Iranian nurses' constraint for research utilization

<p>Abstract</p> <p>Background</p> <p>This paper identifies the views of Iranian clinical nurses regarding the utilization of nursing research in practice. There is a need to understand what restricts Iranian clinical nurses to use research findings. The aim of this study was to identify practicing nurses' view of aspects which they perceived constrain them from research utilization that summarizes and uses research findings to address a nursing practice problem.</p> <p>Methods</p> <p>Data were collected during 6 months by means of face-to face interviews follow by one focus group. Analysis was undertaken using a qualitative content analysis.</p> <p>Results</p> <p>Findings disclosed some key themes perceived by nurses to restrict them to use research findings: level of support require to be research active, to be research minded, the extent of nurses knowledge and skills about research and research utilization, level of educational preparation relating to using research, administration and executive challenges in clinical setting, and theory-practice gap.</p> <p>Conclusion</p> <p>This study identifies constraints that require to be overcome for clinical nurses to actively get involved in research utilization. In this study nurses were generally interested to use research findings. However they felt restricted because of lack of time, lack of peer and manager support and limited knowledge and skills of the research process. This study also confirms that research utilization and the change to research nursing practice are complex issues which require both organizational and educational efforts.</p

Strategies for enhancing nurses' clinical judgment in care for patients with chronic diseases: A grounded theory study in Iran

BACKGROUND: A varying background in situations of chronic diseases affects the selection of strategies in clinical judgments. This study explained the strategies used to enhance the clinical judgment in chronic diseases situations. METHODS: This article was the part of a grounded theory study. Obtained data from open and semi-structured interviews were analyzed simultaneously with data collection and according to the Corbin and Strauss approach. The first experienced nurse was selected with purposive sampling and 25 other participants were selected on the basis of the theoretical sampling from different wards of the clinical and educational care centers of Sanandaj, Iran from 2011 to 2013. RESULTS: As shown in results, the core variable “situation-based efforts for enhancing clinical judgment” represented the main process used by participants in the promotion of clinical judgment in situations of chronic disease. The main categories included a "comprehensive collaboration", "inclusive education", "matching of clinical judgment skills", "maintaining patient's and nurses' autonomy" in a clinical judgment. CONCLUSION: Participants were trying to use strategies appropriate to different situations for clinical judgment in terms of chronic diseases conditions. Applying these processes with regard to the present context, can enhance the clinical judgment in chronic diseases situations

A qualitative study of Iranian nurses' understanding and experiences of professional power

BACKGROUND: Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. Some researchers have emphasized that understanding the concept of power is an important prerequisite of any empowerment program. While many authors have tried to define the concept of power, there is no comprehensive definition. This paper is an attempt to clarify the concept of power in nursing. It also would present a model describing the factors affecting nurse empowerment. METHODS: We chose the grounded-theory approach for analysis of the participants' experiences and their viewpoints regarding the concept of professional power in nursing. Semi-structured interviews and participant observation methods were used to gather the data. Forty-four participants were interviewed and 12 sessions of observation were carried out. The constant comparative analysis method was used. RESULTS: Six main themes emerged from the data: "Application of knowledge and skills", "Having authority", "Being self-confident", "Unification and solidarity", "Being supported" and "Organizational culture and structure". According to the participants, nurses' power is influenced by these six variables. A theoretical model was designed to represent the interrelationships between these six variables. CONCLUSIONS: Nurses' power depends on gaining and applying professional knowledge and skills. Delegating authority and enhancing self-confidence of the nurses also help them to apply their knowledge in practice. Unification of the nurses and their mutual support play the key roles in development of their collective power and provide a base for better working conditions, professional independence and self-regulation

Nursing in the Pre-paradigm or Paradigm Stage?

