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BACKGROUND: Patients in the post-resuscitation period experience critical conditions and require high-quality care. Identifying the challenges that critical care nurses encounter when caring for resuscitated patients is essential for improving the quality of their care. AIM: This study aimed to identify the challenges encountered by critical care nurses in providing care during the post-resuscitation period. METHODS: A qualitative study was conducted using semi-structured interviews. Sixteen nurses working in the intensive care units of three teaching hospitals were selected through purposive sampling. The Data collected were analyzed using qualitative content analysis. RESULTS: Participants experienced individual, interpersonal, and organizational challenges when providing post-resuscitation care. The most significant challenges include inadequate clinical knowledge and experience, poor management and communication skills, lack of support from nurse managers, role ambiguity, risk of violence, and inappropriate attitudes of physicians towards nurses' roles. Additionally, nurses expressed a negative attitude towards resuscitated patients. CONCLUSION: Critical care nurses face several challenges in providing care for resuscitated patients. To enhance the quality of post-resuscitation care, address the challenges effectively and improve long-time survival it is crucial to implement interventions such as In-service education, post-resuscitation briefing, promotion of interprofessional collaboration among healthcare teams, providing sufficient human resources, clarifying nurses' roles in the post-resuscitation period and increasing support from nursing managers.
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Nurses' perceptions of resuscitated patients may affect their care, and this has not been investigated in previous literature. The aim of this study was to explore nurses' perceptions towards resuscitated patients. In this descriptive-qualitative study seventeen clinical nurses participated using purposive sampling. In-depth, semi-structured interviews were conducted and data were analyzed by conventional content analysis. Four main categories emerged: Injured, undervalued, problematic, and destroyer of resources. Participants considered resuscitated patients to have multiple physical injuries, which are an important source of legal problems and workplace violence, and they believed that these patients will eventually die. Resuscitated patients are considered forgotten and educational cases. Iranian nurses have a strong negative perception towards resuscitated patients. Improving the quality of cardiopulmonary resuscitation, improving the knowledge and skills of personnel in performing resuscitation, and supporting managers and doctors to nurses in the post-resuscitation period can change the attitude of nurses and improve post-resuscitation care.
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CONTEXT: Nurse-patient communication is one of the important factors affects the promotion and maintenance of the dignity of cancer patients in the hospital settings. AIMS: This study aimed to determine the perceptions of cancer patients regarding respecting their dignity and its correlation with nurse-patient communication in the hospital settings. SUBJECTS AND METHODS: This correlational study was conducted on 250 cancer patients admitted to the Oncology Departments of Tabriz Shahid Ghazi University Hospital, Iran. These patients were selected using a convenience sampling method. The Patient Dignity Inventory and Nurse Quality of Communication with Patient Questionnaire were used for collecting the data. STATISTICAL ANALYSIS USED: Descriptive and inferential statistics were applied to the data. RESULTS: The score of nurse-patient relationship is significantly correlated with patient's dignity score (R = -0.21, P = 0.001). CONCLUSIONS: Due to the importance of nurse-patient communication on maintenance of the dignity of cancer patients, it is a necessary requirement to take proper actions in this area, particularly by promoting "nurse's communication skills."
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BACKGROUND: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses' attitudes towards DNR orders. AIMS: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. MATERIALS AND METHODS: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. RESULTS: Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. CONCLUSIONS: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education.
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AIM: This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period. DESIGN: An exploratory-descriptive qualitative design was used. METHODS: In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. RESULTS: Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. CONCLUSION: Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses. IMPLICATIONS FOR THE PROFESSION: Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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BACKGROUND: Chronic and cancer diseases are expected to rise with the growing population of the elderly in the world. Home palliative care might be a possible solution for improving these patients' quality of life; therefore, the present study sets out to investigate home care nurses' attitude towards and knowledge of home palliative care. MATERIALS AND METHODS: This is a descriptive cross-sectional study (2018-19), in which 168 home care nurses and nursing assistants in East Azerbaijan Province (Iran) were included (2018). The questionnaire used was specifically designed by Shimizu et al. in 2016 for determining the nurses' attitude towards and knowledge of home care. Data analysis was carried out using descriptive and inferential statistics (T-test and ANOVA). RESULTS: In this study, 95 (56.60%) and 113 (67.90%) of the participants were found to have negative attitudes and limited knowledge, respectively. The other participants seemed to have neutral attitudes towards and average knowledge of home palliative care. The Mean (SD) attitude score on terminal home care was estimated 2.33 (0.83), and the knowledge score on dying care was calculated 41.76%, which were the lowest in comparison with the scores of other dimensions. CONCLUSIONS: The home care nurses' attitude towards and knowledge of home palliative care were found to be negative and limited, respectively, which underscores the need to endeavor to improve the attitude towards home care and the knowledge of dying care.
