Lymphedema self-management mobile application with nurse support for post breast cancer surgery survivors: description of the design process and prototype evaluation.

BACKGROUND: Self-management is the key to control breast cancer related lymphedema (BCRL). This study aimed to develop a mobile application with nurse support for lymphedema self-management and evaluate its usability from the patients' points of view. METHODS: This applied developmental study was conducted on 87 women in a lymphedema clinic, Shiraz, Iran, May-November 2023. The study included three phases: development, distribution of the application and usability evaluation. In the development phase, the researchers developed application using the Java programming language. In distribution phase, the application was installed on the participants' phones. For usability evaluation, 87 patients completed the user satisfaction questionnaire after three months access to the application. Data was analyzed using descriptive and analytical statistics using SPSS software 22. P-value less than 0.05 was considered significant. RESULTS: We designed a self-management application specific to BCRL that included ten unique modules mainly related to patient education, interaction with peers and nurse, self-management support, and settings. The application mean usability score was 7.72 ± 1.08. The usability dimensions of "screen" (8.06 ± 1.02) and "terminology and systems information" (7.29 ± 1.62) received the highest and lowest mean scores, respectively. CONCLUSION: The application has new features to meet more patients' needs compared to what other existing lymphedema self-management applications already have addressed. The findings showed that the participants rated the application usability at the "good" level that is similar to some previous studies. Considering the unique nature of the application and its favorable usability, we recommend its use for BCRL self-management.

Structural Equation Modeling of Associations Between Nursing Practice Environment And Missed Nursing Care: A Cross-sectional Study.

BACKGROUND: Missed nursing care (MNC) negatively impacts the quality of patient care. There may be a relationship between the nursing practice environment (NPE) and MNC; however, this relationship has not been examined in developing countries during the COVID-19 pandemic. PURPOSE: To determine the relationship between the NPE and MNC during the COVID-19 pandemic. METHODS: A cross-sectional study of 300 participants was conducted in 4 teaching hospitals in Iran. Data were collected using a demographic and clinical form, the Nursing Professional Practice Environment Questionnaire, and MISSCARE survey and analyzed using structural equation modeling. RESULTS: The hypothesized model was well fit, showing that 1 unit improvement of the NPE domains of patient-centered care , effective leadership , and policy transparency decreased MNC by 0.18, 0.12, and 0.05, respectively. CONCLUSION: The model confirmed the association between the dimensions of the NPE and MNC. These findings can assist health policymakers and nursing managers in improving the NPE.

Live experience of nursing students with internship program: A phenomenological study.

BACKGROUND AND AIM: The internship is a program for transition of nursing students to the clinical setting. This study was conducted to describe and interpret the experiences of nursing students from the internship program. MATERIALS AND METHODS: This was an interpretative phenomenological study following Van Menen's approach in six steps. Twelve nursing students were selected from 12 different universities in Iran from April to August 2020. Data was collected through 15 in-depth interviews (three supplementary interviews) over the course of 25-90 min and verbatim transcriptions. Data were analyzed with MAXQDA version 10 software. The researcher used four Guba and Lincoln criteria to obtain a rigorous study. RESULTS: In this study, three main themes and eight subthemes were extracted. The main themes included "professional identity development," "moving toward professional self-efficacy," and "developing coping strategies for workplace adversities." The subthemes were "promoting the cognition of profession," "acceptance among colleagues as a nurse," "accepting professional roles," "self-awareness of weaknesses in patient care," "self-reliance," "advancing clinical skills," "adopting effective coping strategies," and "avoiding tension in clinical settings." CONCLUSION: Nursing internship students have experienced moving toward professionalization with professional identity and self-efficacy development, and they succeeded in clinical challenges by learning coping approaches.

Psychometric testing of the Persian version of the Nursing Care Quality Scale: A methodological study.

