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

Azeri Women’s Experiences of Induced Abortion: A Qualitative Research

Introduction: The Centers for Disease Control and Prevention (CDC) (2009) reported that since women’s experiences of induced abortion are poorly known, examining the effectiveness of current policies and planning for the future are difficult. Due to illegality of induced abortion in Iran and the significant knowledge gap in this area, the present study was designed. Method: The data were collected through 23 semi-structured in-depth interviews from May to September 2013 in Tabriz, Iran, and analyzed using descriptive-interpretive approach of content analysis. The participants were 15 women who had recently undergone an induced abortion (during the past year). All interviews were audio-recorded and transcribed verbatim. Data analysis was conducted simultaneously to data collection and using MAXQDA 2007. Results: Findings fell into three main themes: individual reflections, gaining social support, and postabortion conflicts. This means that the study participants, when facing an unplanned pregnancy, showed negative reactions and had some concerns. Then, they begin to gain social support for having an abortion. Due to the incompatibleness of abortion with religious beliefs and values, post-abortion conflict was a common experience. Conclusion: Unplanned pregnancy for women begins with initial negative reactions and leads to postabortion conflicts. These findings highlight the importance of psychological support of women with unplanned pregnancies, prevention of unwanted pregnancy occurrence, and designing secondary prevention programs. Keywords: Unwanted pregnancy, Abortion, Women’s experience, Qualitative researc

The Perception of Cardiac Surgery Patients on Comfortable Resources: A Qualitative Study

Introduction: Comfort is a basic human need throughout life and an outcome of nursing. Therefore, it is necessary to understand the comforting needs of cardiac surgery patients, who experience the complications and problems of this surgery. This study was performed to explain the perception of cardiac surgery patients of comfortable resources. Method: This study was conducted with a qualitative, content analysis approach. The participants were 20 cardiac surgery patients. Data collection was performed through unstructured interview and purposive sampling, and continued until data saturation. Continuous analysis of data was performed concurrently with data collection and through a comparative method. Results: During the content analysis process, 4 themes emerged that indicated the nature and dimensions of the patients’ perception of comfortable resources. These themes included “Feeling a close and humanistic relationship with the nurse”, “Understanding the constant presence and monitoring of the nurse”, “Advocacy of family and peer patients”, and “Being in a safe environment”. Conclusion: The results of the current study showed that patients receive more comfort from human resources than environment and modern equipment. This issue shows the importance of highlighting the role of nurses and humanistic nursing care, despite the need for specialized nursing with modern technical facilities. Therefore, considering nurses and the standardization of human resources in health centers is more important than the physical standardization. This will result in nursing interventions being done with real understanding of the patients’ needs. Keywords: Patient perception, Comfortable resources, Qualitative content analysis, Cardiac surgery

Mothers' Experiences of Caring for Prematurely Born Infants: Growth Sparks in the Face of Caregiver Burden

Introduction: Mothers of premature infants are exposed to maternal care needs beyond the ordinary and everyday responsibilities of caring for an infant. These special and unique needs will affect different aspects of life of the caregiver. Understanding these mothers’ experiences could help nurses in providing better care services. Thus, this study aimed to explain the experience of mothers of caring for prematurely born infants. Method: The data collection process included 15 semi-structured and in-depth interviews with the mothers of infants born prematurely during 2012-2013 in four neonatal intensive care units (NICU) affiliated with the medical educational centers in Iran. All the interviews were tape-recorded, transcribed verbatim, and finally, analyzed using qualitative content analysis with a conventional method. Robustness of data analysis was evaluated by the participants and external control. Results: Data analysis led to the extraction of "growth sparks" and "burden of care" categories. These categories have been revealed, respectively, in mothers with the subcategories of "improving maternal mental and physical conditions, changes in understanding, peace, and comfort of life", and " physical tension, psychological tension, and restrictions of life". Conclusion: The findings of this study confirmed the necessity of developing interventions to help mothers of premature infants during admission and after discharge from the hospital. Moreover, the nurses can benefit from the knowledge gained from this study in providing care and support for mothers and reducing their burden. Keywords: Premature infant, Mothers' experiences, Caring, Growth, Caregiver burden, Qualitative researc

Mothers’ Experiences of the Strategies Used to Gain Successful Exclusive Breastfeeding: A Qualitative Study

