[Nursing knowledge development in the age of postmodernism]

Introduction: The knowledge of nursing is an essential part in nursing practice. Nursing knowledge, over the years influenced by philosophical thought, and has been changed a lot. The main aim of this article is, exploring the development of nursing knowledge in the age of postmodernism

Method: To find relevant sources, library studies and review the books available databases include [CINHAL], [Blackwell], [Proquest], [science direct], [Ovid], [Magiran], [web of science], [pub med] from the Tehran University of Medical Sciences Electronic Library and available book in the faculty of nursing library were searched by keywords [postmodernism] [knowledge development], [science development], [nursing knowledge] [nursing science] separately and in combination in the title, abstract and keywords. [36] Full Article and [10] relevant books from 1990 to 2012 were used as the source

Results: Development of nursing knowledge is obvious in research methodology, intuition, and health care service. All these are because of postmodern bases such as pluralism, relativism, met narrative, and discourse

Conclusion: Being aware of development of nursing knowledge provide a new vision for professionals in nursing that lead to professional progress and promotion in nursing practice

[Developing and psychometric properties check list of clinical competency in mental health nursing students]

Introduction: One of the challenges in the medicine education system is evaluation of clinical competency of students. Evaluation of students in clinical education courses sometimes is not following a certain principles and also it is not clear that how much they reach to educational objectives at the end of courses. Aim of this study was developing and psychometric properties assessing psychometric properties of check list of clinical competency in mental health nursing students

Methods: This study was methodological approach. Participants were faculty members, head nurses and nurses who work in psychiatric wards and students [undergraduate and master sciences] of Medical Sciences universities of Iran. Based on entry criteria, sampling approach was depending on objective. Domains of tool developed with use of results of first step of research[qualitative part] in addition to study of valid references this filed .After developing primary check list, stages of psychometric properties including determination of validity[content and facial] and reliability[internal consistency and inter-observer correlation] developed. In order to analyze the data descriptive and analytic statistics with SPSS [20th version] were used

Results: Check list of "Clinical Competency of Mental Health Nursing Students" with 73 items was developed. Content validity ratio was. 83 and content validity index was. 98. Measurment of reliability with the use of internal consistency [Cronbach's alpha] was .98 and inter-observer correlation was.70

Conclusion: Check list of "Clinical Competency of Mental Health Nursing Students" in two issues include general and specific competencies with 73 items was developed .It seems for assessment of different dimensions of clinical competencies of mental health nursing students is appropriate tool

[Nursing as an art]

In the many definitions that are accompanied with nursing, in addition to the scientific aspect, art has always been mentioned. Since Florence Nightingale introduced nursing as an art, several theorists have emphasized the aesthetic aspect of nursing in their literature. However, many experts believe that the word "art" has been accepted in nursing without deep thought and criticism. To judge the statement: "Nursing is an art", it seems that it is necessary to review the similarities and differences of "art" concept in nursing and other fields literature. Art has a complex and multidimensional meaning that is the backbone of many theories presented; however, they each have their own strengths and weaknesses. Nursing has artistic properties; but this characteristic is referred to as folk art and not to specific features of art. In comparing these theories with the concept of art used in nursing, it is essential to note that art in nursing refers to skills of nursing. In other words, nursing is not a kind of fine art. From the aesthetic perspective, nursing can be easily defined as a form of art; however, we must put great importance in the inseparable words of "aesthetic" and "art of nursing". With such a connection, we are able to introduce and capture the true spirit of both art and nursing. In this article, we have reviewed the most important definitions and theories of art as a "specific term", and as "skill", where they have linked nursing to art. Moreover, we have discussed their similarities and differences

[Nurses' readiness in research utilization: moving toward evidence-based practice]