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BACKGROUND: Caring is the essence of nursing. Caring to be meaningful needs to be based on mutual agreement between nurses and patients as to what constitutes nurse caring behaviors. As a result, healthcare professional can enhance patients' satisfaction of care by providing appropriate caring behavior. However, previous research that combined multiple types of patients, nurses and institutions demonstrated disagreement in prioritizing important behaviors. This paper reports a study that aimed at determining the caring behaviors which oncology patients and oncology nurses perceive to be the most important. METHODS: This study is a comparative descriptive design that was conducted in an Iranian oncology centre. Convenience sampling was used to recruit 200 patients and 40 nurses to take part in the study. Data were collected over a period of 4 months in 2009 using the Caring Assessment Questionnaire, developed by Larson. Caring behaviors (n = 57) were ranked on a 5-point Likert-type scale and ordered in six subscales: "Being accessible", "Explains and facilitates", "Comforts", "Anticipates", "Trusting relationship", "Monitors and follows through". The data were analyzed using SPSS software version 13.0. The overall mean was calculated for each subscale to determine the rank distribution of the subscales. The nonparametric Mann-Whitney U test analysis of variables was used to compare patients' and nurses' scores on subscales. RESULTS: The results demonstrate that both groups considered the same order of importance of caring, the high ranking of "Monitors and Follows through and "Being Accessible" and the low ranking of "Comforts" and "Trusting Relationships". Also, Patients only ranked "Being accessible" (p = 0.04) and "Explains and facilitates" (p = 0.03) higher than nurses. CONCLUSIONS: The oncology patients and nurses perceived highly physical aspects of caring and the results provide for nurses to be aware of the need, during their interactions with patients, to validate the effect their intended caring has upon patients. By so doing and with further refinement of the concept of caring for nursing in studies such as this, the practical aim of making patients feel cared for can be achieved.
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Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills.
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Introduction: Despite being aware of the importance of nurses' role in providing clinical training to nursing students, studies show that sufficient research has not yet been conducted on the experience of clinical nurses who are engaged in training nursing students outside their normal working hours. The present study aim to describe the experience of these nurses who are training outside their routine working hours. Methods: This study was conducted using descriptive-phenomenology method. Twelve nurses was participated in this research. Data were collected using purposive sampling method and face to face interviews based on nurses' real life experience of students' learning in clinical settings through answering open-ended questions. Spiegel burg analysis method was used to analyze the data. Results: The result of data analysis was the derivation of four themes and eight sub-themes. Themes included "nurses as teaching sources", "changes in the balance of doing routine tasks", "professional enthusiasm", and "nurses as students' professional socialization source of inspiration". Sub-themes included "efficient education", "poor education", "support", "interference in the role," "self-efficacy development", "inner satisfaction", "positive imaging" and "being a model". Conclusion: It is necessary that academic centers plan for teaching nurses working on a contractual basis in the field of the evaluation method and various methods of teaching. The findings also suggested the development of individual self-efficacy in clinical nurses who train students.
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BACKGROUND: Many articles have studied workplace incivility and its influence on outcomes, but very few have been conducted to assess how to prevent this issue. In this study, we aimed to determine how to prevent workplace incivility from the nurses' perspective. MATERIALS AND METHODS: This was a qualitative study which was based on a conventional content analysis approach. Thirty four nurses (25 to 52 years old) from seven training hospitals in Tabriz, Iran were selected through purposive sampling. Thirty six semi-structured interviews and eight field notes were analyzed. RESULTS: The data analysis revealed 417 codes, ten categories, three subthemes and one theme, that is, A Need for a Comprehensive Attempt. Attempt of organization, nurses, and public as subthemes are needed to prevent workplace incivility. CONCLUSIONS: The findings of the study indicated that a comprehensive and systematic attempt was needed to prevent incivility. Nurses should try to improve their skills; officials should try to show the real image and position of nurses and hospitals to the community.
