[Nurses mental health in Iran: a national survey in teaching hospitals]

Background and Aim: Mental health disorders are common problems among health care professionals such as nurses, which can create great problems .The aim of this study was to evaluate mental health status in nursing personnel in the teaching hospitals

Materials and Methods: This descriptive and cross-sectional study was performed in 2013 and included 5837 nurses working in educational hospitals affiliated to the medical universities in Iran. Data were collected by using a general health questionnaire [GHQ- 28] and were analyzed by descriptive and analytical statistics using SPSS 18 software

Results: The results showed that 30.2% of the nurses were mentally healthy and 69.8% of them were exposed to mental health disorders. The mean score of mental health was 31.11+/- 12.37. The highest mean score [the worst condition] of the unhealthy nurses belonged to social performance domain [12.86 +/- 3.38] and the lowest mean score [the best condition] was related to depression domain [4.1 +/- 3.02]

Conclusion: Attention to mental health of the nursing personnel is of great importance and can lead to improvement of nursing care quality. Psychological counseling for nursing personnel is also recommended

[Addicts' perspectives about factors associated with substance abuse relapse]

It has been known for many years that there is a high risk of relapse after treatment of drug abuse. This has made addiction more complicated. Knowledge of related factors allows the health care professionals to initiate much broader, client - centered, relapse prevention strategies. This study had a descriptive design. The sample comprised 200 addicts who all were male and had at least one relapse episode after treatment. Data were collected by structured face-to-face interviews. The related factors to relapse are divided in two groups as individual and environmental factors. The intensity of related factors was asked as "not any", "a little", "medium" and "very much". The results showed that 33.5% of the subjects had 1 relapse, 38% 2-3 relapse and 28.5% more than 3 relapse. Also, 53% of them relapse in less than 3 month after treatment. Only 12% could avoid drug use for more than 1 year. The mean time of abstinence was 6.3 +/- 3 month. According to Friedman test, insomnia and temptation were the most important individual factors [P<0.000], and simple access to drugs, family conflicts and noncompliance with treatment were the most important environmental factors [P<0.000]. With respect to results, since psychological factors were the most important [mean= 1.6 +/- 0.5], mere detoxification is not efficient enough and may end in client's relapse. Treatment services should be developed further and strengthen relapse prevention and relapse coping skills among drug misuser's and pschological health is the first thing that should be notified by them

Teaching styles in clinical nursing education: a qualitative approach

Background and purpose: There are many studies about nursing clinical settings and their problems, but the teaching style of teachers on the bedside has not been studied as a whole. Therefore, this study was conducted to assess, describe and interpret nursing trainers' perceptions of the teaching style in clinical settings

Methods and Materials: The grounded theory approach was used to conduct this study. Fifteen nursing teachers were interviewed individually in 2006-2007. The interview protocols were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using Strauss and Corbin's method

Results: Three major themes and 12 sub-themes emerged from the study data which portray the clinical teaching styles of the nursing teachers. The main themes are multiple styles in teaching, nature of clinical teaching, control and adaptation in the educational atmosphere and multiplicity in teaching style. Individualized styles were observable across teachers, but they varied across situations, type of skills [content], educational environment and facilities, levels of the learners, and the control and accommodation of teachers with the teaching atmosphere

Conclusion: Although teaching style is a complex phenomenon, but this study has helped emerge some of the rules and principles of clinical training of nurses

[Prevention of harm to patients or to nurses: a major moral conflict for nurses in the context of ethical decision making]

Factors such as improved medical technology, resource allocation, increasing costs, the rights of individuals and the changing roles of nurses can result in ethical conflicts that demand the ability of nurses to recognize moral dilemmas and conflicts and to make appropriate ethical decisions. The aim of this article is to explain the concept of patient or nurse harm in the context of ethical decision making in patients care. This study was conducted using the Grounded Theory method. The participants were 17 Iranian nurses, who work in hospitals of universities of medical sciences. The data was gathered using semi-structured, unstructured and in-depth interviews. All interviews were transcribed verbatim and simultaneously and were coded according to the Strauss and Corbin method in open, axial and selective coding. Preventing harm to patients or to nurses is one of the major moral conflicts for nurses in ethical decision making. For nurses, the concept of harm is a process which consists of a prediction, a prevention and an outcome that may be harmful or non-harmful. The outcome may affect either the nurse or the patient or both. It seems that the context of ethical decision making plays a major role in moral conflicts for nurses and the outcome of this process. Participants believed that the context of ethical decision making is a major factor in nurse's moral conflicts and in the prevention of harm to themselves or to the patients. Therefore, it is necessary that nurses consider the context of ethical decision making in their moral decisions and resolutions to conflicts. Also, structures with agents and nursing managers must attempt to reform and improve the context especially for structural conditions so nurses could make better decisions without conflict and moral distress

Comfort of hospitalized patients: a missed concept

Historically, comfort has been an optimal outcome in caring of hospital patients though, the concept of comfort from patients perspective is rarely assessed. The aim of this study was to explore hospitalized Medical-Surgical patients experiences and perceptions regarding of comfort and discomfort. A qualitative approach using grounded theory was adopted in this study. The data collected by semi-structured interviews and participants' observation, from a purposive sample of 31 medical-surgical patients, with 11 patients accompanied relatives who were subjected to questions and constant comparative analysis. This study was conducted in five large teaching and semi-private hospitals in Iran. Date analysis covered a number of themes obviously included discomfort. In fact, experiencing discomfort was so persistent in the data, that it formed several categories including [physical, psychosocial and environmental discomfort]. Self help and organizing of informal caring web, and seeking help from others, were the participants' main strategies to deal with discomfort. The finding indicated that hospitalization of patients is not always necessarily equivalent to effective deal with caring and therapeutic needs. Patients experience a lot of distress related to hospital's policies, regulations and priorities. Patients can have active role for discomfort management. In addition, it is highlited the roles of patients' relative and care-givers in hospitals. Therefore, without cooperation of care-givers [patients' relatives], the quality of nursing care could be disturbed seriously

Patient advocacy properties

Patients' vulnerability calls for advocacy to be done during hospitalization. Although all members of health care team may advocate patients, nurses show more commitment and tendency towards patient advocacy. Nursing profession has embraced patient advocacy role for nurses, however, what advocacy is needs to be more clarified. This study aims to investigate the patient advocacy perception among Iranian nurses, over 2004. This qualitative study was conducted through Grounded Theory Method. Participants were 24 nurses [clinical nurses, head nurses, supervisors] working in Rasoul Akram hospital affiliated with Iran medical university. Semi-structured interview was used to gather data. All interviews were transcribed verbatim and constant comparative analysis was used simultaneously according to Strauss and Corbin method. One of the main categories emerged during data analysis process was "perception of patient advocacy". This category and its sub-categories dealt with perceptions regarded advocacy by the participants in this research and consisted of performances like informing and educating, valuing and respecting, supporting, protecting and persistent care, follow-up and coordinating. Nurses consider advocacy as an ethical duty and one of their professional roles. Participants also believed that they acted as patient's advocate through performing various activities. Hence, harmonized attempts in educational, research and nursing management units are essential to professionalize the role