Barriers to effective clinical supervision from the perspective of nurses: A descriptive qualitative study.

AIM: The present study aimed to explain the barriers to effective clinical supervision from the perspective of nurses. DESIGN: Qualitative descriptive study. METHODS: The present study enrolled 21 nurses selected by purposive sampling. Data were collected through semi-structured interviews, which were digitally recorded and immediately transcribed verbatim, and analysed using content analysis method. RESULTS: From the nurses' perspective, the influential barriers included poor academic, ethical, communicational, professional competencies at the passive management level, defects in supervision prerequisites, conventional beliefs, ineffective organization, shortage of workforce at the level of inappropriate context, lack of motivation and poor accountability at inadequate professional maturity level. PUBLIC CONTRIBUTION: The following items affect how clinical supervision is implemented: Motivation, accountability at the personal level, sufficient workforce, conducive conditions, effective organization of resources, and preparing the individual for supervision at the organizational level to implement effective clinical supervision.

Health-care workers' experience of stressors and adaptation strategies for COVID-19: A qualitative research.

BACKGROUND: The mental health of health-care workers with their unique role in responding to the COVID-19 pandemic is strictly essential. Hence, to react effectively to the pandemic, it is essential to collect further data on the stressors and adaptation strategies. The aim of this study is to explain the health-care workers' experiences of stressors and adaptation strategies used during the COVID-19 pandemic outbreak. MATERIALS AND METHODS: A qualitative content analysis approach was employed in this study, with semi-structured in-depth interviews. Nineteen health-care workers participated in the study by purposeful sampling method. The study setting included selective educational hospitals that admitting patients infected with COVID-19. The data were analyzed using content analysis method. RESULTS: Stressors were classified under four major categories: idiopathic, i.e., arising from unknown causes, individual and familial, stressful work environment, and socially imposed stressors. The adaptation strategies were classified under inactive and active adaptation strategies. CONCLUSIONS: The stressors include the stresses arising from the unknown nature of the disease, stressful work environment, individual and familial stresses, and the socially imposed stresses. The adaptation strategies include inactive and active adaptation strategies. Identification of these factors can help workers and management to effectively react to the pandemic.

Aspects associated with waterpipe smoking in Iranian youths: a qualitative study.

BACKGROUND: Waterpipe is one of the oldest methods of tobacco smoking, which has become the public health challenge, especially in the Eastern Mediterranean countries such as Iran. This study aimed to investigate the waterpipe smoking (WPS) in the young people of Kermanshah in 2020, using a qualitative method. METHODS: This was a qualitative study conducted with the approach of content analysis. Participants were young waterpipe user aged 17 to 25 years selected by purposeful sampling method in Kermanshah city, located in the west of Iran. Data were collected through semi-structured interviews in face-to-face and audio-recorded methods based on an interview guideline during June to August 2020. Then researchers transcribed verbatim and analyzed the content of the interviews thematically. RESULTS: In this study, 23 young people who were waterpipe users at the time of the study participated. The results showed that social aspects in three sub-categories were involved in WPS including "socio-cultural aspects", "socio-environmental aspects", and "social relations". Individual aspects of waterpipe use as second category also consisted of two sub-categories including "motivational aspects" and "lack of psycho-protective aspects". CONCLUSIONS: It seems that the implementation of the policy of reducing access to waterpipe in public environments is effective in reducing waterpipe consumption. It is suggested that educational and interventions, based on targeted models and theories be implemented in order to increase young people's belief and perception on dangers of WPS, and to improve their self-efficacy to smoking cessation.

Health Care Failure Mode and Effect Analysis in the Operating Room Setting.

OBJECTIVES: Operating rooms (ORs) and surgical settings are potential sources of sentinel adverse events. To better understand the characteristics of errors in OR processes, we performed prospective risk analysis. METHODS: The study was mixed qualitative and quantitative research. We used the Healthcare Failure Mode and Effect Analysis (HFMEA) method to analyze the selected perioperative, operative, and postoperative processes in the OR via a 2-round Delphi technique. We identified the most prominent failure modes according to a Hazard Decision Matrix, analyzed and categorized proposed possible causes, and provided solutions to mitigate hazard scores. RESULTS: Ten important processes and 7 subprocesses within the OR were selected and mapped, and 187 failure modes were identified and scored on the basis of severity and probability. A total of 36 potential failure modes were highlighted as high-risk failures and moved to decision trees for further analyses. CONCLUSION: Developing policy for the familiarization of new personnel designing a checklist for accurate gases counting; drafting comprehensive presurgical posters; preparing all necessary equipment in difficult intubation; developing instruction for monthly checking of the OR equipment; and developing the evaluation criteria of staff performance are examples of solutions that are proposed to improve the quality of OR processes.

The framework for developing nursing specialist roles in the health care system of Iran.

BACKGROUND: A key step to the development of a roadmap for developing nursing specialist roles is to create its framework based on the immediate context. PURPOSE: This study aimed to create the framework for developing nursing specialist roles in the health care system of Iran. METHODS: This was a descriptive qualitative study. A purposeful sample of 81 nursing and nonnursing experts was recruited. The directed content analysis approach was used for data analysis. FINDINGS: The framework for developing nursing specialist roles in the health care system include eight main categories. These categories are role titles, prioritization of the necessary specialties, the necessary competencies of nurses at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators. DISCUSSION: Creating a context-based framework for nursing specialist role development based on the characteristics of each country is recommended.

