effect of family-centered empowerment program on self-efficacy of adolescents with thalassemia major: a randomized controlled clinical trial

Background: Chronic nature of thalassemia causes changes in different aspects of life in patients, including their self-efficacy. The aim of this study was to determine the effect of family-centered empowerment program on the self-efficacy of adolescents with Thalassemia major

Methods: A quasi-experimental study was performed on adolescents with thalassemia major in 2013 in Bandar Abbas, Iran. The participants were divided into intervention and control groups, respectively. Research instruments included demographic data questionnaire, need assessment self made questionnaire, general self-efficacy scale, and sickle cell self-efficacy scale. After collecting the data from the pre-intervention step, family-centered empowerment program was implemented for the intervention group and secondary test was conducted six weeks after the intervention and the results were analyzed by statistical SPSS-21 software, using independent t-test, paired t-test, Chi-square and Fisher's exact test, and descriptive statistics. A significance level of P<0.05 was considered as significant

Results: The mean and standard deviation of the adolescents' age were 16 +/- 1.9 in the intervention group and 15.2 +/- 2 in the control group. Independent t-test showed a significant difference between the two groups after the intervention for both self-efficacies [P<0.01 and P=0.02]. In the control group, the results of general self-efficacy scores after six weeks' time were reduced compared to the previous one while disease-related self-efficacy scores in the same group after six weeks' time increased and paired t-test indicated a significant difference in the mean scores for both self-efficacies in both groups

Conclusion: Implementation of family-centered empowerment program for patients with thalassemia major is practically feasible and it can increase self-efficacy in these patients. It is suggested that the program should be used in comprehensive care protocols of children and adolescents

Study protocol for promoting physical activity among women based on the MAPP process

Background: The participation of all stakeholders is necessary when a community-based intervention is designed. For running a practical intervention, it is necessary to have a framework to design the programme while considering all stages of planning, implementation and evaluation.

Aims: To describe a study protocol based on the MAPP process [Mobilizing for Action through Planning and Partnerships] for promoting physical activity [PA].

Methods: This protocol is implemented in 6 distinct phases. The goal of the first and second phase is to organize the programme and increase participation, and to determine the vision of the programme, respectively. The third phase provides a comprehensive picture of a community. The fourth and fifth phases identify strategies for the programme. The sixth phase is about the action cycle.

Conclusion: The framework considers all factors on PA improvement and, consequently, results in a culture-based programme for women

Concept Development of “Nursing Presence”: Application of Schwartz-Barcott and Kim's Hybrid Model

PURPOSE: Although nursing presence is a foundation for professional nursing practice and has known positive outcomes such as patient satisfaction and recovery; it is not well known. The ambiguity surrounding how to define nursing presence has challenged its evaluation and education. Therefore, in an attempt to discover attributes of this underdeveloped concept and studying it in a new context, concept development is essential. The purpose of this study was to clarify the concept of nursing presence through concept development, to produce a tentative definition of this subjective concept in clinical practice. METHODS: Concept development was carried out using Schwartz-Barcott and Kim's hybrid model including, theoretical, fieldwork and final analysis phases. First, 29 related articles available on the databases from 1990–2015 were reviewed and analyzed. Then, 22 interviews were conducted with 19 participants, followed with inductive content analysis. At last, an overall definition was performed. RESULTS: Nursing presence can be explained as co-constructed interaction identified by deliberate focus, task-oriented/patient-oriented relationship, accountability, clarification, and ubiquitous participation. Nursing presence requires clinical competence, self-actualization, reciprocating openness, and conducive working environment. Worthwhile communications, balance/recovery, and growth and transcendence are the main consequences of this concept. CONCLUSION: Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.

Passing through a rocky way to reach the pick of clinical competency: a grounded theory study on nursing students' clinical learning

Clinical learning is one of the important issues that helps the perception of nursing students' practice in a clinical setting and its effect on their professional development. The aim of this study is to describe and state the manner of clinical learning in nursing students. This qualitative study was conducted as a grounded theory. The individual semi-structured interviews and participants' observations were taken into account with a purposive and theoretical sample of 27 participants. The data were analyzed using the grounded theory approach and the constant comparison analysis method. The results showed that students use two approaches of Micro- and Macrolearning. The first includes learning conditions and situations that act like a foundation for the second one [Macrolearning]. Macrolearning is a continuous process including all categories of "Facing unfavorable clinical facts," "Clinical situation and appropriate decision making," "Bridging the gap between practice and theory," "Struggle for clinical independence," and "Dynamism" in a continuum reflecting the struggle to obtain clinical competency [core variable]. Through provision of such conditions as students' gradual acquaintance with real situations, selection of more resistant students, use of mentorship and preceptor ship in clinical learning, enhancement of educational standards in hospitals, handling collaborative learning methods to make a cooperation spirit in internship environment, and so on, students can be helped to obtain clinical competency.

Concept analysis of professional commitment in Iranian nurses

Professional commitment has been widely discussed during the last decade. There is no comprehensive definition about "professional commitment in Iranian nurses." Hence, this study was conducted with the aim of analyzing the concept of professional commitment in Iranian nurses. Hybrid model was used in three phases. Firstly, in the theoretical phase, data were retrieved from the CINHAl, MEDLINE, PubMed, OVID, Google scholar, and SID databases. The literature search used the keywords "professional commitment" and "nursing." The final sample included 27 papers published in English between 2001 and 2011.Secondly, in the fieldwork phase, deep interviews with five clinical nurses were carried out, and thirdly, in the final analytical phase, the obtained data from theoretical and fieldwork phases were combined and a comprehensive analysis was conducted. Loyalty and tendency to remain in the profession and responsibility to the professional issues were extracted in theoretical phase. Commitment to promote caring abilities, satisfying of being a nurse, and belonging to the nursing profession were obtained in fieldwork phase. Finally, two main themes including "commitment to offering the best nursing care" and "commitment to promotion of the nursing profession" were extracted. Nursing is a humanistic profession; it has some particular characteristics due to the profession's nature. In this paper, a definition composed of two main dimensions of professional commitment in nursing has been introduced.