Publications by authors named "HeidarAli Abedi"

37 Publications

Information Seeking Experiences of Family Caregivers of Patients with Persistent Vegetative State: A Qualitative Study.

Iran J Nurs Midwifery Res 2020 Sep-Oct;25(5):393-400. Epub 2020 Sep 1.

Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Providing care for patients in Persistent Vegetative State (PVS) by family caregivers without enough training and knowledge may be problematic both for the patients and for the caregivers. Therefore, the present study tries to explain the experiences of family caregivers of patients with PVS of seeking information needed to provide adequate care.

Materials And Methods: Twenty two participants, including 17 family caregivers and 5 professional caregivers were enrolled by purposive sampling into this qualitative content analysis study, carried out between 2013 and 2015. Unstructured interviews and field notes were used to gather the data. Data collection was stopped when data saturation was achieved. Data analysis was performed by content analysis based on Graneheim and Lundman's approach.

Results: As a result of the analysis of the collected data a main theme emerged labeled as "Seeking constructive education" with three categories including "Neglected requisite education," "Greedy search for useful education" and "Dynamic independence in care."

Conclusions: In this study, information seeking by family caregivers of patients with PVS was constructive. Family caregivers insistently sought needed information from various sources. Ultimately, they found these insistent efforts beneficial and fruitful, because their efforts made them independent in providing care for their patients.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_187_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737835PMC
September 2020

Evaluation of the Effect of Support-Training System of Peer Group on Promotion of Self-Care in β-Thalassemia Major Patients in Southern Iran.

Hemoglobin 2019 May 19;43(3):198-203. Epub 2019 Aug 19.

Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Iran.

β-Thalassemia (β-thal) is a chronic illness and its complications make the patient less compliant with the treatment protocol. This study aimed to evaluate the effect of a support-training system of peer group on promotion of self-care in β-thal major (β-TM) patients. In this semi-experimental study, 112 β-TM were randomly selected and assigned to the study and control groups. Seven β-TM patients, who were physically, mentally and socially normal, were selected and trained as the peer group. Eight training sessions over 4 months were done by the peer group. The questionnaire with 50 questions was scored using the Likert scale, always with 1 point, sometimes 0.5 point and never 0 points. In the study group, before intervention, the mean score of the patients was 29.84 ± 6.16, which, after intervention, increased significantly to 37.14 ± 4.35,  < 0.001. In the control group, the overall mean self-care patients' score decreased significantly, from 29.76 ± 7.18 to 29.48 ± 7.02. No significant difference was observed between pre and post intervention in the control group in all aspects of self-care (daily activities, fitness and wellness, nourishment, stress relief, job and home environment, time management, expression and creativity, support, items supporting self-care, self-care of the sickness), but it was significant in the study group. The results revealed the positive impact of peer group in promoting self-care of β-TM patients in the study group compared to the control group, which may be used as a frontline educational model in these patients.
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http://dx.doi.org/10.1080/03630269.2019.1651331DOI Listing
May 2019

The Resilient Care of Patients with Vegetative State at Home: a Grounded Theory.

J Caring Sci 2018 Sep 1;7(3):163-175. Epub 2018 Sep 1.

Department of Nursing, Nursing and Midwifery Faculty, Qazvin University of Medical Sciences, Qazvin, Iran.

The care of patients in vegetative state at home is difficult because they need continuous medical interventions and extensive care. The present study aims to explain the process of home care of patients in vegetative state at home. This study was a qualitative research with a grounded theory approach. The participants were 22 people (included 17 family caregivers and 5 professional caregivers) who were enrolled in a purposive sampling. Data was gathered through unstructured interviews, observations and field notes. Data collection was continued to saturation. Data analysis was performed through the Strauss and Corbin 1998 approach. The MAXQDA10 software was used to facilitate data analysis. The data analysis led to emerge four main concepts included "erosive care", "erosive expenditures", "seeking solver education" and "lasting hope" as the axes of the study. Participants' experiences showed that the main concern of family caregivers of vegetative patients was "playing an inevitable role in care", in which they did not hesitate to make any effort, and they tolerated all the problems and issues. Therefore, "resilient care" was extracted as the underlying idea of this study. The process of resilient care of vegetative patients at home showed planning by policy makers in health system is very important and underscored the necessity for supporting families and family caregivers of these patients. So some changes in the health system for this goal might include considering home care and supporting them in various aspects, especially information, financial and emotional dimensions.
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http://dx.doi.org/10.15171/jcs.2018.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163151PMC
September 2018

The experience of Iranian entrepreneurial nurses on the identification of entrepreneurial opportunities: A qualitative study.

J Family Med Prim Care 2018 Jan-Feb;7(1):230-236

Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: To respond to the growing and emerging needs of the people in the health sector, the nurses need to develop their working domain from the hospitals to the community and be prepared to provide entrepreneurial roles at different care levels. Thus, to discover how to identify entrepreneurial opportunities in the field of nursing entrepreneurship, a study was conducted with the aim of describing the experiences of Iranian entrepreneurs on the identification of proper opportunities in entrepreneurship.

