Challenges of Cooperation between the Pre-hospital and In-hospital Emergency services in the handover of victims of road traffic accidents: A Qualitative Study.

OBJECTIVES: To take a deep look at the challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents. METHODS: This is a qualitative study and the method used is of content analysis type. Semi-structured interviews were used to collect the data. Through purposive sampling, fifteen employees from ambulance personnel and hospital emergency staff were selected and interviewed. They expressed their experiences of cooperation between these two teams in the handover of traffic accident casualties. The interviews were transcribed verbatim and content analysis method was used to explain and interpret the content of the interviews. RESULTS: Three major categories were derived from the analysis of interviews: Shortage of infrastructure resources (Shortage of equipment, Shortage of physical space, and Shortage of manpower); Inefficient and unscientific management (Shaky accountability, Out-of-date information based activities, Poor motivation, and Manpower low productivity); and Non-common language (Difference in understanding and empathy, and Difference in training and experience). CONCLUSIONS: The obtained results of this study suggest that the careful planning of resources, the promotion of managerial practices as well as empowerment program of the staff, healthcare managers and policymakers can take a pace forward in order to enter into a hearty coordination between these two services for the attention of victims of road traffic accidents.

Challenges of Cooperation between the Pre-hospital and In-hospital Emergency services in the handover of victims of road traffic accidents: A Qualitative Study

Objective. To take a deep look at the challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents. Methods. This is a qualitative study and the method used is of content analysis type. Semistructured interviews were used to collect the data. Through purposive sampling, fifteen employees from ambulance personnel and hospital emergency staff were selected and interviewed. They expressed their experiences of cooperation between these two teams in the handover of traffic accident casualties. The interviews were transcribed verbatim and content analysis method was used to explain and interpret the content of the interviews. Results. Three major categories were derived from the analysis of interviews: Shortage of infrastructureresources (Shortage of equipment, Shortage of physical space, and Shortage of manpower); Inefficient and unscientific management (Shaky accountability, Out-ofdate information based activities, Poor motivation, and Manpower low productivity); and Non-common language (Difference in understanding and empathy, and Difference in training and experience). Conclusion. The obtained results of this study suggest that the careful planning of resources, the promotion of managerial practices as well as empowerment program of the staff, healthcare managers and policymakers can take a pace forward in order to enter into a hearty coordination between these two services for the attention of victims of road traffic accidents.

Objetivo. Examinar los desafíos para la cooperación entre los servicios de emergencias prehospitalarias y hospitalarias en la entrega de víctimas de accidentes de tránsito. Métodos. Estudio cualitativo con análisis de contenido. Se utilizaron entrevistas semiestructuradas para la recopilación de los datos. Se seleccionaron y entrevistaron quince personas de los equipos de atención prehospitalaria y del servicio de emergencias de un hospital a partir del muestreo intencional. Los participantes expresaron sus experiencias de cooperación entre estos dos grupos en la entrega de víctimas de accidentes de tráfico. Las entrevistas se transcribieron textualmente y se utilizó el análisis de contenido para explicar e interpretar el contenido de las entrevistas. Resultados. Emergieron tres categorías principales: Escasez de recursos de infraestructura (equipos, espacio físico y de personal); Gestión ineficiente y no científica (responsabilidad inestable, actividades basadas en información desactualizada, motivación deficiente, y baja productividad de personal); y Lenguaje no común (diferencia en comprensión y empatía, y diferencia en capacitación y experiencia). Conclusión. Los resultados obtenidos en este estudio muestran dificultades con la planificación de los recursos y la promoción de las prácticas de gestión, así como la necesidad de un programa de empoderamiento del personal. Se deben formular políticas para poder avanzar en el mejoramiento de la coordinación de los servicios en la atención a víctimas de accidentes de tráfico.

