Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study

PURPOSE: The purpose of this study is to explore problems of clinical nurse performance appraisal system. METHODS: This study employed a descriptive qualitative approach. The participants were purposively selected from clinical nurses working across all of the hospital units in a large metropolitan teaching hospital in Tehran, Iran in 2012. Data were collected using five focus group interviews, which were audio taped. The number of participants in each group ranged from 7 to 10. The semi-structured interviews were guided by a set of nondirective questions, and continued until the data reached saturation. Data were analyzed using framework analysis. RESULTS: Four major themes regarding the problems of clinical nurse performance appraisal system emerged from the analysis of textual data. These themes were contextual problems, problems related to performance appraisal structure, problems related to performance appraisal process and those related to performance appraisal results. CONCLUSION: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

Promotion of self-transcendence in a multiple sclerosis peer support groups

Self-transcendence can organize the challenges of multiple sclerosis patients to achieve and maintain a constant state of well-being and sense of integrity in the disease process. As a research based on self-transcendence didn't done in Iran, the present study was conducted to evaluate the effectiveness of peer groups on promoting self-transcendence level in multiple sclerosis [MS] patients. This study is a before and after quasi-experimental study that was conducted on 33 patients with confirmed MS participated in three peer support groups: 10 men in male group, 11 women in female group and 12 men and women in mixed group. Eight weekly sessions and each session was 2 hours were held. Data collection tool was Self-Transcendence Scale [STS] with 15 item and Cronbach's coefficient was 0.68 that after modifying, it increased to 0.81. Patients completed self administered questionnaires pre- and post of sessions. Results showed that peer support groups promote the self-transcendence [p=0.001] with increases in mean self-transcendence scores in all 3 groups [men group: 0.008, women group 0.005 and mixed group: 0.003]. Comparing scores before and after intervention demonstrated that self-transcendence increased equally in all groups. The results showed an improving in self-transcendence in peer support group participants at the end of the intervention. The results can be used in areas of nursing education and management. It is proposed that the self-transcendence assessment to be done in other chronic disease in order to evaluate its efficiency

Development and validation of self-care requisites assessment tool for prevention of diabetic foot ulcer

Assessment of patient's needs is the first step for recognizing problems and prevention of complications. Assessment tools are needed in order assess needs, and plan nursing care to prevent complications such as diabetic foot ulcer .The purpose of the present study was to develop self-care requisites assessment tool for prevention of diabetic foot ulcer and examine its validity and reliability. This methodological study consisted of two phases, phrase I was development of the comprehensive assessment form, for which a qualitative study and a literature review was conducted. Phase 2consisted of testing the instrument for validity and reliability. In qualitative study unstructured interviews were conducted with 8 patients with type 2 diabetes. Validity of the instrument was measured by content validity, concurrent validity [criterion related validity] and construct validity. A sample of 153 type two diabetic patients were selected to conduct factor analysis of the tool. Reliability was confirmed by internal consistency. Data were analyzed by SPSS statistical software. The initial form consisted of 103 items. Final version of self-care requisites assessment form for preventing diabetic foot ulcer consisted of 43 items with 5 sub scales. Validity was established for content, construct and concurrent validity. Content validity was assured by a panel of experts .Concurrent validity was measured by comparing the scores from assessment tool with self-care agency and diabetic clients' quality of life scales, which demonstrated an acceptable correlation among the scores. Internal consistency reliability of the tool was demonstrated with Cronbach's a coefficient ranged from 0.70 to 0.89 for subscales, the overall test re test reliability was 0.97. The self-care requisite assessment tool for prevention of diabetic foot ulcer is a reliable and valid instrument to measure self-care needs for prevention of diabetic foot among individuals with type two diabetes mellitus