Materials And Methods: This study was a qualitative research in which the Graneheim and Lundman's content analysis was used to collect and analyze the data. Thirteen entrepreneurial nurses were purposefully selected, and the data were collected by unstructured interviews.

Results: As a result of data analysis, three main themes were obtained including the resources for opportunity identification and opportunity assessment and identification of proper opportunities.

Conclusion: The findings indicate how to identify entrepreneurial opportunities in the field of health by entrepreneurial nurses which is the first step in the entrepreneurial process. Therefore, the findings of this study can be used to educate nurses who are interested in entering the field of nursing entrepreneurship.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_233_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958575PMC
June 2018

Nurses' commitment to respecting patient dignity.

J Educ Health Promot 2017 19;6:16. Epub 2017 Apr 19.

Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Although respecting human dignity is a cornerstone of all nursing practices, industrialization has gradually decreased the attention paid to this subject in nursing care. Therefore, the present study aimed to investigate nurses' commitment to respecting patient dignity in hospitals of Isfahan, Iran.

Methods: This descriptive-analytical study was conducted in hospitals of Isfahan. Overall, 401 inpatients were selected by cluster sampling and then selected simple random sampling from different wards. Data were collected through a questionnaire containing the components of patient dignity, that is, patient-nurse relationships, privacy, and independence. All items were scored based on a five-point Likert scale. The collected data were analyzed using descriptive statistics and Chi-square tests. < 0.05 were considered significant in all analyses.

Findings: Most patients (91%) scored their relationships with nurses as good. Moreover, 91.8% of the participants described privacy protection as moderate/good. Only 6.5% of the subjects rated it as excellent. The majority of the patients (84.4%) believed their independence was maintained. These subjects also approved of taking part in decision-making.

Conclusion: According to our findings, nurses respected patient dignity to an acceptable level. However, the conditions were less favorable in public hospitals and emergency departments. Nursing authorities and policy makers are thus required to introduce appropriate measures to improve the existing conditions.
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http://dx.doi.org/10.4103/2277-9531.204743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433636PMC
April 2017

Perspectives and Experiences Related to Help-Seeking Behaviors: A Content Analysis Study of Iranian Patients With Multiple Sclerosis.

J Nurs Res 2017 Jun;25(3):251-259

1PhD, Assistant Professor, Health Education and Health Promotion Department, Health School, Shahrekord University of Medical Sciences, Shahrekord, Iran 2PhD, Professor, Faculty of Nursing and Midwifery, Khorasgan (Isfahan) Branch, Islamic Azad University 3PhD, Associate Professor, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 4PhD, RN, Associate Professor, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 5PhD, RN, Assistant Professor, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Patients with multiple sclerosis practice help-seeking behaviors largely because of the progression of this physically exhausting disease, which has far reaching psychosocial consequences and requires hospitalization during severe disease exacerbations.

Purpose: The aim of this study was to describe the perspectives and experiences of Iranian patients with multiple sclerosis regarding help-seeking behaviors.

Methods: A qualitative design, based on the content analysis approach, was used. Data were drawn from unstructured interviews that were held with 23 participants, who were referred from two teaching hospitals and from the Multiple Sclerosis Society in Ahvaz, Iran.

Results: During the data analysis, four main themes emerged, including "reliance on God and recourse to the imams," "striving to gain caring knowledge," "a need for comprehensive support," and "attention to spiritual care."

Conclusions/implications For Practice: Healthcare team members, especially nurses, should pay attention to perspectives of patients with multiple sclerosis and try to address these patients' help-seeking behaviors to provide high-quality care.The authors hope that the findings of this study will inform the construction of interventional strategies to improve nursing care and facilitate the provision of better support services for people with MS.
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http://dx.doi.org/10.1097/JNR.0000000000000216DOI Listing
June 2017

Self-medication and its Effective Modifiable Factors among Elderly Referred Health Care Centers in Shahr-e-Kord in 2015.

Electron Physician 2016 Nov 25;8(11):3205-3213. Epub 2016 Nov 25.

M.Sc. of Critical Care Nursing, Faculty member, Faculty of Nursing and Midwifery, Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

Introduction: Drug overuse is a serious problem for health care, and one of the biggest problems for the socio-economic well-being of different communities. The elderly tend to use more drugs due to changes in their cognitive and physiological factors. One of the best ways to evaluate the health level of elderly people is to evaluate their self-medication. This study was conducted to investigate self-medication among the elderly in Shahr-e-Kord.

Methods: This cross-sectional study was conducted on 350 people older than 65 in Shahr-e-Kord in 2015. Sampling was done in two stages. In the first stage, the city of Shahr-e-Kord was divided into four areas using geographical maps. Eighty-eight people were selected from each area. The research instrument was a questionnaire called the Health Belief Model (HBM). The data were analyzed using SPSS version 20, the chi-squared test, the independent-samples t-test, and the Pearson correlation coefficient.

Results: No significant relationship was observed between the prevalence of self-medication with demographic variables and level of awareness. But there was a significant difference between sensitivity, perceived severity, and perceived barriers and educational level. There also was a significant difference between the perceived benefits and their income level. There also was a significant difference between the level of awareness, sensitivity, severity, benefits, and barriers of people with and without a history of self-medication (p < 0.05).