AIM: To evaluate the psychometric properties of the Persian version of the Cambodian Nursing Care Quality Scale. DESIGN: Methodological design. METHODS: This study was carried out in several steps: a forward-backward translation was done, face and construct validity was measured using exploratory and confirmatory factor analysis and the reliability was evaluated. A convenience sampling method was employed to recruit 350 nurses from May 2021 to March 2022. RESULTS: The exploratory factor analysis extracted six factors that explained 60.76% of the total variance. The six-factor model is supported by confirmatory factor analysis. The Cronbach's alpha and the intra-class correlation coefficient were 0.94 and 0.85, respectively. PATIENT OR PUBLIC CONTRIBUTION: Evaluation of the quality of care can lead to the enhancement of the quality of nursing services and patient safety. This will subsequently increase the patients' and community satisfaction.

A smartphone-based supportive counseling on health anxiety and acceptance of disability in Systemic Lupus Erythematosus patients: A randomized clinical trial.

OBJECTIVE: This study aimed to evaluate the effects of a supportive counseling via the smart phone on the health anxiety, and acceptance of disability in the patients with Systemic Lupus Erythematosus. METHODS: The present study was a randomized clinical trial with pre-post design. Randomly dividing 124 patients into experimental and control groups. Before and after the intervention, all patients answered the health anxiety and disability acceptance questionnaires. For eight weeks, the trial group received remote counseling help using the WhatsApp platform. RESULTS: All 124 patients randomized into groups, completed follow-up which were analyzed. By the end of 8th week, the level of health anxiety (MD=11.34, P < 0.001) of the experiment group was significantly lower than the control group, while the level of acceptance of disability (MD=91.42, P < 0.001) of experiment group was significantly higher than the control group. CONCLUSION: Smartphone-based supportive counseling may help people with Systemic Lupus Erythematosus manage their symptoms better, and live better by reducing health worry and increasing acceptance of impairment. PRACTICE IMPLICATIONS: Virtual supportive counseling can assist healthcare professionals to optimize the potential of education and support processes.

The effects of continuous care model using a smartphone application on adherence to treatment and self-efficacy among patients with multiple sclerosis.

BACKGROUND: Adherence to disease-modifying therapy is important in patients with Multiple Sclerosis (MS) to increase the positive outcomes and improve the quality of life. This study aimed to determine the effects of Continuous Care Model (CCM) using a smartphone application on adherence to treatment and self-efficacy among MS patients. METHODS: This quasi-experimental study with pre/posttest design was conducted on 72 MS patients in Shiraz, Iran from June 2020 to August 2021. The samples were randomly assigned to intervention (n = 36) and control (n = 36) groups. In the intervention group, the CCM using a smartphone application was implemented during two months. However, no intervention was performed for the control group. The data were collected using the self-report Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) and MS Self-Efficacy Scale (MSSS) at baseline and two and four months after the intervention. RESULTS: The results showed an improvement in adherence to treatment and self-efficacy in the intervention group compared to the control group after implementing the virtual CCM and at the two-month follow-up (p < 0.001). CONCLUSIONS: Implementing the CCM using a smartphone application resulted in improvements in the MS patients' adherence to treatment and self-efficacy. It can be concluded that providing care using an interactive multimedia application can improve the outcomes as well as patients' satisfaction, especially during the COVID-19 pandemic. Therefore, this approach is recommended to be used for nurses, healthcare providers, and clinicians.

Improving nurses' knowledge, attitude, and performance in relation to ethical codes through group reflection strategy.

