Probing Concept of Critical Thinking in Nursing Education in Iran: A Concept Analysis

PURPOSE: Given the wide disagreement over the definition of critical thinking in different disciplines, defining and standardizing the concept according to the discipline of nursing is essential. Moreover, there is limited scientific evidence regarding critical thinking in the context of nursing in Iran. The aim of this study was to analyze and clarify the concept of critical thinking in nursing education in Iran. METHODS: We employed the hybrid model to define the concept of critical thinking. The hybrid model has three interconnected phases-the theoretical phase, the fieldwork phase, and the final analytic phase. In the theoretical phase, we searched the online scientific databases (such as Elsevier, Wiley, CINAHL, Proquest, Ovid, and Springer as well as Iranian databases such as SID, Magiran, and Iranmedex). In the fieldwork phase, a purposive sample of 17 nursing faculties, PhD students, clinical instructors, and clinical nurses was recruited. Participants were interviewed by using an interview guide. In the analytical phase we compared the data from the theoretical and the fieldwork phases. RESULTS: The concept of critical thinking had many different antecedents, attributes, and consequences. Antecedents, attributes, and consequences of critical thinking concept identified in the theoretical phase were in some ways different and in some way similar to antecedents, attributes, and consequences identified in the fieldwork phase. Finally critical thinking in nursing education in Iran was clarified. CONCLUSION: Critical thinking is a logical, situational, purposive, and outcome-oriented thinking process. It is an acquired and evolving ability which develops individually. Such thinking process could lead to the professional accountability, personal development, God's consent, conscience appeasement, and personality development.

Women's health concept: a meta-synthesis study

It is necessary to identify unidentified or less- concentrated issues in women's health dimension through an extended study. This study is done to identify different dimensions of women's health among qualitative research. The present meta-synthesis study is done through a systematic review. The main criteria were to use qualitative studies issued in the same language and researches in which their participants were women. All the published and indexed articles related to women's health in Iran at SID, Magiran and Iranmedex databases from 2001 to 2013 were scrutinized. Search in these databases was done using key words "health" and "women". Finally, 29 qualitative articles were chosen. Data analysis was performed using qualitative content analysis. Generally, concepts extracted from women's health dimension are classified in three main categories including personal, familial and social dimensions. Each category includes some subcategories, too. Personal factors consist of physical, psychological -emotional and spiritual; familial factors consist of fertility, husband's support and women's fundamental roles, and social factors consist of cultural, socioeconomically support, and women's management issues. In this meta-synthesis study, there was an effort to present a new interpretation of the previous studies. This study helped attain a more comprehensive and deeper knowledge about women's health concept and reveal its different aspects, which are not assessed in the country

[Sampling in qualitative research: a guide for beginning]

Sampling in qualitative and quantitative research are very different, because it aims, gaining a deep understanding of the phenomenon is being investigated, rather than generalizing the results. Participants Selection in the qualitative study is done with aim of achieve the maximum information about the phenomenon under study. In quantitative research there is too much emphasis on a random selection, an equal chance for selection of all members of the research community, but in the qualitative study samples or participants are selected or invited. Purposive sampling that also is called purposeful or qualitative sampling that means purposeful selection of samples for acquiring knowledge or information. This type of sampling does not focus on developing the fixed and immutable rules or generalizing the results but try to better understand the phenomenon in special field. Purposive sampling consists of three main types including "Sampling to Achieve Representativeness or Comparability", "Sampling Special or Unique Cases" and "Sequential Sampling". Saturation in qualitative research as a method of sampling is considered the gold standard. In this paper, we tried to introduce the participant's selection methods and the differences between quantitative and qualitative method and the strategy for decision making about data saturation will be offered

[Perspectives of nurses on barriers of parental participation in pediatric care: a qualitative study]

Parental participation in pediatric nursing is not ideally done due to several barriers. This qualitative study aimed to explore the barriers of parental participation in pediatric care during 2011-2012. This qualitative study was carried out using content analysis approach. Data were gathered through face to face semi-structured interviews with a sample of pediatric nurses [n=11] who were recruited through purposeful sampling from a pediatric hospital in Tehran. After gaining data saturation, data were analyzed using content analysis method. Four main themes were emerged as barriers of parental participation in pediatric care including mutual motivation and interest in both parties [motivation and attitudes of nurses and interest in parents], management [lack of support for nurses, nursing shortage, nurses' workload, and poor teamwork between nurses and physicians], confidence in the nursing profession, and finally undefined role for mothers. Findings revealed the barriers of parental participation in caring for their hospitalized children. Managers and nurses can take advantages of these findings to improve and strengthen parental participation in pediatric care units during hospitalization