Conclusion: Due to the adverse effects of self-medication and the high prevalence of this activity among the elderly, it is recommended that a training program be developed and implemented to change the knowledge and beliefs of the elderly about self-medication.
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http://dx.doi.org/10.19082/3205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217812PMC
November 2016

Design and Evaluation of Reform Plan for Local Academic Nursing Challenges Using Action Research.

Asian Nurs Res (Korean Soc Nurs Sci) 2016 Dec 30;10(4):263-270. Epub 2016 Nov 30.

Department of Statistics, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose: This study identifies challenges to the first nurse training program for undergraduate nursing students at a nursing and midwifery school in Iran using a collaborative approach in order to improve the program.

Methods: Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. The participants were 148 individuals from nursing academic and clinical settings, including administrators, faculty members, students, and staff nurses. We obtained approval from the research deputy and ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran for this study.

Results: Lack of coherence in the educational program and implementation of the program, inadequate communication between management inside and outside the organization, insufficient understanding of situations by students, and improper control of inhibitors and use of facilitators in teaching and in practice were among the major challenges in the first training process in the context of this study. After classification of problems, the educational decision-making authorities of the school developed an operational program with stakeholder cooperation to plan initial reforms, implementation of reforms, reflection about the actions, and evaluation. Comparison of student satisfaction with the collaborative learning process versus the traditional method showed that except for the atmosphere in the clinical learning environment (p>.05), the mean differences for all dimensions were statistically significant.

Conclusions: The results confirm the overall success of the revised partnership program, but stressed the need for further modification of some details for its implementation in future rounds.
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http://dx.doi.org/10.1016/j.anr.2016.01.006DOI Listing
December 2016

Factors Influencing School Health in Elementary Schools in Isfahan, Iran: A Qualitative Study.

Int J Community Based Nurs Midwifery 2016 Oct;4(4):352-362

Department of Nursing, Kerman University of Medical Sciences, Kerman, Iran.

Background: Students' health and future health of the community are related to providing health care in schools and since in every society, different contextual factors affect this matter, the present study aims to recognize the factors influencing the health care elementary students are provided with.

Methods: This qualitative content analysis was performed in 2014 in Isfahan. This study was conducted on school health instructors of elementary schools. Through targeted sampling, 15 health care providers, two mothers and 3 principals from 23 elementary schools were selected. Twenty-two semi-structured interviews were performed. Qualitative data analysis was done using qualitative content analysis.

Results: In this study, 3 concepts were extracted: family umbrella over health (with two sub-categories of 'family's social status and its effect on health' and 'family and health'), functional resources (with two sub-categories of 'opportunity', 'availability of resources for diagnosis') and health components (with two sub-categories of 'culture', 'the value of school health'). These contextual factors must be considered in providing health care for schools.

Conclusions: Consideration of effective contextual factors on providing elementary students with health care can help improve health for this group.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045979PMC
October 2016

The Lived Experience of Psoriasis Patients from Social Stigma and Rejection: A Qualitative Study.

Iran Red Crescent Med J 2016 Jul 21;18(7):e27893. Epub 2016 May 21.

Department of Nursing, Nursing and Midwifery School, Khorasgan Branch, Islamic Azad University, Khorasgan, IR Iran.

Background: Psoriasis is a common, chronic skin disease that causes challenges such as stigma and labeling from both the community and individuals due to its effects on appearance.

Objectives: The objective of this study was to describe and explain the social stigma and rejection experienced by patients with psoriasis.

Patients And Methods: The present research is a qualitative study with a hermeneutic phenomenological approach conducted among psoriasis patients referring to the dermatology clinic and ward of Imam Khomeini hospital in Ahvaz, Iran between June and December 2014. In this study, 15 patients with psoriasis were selected by purposeful sampling, and they were asked to express their experience of stigma and rejection. The data were collected through in-depth semi-structured interviews, and Diekelmann and colleagues' method was used for data analysis.

Results: After analysis of interviews, four themes were extracted: lack of social support, unrealistic and inappropriate labeling, rejection and isolation, and feeling of absurdity and futility. These can be indicative of the patients' experience from social stigma and rejection phenomena.

Conclusions: Patients' experiences of stigma and rejection phenomena indicated that all aspects of their lives are affected. Moreover, these findings highlight the significance of stigma and rejection concepts in providing better care to these patients.
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http://dx.doi.org/10.5812/ircmj.27893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5026766PMC
July 2016

Investigating the effect of an empowerment program on physical activity of the elderly in Rezaeian Health Center, Iran, in 2014.

Iran J Nurs Midwifery Res 2016 Jul-Aug;21(4):345-50

Nursing Department, Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

Background: Reaching geriatric period is one of the greatest successes in human Beings. The older adults are predisposed to risk of many diseases and disabilities, and physical activity is one of the most efficient methods to prevent geriatric period disorders. Therefore, the present study aimed define the effect of an empowerment program on physical activity of the elderly residing in Shahid Rezaian health care center in 2014.

