Facilitators and barriers to the professionalization of nursing in Iran

In recent years, Healthcare organizations have supported the professionalization of nursing in order to improve the quality of care delivered to patients. The purpose of this study was to explore facilitators and barriers to professionalization of nursing in Iran. A qualitative study was conducted using the conventional content analysis. Semi-structured interviews were held with 18 nurses working in various nursing positions and in different healthcare settings. Themes related to the professionalization of nursing was developed. During the data analysis, five themes were developed: [communication], [motivation and attitude], [organizational culture and structure], [academic education], and [supportive resources]. Each theme as a factor impacted the professionalization of nursing in a positive or negative manner. Recognizing factors influencing professionalization of nursing contributes to improvement of quality of nursing care delivered to patients. Healthcare system authorities can facilitate the development of the nursing profession and facilitate the professionalization of nursing through increasing the number of postgraduate nurses and also improving the nurses work conditions

[Effect of implementation of motivational program based on "expectancy theory" by head nurses on patients' satisfaction]

Implementation of the motivational program by nurse managers can improve nurses' performance and behaviour, provide better care for patients, and promote patients' satisfaction. This study aimed to determine the effect of implementation of the motivational program designed using "Expectancy Theory" by head nurses on patients' satisfaction. This was a quasi-experimental study conducted in medical and surgical units of two hospitals in Zanajn in 2011. Data were gathered using a patient satisfaction questionnaire. The reliability of the questionnaire was confirmed [alpha=0.72]. Forty participants were selected and allocated in two study groups. The groups were matched for some variables before the intervention. The motivational program was implemented in the intervention group for five months. The program had two designing and implementation phases including: 1] determining nurse managers' expectancies from nurses, assessing nurses' attitudes about valuable rewards, founding reward management committee and management improvement committee, and providing evaluation checklists for nurses' performance; 2] implementing standards of nursing care and patient education by nurses, monthly evaluation of nurses by head nurses and collaborative members of the reward management committee, determining level of rewards based on the results of nurses' performance evaluation, and giving reward to nurses at the end of each month in a reward ceremony. Data were analyzed using the Paired t-test, Independent t-test, Mann-Whitney, and Chi-squared in the SPSS v.16. There were no significant differences between the two groups at baseline dealing with the demographic variables. The results showed that patients satisfaction was significantly higher in the intervention group after the intervention [P<0.05]. This motivational program designed based on the "expectancy theory" has clear steps to be implemented among nurses and can be used as a practical guide by nurse managers to improve patients' satisfaction

Challenges of training diabetes nurse educator in Iran

The purpose of this study was to describe the first attempts and performance of health system in Iran in training specialist nurses in the field of diabetes- related care and education. This was a qualitative content analysis. Three diabetes management planners in the Ministry of Health and Medical Education, three provincial executive authorities of diabetes in the health system and ten nurses who worked as diabetes nurse educators [DNEs] participated in this study. Data obtained through semi-structured faceto-face interviews, a focus group, existing documents, field notes, and multiple observations. Data analysis was guided by the conventional approach of qualitative content analysis. Three major themes and six sub-themes were emerged through data analysis. Main themes were: [a] decentralization diabetes nurse educator training without any management [stop education due to transition training responsibility to provincial health authorities and lack of supervision of managers on training]; [b] try to reform nursing education infrastructures [try to train qualified educators who were candidate for teaching to DNEs, try to reform undergraduate nursing curriculum]; [c] failure of DNE curriculum [lack of consistency between content and timing with the curriculum objectives and lack of attention to learn evaluation process]. The findings of this study reflected the failure and multiple challenges in educating nurses working in diabetes units. Despite the fact that important roles were defined for nurses in the action plan for preventing and controlling diabetes, any specific action was not done in preparing nurses for these roles.

Semantic divergence in clinical education: Student-centered or student democracy

Although several studies have confirmed the validity and the strength of the student centered approach and most training centeres have put it as the heading of their agenda, there are still problems in the method of implementation, increasing the need for further research to review the mode of implementation. In this regard, the present study has been conducted to investigate students' and educators' perception in terms of interaction manner in clinical education process. This study was performed in a qualitative approach and by the conventional content analysis method. Data were collected until saturation through use of individual semi structured interviews. Twenty one subjects including undergraduate nursing students [8 cases], faculty member educators [9 cases], head nurses [3 cases], and educational supervisor [1 case] participated in the study, and the data were analyzed using MAXQDA3 software. "Student democracy" was extracted through data analysis as the main theme of the study. Participants' experience in terms of the five sub themes included instructor's loss of dignity, negligence in the evaluation of the students, poor discipline, lack of compliance with the educator, and lack of motivation. Instructor's weaknesses in planning, guiding, and evaluating the students led to student's interference in these affairs and a challenge in effective student centered approach. Although excessive emphasis on students' opinion for educational evaluation is apparently a sign of tribute to the students, it ultimately contributes to ignoring the process of learning to attract students' interest, occupational devaluation, and a decrease in students' motivation.

[ spiritual approach to job satisfaction in nursing staff: a qualitative study]

To explore nursing staff's perspectives about spiritual mode of job satisfaction. This was a qualitative study. Data was obtained through interviews, which were recorded and subsequently transcribed. The analysis was carried out by the qualitative content analysis. Five matter themes emerged from the data analysis: spiritual joy and interest, patients as bless of God, spiritual assurance, spiritual remuneration, and spiritual repugnance. Spiritually as an important and integral aspect of nursing profession was supported in this study. Spirituality is the inner, intangible dimension that motivates staff nurses to search for meaning and purpose, and establish positive and trusting relationships with patients and God

[ effect of implementing [goal setting theory] by nurse mangers on staff nurses' job motivation]

One of the primary tasks of the managers is staff motivation in order to improve their performance to a high level. It has been staff struggles to accomplish the organizational goals and decisions. The [goal setting theory] has designed for this aim. The purpose of this study was to examine the effect of implementing [goal Setting Theory] by nurse mangers on staff nurses' job motivation. This study was quasi- experimental one in which 51 nurses from one hospital were allocated to either experimental [n=30] or control [n=21] group. The two groups were compared before and after intervention for their job motivation. The instrument, measuring job motivation with 48 items, was used after providing content validity and reliability [r=0.80]. In order to avoid exposure bias, at first, job satisfaction in control group in two times were measured. Then, the intervention [goal setting theory] was implemented by subjects of experimental group for three months in three stages; a] nurse managers development, b] staff nurse development, c] implemented discharge planning as a [goal] by staff nurse. Data were analyzed by SPSS. The results showed that the level of staff nurse job motivation in two groups before intervention were moderate and two groups were homogenous [p=1.000]. After intervention, the level of staff nurse job motivation in control group did not changed [P=1.000], but in experimental group, the level of staff nurse job motivation was significantly increased to a higher level [P=0.000]. Implementing the [goal setting theory] based on the methods used in this study showed that whenever nurse managers had a specific and clarified goal for nurses, the level of job motivation in staff nurse increased to a higher level