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INTRODUCTION: Individualized nursing care is the key element in quality of nursing care. In fact, it changes all standardized nursing procedures and activities. In addition, it tailored nursing activities with unique peculiarity of each patient. Focusing on patient during care process is one main reason for supporting individualized care. Individual differences among patients in terms of their health, illness and needs which emphasize on providing individualized care. This research aimed to demonstrate patients' point of view about nurses' support of individualized care. METHODS: A descriptive study conducted with participation of 400 being discharged patients from internal and surgical units in teaching hospitals of Tabriz University of Medical Sciences. Proportional stratified random sampling method was used. Data was collected by interviewing with patients using Suhonen Individualized Care Scale, after assessing its content validity and reliability with Chronbach's alpha method. Data analysis were done by using SPSS ver. 13. RESULTS: The mean of patients' point of view about nurses' support of individualized care was 2.60 (1.14). The results showed the mean of support for clinical situation 2.61 (1.27), support for personal life situation 2.36 (1.28), and support for decisional control over care 2.77 (1.17). Comparing aspects of support showed that support for decisional control over care was the highest and the lowest was support for personal life situation. CONCLUSION: According to results of the study and comparison with other researches in other countries, it is recommended that nursing care planners pay more attention to the aspects of nursing support based on individuals.
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INTRODUCTION: There are many opportunities for nurses to assist improving patient's ex-perience of cancer. In fact, in every stage of cancer process, nurses can provide the re-quired and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients' satisfaction toward nursing services. However, a few studies have ever been done about perception of oncology nurses about prioritization of caring behaviors. METHODS: This was a descriptive study done among all the nurses of oncology wards (n = 40) in Shahid-Ghazi-Tabatabaei Hospital of Tabriz in 2009. Data collection performed using Larson's CARE-Q tool that assessed the importance of caring beha-viors in six subscales as the following: "Monitors and follows through", "Explains and facilitates", "Physical and emotional comforts", "Trusting relationship", "Anticipates" and "Being accessible". RESULTS: In this study, the importance of caring behaviors was evaluated in moderate to high level and the priorities of care dimensions were deter-mined. "Monitors and follows through" and "Being accessible" received a high priority and "Anticipates", "Explains and facilitates", "Physical and emotional comforts" and "Trusting relationship" were given the low priority by nurses. CONCLUSION: The difference of caring prioritization by the nurses of this study compared to other studies can be attributed to the influence of cultural background on caring. Considering the high prioritizing of "Monitors and follows through" and "Being accessible", nursing service officials and planners are recommended to attempt providing prerequisites of these two caring aspects.
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BACKGROUND: Respect to patients' autonomy is a cornerstone of medical ethics and nurses have a key role in respecting patients' autonomy. In review of Iranian literature, there is no study investigating the respect to patients' autonomy during nursing cares. The aim of the present study was to compare nurses and patients' perceptions regarding respecting to patients' autonomy during nursing care. METHODS: This study had a comparative descriptive design and conducted in 2008. The study population was consisted of all nursing staff (n = 79) working in three related hospitals of Tabriz University of Medical Science using census sampling. Also, 187 hospitalized patients in these hospitals participated with convenience sampling. To assess the respecting to patients' autonomy, two parallel questionnaires were prepared. Data analysis was done in SPSS using Mann-Whitney and Kruskal-Wallis tests and Spearman correlation coefficient. RESULTS: Nurses reported that they respected to patients' autonomy, but patients believed that their autonomy was not respected. Also, there was a significant statistical relation between perception of health status, need for nursing care, and age of patient and their report of respect to their autonomy. CONCLUSIONS: There is an exiting difference in viewpoint of nurses and patients regarding respecting to patient autonomy. But, because of insufficient evidence more studies are recommended.