Materials And Methods: This quasi-experimental study was conducted on 70 older adults, age 65 years and over, selected through convenient sampling and assigned to groups of study and control. Study group was divided into 5 seven-member subgroups and a one-hour session of physical exercises was administrated for them once a week for eight sequential weeks. All subjects evaluated before and after intervention by International Physical Activity Questionnaire. Subjects' physical activity was scored, based on the personal activity protocol,and the results were compared. Significance level was considered as P<0.05.

Results: Frequency distributions of the female subjects were 29 (82%) and 28 (80%) in study and control groups respectively. Mean (SD) scores of physical activity were 347.8 (174.1) and 321.7 (119.2) before intervention, and 641.3 (240.6) and 331.3 (101.5) after intervention in study and control groups respectively. Independent t-test showed a significant increase in physical activity score in study group, compared to control (t=4.06, P<0.001).

Conclusions: The level of physical activity can be improved in the elderly through application of an empowerment program so as to take steps toward solving their immobility related problems and promoting their health through application of an empowerment program at this period of their life.
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http://dx.doi.org/10.4103/1735-9066.185570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979255PMC
August 2016

Policy makers' viewpoints on implementation of the World Health Organization Framework Convention on Tobacco Control in Iran: A qualitative investigation of program facilitators.

ARYA Atheroscler 2016 Mar;12(2):94-9

Tobacco Prevention and Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The epidemic of smoking is a great concern of health systems. Moreover, the number of smokers is increasing worldwide and this has led to an escalating trend of morbidity, mortality, and burden of smoking-related diseases. Therefore, monitoring the implementation of tobacco control laws in different countries is of extreme importance. This study aimed to describe policy makers' experiences and perceptions of the facilitating factors of the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in Iran.

Methods: This was a qualitative research in which data were collected through individual interviews. The participants included policy makers who were members of the national assembly for tobacco control. In this study, 13 unstructured interviews of about 45 to 60 minutes duration were conducted in an extrapolative manner. The qualitative content analysis method was applied until extrapolation of basic themes was complete.

Results: As a result of the analysis, the themes of performance through training, through research, through intersectoral collaboration, and through setting priorities emerged. The emerged themes connote some critical points that have key roles in promoting the effective implementation of the WHO FCTC. Furthermore, the main role of the health sector becomes predominant.

Conclusion: The study findings suggested the managed and coordinated work as one of the main facilitating factors of the implementation of the WHO FCTC at a national level.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933748PMC
March 2016

Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study.

Iran J Nurs Midwifery Res 2016 Jan-Feb;21(1):45-53

Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Background: To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses' perceived barriers to entrepreneurship, in order to identify the existing barriers.

Materials And Methods: This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews.

Results: As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business.

Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.
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http://dx.doi.org/10.4103/1735-9066.174749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776560PMC
March 2016

Caring in an atmosphere of uncertainty: perspectives and experiences of caregivers of peoples undergoing haemodialysis in Iran.

Scand J Caring Sci 2016 Sep 19;30(3):594-601. Epub 2015 Nov 19.

Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.

Background: Chronic renal failure is one of the major causes of mortality and disability worldwide. Although dialysis treatment is considered as a life-saving treatment for these patients, their caregivers face various problems making the atmosphere of caring uncertain.

Aims: This study is aimed to explore and describe the experiences and perspectives of family caregivers of the patients undergoing haemodialysis.

Methods: In this study, 20 haemodialysis family caregivers were selected by purposeful sampling. Data gathering techniques in this research were in-depth and unstructured interview and field observation. The researchers used an inductive thematic analysis approach to analysing the interviews' data.

Findings: Three main themes emerged from the data indicating the patients' care are conducted in a state of uncertainty including constant struggle to learn, effort and adherence to the divine thread, and in disease's captivity.

Conclusions: Caring in an uncertain atmosphere leads to decreased efficiency and quality of family caregivers' care. To promote and improve the efficiency of care, healthcare planners should pay attention to the challenges and perspectives of caregivers of the patients undergoing haemodialysis.
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http://dx.doi.org/10.1111/scs.12283DOI Listing
September 2016

Resources of learning through hidden curriculum: Iranian nursing students' perspective.

J Educ Health Promot 2015 6;4:57. Epub 2015 Aug 6.

Chronic Disease Care Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Students tend to internalize and perpetuate the patterns of behavior and the values surrounding them. Review of literature showed that there are several student learning sources through the hidden curriculum, but they have not been identified in nursing yet. Hence, the purpose of this study is explanation of learning resources in the hidden curriculum in the view of baccalaureate nursing students.

Materials And Methods: This qualitative study was carried out in 2012 with the participation of 32 baccalaureate nursing students in Nursing and Midwifery College of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran by purposeful sampling strategies. Data were collected by semi-structured interviews and continued to the level of data saturation and themes' emergence. Data analysis was performed through inductive content analysis method.

Result: "Instructor as the unique learning element," "various learning resources in the clinical setting," and "instructive nature of the education environment" were extracted as the main themes, each of which incorporated some categories.

Conclusion: Baccalaureate undergraduate nursing students learnt the hidden curriculum by the resources such as instructors, resources existing in the clinical setting, and the university campus. Therefore, more research is recommended for the identification of other resources. In order to promote positive messages and reduce the negative messages of the hidden curricula running at academic and clinical settings, nursing educators and nurses need to learn more about this issue in the nursing profession.
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http://dx.doi.org/10.4103/2277-9531.162368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579768PMC
October 2015

Self-Preservation in Both Sides: Pathology of Spiritual Care in Iran.