BACKGROUND: The most basic responsibility of nurses that even precedes their therapeutic role is respect for professional ethics in providing clinical care. The present study was conducted to determine the effect of group reflection on the knowledge, attitude and performance of nurses in relation to ethical codes. METHODS: The present blinded, before-after, educational trial was conducted on 86 nurses working at a general hospital in the south of Iran who were randomly divided into a intervention (n = 44) and a control (n = 42) group. Data were collected before and after the intervention using three tools, including a knowledge test, an attitude rating scale and a performance questionnaire. In the intervention group, the intervention given consisted of four sessions of group reflection, and the control group received a single lecture on ethical codes. RESULTS: The mean changes in the nurses' score of knowledge after the intervention compared to before differed significantly in both intervention and control groups (P < 0.001), but there was no significant difference between the two groups in terms of the mean changes in the score of knowledge (2.73 ± 3.45 in intervention group vs. 2.57 ± 3.36 in control group, P = 0.83). Although the mean score of attitude differed significantly between the intervention and control groups in the posttest (34.7 ± 8.44 in intervention group vs. 29.95 ± 9.09 in control group, P < 0.014), the two groups were not significantly different in terms of the mean changes in the score of attitude in relation to ethical codes before and after the intervention (P < 0.14). Moreover, the two groups were significantly different in terms of the mean changes in the scores of performance in the two stages (9.07 ± 16.84 in intervention group vs. 0.67 ± 20.01 in control group, P < 0.001). CONCLUSION: Group reflection can improve the knowledge, attitude and performance of nurses in relation to ethical codes. Although lectures can help improve nurses' knowledge and attitude in this area, they have no significant effects on their performance. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (No: IRCT2016070317546N6, registration date: 10 October 2016), https://www.irct.ir/trial/16112.

The effects of aromatherapy massage with lavender essential oil on neuropathic pain and quality of life in diabetic patients: A randomized clinical trial.

OBJECTIVE: to determine massage lavender essential oil on neuropathic pain and quality of life in diabetic patients. METHODS: A randomized three-group control trial with the pre-post design was performed from 2019 to 2020 on 75 diabetic neuropathic patients. The patients were randomly allocated into aromatherapy (n = 26), placebo (n = 26), and control (n = 26) groups. Patients in the intervention group used 2.5 cc of 3% lavender oil on their feet as a gentle massage for 10 min every night before bedtime for a month. Data collected using the Visual analog scale (VAS), Douleur Neuropathic 4 (DN4) and Quality of Life Questionnaire (SF36). RESULTS: The mean difference of pain scores in short-term and long-term in the aromatherapy group was significantly reduced compared to the placebo and control groups (P < 0.001). In addition, after four weeks, a significant increase was found in the QoL domains in the aromatherapy group (P < 0.001). CONCLUSION: Aromatherapy massage with lavender oil helped reduce neuropathic pain two to four weeks after the intervention and improved the patients' QoL without causing any side effects. Thus, nurses are recommended to use it as a complementary method to reduce neuropathic pain and improve patients' QoL.

Exploring the necessity of establishing a doctor of nursing practice program from experts' views: a qualitative study.

BACKGROUND: Complex healthcare systems increasingly demand influential nurse leaders adept at managing changes in unstable environments. The doctor of nursing practice (DNP) prepares the nurses for the most advanced level of clinical practice. The aim of this study was to explore the necessity of establishing a DNP program in Iran from experts' views. METHODS: The study used a qualitative descriptive approach. The participants consisted of 13 faculty members and Ph.D. candidates selected using purposive sampling. Data were collected through focus group and semi-structured interviews, and analyzed using qualitative content analysis. RESULTS: The content analysis led to the extraction of two main categories: "providing infrastructures" and "DNP as an opportunity to make positive outcomes." CONCLUSIONS: It is concluded that it is not necessary to establish a DNP program for Iran's nursing education system. Supplying infrastructures is a crucial component to establishing a new program in Iran. Although DNP, as an opportunity to drive positive changes, is recommended, in the current situation, using alternative solutions may yield better outcomes than establishing a DNP program.

Nursing professional practice environment and its relationship with nursing outcomes in intensive care units: a test of the structural equation model.