Research utilization is a mechanism for transferring the results of research into practice and improving the quality of care in nursing. The aim of this study was to determine nurses' readiness to utilize research needed for applying evidence-based practice. In this descriptive study, 375 nurses in all teaching hospitals affiliated with Tehran University of Medical Sciences were selected by stratified random sampling method. A 4-part questionnaire with open and close-ended questions including professional profile, research activities, research skills and access to research resources was used for data collection. Content as well as face validities and Cronbach's alpha for reliability [0.82] were identified. 85.9% of nurses had weak readiness in research utilization. Both research activities and skills were also low [71.4% and 82.7% respectively]. 44% of nurses had insufficient access to research resources. A significant relationship was found between nurses' educational level, participation in research activities as well as English language skills and their readiness in research utilization. Lack of skills and inaccessibility to research findings lead to weak readiness for research utilization. With respect to the importance of utilizing research findings, organizational and administrative support, continuing education programs, well-defined processes and pathways to facilitate research utilization need to be provided for nurses

[Coherence in qualitative research]

Coherence describes the fit between the aim, the philosophical perspective adopted, and the researcher role in the study as well as the methods of investigation, analysis and evaluation undertaken by the researcher. This review study aimed to elucidate one of the important qualitative methodology issues entitled coherence, which is usually undermined during a qualitative study. The authors logged on to some general and specialized search engines as well as conducted a library research in healthcare and social science textbooks to perform an in-depth study regarding coherence in qualitative research. The search resulted in 95 articles and 20 textbooks. In spite of the importance of coherence in qualitative methodology, 23 articles and 7 textbooks had more content regarding the subject, which were employed to write this paper. The gathered data were classified into 4 categories: the definition of coherence; the proofs for incoherence in qualitative methodology; the causes of incoherence; and, finally, the strategies for coherence improvement in qualitative methodology. Different factors may cause incoherence in qualitative research, which reduce the rigor and credibility of it. In addition, in the long run, it results in uncontrolled methodological diversities and inability to define criteria to judge qualitative research reports

[Clinical decision making process in last year nursing students: a qualitative study]

Although improving clinical decision making skills is declared as one of the main aims of nursing education, evidences show that it is not presented effectively within nursing education programmes. The present study aimed at exploring clinical decision making process among last year nursing student. Using qualitative method [Grounded theory], six focus groups and 12 sessions of participants' observation were conducted with a purposeful sample of 32 last year nursing students. The data were analyzed through constant comparative analysis. Participants believed competent clinical instructor, applicable knowledge, clinical experience; appropriate setting for clinical education and professional self confidence are the main influential factors on students' clinical decision making. Acquiring professional self confidence is the most important factor in experiencing and learning clinical decision making. The study revealed nursing student believe that not acquiring applicable knowledge and appropriate clinical experiences have impact on low professional self confidence required for clinical decisions. Therefore they are not satisfied with their gained competencies in clinical decision making. The result of this study showed that nursing students were not satisfied with the competency in clinical decision making. They experience low professional self-confidence as a result of feeling incompetent due to lack of applicable knowledge, suitable clinical experiences and conductive clinical learning climate

[Critical thinking skills and critical thinking dispositions in freshmen and senior students of health care management]

Nowadays, experts introduce critical thinking as the main outcome of higher education and consider teaching "how to think" as the basis for learning. This study compares the critical thinking skills and critical thinking dispositions in freshmen and senior students of health care management. This descriptive cross-sectional study was performed on a sample of 60 freshmen and senior students of health care management. The data gathering tools included California critical thinking skills test, as well as California critical thinking dispositions inventory. Data was analyzed by SPSS software using descriptive statistics, T-test, and Chi[2]. The mean and standard deviation of critical thinking skills total score in freshmen and senior students was respectively 11.55 +/- 2.18 and 11.21 +/- 2.59, which was in the normal limit for both. There was no significant difference between the freshmen and senior students' score patterns. Considering critical thinking disposition total score, the mean and standard deviation in freshmen, was 282.37 +/- 27.93 and in senior students was 289.64 +/- 21.13. There was a significant difference between the score pattern of critical thinking disposition in freshmen and senior students. The scores of senior students were higher than freshmen scores. The total score of critical thinking skills achieved by students was in a normal limit. Also, the total score of critical thinking dispositions revealed the students' positive tendency. But, with regard to the reported scores from other similar schools of the world, administrators and teachers should pay more attention to their educational planning in developing cultivating critical thinking skills

[ extent of research utilization in nursing clinical practice, Tehran, Iran]