J Relig Health 2017 Feb;56(1):77-88

Medical Education Development Centre, Isfahan University of Medical Sciences, Isfahan, Iran.

The aim of this study was to create a deeper understanding of the variables that may restrain or progress spiritual care in Iran. This manuscript provides an in-depth description of barriers to delivering spiritual care by nurses as well as patients' compensatory mechanisms against deprivation from spiritual care termed "self-preservation in both sides" emerged from an empirical study. It brings issues such as structural, hierarchical, social and personal concerns, which may prevent advancing spirituality within health care, to light. Thirty-five participants, nurses (n = 10), patients (n = 22) and their relatives (n = 3), took part in this study, and data were analyzed using qualitative content analysis method. Being aware of these results may help nurses and healthcare professionals to engage with and overcome some of the structural, hierarchical and social variables affecting spiritual care.
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http://dx.doi.org/10.1007/s10943-015-0116-4DOI Listing
February 2017

Multiple Victims: The Result of Caring Patients in Vegetative State.

Iran Red Crescent Med J 2015 Jun 23;17(6):e23571. Epub 2015 Jun 23.

Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran.

Background: Having a patient in a vegetative state in the family is a complicated and stressful experience. Caring for such patients with complete disability at home is very challenging.

Objectives: The present study aimed to explore the outcomes of caring for patients in a vegetative state for families and caregivers at home.

Patients And Methods: In this qualitative study, 16 vegetative patients' caregivers were selected through purposive sampling. Unstructured interviews and observations were used for data gathering. Data collection was continued until saturation of data and emergence of the main themes. Data analysis was performed by the content analysis method.

Results: The analysis of the gathered data led to three themes: "lost main caregiver", "affected caring partner" and "affected family". Each theme had some subthemes and subcategories.

Conclusions: The three emerged themes in this study showed that all the family members of vegetative patients, depending on their responsibilities, were affected by physical, mental, social and economic issues.
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http://dx.doi.org/10.5812/ircmj.23571DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553169PMC
June 2015

Improvement of the First Training for Baccalaureate Nursing Students--A Mutual Approach.

Glob J Health Sci 2015 Mar 26;7(7 Spec No):79-92. Epub 2015 Mar 26.

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Background: Examination of problems and application of strategies appropriate for clinical education and learning, especially nursing clinical principles and skills internship can improve educational process and satisfaction of nursing students. The aim of the current study was to revise the current status of the fundamentals of nursing course and implement an improvement plan (2012-2014).

Participants & Methods: The present study reports the three rounds of a participatory action-research study with a mutual cooperation approach and focus group discussion, with participation of 104 stakeholders. Content analysis approach was used to analyze the data obtained in focus discussion interviews. In addition, evaluation and reflection were done during the operating rounds, with the participation of all members, including students, were involved. This research program was approved by Shahid Beheshti University of Medical Sciences in Tehran-capital of Iran, at the Research Deputy of Nursing and Midwifery School and ethics committee of the university.

Results: The findings of qualitative study detected Lack of consistency in planning and implementation of curriculum, inadequate intra/extra-organizational communication management, inadequate student understanding of situation, improper control of restrictors and improper use of facilitators in teaching and in clinical setting, were among major challenges in clinical skills and principles internship process in the context of this study. Educational decision-making authorities of the School developed an operational program within national curriculum framework through cooperation and reflection in clinical skills and principles training program.

Conclusion: Planning Fundamentals of Nursing training in partnership with all those involved in practice and education, together with students involved can be effective in reducing educational failures, gap between theory and practice, and in students' accountability and satisfaction.
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http://dx.doi.org/10.5539/gjhs.v7n7p79DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804022PMC
March 2015

Comparison of anxiety prevalence among based and offshore National Iranian Drilling Company staff's children in Ahvaz, 2013.

J Educ Health Promot 2015 19;4:37. Epub 2015 May 19.

School of Nursing and Midwifery, Islamic Azad University, Khorasgan (Isfahan) Branch, Isfahan, Iran.

Background: Anxiety is one of the most common psychological issues among all age groups including children. The main role of parents has been known to support their children. Being far away from a source of support has been shown to be a potential trigger for childhood anxiety. Periodical jobs, including offshore work, are among the main reasons for absence of one of the parents. Therefore, this study aims to assess anxiety in children of National Iranian Drilling Company offshore staff.

Materials And Methods: In this historical cohort study, 160 students including 80 boys and 80 girls were selected through convenient random sampling from the schools of National Iranian Drilling Company. Data were collected using Revised Children's Manifest Anxiety Inventory (by Reynolds and Richmond), consisting 37 items and a demographic questionnaire. The collected data were statistically analyzed by t-test and logistic regression tests through SPSS software.

Results: The mean anxiety score was 12.80 among offshore staff's children and 11.67 among the children of the based staff. The ratio of manifest anxiety among the offshore workers' children was significantly more than the based ones'.