INTRODUCTION: Burnout, intention to leave and ultimately shortage of skilled nurses are associated with poor practice environments; however, in Iran comprehensive data are unavailable. The aim of this study was to investigate the relationships between the nursing professional practice environment with nurses' burnout and intention to leave in intensive care units, using structural equation modelling analysis. METHODS: This cross-sectional, multi-centred study was conducted among 320 nurses in twenty ICUs of five teaching hospitals affiliated with Shiraz University of Medical Sciences from September 2018 to June 2019. Valid measurement instruments including Nursing Professional Practice Environment Questionnaire (NPPEQ), Maslach Burnout Inventory (MBI) and Anticipated Turnover Scale (ATS) were used for data collection. RESULTS: Goodness-of-fit statistics confirmed a model with burnout dimensions in mediating positions between nursing professional practice environment dimensions and intention to leave, explaining 86.4% of the variation. CONCLUSION: The results confirmed a theoretical model with structural the relationships among the nursing professional practice environment, burnout and intention to leave in nurses working in ICUs. In this model, burnout had a strong direct positive effect on intention to leave. The results can provide guidance for various stakeholders, such as health policymakers and nurse managers attempting to improve the quality of nurses' workplace, by drawing their attention to various factors influencing the retention of technically trained nurses in the critical care units.

Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units.

OBJECTIVES: To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). METHODS: This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). RESULTS: Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p < 0.001). CONCLUSIONS: Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.

Investigating the Effect of Acupressure on the Patients' Anxiety Before Open-Heart Surgery: A Randomized Clinical Trial.

BACKGROUND: Anxiety is a common complaint of patients before diagnostic or therapeutic invasive procedures, especially before open-heart surgery. The most well-known method to reduce anxiety is the use of sedatives, which have pronounced side effects. OBJECTIVES: The purpose of this study was to determine the effect of acupressure on anxiety in patients undergoing open-heart surgery. METHOD: This is a randomized clinical trial study conducted on 90 patients who were candidates for open-heart surgery. The patients were randomly assigned into either intervention or control groups. Acupressure intervention was applied at three real acupoints over two consecutive days in the intervention group. The control group received acupressure on sham points. We used Spielberger State-Trait Anxiety Inventory to assess anxiety in our study. RESULTS: The results showed that before acupressure, there was no statistically significant difference between state anxiety scores and intergroup traits, and this difference was only significant in state anxiety after the second intervention. State and trait anxiety were significant before and after the intervention in the test group, respectively include (p < 0.001) (p = 0.01), but these changes in the control group did not show a statistically significant difference. After completing the second phase of the intervention at the actual sites, systolic blood pressure (p = 0.007) and heart rate (p = 0.001) decreased significantly. However, acupressure did not have a significant effect on diastolic blood pressure in any of the groups. CONCLUSION: Based on the results of this study, the application of acupressure in patients who are candidates for open-heart surgery can reduce their state anxiety. Further larger-scale and rigorous studies are warranted.

COVID-19: Threat or Opportunity?

The COVID-19 pandemic is spreading quickly. Despite scientists' best efforts all over the world, there is not a vaccine or definite treatment for it and the novel coronavirus remains a threat to humanity with far-reaching, and in many cases, irredeemable consequences for the economic, political, social-psychological , and cultural aspects of humans' lives.(1)The quick transmission and fatality of the disease, absence of herd immunity, lack of or inequitable distribution of resources, e.g. Personal Protective Equipment ( PPE), and the existing challenges in the implementation of social distancing result in a daily increase in the number of victims and, consequently, an ever-expanding workload in healthcare systems worldwide. Moreover, the increasing mortality and morbidity of COVID-19 and lack of hospital beds and ventilators have led to healthcare provider's exhaustion and burnout.(1,2) Healthcare providers, especially nurses are the most vulnerable group in the face of the current disaster. Unfortunately, In the world, many front-line experts have lost their lives.(3)

Assessment of the Relationship between Nurses' Perception of Ethical Climate and Job Burnout in Intensive Care Units

Objective. To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). Methods. This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). Results. Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p<0.001). Conclusion. Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.