Research utilization is an important way to extent the knowledge in nursing practice. It empowers the nursing profession. Research utilization is a new paradigm in Iran's nursing care. This study aimed to assess the extent of research utilization in nursing clinical practice in Tehran, Iran. This is a cross-sectional study. The clinical nurses with at least one year of work experience were selected through a multistage stratified sampling method. They completed a five-sectioned self-report questionnaire. The scores were categorized into high, intermediate, and low. Data were analyzed using descriptive statistics and Chi-Square test in SPSS. Findings revealed that the research utilization in 66.9% of the nurses was low. There was significant relationships between the extent of research utilization and the level of education, professional condition, clinical setting, research activities, work shift, job satisfaction, and English language skills. The majority of nurses' practice is not according to the research findings. We need to find appropriate strategies to enable us to utilize the research findings

[Strategies in developing research based nursing practice: a review article]

Research utilization is the link between research and clinical practice which promotes the quality of care. Research-based practice is the main criteria to demonstrate how nurses implement the findings of research and how provided healthcare is based on research findings. In spite of the increased outputs of research, research implementation hasn't gone so fare compare to growing nursing research quantitatively. Now, it's time to shift the nursing focus to empower the research implementation in care. The present study is a review article aimed at describing the strategies used in developing research based practice in nursing. The published articles and theses reports discussing research utilization and evidence-based practice in nursing during last decade were systematically searched. The review was carried out using the databases of ISI, CINAHL and MEDLINE which cover a wide range of journals and literature. The literature in Persian was searched in SID databases. 51 research studies regarding strategies in research based practice in nursing were chosen to be included in the study. The results revealed the strategies recommended based on research implementation' models and two main concepts of acceptance and preparation. Using these strategies could facilitate research utilization in nursing. Successful research-based practice requires a suitable, supportive for creativity and motivating environment, having resources available and valuing persons' performances. Accessing the valid research outcomes, having competency in conveying and utilizing the results in practice and a supportive context which creates creative atmosphere and research mind is demanded in implementing research-based practice in nursing

[Management by objective approach in nursing performance appraisal and its impact on quality of nursing care]

Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality. This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed. Significant difference was found between quality of nursing care in the experiment and control units [P<0.001]. Quality of nursing care was significantly different before and after intervention in the experiment unit [P=0.009]. Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care

[Nurses attitudes toward research utilization in clinical practice]

Research utilization is a new phenomenon in Iran and the Iranian nurses tend to practice based on evidences. The objective of this research is to investigate nurses' attitude toward research utilization. This research is an analytical-descriptive study. The sample included 410 clinical nurses and instructors who were selected through multistage stratified sampling method. Data were gathered using a two-section questionnaire and analyzed using statistical package for social sciences [SPSS]. 91.2% of respondents believed in using research findings in practice. 77.6% of nurses agreed with the following statement: "Research is not applicable in practice". Furthermore 88.3% agreed that" Research helps to build a scientific base for nursing". The majority of respondents had positive attitude toward research utilization. There was a significant difference between attitude and kind of professional activity, setting and research activity. It seems having positive attitude toward research utilization is not sufficient for applying research results in practice. In order to utilize the research findings, more relevant research in this field of nursing is required

[ facillative and preventative factors of implementation of research findings in nurses clinical practice]

Research utilization provides quality and cost- effective care, optimizing patient outcomes and enhancing the credibility of nursing. Despite of increase in the amount and quality of nursing research, the conduct of research and use of its results remains poor. In Iran one of the most important barriers of research is related to research utilization. The aim of this study is to identify the barriers and facilitators of research utilization in nursing practice. The study used a descriptive- analytic design. The questionnaire was divided into two sections: The former asked for information on the academic and professional profiles of respondents, the latter was based on the BARRIERS Scale. In addition there was one open -ended question to measure the facilitators of research utilization. Content and face validity was further enhanced by submitting it to nursing researchers. In factor analysis procedure four factors were extracted. The factors were labeled as: organization barriers and limitations, Quality of research, Nurses' values, awareness and skills, Communication of research. Factor loading for barrier item "the nurse is unaware of the research" was not included under factor headings. The top three barriers were The nurses do not have time to read research, the facilities are inadequate for implementation and the nurses do not feel they have enough authority to change patient care procedures. All the participants suggested facilitators to increase research use The most frequently mentioned facilitators were related to human resources, individual and organizational factors. The most dominant findings were related to organizational support. The top three barriers mentioned by the participants reflect a traditional organizational culture which hinders professional autonomy. Organizations need to ensure that facilities are provided and give the authority to the nurses to change the practice based on research