Conclusions: Based on the findings, offshore fathers' job affects the anxiety of the children.
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http://dx.doi.org/10.4103/2277-9531.157215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456867PMC
June 2015

The perspectives of Iranian patients with multiple sclerosis on continuity of care: a qualitative study.

J Nurs Res 2015 Jun;23(2):145-52

1PhD, Assistant Professor, Department of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran 2PhD, Isfahan, PhD in Nursing, Associate Professor, Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran 3PhD, Assistant Professor, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 4PhD, Assistant Professor, Member of Faculty, Medicine School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Continuity in multiple sclerosis (MS) care has been cited as a critical feature of this care and necessary to improve medical outcomes.

Purpose: This exploratory and descriptive research attempts to identify continuity of care from the experience and perspective of patients with MS at two teaching hospitals and the MS Society in Ahvaz, Iran.

Methods: In this study, 23 patients with MS were selected through purposeful sampling. Data were collected through in-depth and unstructured interviews and were analyzed using an inductive thematic analysis approach.

Results: Four main themes emerged from the analysis: human-oriented attention, the necessity of purposeful planning, importance of responsibility, and caring with empathetic sensing.

Conclusions/implications For Practice: Because of the importance of professional caring practice to continuity of care for patients with MS, we suggest that healthcare providers should include these aspects in care planning.
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http://dx.doi.org/10.1097/JNR.0000000000000070DOI Listing
June 2015

Life experiences in heart transplant recipients.

J Educ Health Promot 2015 26;4:18. Epub 2015 Mar 26.

Department of Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Heart transplantation is considered as a golden standard of treatment for advanced heart failure. After - transplantation health of patients is influenced by numerous issues which many of them are unknown to the treatment team including nurses. This research - with the aim of describing the life experiences of heart transplant patients - help us to get close to the patients private life and gain comprehensive and a general understanding of all aspects of their life.

Methods: This study applied qualitative approach using phenomenology method. The purposive sampling was conducted and continued with 9 participants until information reached saturation point. The participants are the heart transplant recipients who had surgery in Esfahan's Heart Surgery Center of Shahid Chamran.

Results: The extracted interviews were analyzed through Colaizzi method: The eleven extracted main concepts were included: Belief, tendencies of the recipient and family of donor, bewilderment, moment of facing with transplantation, satisfaction, vital organ, support, temperament, physical effects of transplantation, mental changes, paradox of life and death.

Conclusion: In heart transplant patients, being in touch with peers and family support have an important role in putting up with the transplantation issue. Lack of social situation and social support were among the patients distresses. Lack of the necessary information about transplantation made patients dissatisfied with the heart transplantation. Regarding the research findings, training received by patients would not be suffice and lack of information has been made them face with problems; therefore, the nurse team of transplantation should play more an active role in training the patients.
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http://dx.doi.org/10.4103/2277-9531.154037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4389363PMC
April 2015

Influential factors on learning through the hidden curriculum in the perspective of undergraduate baccalaureate nursing students.

J Adv Med Educ Prof 2014 Apr;2(2):53-7

Department of Nursing, Nursing & Midwifery School, Khorasgan (Isfahan) Branch, Islamic  Azad University, Isfahan, Iran.

Introduction: Nursing curriculum is not always overt; it can also exist covertly in the form of a hidden curriculum. This study aims to explain the factors influencing learning through the hidden curriculum in the perspective of undergraduate baccalaureate nursing students.

Methods: This qualitative study was conducted through purposeful sampling strategy on 24 undergraduate baccalaureate nursing students studying in the first to the fourth years of their education. The data were collected using semi-structured interviews and this process continued until data saturation and categories' emergence. Inductive content analysis was used for data analysis.

Results: Professional promotion as a learning factor, impact of personal characteristics on learning, educator's behavior as a learning stimulus, and feedback as a learning stimulus are the main categories emerged in this study; some of them included sub-categories as well.

Conclusion: Professional promotion, personal characteristics, educator's behavior and feedback were the main influencing factors on learning through the hidden curriculum in undergraduate baccalaureate nursing students. The findings of this study can be used for developing strategies to promote nursing education and as a result patient care. Further studies are recommended to identify other factors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235555PMC
April 2014

Do Iranian tobacco growers support the World Health Organization framework convention on tobacco control?

J Educ Health Promot 2014 5;3:32. Epub 2014 May 5.

Tobacco Prevention and Control Research Center, Medical University of Shahid Beheshti, Tehran, Iran.

Context: Studies on the World Health Organization Frame-work Convention on Tobacco Control (FCTC) are scarce in Iran and the Eastern Mediterranean region (EMR).

Aim: This study was conducted in 2007-2008 in Iran to design a practical evaluation model of the implementation of FCTC with the potential to be adopted in the EMR. Given that, the findings of this evaluation can be useful in increasing political and public support for enforcing the implementation of legislations, testing their feasibility, and maintaining sustainability. The viewpoints of tobacco growers as part of stakeholders in this regardwould have an influential role.

Settings And Design: This study was a qualitative one to investigate the tobacco growers viewpoints about thestrengths/weaknesses of FCTC implementation in Iran.