Health promotion perception among health-care providers working in educational hospitals of Isfahan, Iran: A Qualitative study.

BACKGROUND: Although the World Health Organization has emphasized the need for reorientation of hospitals toward health promotion (HP), HP in hospitals of Iran is a new concept. This study investigated the concept of HP among health-care professionals working in educational hospitals of Isfahan, Iran, 2015. METHODS: A descriptive exploratory qualitative approach was employed in this study, with semi-structured interviews to investigate HP concept. The study settings included four selected educational hospitals affiliated to the Isfahan University of Medical Sciences. A purposive sample consisted of 15 health-care professionals who were participated in the study. RESULTS: Most of the participants perceived HP as a concept synonymous to health education and disease prevention. Other meaning attributes to HP were improved quality of life and well-being, clinical practice, individual and group approach to increase health, and holistic view to health. Some empowerment strategies were described by participants, but most of the participants rarely went beyond traditional health education strategy aimed at an individual target. A sizeable number of participants used interchangeably the terms "health promotion" with "prevention," "health education," and "hygiene". CONCLUSIONS: It seems that participants of this study had limited knowledge about HP. Health-care staff have a decisive role for reorienting hospitals toward HP; thus, there is a need for ongoing in-service training for health-care professionals of hospitals to focus on HP.

Hospitals reorientation towards health promotion: A qualitative study of barriers to and strategies for implementation of health promotion in hospitals of Isfahan, Iran.

CONTEXT: The World Health Organization (WHO) has emphasized the need for reorientation of hospitals toward health promotion (HP). AIMS: This study explores health-care professionals' perception of barriers and strategies to implementing HP in educational hospitals of Isfahan Province in Iran. SETTINGS AND DESIGN: The study settings included four selective educational hospitals and the Treatment Administration affiliation to the Isfahan University of Medical Sciences. SUBJECTS AND METHODS: A qualitative content analysis approach was employed in this study, with semi-structured in-depth interviews. Eighteen participants from hospital and accreditation managers, nurses, community medicine specialist, and directors of health-care quality improvement and accreditation participated in the study by purposeful sampling method. The data were analyzed using content analysis method. RESULTS: The barriers can be categorized into the following areas: (1) barriers associated with patient and community, (2) barriers associated with health-care professionals, (3) barriers associated with the organization, and (4) external environment barriers. The results were summarized into four categories as strategies, including: (1) marketing the plan, (2) identifying key people and training, (3) phasing activities and development of feasible goals, and (4) development of strategic goals of health promoting hospitals and supportive policies. CONCLUSIONS: The interactions of individual, organizational, and external environmental factors were identified as barriers to implementation of HP in hospitals. To hospital reorientation toward HP, prioritizing the barriers, and using the proposed strategies may be helpful.

Using theory of planned behavior for prediction of delivery mode among pregnant women: a theory-based cross-sectional research.

Background Nowadays, in Iran cesarean rates have increased from the recommended level of the World Health Organization (WHO). Objectives The objective of the present study was to determine which theory of planned behavior (TPB) constructs predict intentions and delivery mode among pregnant women. Methods One hundred and four pregnant nulliparous women in their third trimesters of pregnancy referred to Semirom health care centers were investigated based on census reports. The data were collected by valid and reliable questionnaire based on the TPB constructs and analyzed by SPSS16. Results In examining predictors using linear regression analysis to choose normal vaginal delivery (NVD), all constructs of TPB, including attitude toward NVD (p < 0.0001), subjective norms (p < 0.05) and perceived behavioral control (p < 0.001) were significantly correlated. Finally, after telephone follow-up with the women who had delivered newborns on their delivery method, it was found that 71.15% had a NVD and 28.14% had a cesarean delivery. Conclusions Regarding the effect of attitude to NVD, subjective norms and perceived behavioral control in NVD intention and its crucial role in anticipating the final delivery method, it is recommended considering these constructs in designing educational interventions for safe delivery in the investigated area.

Health promoting hospitals: a study on educational hospitals of Isfahan, Iran.

BACKGROUND: The current situation of health promotion (HP) services in hospitals of Iran is unclear. The aim of this study was to assess the status of HP in hospitals in Isfahan, Iran. METHODS: This study is a cross-sectional survey in which 9 educational hospitals selected through census sampling. HP self-assessment was used for the data collection. The assessment teams formed, and evidence examined in line with the tools. RESULTS: The results identified five categories of HP activities in the hospitals consisted: patients,staff, environmental, community, and organizational. The mean of total score of HP was 48.8(9.8). In terms of the HP standards scores, 5 hospitals (55.5%) were at the intermediate level;3 hospitals (33.3%) were at the weak level, and 1 hospital (11.1%) was at the good level.About the standards, the highest score was "information and patient interventions" standard 79.8 (13.5), and the lowest was "continuity and cooperation" standard 36.2 (10.8). CONCLUSION: It seems that some of the health promoting hospitals (HPS) duties carried out by hospitals. So, to improve the quality of health services, it seems useful to encourage policymakers and health service managers to create coherent policies and guidelines in HPS.