Objetivo. Examinar os desafios para a cooperação entre os serviços de emergências pré-hospitalar e hospitalar na entrega de vítimas de acidentes de trânsito. Métodos. Estudo qualitativo com análise de conteúdo. Se utilizaram entrevistas semiestruturadas para a recopilação dos dados. Através da amostra intencional se selecionaram e entrevistaram quinze pessoas das equipes de atenção pré-hospitalar e do serviço de emergências de um hospital. Os participantes expressaram suas experiências de cooperação entre estes dois grupos na entrega de vítimas de acidentes de trânsito. As entrevistas se transcreveram textualmente e se utilizou a análise de conteúdo para explicar e interpretar o conteúdo das entrevistas. Resultados. Emergiram três categorias principais: Escassez de recursos de infraestrutura (equipamentos, espaço físico e de pessoal); Gestão ineficiente e não científica (responsabilidade instável, atividades baseadas em informação desatualizada, motivação deficiente, e baixa produtividade de pessoal); e Linguagem não comum (diferença em compreensão e empatia, e diferença em capacitação e experiência). Conclusão. Os resultados obtidos neste estudo mostram dificuldades com a planificação dos recursos e a promoção das práticas de gestão, assim como a necessidade de um programa de empoderamento do pessoal. Se devem formular políticas para poder avançar no melhoramento da coordenação dos serviços na atenção as vítimas de acidentes de trânsito.

Experiencias de la práctica clínica de los estudiantes de enfermería: un estudio cualitativo / Nursing Students' Experiences of Clinical Education: A Qualitative Study

Objective. To comprehend the experiences of nursing students in clinical education. Methods. A qualitative study using conventional content analysis was conducted. Data were collected using focus group interview with 16 nursing students from two public nursing schools of Shiraz and Fasa, Iran. The participants were selected by purposeful sampling. Data analysis accomplished according to conventional content analysis. Results. From this study five categories were emerged: Theory and practice disruption (The inability to use the lessons learned in practice, Routine-oriented work, The difference between theoretical knowledge and clinical training), Shaky communications (Inappropriate behavior, Inadequate support of nurses, instructors and other caregivers), Inadequate planning (Wasting time for students in clinical training, Inadequate preparation of instructors and students), Perceived tension (Stress, Anxiety and Fear), Personal and professional development (Learning more steadily, Paying attention to the spiritual dimension of care, Increasing interest in the profession, More knowledge, greater Self Confidence). Conclusion. The results of this study showed that nursing students have desirable and undesirable experiences in clinical education in the process of training, which must be addressed with proper planning for reduce the students' problems in the clinical education of future nurses.(AU)

Objetivo. Comprender las experiencias de los estudiantes de enfermería en la educación clínica. Métodos. Se realizó un estudio cualitativo en el cual se utilizó el análisis de contenido. Los datos se recolectaron mediante entrevistas en grupos focales con 16 estudiantes de pregrado de dos escuelas de enfermería de carácter público de las ciudades de Shiraz y Fasa (Irán). Los participantes se seleccionaron por muestreo intencional. El análisis de datos se realizó de acuerdo con la técnica de análisis de contenido. Resultados. De este estudio surgieron cinco categorías: Interrupción entre la teoría y la práctica (diferencia entre conocimiento teórico y el entrenamiento clínico, incapacidad para usar el conocimiento teórico en la práctica, rutinas), Comunicaciones inestables (comportamientos inapropiados, apoyo deficiente de enfermeras, instructores y otros cuidadores), Planificación inadecuada (pérdida de tiempo para los estudiantes en las prácticas clínicas, preparación inadecuada de instructores y estudiantes), Tensión percibida (estrés, ansiedad y miedo), Desarrollo personal y profesional (aprendizaje más constante, atención a la dimensión espiritual del cuidado, aumento del interés por la profesión, aumento de conocimiento y mayor autoconfianza). Conclusión. Los resultados de este estudio mostraron que los estudiantes de enfermería tienen experiencias deseables e indeseables en la práctica clínica durante el proceso de formación, las cuales deben ser tenidos en cuenta con una planificación adecuada con el fin de reducir los problemas en la educación clínica de los futuros enfermeros. (AU)

