Uncertainty, the overbearing lived experience of the elderly people undergoing hemodialysis: a qualitative study

Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis

Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach

Results: One of the most important findings emerging in the main study was "uncertainty", which can be important and noteworthy, given other aspects of the elderly life [loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems]. Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis

Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications

role of nurses in coping process of family caregivers of vegetative patients: a qualitative study

Background: Vegetative state [VS] occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients

Methods: This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014 - 2015. Purposive and theoretical sampling was used. 14 caregivers participated in the study. Data were gathered using face-to-face in-depth interviews and managed by MAXQDA 10 software. Analysis was done through constant Comparative Method

Results: Three themes of "nurse as a pursuer teacher", "nurse as a compassionate caregiver", and "nurse as a supporter" were derived from analysis that represent various roles of a nurse in the coping process of family caregivers of vegetative patients during the care process

Conclusion: Nurses can play an effective role in improving the caregivers' well-being by considering the importance of training at discharge time and during home care, helping families in providing care and support them during care process

Death anxiety among nurses and health care professionals: a review article

Death anxiety, a negative affective state that is incited by mortality salience, may be experienced by nurses and other health care workers who are exposed to sickness, trauma, and violence. This paper examines death anxiety and management strategies among health providers in different health settings across cultures. A literature review of the research published since 2000 in the English language was conducted using PubMed, Science direct, CINAHL, and PsychInfo databases. Death anxiety is commonly experienced and is associated with more negative attitudes about caring for dying patients and their families. Performing educational and psychological interventions to help nurses build strong coping strategies for managing death anxiety are recommended to offset negative consequences such as leaving positions, poor communication, and decrements in personal health and quality of life

How Do Family Caregivers of Older People Give Up Caregiving?

Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes [average 52 minutes]. Constant comparative analysis was used to analyze the data. Three main categories appeared at the end of the analysis: [going out of the road of usual life], [challenge of meeting older person, family and caregivers care needs], and [the appearance of inconstancy in the family]. They explained exclusively how family caregivers of old people give up caregiving. Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers

Effect of support program on satisfaction of family members of ICU patients

Background: This study has been conducted to investigate the effect of family-centered support program on satisfaction of the family members of patients in intensive care unit. Hospitalization of patient in intensive care unit causes crisis in family. It is very important to pay attention to the role of patient's family in support and care of patients in intensive care unit, to pay attention to fulfillment of the family's needs in order to increase their satisfaction

Methods: This study was a quasi-experimental study with control group. Seventy six family members of the patients hospitalized in medical and surgical intensive care units were recruited through purposeful sampling method and were divided in two groups [control and trial with 38 people in each groups]. In the control group, action was taken according to routine way of the unit and in trial group, intervention was conducted within three days in three dimensions of support, information and reassurance. In the fourth day, satisfaction was measured using Family Satisfaction Intensive Care Unit questionnaire

Results: Mean and standard deviation of the satisfaction with care in the control and trial groups were 37.78[18.36] and 69.26[8.39], respectively, mean and standard deviation of satisfaction in information and decision-making domains were 25.65[17.48] and 61.84[12.21] and total satisfaction score were 32.73[16.92] and 66.17[9.07], respectively. These scores indicated significant increase of satisfaction after intervention [P<0.001]

Conclusion: This research showed that information, emotional support and reassurance of the family of patients in intensive care unit has considerable effect on increase of their satisfaction. It is suggested to educate intensive care nurses and other health care personnel about psychosocial and behavioral skills to support family members during hospitalization of their patients in intensive care unit

[Introducing the professional metamorphosis theory of the BSN students and its application in the nursing education]

Background and aim: Professional socialization is a critical aspect of nursing students' development. This process begins with entering into the nursing program and continues after graduation and beginning of professional practice. This paper aimed to introduce the professional metamorphosis theory of BSN students and its application in the nursing education

