Moral distress in Iranian nurses' experiences

Ethics is an integral part of nursing practice. Nurses and other professional caregivers are increasingly recognizing the issue of moral distress. The aim of this study is to describe Iranian nurses' experiences in moral distress. In this study the qualitative phenomenological approach was used. 11 nurses from teaching hospitals of Hamadan University of Medical Sciences participated in the study. The data were collected by in-depth interviews. Transcripts were analysed by constant comparative contant analysis. The results sorted into 4 content areas: individual characteristics of team care [including knowledge, ability, experience, responsibility and mental-affective reactions [including faulty, defensive reactions, lack of motivation and laws and officials [including, limitation of laws and contradictory of laws with ethics, religion, knowledge and ability] and circumstances of workplace [including physical circumstances, manpower, facilities and equipments]. It is necessary that nurses become familiar with ethical problems, nursing code of ethics and promote the skills for encounter to moral distress

[Challenges and opportunities of doctorate of nursing graduates in clinical settings]

Introduction: From the past, nursing profession has encountered many challenges in its developmental process route. One of the update challenges is to recruit doctorates of nursing in clinical settings. The aim of this study was to describe Challenges and opportunities of doctorate of nursing in clinical settings. This is based on nursing lecturers and students [PhD] views

Methods and Materials: This is a qualitative descriptive phenomenological study that conducted with consent and participation of 10 nursing students [PhD] and nursing lecturers in Tehran nursing schools. Data gathering method was semi-structured written report with open ended questions. Colaizzi's method was used to data analysis. Lincoln and Guba criteria assessed to confirm data accuracy

Findings: Analyzing data led to 24 preliminary cods, 12 sub- categories and 5 categories. Emerging categories included; managing and organizing clinical settings, gap between theory and practice in nursing doctoral program, doctorate of nursing practice education, promoting and optimizing quality of education and nursing clinical services

Conclusion: Results revealed that doctorates of nursing should be recruited in their specialty and higher levels of nursing and their positions should be designed and clarified in clinical settings prior their recruitment. In regard to advanced services and evidence-based nursing delivery, it is better to educate nurses as doctor of nurse practice or professional doctorate

Positive effects of illness following acute myocardial infarction

Myocardial infarction is an important event and a huge change in patients' and their family life. The negative psychosocial consequences of the disease are well documented. However, studies on positive effects following myocardial infarction are much more limited. The aim of this study was to explore positive effects of illness following acute myocardial infarction. This paper is a part of findings of a more extensive grounded theory study. Eighteen people with first time myocardial infarction were selected by purposeful and theoretical sampling. Semi-structured interviews were used for data collection. The data were analyzed using constant comparison method. The findings showed that the participants have experienced one or more positive effects of the disease. Positive effects of illness were emerged in three main categories including: healthy lifestyle, worthwhile life/health, and promotion of social interaction/ interpersonal relationship. Patient with myocardial infarction experience huge tensions. However, the disease would also result in positive effects which could, in turn, facilitate recovery from illness and the process of adjustment to illness

[Action research: a way to improving quality nursing practice]

Improving the quality of health care is an important priority. However, research has shown that methods of altering clinician's behavior or implementing organizational change are often ineffective. Action research has been used successfully to facilitate change and improve service provision in industry, education and more recently in health care. In this paper action research methodology and why it could be successful in promoting change and quality of nursing services are outlined. Recently published studies using action research demonstrate that action research improves clinical care, teamwork, communication and administration. It also encourages practice teams to audit their work and identify their educational needs. Action research should be a useful means of improving quality in health care and could be used more widely. Action research could be a useful method of transforming theory to practice

[Nurses' perspective about evidence based nursing]

The complex and rapid changes in health care require using the best available evidences to have essential performance in caring. Considering nursing as an academic discipline, utilizing the results of research for improving nursing care and creating more satisfaction in patients is important so this study was designed to determine nurse's perspectives about the concept of evidence based nursing. The approach of current study was descriptive phenomenology which was designed to study the perspective of nurses about the concept of evidence based nursing. Data collection method was semi structured interview and 7 participants were chosen by to purposive sampling. The study was conducted in Shahid Beheshti university affiliated hospitals and data were analyzed using Strubert's phenomenological method. The findings about evidence based nursing were codified in three main categories as improvement of quality of care evidences and values. In the case of second question about influencing factors two main categories as facilitating and interceptor factors were narrowed down. All indicated that knowledge of nurses about evidence based nursing is low therefore the utilization of research results as evidences were low also. Considering the findings of this study introducing the concept and utilization of research results should have patient's higher satisfaction of received care

Self-efficacy and self-regulated learning in clinical performance of nursing students: a qualitative research

Self-efficacy and self-regulated learning play an important role in applying clinical knowledge and competencies. The aim of this study was to define self-efficacy and self-regulated learning in nursing students' clinical performance during field training. In a qualitative study, 50 participants were selected through purposive sampling method from Iran, Tehran, and Shahid Beheshti Medical Universities. Then 28 semi-structured and 3 focus group interviews were performed with volunteer nursing students. Data was analyzed using content analysis methods. The definition of self-efficacy and self-regulated learning were categorized in five and three themes, respectively. Self-efficacy in clinical performance based on the viewpoints of participants was equal to acquiring clinical skills, assessing patients, and planning, executing, and evaluating care plans. The experience of self-regulated learning in clinical performance was equivalent to efforts for clinical learning along with self-motivation, and practicing nursing process, as well as for acquiring professional behaviors. Self-efficacy and self-regulated learning affect independent patient care capability and help nursing students to promote their competencies and professional skills in this field