Clinician's and women's perceptions of individual barriers to vaginal birth after cesarean in Iran: A qualitative inquiry.

BACKGROUND: High rate of repeat cesarean section and its complications are the results of cesarean tsunami in the last two decades in Iran. Vaginal birth after cesarean (VBAC) is an important alternative for repeat cesarean. However, the rate of VBAC in Iran is very low subject to some organizational and individual barriers is very low. This study explored the clinician's and women's perceptions of individual barriers to achieve VBAC. METHODS: In this conventional content analysis, 28 semi-structured interviews and one focus group discussion was conducted with health care providers including gynecologists, midwives and family physicians as well as prior cesarean section mothers attended one of the women's hospitals in Mashhad, Iran in 2017. Participants were selected through purposive sampling considering the strategy of maximum variation. Data were analyzed according to Graneheim and Lundman (2004) method using MAXQDA.10 software. RESULTS: The theme of "obstacles to acceptance and committed actions" emerged from two categories of "psychological barriers" and "operational barriers". Psychological barriers included 'sense of danger", "financial displeasure" and "negative attitude"; whereas, operational barriers consisted of 'barriers to decision making' and 'indolence'. CONCLUSION: Improving women's attitude via maternity care promotion, creating supportive environment, informing mothers about choice of birth mode and empowering them in shared decision making could influence women's VBAC request. Also organizing VBAC care team and creating motivations in medical team and hospital directors through reporting of research project outcomes on safety and benefits of VBAC could affect the VBAC rate.

Conflict management styles among Iranian critical care nursing staff: a cross-sectional study.

BACKGROUND: Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. OBJECTIVE: The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. METHODS: In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. RESULTS: Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. DISCUSSION: Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.

A qualitative content analysis of knowledge storage in nursing education system.

BACKGROUND: The need for effective management of intellectual and academic assets is constantly growing. The nursing educational system should be considered as a storage of knowledge since it is deposited in the nursing educational system in the form of intellectual investment. OBJECTIVES: The purpose of the present study was to explore nursing knowledge storage in the nursing educational system. MATERIALS AND METHODS: The participants of this study consisted of eight nursing educators and five students. The inductive content analysis method was used in this research. Participants were interviewed through the semi-structured method. Data analysis was done by five stage framework approaches. The trustworthiness of the study was ensured through validity and acceptability criteria. RESULTS: Data analysis showed that nursing educators and students were involve in teaching and learning activities by storing knowledge in subjective and objective forms. Knowledge was gained through the different educational activities of the nursing educators and through contact with their peers. Moreover, the nursing students gained knowledge for better learning and a more knowledgeable and advanced performance with the help of the educators. CONCLUSIONS: This study revealed the main components of knowledge storage. An enhanced preservation of explicit knowledge is recommended in the nursing educational system so that in the future, students and educators can easily access the same knowledge from storage sources and not from individuals who might be carrying only a single experience of the subject.

Knowledge creation in nursing education.

In today's society, knowledge is recognized as a valuable social asset and the educational system is in search of a new strategy that allows them to construct their knowledge and experience. The purpose of this study was to explore the process of knowledge creation in nursing education. In the present study, the grounded theory approach was used. This method provides a comprehensive approach to collecting, organizing, and analyzing data. Data were obtained through 17 semi-structured interviews with nursing faculties and nursing students. Purposeful and theoretical sampling was conducted. Based on the method of Strauss and Corbin, the data were analyzed using fragmented, deep, and constant-comparative methods. The main categories included striving for growth and reduction of ambiguity, use of knowledge resources, dynamism of mind and social factors, converting knowledge, and creating knowledge. Knowledge was converted through mind processes, individual and group reflection, praxis and research, and resulted in the creation of nursing knowledge. Discrete nursing knowledge is gained through disconformity research in order to gain more individual advantages. The consequence of this analysis was gaining new knowledge. Knowledge management must be included in the mission and strategic planning of nursing education, and it should be planned through operational planning in order to create applicable knowledge.