[ analysis of status of added colors to dried sweets in South of Tehran using thin layer chromatography]

Foodstuffs additives are a general term for materials that are added to the foodstuffs in order to increase durability and to improve the appearance, composition, taste and food nutritional value. Colors are classified in this group and are added to foodstuffs in order to increase their attraction. Colors may cause illness such as allergy, rash and hyper activation in children and also they may debilitate the Immune system, Anaphylaxis reactions may also occur and they may have cancerous effect. The aim of this survey was to analyze status of added colors to the dried sweets which are produced in south of Tehran city. 191 samples of dried sweets were randomly collected and analyzed from south of Tehran areas. First, the samples were de-colored by Clorhidric Acid, and then were analyzed after refining by Thin Layer Chromatography [T.L.C] method. Samples were identified by taking Retention Factor [RF values] into consideration. 93.2 percent from the total samples contained colors. Among chromatic samples, 42 samples [22%] out the total samples, contained artificial, non-edible colors and 96 samples [50.3%] from the total samples contained artificial and edible colors [for Industrial Producers] and 40 samples [21%], contained natural colors. Sunset yellow color was detected more than other added colors in sweets. Low costs, stability, PH, purity, and environmental conditions, motivate the producers for high utilization of edible colors without considering their possible hazards and/or their edible quality aspects. It is suggested that, based on the findings of this study and high consumption of colors

Facilitating and impeding factors in health promotion for patients with chronic illness: a qualitative study

Chronic illnesses are by definition long lasting and without a definitive cure. In Iran, like in many other developing countries, chronic diseases are not merely diseases of the elderly. They also affect a much higher proportion of people during their prime working years and more so than in the developed countries. Therefore, it is essential to understand the factors influencing the health promotion of patients who suffer from chronic illnesses in order to be able to advance a sense of well-being amongst this patient group. A content analysis with a qualitative approach was conducted and 35 patients with chronic illness were interviewed. Six main themes emerged from the collected data, all of which affected the health promotion in patients. A positive interaction of the aforementioned factors can lead to a better health attainment, whilst a negative effect may result if these factors operate in the opposite direction

[Factors affecting the process of obtaining clinical competency]

Nurses form the most significant sector of the health care provision and play a fundamental role in providing on-going quality care for patients. To attain clinical competency, it is essential to understand the factors influencing it. Due to the fact that clinical competency is directly affected by specific features of the educational and health care system and the medical training within each country, it is necessary to assess the factors influencing clinical competency. This study was based on the Grounded Theory method. The sample of 36 comprised of clinical nurses, as well as trainers and managers within the Ministry of Health and Medical Training, Nursing and Midwifery faculties, hospitals and members of the Nursing Council in Tehran. Data was obtained through semi-structured interviews, which were recorded and subsequently transcribed. The analysis was carried out by the Straus and Corbin method. In this study, personal factors were identified as one of the contextual factors affecting clinical competency. The respondents branded this category as "the internal and personal factors". This included a significant number of sub-categories such as education and skill, moral values, consciousness responsibility and accountability. Another category was identified as "the external and organizational factors" which included categories such as educational and clinical environments, work license, control and supervision and effective educational system. The clinical competency process resulted from the interaction between three factors; ethics, effective experience and environmental factors