Objetivo. Determinar la percepción de las enfermeras sobre el clima ético y el agotamiento laboral en las Unidades de Cuidados Intensivos (UCI). Métodos. Este estudio de corte transversal y multicéntrico se realizó con 212 enfermeros que trabajaban en UCI para adultos de seis hospitales afiliados a la Universidad de Ciencias Médicas de Shiraz, Irán, en 2019. Los participantes se seleccionaron mediante una técnica de muestreo aleatorio sistemático. Los datos se recolectaron a partir de la utilización de instrumentos Encuesta de Clima Ético en Hospitales (HECS) de Olson y el Inventario de Burnout de Maslach (MBI). Resultados. El clima ético fue favorable (3.5±0.6). La intensidad (32.2±12,4) y la frecuencia (25.5±12.4) del agotamiento fueron altas. El clima ético tuvo relaciones significativas e inversas con la frecuencia de Burnout (r=-0.23, p=0.001) y con la intensidad del burnout (r=-0.186, p=0.007). El clima ético explica el 5.9% del agotamiento. También se encontraron relaciones estadísticamente significativas entre edad y clima ético (p=0.001), turnos de trabajo y burnout (p=0.02), además de género y frecuencia de intensidad de burnout (p=0.038). El coeficiente de correlación de Spearman mostró relaciones significativas e inversas entre el clima ético y el agotamiento laboral (r=-0.243, p<0.001). Conclusión. Las enfermeras en las UCI percibieron que el clima ético era favorable, sin embargo, el desgaste fue alto. Por tanto, el burnout puede verse influido por muchos factores y es necesario apoyar a estas enfermeras que cumplen una tarea difícil y complicada. Se recomienda evaluar los factores que aumentan el agotamiento y adoptar medidas y enfoques específicos para aliviar el burnout de enfermería.

Objetivo. Verificar a diferença entre a percepção dos enfermeiros sobre o clima ético e o desgaste no trabalho em Unidade de Terapia Intensiva (UTI). Métodos. Este estudo transversal e multicêntrico foi realizado com 212 enfermeiras que trabalham na UTI adulto de seis hospitais afiliados à Universidade de Ciências Médicas de Shiraz, Irão, em 2019. Os participantes foram selecionados por meio de uma técnica de amostragem aleatória sistemática. Os dados foram coletados usando os instrumentos Enquete de Clima Ético em Hospitais (HECS) de Olson e o Inventário Burnout de Maslach (MBI). Resultados. O clima ético era favorável (3.5±0.6). A intensidade (32.2±12.4) e a frequência (25.5±12.4) de exaustão foram altas. O clima ético teve relações significativas e inversas com a frequência de Burnout (r=-0.23, p=0.001) e com a intensidade de Burnout (r=-0.186, p=03007). O clima ético explica 5,9% do esgotamento. Também foram encontradas relações estatisticamente significativas entre: idade e clima ético (p=0.001), turnos de trabalho e Burnout (p=0,02), além de gênero e frequência da intensidade do Burnout (p=0.038). O coeficiente de correlação de Spearman mostrou relações significativas e inversas entre clima ético e Burnout (r=-0243, p<0.001). Conclusão. As enfermeiras das UTIs perceberam que o clima ético era favorável, porém, o desgaste foi alto. Portanto, o Burnout pode ser influenciado por diversos fatores e é necessário apoiar essas enfermeiras que cumprem uma tarefa difícil e complicada. Recomenda-se avaliar os fatores que aumentam o Burnout e adotar medidas e abordagens específicas para aliviar o Burnout da enfermagem.

Validation of the Iranian Version of the Hospital Ethical Climate Survey.

BACKGROUND AND PURPOSE: The aim of this study was to determine validation of the Iranian version of the Hospital Ethical Climate Survey (HECS). METHODS: This is a methodological study with a cross-sectional design that was conducted in 2016. A forward-backward translation method was used to translate the questionnaire from English to Persian and face, content, and construct validity as well as reliability were assessed. RESULTS: The factor structure of the HECS through explorative Principal Component Analysis (PCA) confirmed five factors that explained 64.7% of total variance. The overall Cronbach's alpha coefficient was .86 and the Cronbach's alphas for five of the subscales were between .63 and .92. CONCLUSIONS: The Iranian version of HECS has adequate validity and reliability for measuring the hospital ethical climate in the Iraniansociety.