Materials and Methods: This study was conducted with the aim of the introduction of the professional metamorphosis theory of BSN students. For this purpose, a search was performed on scientific databases [Pub Med, CINAHL, SID and IranMedex] using the key terms "professional socialization", "professionalization", "nursing education", and " metamorphosis". Ultimately 27 scientific articles and 2 Textbooks selected and reviewed. The results were compared with the present theory

Findings: In this study, the professional metamorphosis nursing students as a grounded theory was introduced. The theory was compared with related models and theories in the nursing literature. The applications and practical suggestions were provided in the nursing education

Conclusions: This study introduced "professional metamorphosis of nursing students" as a grounded theory in the sociocultural context of the health system of Iran. The nursing students' experiences during these stages [dependence, disintegration, and integration] and surrounding professional and extra- professional contexts help the nurse educators and administrators to develop effective educational interventions

Relapse model among Iranian drug users: a qualitative study

Relapse is a common problem in drug user's rehabilitation program and reported in all over the country. An in-depth study on patients' experiences can be used for exploring the relapse process among drug users. Therefore, this study suggests a model for relapse process among Iranian drug users. In this qualitative study with grounded theory approach, 22 participants with rich information about the phenomenon under the study were selected using purposive, snowball and theoretical sampling methods. After obtaining the informed consent, data were collected based on face-to-face, in-depth, semi-structured interviews. All interviews were analyzed in three stages of axial, selective and open coding methods. Nine main categories emerged, including avoiding of drugs, concerns about being accepted, family atmosphere, social conditions, mental challenge, self-management, self-deception, use and remorse and a main category, feeling of loss as the core variable. Mental challenge has two subcategories, evoking pleasure and craving. Relapse model is a dynamic and systematic process including from cycles of drug avoidance to remorse with a core variable as feeling of loss. Relapse process is a dynamic and systematic process that needs an effective control. Determining a relapse model as a clear process could be helpful in clinical sessions. Results of this research have depicted relapse process among Iranian drugs user by conceptual model

Relapse experience in Iranian opiate users: a qualitative study

To understand the relapse process, it is required to notice the clients learned behaviors and environmental contexts. We aimed to explore and describe relapse experiences of Iranian drug users. This is a grounded theory study and twenty two participants were selected using purposive sampling, snowball and theoretical sampling. After obtaining written informed consent, data gathering was done by means of in-depth semi-structured interviews. According to Strauss and Corbin three phases of open coding, axial coding and selection coding were done for qualitative analysis and continuous comparison. During the research period Guba and Lincoln criteria were used to be reassured of the accuracy and rigor of the study findings. The main categories of this study were craving and conflict, family stress and psychological indicators of relapse that emerged in three phases including recovery, tension and pre-relapse. High anxiety, withdrawal, rationalization and lying were the most common symptoms. Family reactions and social conditions play a key role in relapse. Relapse process is an active and multidimensional event in which the clients experience a psychosocial status continuum from recovery to relapse. Most psychological problems are seen in the tension phase

Passing through a rocky way to reach the pick of clinical competency: a grounded theory study on nursing students' clinical learning

Clinical learning is one of the important issues that helps the perception of nursing students' practice in a clinical setting and its effect on their professional development. The aim of this study is to describe and state the manner of clinical learning in nursing students. This qualitative study was conducted as a grounded theory. The individual semi-structured interviews and participants' observations were taken into account with a purposive and theoretical sample of 27 participants. The data were analyzed using the grounded theory approach and the constant comparison analysis method. The results showed that students use two approaches of Micro- and Macrolearning. The first includes learning conditions and situations that act like a foundation for the second one [Macrolearning]. Macrolearning is a continuous process including all categories of "Facing unfavorable clinical facts," "Clinical situation and appropriate decision making," "Bridging the gap between practice and theory," "Struggle for clinical independence," and "Dynamism" in a continuum reflecting the struggle to obtain clinical competency [core variable]. Through provision of such conditions as students' gradual acquaintance with real situations, selection of more resistant students, use of mentorship and preceptor ship in clinical learning, enhancement of educational standards in hospitals, handling collaborative learning methods to make a cooperation spirit in internship environment, and so on, students can be helped to obtain clinical competency.