Clinical decision-making: a way to professional empowerment in nursing

The dynamic and uncertain nature of health care environment requires nurses to be competent decision makers and to respond to the clients needs. Recently, the public and the government have criticized Iranian nurses because of a low quality patient care. However, the nurses' views and experiences concern- ing the factors affecting their clinical practice and clinical decision making have rarely been investigated. Therefore, this research tried to study the viewpoints, perceptions and experiences of Iranian nurses concerning the factors affecting their clinical decision making. A qualitative research with Grounded theory methodology was used to study the participants' lived experiences and their viewpoints regarding the factors affecting their clinical practice and clinical decision making. Un-structured interviews and participant observation methods were used to gather the data. Thirty eight participants were interviewed and twelve sessions of observation by taking field notes were carried out. Constant comparative analysis method was used to analyze the data. Five main categories emerged from the data, indicating the participants' points of view. "Being competent" and "feeling self-confident" were the most important internal factors, and "organizational culture", "nursing education", and "supporting structures" were considered as the most important external factors affecting their clinical decision -making. As participants in this research implied, although being competent and self-confident were important factors in nurses' clinical decision making, organizational culture and structure were the core variables affecting other variables. Nurse managers and nurse educators are responsible for identifying barriers and enhancing factors within the organizational structure that facilitate nurses' clinical decision-making

[ effect of nurses education with method Group discussion on the quality of nursing care in patients with myocardial infarction]

Background: The aim of the research which is a Quasi- experimental study is determining the effect of nurses education with method group discussion on the quality of nursing care in patients with Myocardial infarction

Materials and Methods: All nurses and 45 patients selected based on convenince sampling in CCU ward of elected teaching hospital in Tehran city. The instrument for gathering data was observational checklist for nurses operation, checklist nursing documentation and satisfication patient's questionnaire. After data collection, nurses education with method group discussion applied within eight sessions. The topic of sessions, consists of: Thinking and doing in nursing, Decision making skills, Critical thinking, Problem solving and Teamwork approach in nursing care for Myocardial infarction. Then, on month after, evaluated and comparad quality of nursing care

Results: The findings showed that 20% of nurses before group discussion had good operation quality, whereas after sessions, 80% had good operation quality. The results revealed 53.3% of documentations was bad quality, whereas after education 28.9% of nurses had good documentation. About patients satisfication indicated 35.6% of patients before education were unsatisfied and only 2.2% were satisfied, whereas 31.1% of patient's were satisfied after intervention. Mean score of operation was 4.6 that prompted to 38 after intervention. Mean score of doumentation was 16.2 that promted to 28.18 after intervention. Operation and documentation were not associated with nurses demograghic chracteristics. Like wise, patient's demographic was not associated with their's satisfication. On the basis of growth test, about nurse's operation, effectiveness group discussion was 54% and about nurse's documentation was 73.9% and about patients satisfaction was 48.01%

Conclusions: Thus, hypothesis under title "quality of nursing care in patients with Myocardial infarction to incresse after intervention is confirmed. Perfectly, this study utilized importance of using of method of innovative education in Medical- surgical and critical care wards

[ effect of nurses education with method group discussion on the quality of nursing care in patients with myocardial infarction]

Background: The aim of the research which is a Quasi- experimental study is determining the effect of nurses education with method group discussion on the quality of nursing care in patients with Myocardial infarction

Materials and Methods: All nurses and 45 patients selected based on convenience sampling in CCU ward of elected teaching hospital in Tehran city. The instrument for gathering data was observational checklist for nurses operation, checklist nursing documentation and satisfaction patient's questionnaire. After data collection, nurses education with method group discussion applied within eight sessions. The topic of sessions, consists of: Thinking and doing in nursing, Decision making skills, Critical thinking, Problem solving and Team­ work approach in nursing care for Myocardial infarction. Then, on month after, evaluated and compared quality of nursing care

Results: The findings showed that 20% of nurses before group discussion had good operation quality, whereas after sessions, 80% had good operation quality. The results revealed 53.3% of documentations was bad quality, whereas after education 28.9% of nurses had good documentation. About patient's satisfaction indicated 35.6% of patients before education were unsatisfied and only 2.2% were satisfied, whereas 31.1% of patient's were satisfied after intervention. Mean score of operation was 4.6 that prompted to 38 after intervention. Mean score of documentation was 16.2 that promted to 28.18 after intervention. Operation and documentation were not associated with nurses demographic characteristics. Like wise, patient's demographic was not associated with their's satisfaction. On the basis of growth test, about nurse's operation, effectiveness group discussion was 54% and about nurse's documentation was 73.9% and about patient's satisfaction was 48.01%

Conclusions: Thus, hypothesis under title "quality of nursing care in patients with Myocardial infarction to incresse after intervention is confirmed. Perfectly, this study utilized importance of using of method of innovative education in Medical- surgical and critical care wards