RESUMO
Background: Job alienation of nurses leads to adverse consequences such as occupational dysfunction and low quality of health-care services provided by these individuals to patients. This study aimed to explain nurses' experience of occupational alienation in the clinical setting. Materials and Methods: This qualitative study was conducted using the content analysis method. Data were collected via 18 in-depth and semistructured interviews from nurses working in the hospitals in Sabzevar, Iran. The participants were selected via purposive sampling and continued till data saturation. The obtained data were simultaneously analyzed using conventional qualitative content analysis. Results: The qualitative analysis of data content led to the extraction of the themes that reflected the nurses' experience of occupational alienation in the clinical environment. After the transcription of each interview, the obtained data were broken down into codes in the form of sentences and paragraphs related to the main concept. The codes were reviewed several times and the relevant semantic unit codes were written down and classified based on conceptual and semantic similarity. Qualitative data analysis led to the emergence of 260 initial codes, 120 subcategories, 30 main categories, and 6 themes. Finally, the main theme of the "nursing gradual separation from caring and clinical aspect" was extracted. Conclusions: According to the results, occupational alienation reduces the quality of patient care, weakens nurses, and reduces the continuity of their effective and active presence in the provision of care services and clinical decision-making. Therefore, managerial and organizational interventions are required to address this issue.
RESUMO
Chronic kidney disease is a significant public health problem worldwide. However, the causes of chronic kidney disease in Iran are unclear. This systematic review and meta-analysis identified the causes of chronic kidney disease in the general population of Iran. International databases (PubMed, Web of Science, Scopus, and Google Scholar) and national databases (Scientific Information Database and Magiran) were searched for studies published until March 1, 2018. The quality of the studies was assessed using the checklist developed by Hoy et al. Of 2518 retrieved studies, 26 studies involving 34,683 patients with chronic kidney disease stages 1 to 5 were included in the meta-analysis. The mean age of the cohort was 53.6±15.02 years. The results of the random-effects model showed that the three leading causes of chronic kidney disease were diabetes, hypertension, and glomerulonephritis, with an overall prevalence of 27.7%, 27.6%, and 6.4%, respectively. These results indicate the importance of addressing these risk factors at the national level to reduce disease prevalence.