Introduction: Effective and appropriate interventions used by nursing mothers in exclusive breast feeding, in accordance with existing conditions, can have a great effect on the maintenance, continuity and promotion of breastfeeding. So, identifying these successful strategies is essential to make future breast feeding health plans for mothers and infants, and to ensure exclusive breastfeeding. Method: This was a qualitative study of conventional content analysis conducted in the year 2014. Participants included sixteen lactating mothers of kids up to one year old, and of successful experience in exclusive breastfeeding, who have refereed to health centers in Golestan and Mazandaran universities of medical sciences, Iran. Their experiences on the strategies used successfully in the first six months of exclusive breastfeeding were collected through unstructured and in-depth interviews. Sampling was purposive and was continued until reaching data saturation. The study data were analyzed using constant comparison analysis technique. Results: Eight main themes related to the nature and dimensions of mothers’ understanding of the strategies used to gain successful exclusive breastfeeding were extracted. These themes were as “comfortable and pleasant preparation before breastfeeding”, “information from reliable sources”, “lifestyle adjustment to breastfeeding”, “intelligent resiliency”, “resolutions for infant’s reluctance in breastfeeding”, “strengthening and ensuring the adequacy of milk and lactation”, “breast care during breastfeeding”, and “the use of religious instructions”. Conclusion: It is recommended to consider the role and eminence of mothers, and their successful strategies and guidelines related to successful exclusive breastfeeding seriously in codification of health care policies. Keywords: Breastfeeding, Exclusive breastfeeding, Empowerment, Mothers, Strategies, Qualitative researc

Exploring perception and experience of patients from nursing care behaviors for providing comfort during hemodialysis

Introduction: One of the goals of professional nurses is to provide patient’s comfort. This is achieved through an understanding of the possible need for scientific, humanistic, ethical and communication care. Thus, how to identify comfort in hemodialysis patients is necessary, because it seems to be a constant presence in the ward. Therefore, this study aimed to "clarify the understanding and experience of patients undergoing hemodialysis nurse caring behaviors in comfort of hemodialysis patients". Method: This qualitative research was conducted with approaches and methods of content analysis. Purposive sampling began and continued until data saturation. Research environment of hemodialysis was at the Hamadan University of Medical Sciences. Collected data and conducted semi-structured interviews with 24 patients reached until saturation. Data were analyzed using qualitative content analysis in eight steps. Results: Main themes extracted from the data included “understanding the caring-humanistic needs”. The categories included "monitoring patients" and “having humanistic relationship”, "having a professional responsibility, “knowledge” and “having job experience” each of which has several sub-categories, respectively. Conclusion: We understand and respect the need for nurses to patient care and how to handle them in order to provide appropriate supportive measures, the measures that have an important role in the convenience of these patients, during hemodialysis. Keywords: Chronic renal failure, Hemodialysis, Comfort, Nurses, Behavioral care, Qualitative researc

Experience of Healthcare Providers to Deal with Victims of Sexual Assault: A Qualitative Research

Introduction: Victims of sexual assault require comprehensive, gender-sensitive health services in order to cope with the physical and mental health consequences of their experience. In most countries, however, there is a gap between the healthcare needs of victims of sexual violence and the existing level of health services provided in such cases. Experiences of the service providers help to deepen the understanding of this phenomenon so, this study aimed to understand the perceptions and experiences of clinical health care providers to victims of sexual assault. Method: This was a qualitative study with content analysis approach. 23 healthcare providers working in private and public hospitals in Ahvaz and Tehran, Iran were selected with purposive sampling method. Data were collected using interviews, observations and recording field notes. All the interviews were recorded and transcribed verbatim. Data were analyzed using descriptive content analysis and the Granheim and Lundman method. Results: Five categories including 255 primary codes were emerged. The derived codes were as follows: 1) focus on the history and physical examination 2) legal considerations 3) diagnostic and para-clinical services4) ostensible prevention and treatment of complications and 5) consult and referral request. The main code included in all derived codes was "routine and task-orientation". Conclusion: The findings showed that clinical healthcare providers provided health care to the victims of sexual violence regardless of their care needs, based on their routine administrative procedures. Therefore, the staff should concerns about the respond to the needs of females who have been sexually assaulted. Keywords: Clinical service, Sexual assault, Qualitative study, Content analysi

