Information Questionnaire and also the Minnesota Satisfaction Questionnaire. The results revealed that the average score of job satisfaction among ICU nurses was 2.50 ± 0.51. Also job satisfaction among women was higher than men (P = 0.03, t = 0.4). One way analysis of variance showed a significant relation between job satisfaction level with employment status and overtime work. Also older nurses had higher levels of job satisfaction. Hospital directors and managers, can use the results of this study in order to have a deeper understanding of job satisfaction among nurses, and the factors affecting it

Dialysis Adequacy among Haemodialysis Patients in Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Introduction: Dialysis adequacy is one of the most important indicators for measuring the quality of care provided in hemodialysis (HD) wards. Despite individual studies, there is still no comprehensive study about dialysis adequacy in the Eastern Mediterranean Region (EMRO). This study was conducted to evaluate the dialysis adequacy in HD patients in the EMRO. Methods: In the present systematic review and meta-analysis international (EMBASE, Scopus, PubMed, Web of Science) and national (SID, MAGIRAN) databases were searched for related articles using keywords “dialysis adequacy” and “EMRO” from 1 January 2000 to April 30, 2020. The quality of studies was studied using Hoy et al instrument. Results: Out of 966 retrieved studies, 63 studies conducted on 15462 HD patients were included. The pooled mean of KT/V and URR were 1.24 (95% CI: 1.19, 1.30) and 63.03% (95% CI: 61.31, 64.75), respectively. The pooled prevalence of Kt/V&gt;1.2 and URR&gt;65.0% were 42.73% (95% CI: 31.58, 53.88) and 42.52% (95% CI: 25.3, 59.7), respectively. Conclusion: The results of the present study indicate the poor dialysis adequacy in the EMRO region and the need to improve the physical infrastructure, workforce, and pieces of equipment in hemodialysis wards

The relationship between some demographic characteristics and organizational commitment of nurses working in the Social Security Hospital of Khorramabad

Background: Reduction in organizational commitment of nurses results in deficiency of care services. Some demographic factors affect organizational commitment. Objective: The present study is intended to determine the organizational commitment of nurses and its relationship with demographic characteristics. Methods: This study was a descriptive correlation (cross-sectional) study in January and February of 2016 on 126 nurses who held Bachelor of Science (B.Sc.) or Master of Science (M.Sc.) and at least one year of work experience in the Social Security Hospital of Khorramabad, selected using the census method. Data collection tools included a demographic characteristics form and Allen and Meyer questionnaire. Data analysis was performed using SPSS 20. Independent-samples t-test and one-way ANOVA were used to determine the relationship between organizational commitment and demographic characteristics. Results: The majority of nurses had moderate organizational commitment, the highest score belonging to the continuance commitment (22.33%), and the lowest score belonging to the normative commitment (19.16%). Also, there was a significant correlation between the continuance commitment and work experience (p=0.001), the staff posts (p=0.01) and shifts (p=0.04). Conclusion: Considering the moderate level of subjects’ organizational commitment in the present study, managers should take necessary measures to increase the attachment and organizational commitment of nurses and provide the ground for improving nursing service

The predictive role of spiritual intelligence in self-management in adolescents with type 1 diabetes

Introduction: Self-management leads to blood glucose control and reduced morbidity and mortality in adolescents with type 1 diabetes. Different factors affect the self-management whose role and effect are still unknown. Among the influential factors whose effect is vague are spiritual intelligence, and this study aims to investigate the predictive role of spiritual intelligence in diabetes management. Materials and Methods: In this descriptive-correlation study, 200 adolescents with type 1 diabetes were enrolled. To measure spiritual intelligence, the 24-question SISRI questionnaire and to measure self-management of diabetes, the SMOD-A questionnaire (48 questions) were used. Data were analyzed using SPSS software version 18 using linear regression analysis tests. Data collection was conducted by simple sampling. Results: Mean score of self-management of diabetes and spirituality was 86.1 ± 15.1 and 60.42 ± 12.9, respectively. Linear regression test (ANOVA: 0.002, F = 9.839) showed effect on diabetes self-management (β: 0.218). Conclusion: This study showed that spiritual intelligence can predict diabetes self-management, though poorly predicted, and by strengthening it, has a decisive role in improving the health of adolescents with diabetes. Considering the findings of this study, a new window of nurses' performance in managing diabetes based on the promotion of spiritual intelligence in the educational, care, counseling, and support roles of nursing science can be opened

Factors affecting clinical reasoning of occupational therapists: a qualitative study

Background: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists. Methods: Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. Results: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1. client beliefs. ; 2. therapist values and beliefs. ; 3. social attitude to disability. The second theme: individual attributions included two subthemes 1. client attributions. ; 2. therapist attributions. The final theme was the workplace environment with the three subthemes: 1. knowledge of the managers of rehabilitation services. ; 2. working in an inter-professional team. ; 3. limited clinical facilities and resources. Conclusion: In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies