ABSTRACT
Psychiatric hospitals and centers have more complex conditions than other hospitals in responding to emergencies, given the differences in the design of their buildings and in non-structural elements. This is a qualitative study aimed at reviewing and investigating the experiences and challenges faced by psychiatric hospital staff in response to different fire incidents. A phenomenological approach was employed to conduct the study, believing that human experiences and beliefs are substances in phenomena and can be understood and examined. The contents of interviews and focus group discussion (FGD) sessions were extracted and classified into five categories, 14 themes, and 49 sub-categories. Many psychiatric hospitals in Iran are not ready to respond properly to incidents like fires. The study revealed that in order to ensure appropriate management of incidents and disasters in the hospitals, it is necessary to focus on five areas called the 5s framework, which includes structures, staff, supplies (facilities, equipment etc.), sick persons and systems. This framework is proposed to enhance preparedness, reduce vulnerability, and provoke an effective response to incidents in psychiatric hospitals.
La réponse à une urgence est plus compliquée qu'ailleurs dans les hôpitaux psychiatriques, en raison de contraintes architecturales comme fonctionnelles. Cette étude a pour but d'explorer les expériences et les difficultés rencontrées par le personnel des hôpitaux psychiatriques face à un incendie dans leur institution. L'approche phénoménologique permet d'évaluer le rôle des croyances et de l'expérience dans ce type de situation. Les résultats d'interviews et de groupes de discussion ont pu être classées en 5 catégories, 14 thèmes et 49 sous-catégories. De nombreux hôpitaux psychiatriques iraniens ne sont pas à même de répondre correctement à un incendie. Pour y parvenir, il faudrait organiser la réponse autour de 5 thèmes : architecture, personnel, patients, équipement et systèmes de réponse. Ceci afin d'améliorer la préparation, diminuer la vulnérabilité et in fine obtenir une réponse efficace en cas d'incendie.
ABSTRACT
BACKGROUND: Healthcare providers have been found to have limited knowledge and skills in interacting with people living with HIV. These factors can adversely affect providers' practice, jeopardize their safety and compromise the care of the patients. AIMS: This study aimed to explore the experiences of Iranian nurses who were caring for patients with HIV. METHODS: A focused ethnography approach was used. Participants consisted of 12 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences and recruited by purposeful sampling. Semi-structured interviews, field observations and field notes were used for data collection. Data were analysed employing content analysis. FINDINGS: Three main themes emerged from the analysis of the participants' experiences of providing care to patients with HIV: 'excessive fear of being infected', 'concerns about the possible consequences' and 'lack of self-confidence in care provision'. DISCUSSION/CONCLUSION: Nurses have experienced a great deal of fear of self and cross-contamination when providing care to people living with HIV. Social stigma and discrimination against people living with HIV amplified the nurses' experience of fear. Providing appropriate education and training for nurses can improve their attitudes, emotions and self-confidence while providing care to such people and increasing the quality of care provided. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Planning more educational programmes focusing on improving their misunderstandings about HIV could result in positive outcomes: for nurses to provide high-quality care and for people living with HIV who receive this care. The healthcare system should consider the culture of care provided by nurses to these people.