Introduction: The modern use of the word paradigm began with the theoretical ideas of Thomas Kuhn and then the scientific revolution occurred. Paradigm is a set of concepts accepted by scientists in their study area and provides a framework in which scientists can solve scientific problems. Paradigm is what separates science from nonscience. Method: This review was undertaken by library studies using databases such as CINHAL, Proquest, Science direct, Magiran and SID. Results: Nursing paradigm, like the foundation of a building, determines the goals and boundaries of nursing. In nursing, paradigm is based on shared values, and assumptions related to key concepts such as the individual, health, environment, and nursing. The boundaries of key concepts are reflected in teaching or nursing culture, work experiences, and values which affect our observations of events and situations. These are the foundation for creating the key concepts of nursing. Conclusion: Some believe that nursing may not have a normal science period therefore, they believe it is in its paradigm period. Others believe that if we accept that nursing is in the preparadigm stage then it cannot be considered a science therefore, because it has a philosophy and is a science it is in the paradigm stage. Keywords: Paradigm, Nursing, Pre-paradigm, Nursing Scienc

Strategies for enhancing nurses' clinical judgment in care for patients with chronic diseases: A grounded theory study in Iran

BACKGROUND: A varying background in situations of chronic diseases affects the selection of strategies in clinical judgments. This study explained the strategies used to enhance the clinical judgment in chronic diseases situations. METHODS: This article was the part of a grounded theory study. Obtained data from open and semi-structured interviews were analyzed simultaneously with data collection and according to the Corbin and Strauss approach. The first experienced nurse was selected with purposive sampling and 25 other participants were selected on the basis of the theoretical sampling from different wards of the clinical and educational care centers of Sanandaj, Iran from 2011 to 2013. RESULTS: As shown in results, the core variable “situation-based efforts for enhancing clinical judgment” represented the main process used by participants in the promotion of clinical judgment in situations of chronic disease. The main categories included a "comprehensive collaboration", "inclusive education", "matching of clinical judgment skills", "maintaining patient's and nurses' autonomy" in a clinical judgment. CONCLUSION: Participants were trying to use strategies appropriate to different situations for clinical judgment in terms of chronic diseases conditions. Applying these processes with regard to the present context, can enhance the clinical judgment in chronic diseases situations

Memo and memoing in qualitative research: a narrative review

Abstract Introduction: Memoing is a logical recording of that which the researcher learns from the data. Lack of memoing in qualitative researches is a major problem which has a negative effect on the final outcome of a project. Therefore, this research was conducted with the purpose of evaluating different aspects of memoing in qualitative research. Method: This was a narrative review study performed through searching the keywords of "memo", "memoing", and "qualitative research" in databases and available printed materials related to qualitative research. Therefore, 42 books and articles published between 1978 and 2013 were reviewed. Results: A qualitative research is a developmental journey. The researcher should expect the formation of different ideas and changes in performance. These differences can be detected and affected through memoing. Memoing is a process in which events, thoughts, and their changes are recorded in chronological order according to reasons and circumstances without a specific writing style. Memoing is a kind of reflection written to consider and explain the meanings ascribed to codes related to the participants and researchers, to clarify, arrange, and develop ideas, to record important quotations or statements, and to identify relationships between codes and hypotheses related to a topic. Memos are divided into code, theoretical, and operational memos. Conclusion: Memoing is an effective tool for a rich research experience in all qualitative research methods. Qualitative researchers, through a comprehensive view of memoing, can stay true to the data and data context and increase the validity and reliability of their research. Keywords: Memo, Memoing, Qualitative researc

Exploration of structure of clinical judgment of nurses: A grounded theory study

Introduction: Clinical judgement as a tool for professionals allows the nurses to play their roles and explore their opinion. This necessitates clarification of the structure of clinical judgment. It is difficult to give a unanimous definition for clinical judgement therefore, exploration of the structure of the concept is necessary to understanding clinical judgment. The aim of this study is to explore the structure of clinical judgment of nurses. Method: This qualitative research was a grounded theory study based on purposed sampling. 18 clinical nurses from Kurdistan University of Medical Sciences were interviewed. The interviews were transcribed in Microsoft Word Office, and then the data were analyzed in MAXQDA2007. Constant comparison analyses were used simultaneously with data collection. Results: The participants in study include 9 men and 9 women, with at least 3 years of experience of nursing in variable clinical settings. Final research findings could be discussed in five categories including: complexity of definition of clinical judgment, context of clinical judgment, continuum of clinical judgment, skills of nurse in clinical judgment, and achieve to professional criteria. Conclusion: Despite the complexity of the concept in the literatures and the field of research, this study could explore the structure of clinical judgment of nurses in the clinical arena. The results of this study would be used to explore nurses' clinical judgment model, based on grounded theory. Keywords: Clinical judgment, Nurses, Grounded theory, Qualitative stud