Adequate Resources as Essential Component in the Nursing Practice Environment: A Qualitative Study.

INTRODUCTION: Attracting and retaining well qualified nurses to develop healthcare systems and ensure patient safety is a global concern. In this regard, the quality of the practice environment plays a crucial role. AIM: To explore Iranian nurses perception on the key constituents of the nursing practice environment. MATERIALS AND METHODS: This study was conducted using a qualitative approach. Twelve participants were purposively selected from five teaching hospitals in Shiraz, Iran. Data was collected through semi structured interviews, and analysed using qualitative content analysis. RESULTS: Data analysis led to the extraction of two categories of 'adequate staff', with two subcategories of balanced workload and well qualified nurses, and 'adequacy of physical resources', with subcategories of equipment adequacy and appropriate physical structure as key elements of the nursing practice environment. CONCLUSION: Imbalanced workloads, inappropriate nurse-patient ratios, and inadequate physical resources negatively affected nurse's perceptions of the quality of the nursing practice environment. The findings provide baseline data for health policymakers in different national and global areas to remodel the practice environment. The improvement of the practice environment, with adequate staffing levels and appropriate allocation of physical resources, is achievable to resolve this challenge and thus improve outcomes.

Effect of collaborative testing on learning and retention of course content in nursing students.

INTRODUCTION: Collaborative testing is a learning strategy that provides students with the opportunity to learn and practice collaboration. This study aimed to determine the effect of collaborative testing on test performance and retention of course content in nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. METHODS: This quasi-experimental study was carried out on 84 students enrolled in the course of Medical-Surgical 2 in Spring 2013 and Fall 2013 semesters. The control group consisting of 39 students participated in the first mid-term exam in an individual format. The intervention group, on the other hand, consisted of 45 students who took the test in a two-stage process. The first stage included an individual testing, while the second stage was a collaborative one given in groups of five individuals chosen randomly. Four weeks later, in order to investigate retention of the course content, both groups took part in the second mid-term exam held individually. RESULTS: The study findings showed significant difference between the mean scores in the intervention group in the Fall 2013 semester (p=0.001). Besides, a statistically significant difference was found between the two groups regarding the tests mean scores (p=0.001). Moreover, retention of course content improved in the collaborative group (p=0.001). CONCLUSION: The results indicated an increase in test performance and a long-term learning enhancement in collaborative testing compared with the traditional method. Collaborative testing, as an active learning technique and a valuable assessment method, can help nursing instructors provide the alumni with strong problem-solving and critical thinking abilities at healthcare environments.

Reaction to and Coping With Domestic Violence by Iranian Women Victims: A Qualitative Approach.

INTRODUCTION: Domestic violence is a continual stressor that motivates its victim to react. The way a woman deals with her husband's violence determine the consequence of the violent relationship. In the present study, a qualitative approach was employed to investigate women's reactions to and ways of coping with domestic violence. METHOD: Semi-structured interviews were conducted in 2014 with 18 women who experienced domestic violence in an attempt to explain how women deal with domestic violence. After the interviews were transcribed word by word, they were explored in the form of meaningful units and encoded as subcategories and categories through inductive content analysis. The reliability and validity of the interviews were measured by an external supervisor. RESULTS: Two categories of reaction and coping were identified through content analysis: passive and non-normative measures and active measures. Passive and non-normative measures included the subcategories of harmful behaviors, retaliation, tolerance, and silence. Active measures included seeking help and advice, legal measures, leaving the spouse, positive and health promoting measures. CONCLUSION: In the present study, ways of coping with a husband's violence among women experiencing domestic violence were divided into two categories: passive and non-normative measures and active measures. These categories confirmed the models of coping with stress in previous studies. Adopting an appropriate approach to dealing with domestic violence is affected by a woman's capacity and beliefs, the dominant culture, intensity of the violence, available social and legal supports, and effectiveness of evaluation measures. To generalize service provision to victimized women, the type of coping and the reason for adopting the chosen approach need to be taken into account.