Experiences of Iranian Nursing Students Regarding Their Clinical Learning Environment

PURPOSE: The aim of this study was to explain the experiences of Iranian nursing students regarding their clinical learning environment (CLE). METHODS: Twenty-one nursing students participated in this qualitative study. Data were collected using semistructured interviews and analyzed using conventional content analysis. RESULTS: Analysis of interviews identified six categories: educational confusion, absence of evaluation procedures, limited educational opportunities, inappropriate interactions with nursing staff, bullying culture, and discrimination. Systematic and consistent methods were not used in clinical education and evaluation of nursing students. In addition, there were inadequate interactions between nursing students and health-care staff, and most students experienced discrimination and bullying in clinical settings. CONCLUSION: Findings showed that the CLE of Iranian nursing students may be inadequate for high-level learning and safe and effective teaching. Addressing these challenges will require academic and practice partnerships to examine the systems affecting the CLE, and areas to be addressed are described in the six themes identified.

Adapting life to the reality of diabetes

Background: Diabetes is one of the most challenging and burdensome chronic diseases of the 21st century. Adaptation to disease is a mental, multidimensional, interactive process and is influenced by social and cultural factors. It should be explained in the cultural context of each society with qualitative studies.

Aims: In this study, we explored the subjective experiences of adaptation to type 2 diabetes among Iranian patients.

Methods: This was a qualitative study using a grounded theory approach. Purposeful sampling was used initially, followed by theoretical sampling based on derived codes and categories as the sampling method. Twenty patients as main participants and 7 from the healthcare system and family members were selected based on a purposeful and theoretical sampling method. Data were collected through semistructured and deep interviews. Data were analysed using the approach of Strauss and Corbin simultaneous with data collection.

Results: Five categories that emerged from the data included: perceived threat of disease, reality compliance, comprehensive reconstruction, normalization of living with illness, and return to resources. Finally, data analysis on selective coding led to recognition of “endeavour to reconstruction of life” as the core variable. The core variable showed the way participants adapted to diabetes.

Conclusions: This study showed that the process of adaptation to diabetes has a dynamic nature in which participants make major changes in their cognitive, emotional and behavioural structures in order to have a normal life.

Coping strategies to hinder intention to leave in Iranian nurses: a qualitative content analysis

Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of [I] Self-empowerment [practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests], [II] Self-controlling [tolerance, avoidance, the routine-based performance], and [III] Pursuing opportunities for advancement and promotion [community development, planning for higher education]. Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares

Details of content validity and objectifying it in instrument development

Researchers in the nursing science study complex constructs for which valid and reliable instruments are needed. When an instrument is created, psychometric testing is required, and the first-step is to study the content validity of the instrument. This article focuses on the process used to assess the content validity. This article examines the definition, importance, conceptual basis, and functional nature of content validity in instrument development. The conditional and dynamic nature of content validity is discussed, and multiple elements of content validity along with quantitative and qualitative methods of content validation are reviewed. In content validity process, content representativeness or content relevance of the items of an instrument is determined by the application of a two- stage [development and judgment] process. In this review, we demonstrate how to conduct content validity process, to collect specific data for items generation and calculation of content validity ratio, content validity index, modified Kappa coefficient, and to guide for interpreting these indices. Face validity through suggestions of expert panel and item impact scores is also discussed in paper. Understanding content validity is important for nursing researchers because they should realize if the instruments they use for their studies are suitable for the construct, population under study, and sociocultural background in which the study is carried out, or there is a need for new or modified instruments

Emotional Labour of Caring for Hematopoietic Stem Cell Transplantation Patients: Iranian Nurses' Experiences

PURPOSE: The purpose of this study was to describe the emotional labour experienced by nurses who care for hematopoietic stem cell transplantation (HSCT) patients in Iran. METHODS: Eighteen nurses participated in semi-structured interviews. The interviews were analyzed using qualitative content analysis methods. RESULTS: Three main categories described the emotional labour involved, namely, emotional intimacy, feeling overwhelmed with the sadness and suffering, and changing self. Nurses had compassion for their patients, contributing to a close nurse-patient relationship. The nurses' emotional labour resulted in their feeling overwhelmed with sadness and suffering. Five subcategories described this emotional toll: (a) witnessing suffering, (b) struggling mentally, (c) hurting emotionally, (d) feeling drained of energy, and (e) escaping grief. Dealing with death and dying on an ongoing basis promoted the nurses' changing self. CONCLUSION: Iranian nurses who care for HSCT patients experience a range of positive and negative emotions. Establishing appropriate support systems for nurses might help mediate the negative aspects of emotional labour. thereby improving nursing work life and ultimately the quality of patient care.

Importance and availability of nursing support for mothers in NICU: a comparison of opinions of Iranian mothers and nurses

The current study was conducted to compare the opinions of mothers and nurses on the importance and availability of nursing support for parents with premature infants hospitalized in NICU. There is no overall picture of the nursing support for parents with hospitalized premature infants in Iran. Nurses, providing care in NICU, must view parent as an essential partner in care. But what is the situation? Assessing the viewpoints of both parents and nurses regarding the importance and availability of nursing support can elucidate this situation. A comparative descriptive design was used. The population consisted of all mothers with hospitalized premature newborns in NICU [n=300] and all NICU nurses [n=32] in three teaching hospitals in Tabriz [Iran], in 2007. Data was collected through the NPST questionnaire. Data analysis was done wit SPSS. Mann-Whitney test showed that there were significant differences between nurses and mothers on four subscales of nursing support. Generally, mothers scored every subscale lower than nurses who cared for them and their children. On the other hand, it could be said that NICU nurses claimed more importance for the subscales and rated the provided support higher in comparison with mothers who did not think so. The opinions of the nurses and mothers toward the availability and importance of the nursing supports in NICU were different. This study provides nurses with concrete information in order to better understand parents' need for support and try to meet their expectations, resulting in improved nursing care in neonatal intensive care units

[Patients- and nurses' perspectives on respecting patients' privacy during nursing care]

Privacy is a major human need and is being considered as the cornerstone of medical care. Nurses, because of the specific nature of their profession, have a substantial role in meeting the patients need for privacy. The aim of this study was to compare viewpoints of patients and nurses about respecting patient's privacy during nursing care. In this descriptive comparative study, all nurses working in three hospitals affiliated to Tabriz University of Medical Science [n= 109] and 161 patients from these hospitals were selected. The data was collected by a single questionnaire was prepared in two forms for either the patients or the nurses. First section of questionnaire consisted of the demographic data of the nurses and patients and the second section measured their viewpoints about respecting patients' privacy during nursing care. The results showed that there was statistically significant difference between nurses' [Mean = 33.06] and patients' [Mean = 27.05] viewpoints about respecting patient's privacy [P<0.001]. Furthermore, there was a positive powerful correlation between the days of hospitalization [P<0.001] and the needs of patients for nursing care [P=0.019] with the patients' viewpoint about respecting to their privacy during nursing care. Also, there was a negative powerful correlation between the perception of patients regarding their health [P<0.001] and the patients' viewpoint of respecting to their privacy during nursing care. This research showed that there were some differences between nurses and patients viewpoint about respecting the patients privacy. Furthermore, the results showed that when the patients need further nursing care, have worse health status or increase in hospitalization day, the patient's viewpoint about respecting to their privacy during nursing care increases. This may indicate that the interaction of the patient with nursing stuff may improve their viewpoint about respecting to privacy