Psychometric properties of the persian version of the nursing clinical reasoning scale.

AIM: The aim of this study was to translate the Nursing Clinical Reasoning Scale (NCRS) into Persian and evaluate its psychometric properties. DESIGN: This study was a methodological and cross-sectional study. METHODS: This methodological study was conducted in 2020 in a teaching hospital. After obtaining necessary permission from its developers, NCRS was translated into Persian through the method proposed by the World Health Organization. Then, its face, content, and construct validity and reliability were assessed. For construct validity assessment through exploratory and confirmatory factor analyses, 300 nurses (two 150-nurse samples), who had randomly been selected, completed the instrument. Reliability also assessed through the internal consistency and the stability methods. Data were analysed using the SPSS (v. 20.0) and the AMOS (v. 5.0) software. RESULTS: The content validity indices of NCRS and its items were 0.97 and more than 0.79, respectively. Exploratory factor analysis revealed an assessment and confirmation factor and an implementation and reflection factor for the scale which together explained 57.30% of the total variance. Confirmatory factor analysis also confirmed this two-factor structure (χ2 /df = 2.11, NNFI = 0.952, RMSEA = 0.053, CFI = 0.91, GFI = 0.94, IFI = 0.95, and NFI = 0.96). The Cronbach's alpha and the intraclass correlation coefficient values of the scale were 0.96 and 0.94, respectively. PUBLIC CONTRIBUTION: The Persian NCRS can help nursing policy makers and mentors identify the need for developing nurses' and nursing students' CR skills and implement need-based educational courses to improve these skills. Moreover, it helps determine whether the educational programmes are effective in improving nurses' CR skills and clinical competence.

Social participation among Iranian community-dwelling older adults: A grounded theory study.

Background: Iran is among the countries whose older adult population is increasing rapidly. The social dimension of health in older adults affects their other existential dimensions. Social participation is a key determinant of health for older adults. This study aimed to explore the process of social participation among community-dwelling older adults. Methods: This is a qualitative study with the grounded theory approach. The study population consisted of eligible community-dwelling older adults. The participants were initially selected by purposeful sampling. Data were collected through semi-structured interviews. The time and place of the interviews were arranged in discussion with the participants in advance. Lincoln and Guba's criteria were used to assess the scientific accuracy and validity of the study. The university ethics committee issued the ethics code for the study. Data were analyzed using Corbin and Strauss approach. Result: The results of interviews with 15 participants, in this study, led to the emergence of 12 main categories and 32 subcategories with the core concept of "older adults' desire to stay active". Social participation of older adults was a concept clarified with the efforts of older adults to stay active in the community. Categories are fully described in the manuscript. Conclusion: Staying active is one of the main concerns regarding the concept of older adults' social participation. The existence of conducive underlying factors, such as a participation-seeking older adult, family, and society, assists in the development of social participation at various levels and multiple forms among older adults.

Barriers to the Development of Clinical Reasoning Skills among Coronary Care Nurses: A Qualitative Study.

Background: Clinical Reasoning (CR) is a main professional competency for nurses which have significant contribution to sound clinical performance in critical clinical conditions. Nonetheless, evidence shows that nurses do not have the necessary competencies and thinking skills for managing complex conditions in critical care units. This study aimed at exploring the barriers to the development of CR skills among coronary care nurses. Materials and Methods: Using conventional content analysis, this qualitative study was conducted in 2020 in the Coronary Care Unit (CCU) of Heshmat Subspecialty Heart Center in Rasht, Iran. Participants were 15 nurses, head nurses, nursing supervisors, nursing managers, and nursing instructors. Data were collected using semi-structured interviews and were analyzed using conventional content analysis. Results: The four main categories of the barriers to CR skill development among nurses were limited professional development, inefficient educational program, ineffective professional interactions, and limited professional self-efficacy. Conclusion: There are different personal, educational, professional, and interprofessional barriers to the development of CR skills among CCU nurses. Study findings can be used to develop effective strategies for supporting and developing nurses' CR skills.