ABSTRACT
Background and Purpose: This study was undertaken to assess the psychometric properties of the Perceived Barriers to Healthcare-Seeking Decision (PBHSD) scale in Iranian patients with acute coronary syndromes (ACS). Methods: In this methodological study conducted from February to June 2022, 255 patients with ACS completed the Farsi version of the PBHSD scale. The study focused on evaluating the face, content, and construct validity of this scale. Additionally, reliability was assessed through measures of internal consistency, including Cronbach's alpha (α) and McDonald's omega, and stability through test-retest analysis. Results: The mean age of the patients in the study was 47.12 (SD = 17.25). Construct validity analysis revealed a single independent factor with an eigenvalue greater than 1, explaining 61.23% of the extracted variance. Cronbach's α and intraclass correlation coefficient were both greater than 0.70 that proved validity of the PBHSD scale. Conclusions: The study's findings indicate that the Farsi version of the PBHSD is both valid and reliable. Consequently, it can be effective to assess and evaluate healthcare-seeking decisions in Iranian patients with ACS.
ABSTRACT
BACKGROUND: The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care. METHODS: This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived. RESULTS: The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care. CONCLUSION: Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.