Materials And Methods: In this study, we conducted semi-structured in-depth individual interviews with 5 tobacco growers. All interviews were carried out with their permissionwere recorded and were assured that their interviews will be kept confidential. All questions were related to different FCTC articles, then written transcripts were prepared and the basic concepts were extrapolated.

Statistical Analysis: After transcribing the recorded interviews, we extracted first level codes and main concepts from them.

Results: The findings suggested that although tobacco growers agreed with FCTC implementation, however, subjects like the necessity to support tobacco growers and obtaining insurance from the government, the necessity of the enforcement of national tobacco control law and planning to decrease access to tobacco by policy makers were the most key points that tobacco growers pointed to them.

Conclusion: Our results showed that tobacco growers agreed with the implementation of FCTC but they worried about their job and the expenses of their daily life. Therefore, it seems that policy makers have to design a plan to support tobacco growers for changing tobacco with a safe cultivate.
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http://dx.doi.org/10.4103/2277-9531.131904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089143PMC
July 2014

What are the people's attitudes toward spinal cord injury victims (from common to elite).

Iran J Nurs Midwifery Res 2014 May;19(3):266-72

Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: One of the acutely fatal and prevalent crises in all societies is acute spinal cord injury. Individuals with a spinal cord injury are prone to numerous challenges, perturbation, and acute mental distresses. One of their concerns, often expressed generally and in the form of a complaint, is how people deal with them. The present study aims to analyze the experiences and interactions of the disabled with the society and to achieve a deep clarification of their internal attitudes and realistic approaches in various social classes (from common people to elite).

Materials And Methods: The present study is a part of a greater research with a classical grounded theory approach conducted on 12 successful and nationally and internationally popular disabled people. Sampling was firstly purposive and then continued with snowball sampling. The data were collected by open deep interviews which were recorded and transcribed verbatim. The obtained data were analyzed by Graneheim content analysis method.

Results: The findings obtained through analysis of the interviews yielded the theme of a socially suppressing attitude which contained four subthemes of compassionate attitude, disability attitude, inhuman attitude, and atonement attitude.

Conclusions: The results showed that both groups of common, and educated and elite classes of Iranian society have identically suppressing attitudes and interactions toward spinal cord injury victims. It seems that traditional attitudes yet preponderate academic and scientific knowledge in Iranian society. This gap needs notable attention of all the Iranians, especially policy makers and social personalities.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061627PMC
May 2014

Indicators developed to evaluate the international framework convention on tobacco control in iran; a grounded theory study.

Iran J Med Sci 2014 Mar;39(2 Suppl):213-7

Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;

This study aimed to develop indicators for evaluating the implementation of The Framework Convention on Tobacco Control (FCTC) in Iran. We used the "grounded theory" framework. Totally, 265 policy-makers, stakeholders, and community members were recruited by purposeful sampling in 2008. After analyzing the gathered data, 251 indicators, including 82 indicators as "applied indicators", were derived from second-level codes for three groups. A suitable evaluation questionnaire can be designed based on the extracted indicators for policy makers, stakeholders, and the community to follow the implementation of the FCTC in Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993040PMC
March 2014

Iranian nurses' experiences of brain dead donors care in intensive care units: A phenomenological study.

Iran J Nurs Midwifery Res 2013 Nov;18(6):475-82

Nursing and Midwifery Faculty, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran.

Background: Care of brain dead donors is complex, critical, and sensitive and has a direct and positive impact on the end result of organ and tissue transplantation process. This study describes the nurses' experiences of care of brain dead donors in intensive care units (ICU).

Materials And Methods: This research was performed by phenomenological method that is a qualitative approach. Purposive sampling was used to gather the data. The researcher reached to data saturation by deep interviews conducted with eight participants from ICU nurses in Isfahan hospitals who cooperated in care of brain dead donors. Data analysis was performed according to Colaizzi analysis method.

Results: Interviews were analyzed and the results of analysis led to "Excruciating tasks" as the main theme formed by psychological effects of facing the situation, heavy and stressful care, defect of scientific knowledge, conflict between feeling and duty, outcome of attitude change in behavior, emotional responses to perceived psychological afflictions, doubt to medical diagnosis, spiritual perceptions, and biological responses when faced with the situation.

Conclusion: Caring of brain dead organ donors is difficult and stressful for intensive care nurses and can be a threat for nurses' health and quality of nursing care. So, providing suitable physical, mental, and working conditions is necessary to make suitable background to maintain and increase nurses' health and quality of care and effective cooperation of this group of health professionals in organ procurement process.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917131PMC
November 2013

An exploration of health, family and economic experiences of leprosy patients, Iran.

Pak J Biol Sci 2013 Sep;16(18):927-32

Faculty of Nursing and Midwifery, Khorasgan Isfahan Branch, Islamic Azad University, Isfahan, Iran.

