RESUMO
Background and Aim: Aging of population, increased cultural and social differences in societies, increased rate of chronic diseases, reduction of financial resources, the flash-like technological changes, emphasis on home care, increased trend toward patient-centered care and evidence based practice have resulted in more complexity in clinical environments. Providing standard safe and effective care in such environmental conditions can only be achieved by development of critical thinking skills in the nursing staff. There are many definitions about critical thinking in nursing. Many of these explanations are complicated, without significant relation to the clinical and professional performances
Material and Methods: We used eight step Rodgers' concept analysis method to provide a clear definition about critical thinking in clinical nursing to determine antecedents, attributes and consequences. We searched valid online data bases for in English and Persian articles from 1995 to 2014. Finally, 58 articles 3 dissertations and 2 chapters from two books were analyzed by means of Rodger's inductive approach
Results: The results of this study showed that, critical thinking in clinical nursing have 3 antecedents and 6 attributes including Use of nursing process in clinical situation, emphasizing on holistic and comprehensive performances, Use of different patterns in order to achieve understanding, Using emotional intelligence skills in predisposing clinical situations, predisposing factors for critical thinking and elements of critical thinking. Achievement of critical thinking leads to positive outcomes such as effective and patient-centered care, creativity, evidence based practice and professionalism
Conclusions: The result of this study let to development of a clear and comprehensive definition of critical thinking in clinical nursing. This definition can correct many misconceptions and misuses of the concept of critical thinking. The findings also can help clinical nurses to create a framework and guidelines for effective clinical performance. This framework can, guarantee the competency in nursing
RESUMO
Psoriasis is an unpredictable, chronic, cutaneous disease with recurrence period that could lead to disability and psychosis. Evidence shows that in addition to routine therapeutic procedures implementing self-care program can contribute to reduction of complications as an inexpensive method. Hence, this study was conducted with the aim of investigating the effect of self-care program on relief of the disease complications in Tehran in 2002. This quasi-experimental study [before and after] was carried out on 50 patients. Self-care program was performed in different fields [food, medicine, bathing, washing, type of clothing, temperature, ] through face to face education and role playing and the cases were investigated in terms of symptom severity [skin dryness including splitting and flaking itching and existence of new plaque] every two weeks for three months. To collect data questionnaire, self-reporting check list, observational check list with Likert scale and correlation of 92.5% were used whose validity had been confirmed through content validity. The data analysis was performed using t-test and Wilcoxon. The results showed that 64% of the studied patients were male, 54% employed, 72% married and 42% had university degrees. 34% were 11-20 years old with the mean age of 11.9. The results indicated that the mean skin splitting severity decreased from 2.34 to 0.04%, flaking from 4.48 to 0.5, itching from 2.5 to 0.54 and area of lesion from 81.77 to 27.33 after intervention [P=0.0001]. The comparison of behavior before and after intervention showed that the extent of all self-care behaviors increased significantly [P=0.001]. The research results show that implementation of self-care program reduces the severity of skin symptoms. Thus, administration of this inexpensive, accessible program in care plans of patients to lower the physical, mental, familial, and social problems of patients is recommended
RESUMO
Background: Many studies about nursing managers' behaviors and job satisfaction show that managers with effective behaviors and use of participative management can empower the nurses and thus causes the enhancement of job satisfaction. This article was conducted to evaluate the effect of participative management based on quality circles on nurses' job satisfaction
Materials and methods: This quasi experimental study with before - after was conducted to evaluate the effect of participative management based on quality circles on nurses' job satisfaction in CCU of army, hospital in 1383[2004] . Samples of research consisted of all CCU nurses [17 individual] data gathering tools included a demographic questionnaire and questionnaire for determining nurses job satisfaction that designed based on Fredric Hertzberg theory that consisted of 34 items which 17 items were due to hygiene factors and 17 items were due to motivation factors. Before intervention job satisfaction was determined, participative management program based on quality circles performed. After intervention job satisfaction was determined again. Then before and after mean average score of nurses job satisfaction was compared the results are assessed through SPSS software
Results: Findings indicate that mean average score of nurses job satisfaction [total average score of hygienic factors and motivation factors] improved from 71% to 97/35%. Also, findings showed significant difference between mean average score of job satisfaction before and after intervention with T test [p<0/001]. Findings showed that there isn't any relationship between demographic characteristics and job satisfaction. Therefore hypothesis of research as; participative management based on quality circles causes the enhancement of nurses' job satisfaction was verified
Conclusions: Participative management based on quality circles lead to some changes in the physical work environment and supportive methods of managers especially head nurses. That causes enhancement of nurse's job satisfaction