Objetivo. Compreender as experiências dos estudantes de enfermagem na educação clínica. Métodos. Se realizou um estudo qualitativo utilizando análise de conteúdo. Os dados foram recolhidos mediante entrevistas nos grupos focais com 16 estudantes de graduação de duas escolas de enfermagem de carácter público das cidades de Shiraz e Fasa (Irão). Os participantes foram selecionados por amostragem intencional. A análise de dados se realizou de acordo com a técnica de análise de conteúdo. Resultados. Deste estudo surgiram cinco categorias: Interrupção entre a teoria e a prática (diferença entre conhecimento teórico e o treinamento clínico, incapacidadepara usar o conhecimento teórico na prática, rotinas), Comunicações instáveis (comportamentos inapropriados, apoio deficiente de enfermeiras, instrutores e outros cuidadores), Planificação inadequada (perda de tempo para os estudantes nas práticas clínicas, preparação inadequada de instrutores e estudantes), Tensão percebida (estresse, ansiedade e medo), Desenvolvimento pessoal e profissional (aprendizagem mais constante, atenção à dimensão espiritual do cuidado, aumento do interesse pela profissão, aumento de conhecimento e maior autoconfiança). Conclusão. Os resultados deste estudo mostraram que os estudantes de enfermagem tem experiências desejáveis e indesejáveis na prática clínica durante o processo deformação, os quais devem ser tidos em conta com uma planificação adequada com o fim de reduzir os problemas na educação clínica dos futuros enfermeiros. (AU)

Effects of a peer- led group education on fear, anxiety and depression levels of patients undergoing coronary angiography.

OBJECTIVES: To investigate the effect of the peer group education on the fear, anxiety and depression levels of the patients undergoing angiography. METHODS: In this clinical trial, 70 patients referred to Vali-E-Asr clinic of Fasa (Iran) for undergoing coronary angiography were selected by random sampling and divided into experimental and control groups. The experimental group (n=35) received the necessary instructions about coronary angiography by those in a trained peer group (Two former patients, having experienced in the procedure), while in the control group (n=35) the routine instructions were presented by the department's nurses. The levels of fear, anxiety and depression of the patients were measured both before and after conducting this intervention. RESULTS: The mean score of the patients' fear and anxiety after the intervention of the peers in the experimental group was reduced compared to that of the control group (p<0.05). But for the mean of the score of the depression test, no statistically significant differences were found between the two groups after the intervention. CONCLUSIONS: The results of this study showed that utilizing the peer group education is effective for reducing the fear and anxiety of patients undergoing coronary angiography.

Efectos de la educación grupal realizada por pares sobre los niveles de miedo, ansiedad y depresión de los pacientes sometidos a angiografía coronaria / Efeitos da educação grupal realizada por pares sobre os níveis de medo, ansiedade e depressão dos pacientes submetidos a angiografia coronária / Effects of a peer- led group education on fear, anxiety and depression levels of patients undergoing coronary angiography

Objective. To investigate the effect of the peer group education on the fear, anxiety and depression levels of the patients undergoing angiography. Methods. In this clinical trial, 70 patients referred to Vali-E-Asr clinic of Fasa (Iran) for undergoing coronary angiography were selected by random sampling and divided into experimental and control groups. The experimental group (n=35) received the necessary instructions about coronary angiography by those in a trained peer group (Two former patients, having experienced in the procedure), while in the control group (n=35) the routine instructions were presented by the department's nurses. The levels of fear, anxiety and depression of the patients were measured both before and after conducting this intervention. Results. The mean score of the patients' fear and anxiety after the intervention of the peers in the experimental group was reduced compared to that of the control group (p<0.05). But for the mean of the score of the depression test, no statistically significant differences were found between the two groups after the intervention. Conclusion. The results of this study showed that utilizing the peer group education is effective for reducing the fear and anxiety of patients undergoing coronary angiography. (AU)