A Narrative Review on Basic Themes and Traits of Classic Grounded Theory

Introduction: There are many challenges and ambiguities on family of grounded theory (GT) notwithstanding their reputation. Learners of bases and methods and commitment to a specific method are necessary because of the vying nature of different approaches. The aim of this article is to know the traits of Classic GT and to help to differentiate Classic GT from other similar methods. Methods: This article is a traditional review on some of key articles and books of Glaser about Classic GT. Seventeen of Glaser’s books and articles have been used in this article. Results: Two Main concerns of Glaser are “avoidance of force” and “differentiation between classic method and qualitative research methods and other GT methods too”. He has tried to solve these two concerns providing proper strategies in any stage. Conclusion: For doing a quality GT research, knowing and commitment to basic principles and details of this method is necessary. Setting the assumptions aside and avoiding the generalization of qualitative research and other members of GT family to classic GT is one of important basic principles for doing successful classic GT research

A grounded theory of the implementation of medical orders by clinical nurses

Abstract Objective To explore the process of implementing medical orders by clinical nurses, and identify specific areas of concern in the implementation process, and uncover strategies to address these concerns. Background The implementation of medical orders is a crucial responsibility for clinical nurses, as they bear legal accountability for the precise implementation of directives issued by medical practitioners. The accurate implementation of these orders not only shapes the quality and safety of healthcare services but also presents numerous challenges that demand careful consideration. Method This study employed a qualitative design using a grounded theory approach to construct a comprehensive theoretical framework grounded in the insights and experiences of nurses operating within the hospital settings of Iran. The study encompassed 20 participants, comprising 16 clinical nurses, two nurse managers, and two specialist doctors working in hospital settings. The selection process involved purposeful and theoretical sampling methods to ensure diverse perspectives. Data collection unfolded through in-depth, individual, semi-structured interviews, persisting until data saturation was achieved. The analytical framework proposed by Corbin and Strauss (2015) guided the process, leading to the development of a coherent theory encapsulating the essence of the study phenomenon. Findings The primary finding of the study underscores the significance of ‘legal threat and job prestige’ highlighting diverse repercussions in case of errors in the implementation of medical orders. At the core of the investigation, the central variable and the theory of the study was the ‘selective and tasteful implementation of orders to avoid legal and organizational accountability.’ This indicated a set of strategies employed by the nurses in the implementation of medical orders, encapsulated through three fundamental concepts: ‘accuracy in controlling medical orders,’ ‘untruth documentation,’ and ‘concealment of events. The formidable influence of legal threats and job prestige was further compounded by factors such as heavy workloads, the doctor’s non-compliance with legal instructions for giving verbal orders, the addition of orders by the doctor without informing nurses, and pressure by nursing managers to complete documentation. The resultant psychological distress experienced by nurses not only jeopardized patient safety but also underscored the intricate interplay between legal implications and professional standing within the healthcare framework. Conclusion Alleviating staff shortages, enhancing the professional rapport between doctors and nurses, offering legal support to nursing staff, implementing measures such as recording departmental phone conversations to deter the non-acceptance of verbal orders, fostering an organizational culture that embraces nurse fallibility and encourages improvement, and upgrading equipment can ameliorate nurses’ apprehensions and contribute to the safe implementation of medical orders

Mothers' Strategies in Handling the Prematurely Born Infant: a Qualitative Study

Introduction: Family, especially mother, is faced with numerous challenges by experiencing a premature birth. Since knowing about mother‟s efforts regarding prematurely born infant helps us in our comprehensive understanding of the impact of this incident on the family system and its performance. The present study was carried out to explore the mothers' strategies regarding prematurely born infant. Methods: In a conventional qualitative content analysis, data was collected through purposive sampling by semi-structured deep interviews with 18 mothers who had prematurely born infant during 2012-2013 in the teaching hospitals of the north and northwest of Iran. All the interviews were recorded, typed, and finally analyzed. Results: Data analysis resulted in the extraction of categories of "asking for help, elevating capacity and reducing personal responsibilities and commitments". These categories were revealed in mothers respectively by the different sub-categories of "religious appeal and relying on beliefs, seeking information from the treatment and caring team, participating in infant‟s care, companionship and support of family and friends”, “focusing on positive thinking and imagination, patience and strength " and "ignoring some routine affairs and reducing role-related activities and duties". Conclusion: Considering the uniqueness of the mother's role in responding to the needs of infants, healthcare system should consider mothers as real target in the intervention strategies in order to promote health and quality of life, so maybe this way, the burden of care and management of critical situations caused by a premature birth on the mother can be reduced