Coping strategies in renal transplants recipients: A qualitative study

Introduction: Renal transplantation is considered as the first and the most effective approach of alternative treatment in patients with end-stage renal disease (ESRD). Although receiving transplant can improve the quality of life, it may also cause new challenges and anxieties in recipients. To be adopted with new challenges, patients have to follow coping strategies. This study aimed to deeply understand the coping strategies used by those undergone renal transplantation to adopt with challenges emerged from that. Method: 11 in-depth semi-structured interviews were done to follow the aim of the study. The age of participants ranged between 18 and 57 years with mean average of 37 years. A purposive sampling was used to emerge statured data, codes and themes. Using content analysis inspired by Graneheim and Lundman, all interviews analyzed. Results: The analysis revealed ten subthemes that finally categories into four themes including: focus on spirituality, developing self-management and empowerment, improvement of self-reflective practice, and reality acceptance. Conclusion: Although it is not possible to say that each coping strategy is used in a specific time schedule, but it seems that in each step, patients are more likely to use a specific coping strategy. Therefore, if nurses and family members are aware of this process, they would be better perceiving the reasons behind renal transplant recipient behaviors. We suggest providing relevant education program for them. This consequently enables family members and care team to have an active role in supporting tranplant recipients. Keywords: Coping strategies, renal transplantation, renal transplantation recipient, content analysi

Quality in Grounded Theory Studies

Introduction: The quality of qualitative research is an important issue for clinicians and researchers that use research in order to deliver high quality care. Gaining quality in qualitative research, such as grounded theory, is not an accident and is achieved by abiding a set of circumstances. The aim of this study was to identify the most important criteria in assessing the quality of grounded theory studies. Method: This is a review study done by an extensive review of literature in the form of electronic and printed materials. This paper therefore, has reviewed 10 related books and 11 related papers. Results: The result of literature review showed that compliance to methodological principles of research is the key element in achieving quality in grounded theory studies. Paying attention to dynamic research process, theoretical sampling, theoretical sensitivity, constant comparison, theoretical saturation, methodological fitness, and linking research and body of knowledge are important factors in achieving quality in grounded theory. Conclusion: Quality in grounded theory is an important issue in qualitative research. Grounded theory researchers must have a thorough understanding of methods used in research. Moreover, they must try to improve the quality of grounded theory studies by considering ontological and epistemological assumptions. Keywords: Quality, Grounded theory, Nursing researc

Clinical Competency in Psychiatric Nursing Students: A Qualitative Study

Introduction: Clinical competency in psychiatric nursing education provides the foundation for the development of competency in nursing practice. There are different definitions of clinical competency, but there is no certain definition for it in psychiatric nursing. The purpose of this study was to explore the definition of and method of achieving clinical competency in psychiatric nursing students. Method: In this qualitative study semi-structured interviews were conducted with 16 participants (5 undergraduate senior students in their last term, 2 MSc students in the psychiatric field, 4 faculty members of the Department of Psychiatric Nursing, 3 head nurses, and 2 nurses working in psychiatric wards). In addition, we used two focused group interviews with nursing students. All interviews were recorded and transcribed. The data were analyzed using conventional qualitative content analysis method. Results: During data analysis, four main themes emerged preparation and familiarization, confrontation, involvement, and competency. Conclusion: Undergraduate nursing students need to pass specific stages before attaining clinical competency as a mental health nurse. Each stage has specific factors that may help the students on their path. Keywords: Students, Mental health nursing, Clinical competency, Qualitative stud