Objetivo. Investigar el efecto de la educación grupal realizada por pares sobre los niveles de miedo, ansiedad y depresión de los pacientes sometidos a angiografía. Métodos. En este ensayo clínico, 70 pacientes remitidos a la clínica Vali-E-Asr de Fasa (Irán) para someterse a una angiografía coronaria se seleccionaron por muestreo aleatorio y divididos en dos grupos. El grupo experimental (n=35) recibió las instrucciones sobre la angiografía coronaria por parte de pares (dos pacientes que habían sido sometidos previamente a angiografía), mientras que al grupo de control (n=35) las enfermeras del departamento les brindaron la instrucción de rutina. Los niveles de miedo, ansiedad y depresión de los pacientes se midieron antes y después de realizar esta intervención. Resultados. La puntuación media del miedo y la ansiedad de los pacientes después de la educación grupal efectuada por los pares en el grupo experimental fue menor en comparación con la del grupo control (p<0.05), pero para la media del puntaje de la prueba de depresión no se encontraron diferencias estadísticamente significativas entre los dos grupos. Conclusión. Los resultados de este estudio mostraron que la utilización de los pares para la educación grupal de los pacientes que serán sometidos a angiografía coronaria es efectiva para reducir el miedo y la ansiedad. (AU)

Objetivo. Investigar o efeito da educação grupal realizada por pares sobre os níveis de medo, ansiedade e depressão dos pacientes submetidos a angiografia. Métodos. Neste ensaio clínico, 70 pacientes remitidos à clínica Vali-E-Asr de Fasa (Irão) para submeter-se a uma angiografia coronária foram selecionados por amostragem aleatório e divididos em dois grupos. O grupo experimental (n=35) recebeu as instruções sobre a angiografia coronária por parte de pares (dois pacientes que haviam sido submetidos previamente a angiografia), enquanto que ao grupo de controle (n=35) as enfermeiras do departamento lhes brindaram a instrução de rotina. Os níveis de medo, ansiedade e depressão dos pacientes se mediram antes e depois de realizar esta intervenção. Resultados. A pontuação média do medo e a ansiedade dos pacientes depois da educação grupal efetuada pelos pares no grupo experimental foi menor em comparação com a do grupo de controle (p<0.05), mas para a média da pontuação da prova de depressão, não se encontraram diferenças estatisticamente significativas entre os dois grupos. Conclusão. Os resultados deste estudo mostraram que a utilização dos pares para a educação grupal dos pacientes que serão submetidos a angiografia coronária é efetiva para reduzir o medo e a ansiedade. (AU)

Nursing Students Experiences of Clinical Education: A Qualitative Study.

OBJECTIVES: To comprehend the experiences of nursing students in clinical education. METHODS: A qualitative study using conventional content analysis was conducted. Data were collected using focus group interview with 16 nursing students from two public nursing schools of Shiraz and Fasa, Iran. The participants were selected by purposeful sampling. Data analysis accomplished according to conventional content analysis. RESULTS: Results From this study five categories were emerged: Theory and practice disruption (The inability to use the lessons learned in practice, Routine-oriented work, The difference between theoretical knowledge and clinical training), Shaky communications (Inappropriate behavior, Inadequate support of nurses, instructors and other caregivers), Inadequate planning (Wasting time for students in clinical training, Inadequate preparation of instructors and students), Perceived tension (Stress, Anxiety and Fear), Personal and professional development (Learning more steadily, Paying attention to the spiritual dimension of care, Increasing interest in the profession, More knowledge, greater Self Confidence). CONCLUSIONS: The results of this study showed that nursing students have desirable and undesirable experiences in clinical education in the process of training, which must be addressed with proper planning for reduce the students' problems in the clinical education of future nurses.