This study aims to explore the life experiences of Iranian leprosy patients in health, family and economic dimensions. Mycobacterium leprae is responsible for leprosy, a type of chronic inflammatory disease that existed from ancient times, still hearing the name of leprosy creates an awful imagination of cutting the organ, blindness and isolation and it has still remained as a serious social problem. The patients are confronted with particular problems physically and mentally. The phenomenological tradition was used to gain knowledge of the leprosy patients lived experiences. Data analysis method was based on Colaizzi's approach. This is a qualitative research using purposeful sampling, interviewing the leprosy patients referring to a contagious diseases department of the Health Network of Nourabad Lorestan City. Data were collected by interviews those were analyzed in Colaizzi's Methods to extract the conceptual codes. Some concepts obtained from the analysis of data in the study such as physical, psychological, social, family, economic experiences, cultural beliefs of society, the context for tendency toward defect and disability and social stigma. These findings suggest that health care professionals should pay attention not only to leprosy patients to reduce their physical and psychological but also to the community and public culture to reduce the leprosy patients suffering from social stigma. The results of the present study can help us in a better understanding of all aspects of patients' lived experiences.
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http://dx.doi.org/10.3923/pjbs.2013.927.932DOI Listing
September 2013

Effect of self-efficacy enhancement program on self-care behaviors in chronic obstructive pulmonary disease.

Iran J Nurs Midwifery Res 2013 Sep;18(5):421-4

Department of Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran.

Background: Given the importance of the chronic obstructive pulmonary disease (COPD) and role of different factors in self-care behaviors of COPD patients, this study was conducted to determine the effect of self-efficacy program on self-care behaviors of COPD patients.

Materials And Methods: In this semi-experimental study, 62 COPD patients were recruited in which 31 subjects were in control group and 31 were in experimental group. Subjects were selected based on purposive sampling from Imam Hospital affiliated to the Urmia University of Medical Sciences, Iran, in 2011. Two valid and reliable questionnaires were filled after completing informed consent form. A month later, and after implementing the planned intervention, the questionnaires were completed by the subjects again.

Results: The mean standard deviation of age were 64.1 (9.1) years in the control group and 65.2 (8.0) years in the experimental group. There was a statistically significant difference between self-efficacy state before and after intervention. Self-care scores in the experimental group were significantly higher after intervention (t = 25.18, P < 0.0001).

Conclusions: Given the high potency of self-efficacy factors on self-care behaviors of the COPD patients, enhancement of self-efficacy in these patients can be very effective in disease control, prevention of complications, reduction of hospitalization costs, and improve their quality of life. Hence, it is suggested that in empowerment programs of these patients, special emphasis will put on the strengthening of their self-efficacy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877467PMC
September 2013

Anxiety of women employees and the process of maternal role.

Int J Prev Med 2013 May;4(Suppl 2):S262-9

Department of Nursing, Islamic Azad University, Najafabad Branch, Isfahan, Iran.

Introduction: Regarding the social and economic changes and developments, the increasing presence of working women in the present society and their important role in the family, paying more attentions to the importance of maternal role among working women who face multiple roles seems to be necessary. Hence, the process of maternal role among working women has been investigated in this study.

Methods: The grounded theory approach is used in this qualitative research. In-depth and unstructured interviews were the main way in collecting the data. Initially, the targeted sampling was started and continued gradually to the data saturation, in the form of theoretical sampling based on the obtained classes. The data was analyzed using Strauss and Corbin analysis. Accuracy and validity by four criteria in this study included: Credibility, dependability, Confirmable potential, Transferability or Fittingness.

Results: Data analysis led to the identification of the core variable of role conflict. The main classes of occupied mothers' experiences included: different pregnancy experience, returning concerns, supportive umbrella, role assignation, role overlap, role strain, gradual acceptance, satisfaction and erosion.

Conclusions: The acceptance of numerous roles such as maternal and marital roles by working women creates various role expectations of them from their children, spouses, family and the society which in turn forces them to meet both family and job requirements and expectations; This causes role conflict in working mothers and endure a lot of pressure and stress, that can influences of mental and physical health of the mothers.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678229PMC
May 2013

A comprehensive model to evaluate implementation of the world health organization framework convention of tobacco control.

Iran J Nurs Midwifery Res 2012 Mar;17(3):244-54

Professor of Cardiology, Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Iran is one of the countries that has ratified the World Health Organization Framework Convention of Tobacco Control (WHO-FCTC), and has implemented a series of tobacco control interventions including the Comprehensive Tobacco Control Law. Enforcement of this legislation and assessment of its outcome requires a dedicated evaluation system. This study aimed to develop a generic model to evaluate the implementation of the Comprehensive Tobacco Control Law in Iran that was provided based on WHO-FCTC articles.

Materials And Methods: Using a grounded theory approach, qualitative data were collected from 265 subjects in individual interviews and focus group discussions with policymakers who designed the legislation, key stakeholders, and members of the target community. In addition, field observations data in supermarkets/shops, restaurants, teahouses and coffee shops were collected. Data were analyzed in two stages through conceptual theoretical coding.

Findings: Overall, 617 open codes were extracted from the data into tables; 72 level-3 codes were retained from the level-2 code series. Using a Model Met paradigm, the relationships between the components of each paradigm were depicted graphically. The evaluation model entailed three levels, namely: short-term results, process evaluation and long-term results.

Conclusions: Central concept of the process of evaluation is that enforcing the law influences a variety of internal and environmental factors including legislative changes. These factors will be examined during the process evaluation and context evaluation. The current model can be applicable for providing FCTC evaluation tools across other jurisdictions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696220PMC
March 2012