[Exploring nurse-patient communication strategies]

Nurses are informed from patients needs using effective mutual communications. This study aimed to explore the communication strategies between nurses and patients. This study had a qualitative approach with the content analysis method. Participants included 23 nurses, patients and their families in medical and surgical wards of Imam Khomeini hospital of Tehran University of Medical Sciences. Data were collected using interviews and observations. The first and second interviews were conducted unstructured. The semi-structured interviews were then conducted according to the derived concepts from the first and second interviews. We used observation in order to gain a deeper understanding and verifying data from interviews. The observations focused on the interactions between nurses and patients during mutual communications. A final theme was emerged through the data analysis: adaptation of nurses' attitudes and performances. This theme derived from three main categories: caring according to acute needs of patients, creating a professional realm, and participation. The caring according to acute needs of patients included subcategories such as identifying patients' acute needs and nurses' communication behavior. Creating the professional realm implicated on the clarifying roles and maintaining of privacy communication. Participation was defined as the audience and content. The findings showed that nurses, in response to the underlying conditions of nursing care, assimilate their attitudes and performances to be able to meet their professional needs and their patients' needs. In fact, the main character of nurse-patient communication is nurses' active role and patients' passive role

[Exploring contextual factors of the nurse-patient relationship: a qualitative study]

Communication is an important aspect of nursing care and much of nurses' duties such as providing physical care, emotional support, and exchanging of information with patients can not be performed without communication. The quality of care is improved through nurse-patient relationship. Nurse and patient relationship in clinical settings is influenced by multiple contextual factors which recognize them can improve the important role of nursing. This study aimed to explore the contextual factors influencing nurse and patient relationship. The study was performed by qualitative research approach. Participants were 17[8 nurses and 9 patients] in medical and surgical wards of Imam Khomeini hospital of Tehran university of medical sciences that selected by purposive sampling method. Data were gathered by interview [unstructured and semi-structured] and observation. Data analyzed by content analysis approach. Three theme emerged form data analysis which influenced the nurse-patient relationship. Those were formative factors, continuative factors and deterrent factors. These themes were explained in detail in the main text of article. Findings showed that in spite of nurses' positive attitude to communicate with patients and caring their needs, there were problems in nurse-patient communication that prevent from a patient centered communication between nurses and patients

Physical and psychological violence against infertile women

To investigate the prevalence of physical and psychological violence against women with female factor infertility. A total of 400 women with primary infertility attending the Vali-e-asr Reproductive Health Research Center in Tehran, Iran, were interviewed using the conflict tactics Scales [CTS2] questionnaire to investigate their experiences of physical and psychological violence. The prevalence of psychological violence was 135 [33.8%], followed by physical 56 [14%]. All women reported their husbands to be the perpetrators. Clinicians should identify the abused women and provide them with medical care and supportive counseling

[ discovery of restrictive factors of research utilization by nurses]

This paper describes the views of clinical nurses regarding the utilization of nursing research in practice. Many studies have taken a quantitative approach and have focused on why nurses constrain to develop research for nursing and research participation. There is a need to understand the factors restricting clinical nurses in using research findings. The aim of this study was to discover practising nurses' view of factors they perceived as restricte to their research utilization. Data were collected within a 6 months period by means of face-to face interviews followed by one session of focus group. Analysis was undertaken using a qualitative content analysis aided by MAXQDA software. In this study, the findings disclosed some key themes perceived by nurses as restrictive to them in using research findings: "level of support to be active in research", "to be research minded", "the extent of nurses knowledge and skills about research and research utilization", "level of educational preparation relating to using research", "theory -practice gap", and "administration and executive challenges in clinical setting". This study identifies constraints that require to be overcome for clinical nurses to get actively involved in research utilization. In this study, nurses were generally interested in using research findings. However, they felt restricted because of lack of time, lack of peer and manager support and limited knowledge and skills about research process. This study adds a qualitative perspective about the subject under study. Albeir the findings are not generalizable, they support quantitative study findings regarding this subject. This study also confirms that research utilization and the change to research nursing practice are complex issues which require both organizational and educational efforts