Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs.

BACKGROUND: Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs. MATERIALS AND METHODS: This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient). RESULTS: The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool. CONCLUSION: The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.

Developing a generic model of program accreditation in Iran.

INTRODUCTION: Higher education plays an important role in the development of countries in social, economic, cultural, and scientific aspects. Also, the field of healthcare is changing rapidly, and to provide better care, health professional students need to be trained at a higher level. This situation has placed demands on academic and clinical settings responsible for training professional health students. The main objectives of this research project can be defined as 1 -to investigate important issues of accreditation and assessment process of health professional education worldwide and 2-to design and develop a uniform, transparent, and scientific accreditation framework for health professional programs in Iran. METHODS AND MATERIAL: The research methodology for the design of a generic accreditation framework in health professional education is outlined by the following step-by-step (1 to 7) procedure according to the developmental research methodology and three phases considering analysis, development, and evaluation. RESULTS: The findings of the analysis phase showed that there is no specific structure and process for accreditation in Iran compared to other countries. The three most common actions of the accreditation include the following: 1. self- assessment, 2. peer-review and site visits, and 3. evaluation and reports. A review of the relevant literature and websites indicate that various assessment frameworks have been developed regionally, as well as internationally, to accredit professional health programs. However, most of these frames seem to be non-uniform, too complex, and non-transparent. In addition to these results, three themes were extracted from the interview analysis, "accreditation barrier," "theoretical foundation of accreditation," and "specific structure and process of accreditation" which indicates the need for education at various levels of educational managers and faculty members. Therefore, these issues were taken into consideration in the design of the accreditation framework of health professional educational programs. After two stages of evaluation from the point of view of specialists and experts of the educational secretariats of the Ministry of Health and Medical Education, the final version of the program's accreditation framework and policy will be finalized. CONCLUSION: In Iran, despite the challenges and valuable activities in different educational secretariats, there was no coherent process that can be considered accreditation. In this study, self-study evaluation guide, external evaluation, standard development, and ethical guide for the programs accreditation were developed. The results of this study can help the educational secretariats of the Health and Medical Education Ministry that is based on the documents developed and operationalize their accreditation process and structure.

The Effect of Scenario-Based Learning on the Performance of Nurses Regarding Delirium in Cardiac Surgery Intensive Care Units: A Quasi-Experimental Study.

Background: Delirium is one of the most common complications of cardiac surgery, and only a small percentage of nurses are able to diagnose and manage it. The aim of this study was to determine the effect of Scenario-Based Learning (SBL) on the performance of nurses in the management of delirium in Cardiovascular Intensive Care Units (CICUs). Materials and Methods: A quasi-experimental research with a pretest-post-test design was conducted on 36 nurses of the cardiac surgery ICUs of Isfahan's therapeutic-educational center from October 2019 to January 2020. The SBL↱ was held in the form of a 2-day workshop. The study data collection tools included a demographic questionnaire, researcher-made knowledge questionnaire, and performance checklist. The data were analysed using descriptive statistics (frequency, mean, and standard deviation), and inferential statistics (repeated measures one-way analysis of variance ANOVA and Fisher's Least Significant Difference (LSD post hoc test). Results: The mean score of performance of nurses differed significantly different between the three study stages (before the intervention, immediately, and 3 weeks after the intervention) (F2,30 = 139.41; p < 0.001). LSD post hoc test showed that the mean score of performance was significantly higher immediately after the training program compared to before the intervention and 3 weeks after the SBL (p < 0.001). Conclusions: Based on the results of this study, it can be concluded that SBL↱ improved the delirium care performance levels of nurses in the cardiac surgery ICU. Thus, it is recommended that SBL be used as a method for training nurses.

Evaluation of the doctoral program in medical education of Isfahan University of Medical Sciences based on the CIPP model.

BACKGROUND: Continuous evaluation is necessary to achieve appropriate quality in educational programs. The aim of this study was to evaluate the doctoral program of medical education at Isfahan University of Medical Sciences based on the CIPP model. MATERIALS AND METHODS: This descriptive and educational evaluation study was conducted in 2020 at Isfahan University of Medical Sciences. The study population consisted of all heads of department, faculty members, students, and PhD graduates of medical education from 2010 to 2020 who were enrolled in the study by census method. The data collection tool was a researcher-made questionnaire of CIPP evaluation model which was used when validity and reliability of them were confirmed. The data obtained from the questionnaires were analyzed in two levels of descriptive statistics of mean and standard deviation and inferential statistics one-sample t-test. RESULTS: Based on the CIPP model, the mean evaluation scores from the perspective of the heads of department, faculty members, and graduates were 4.1 ± 0.1, 3.64 ± 0.42, and 3.33 ± 0.66, respectively, which were significantly higher than the average (P ≤ 0.05). However, the mean evaluation score was not significantly higher than the average from the viewpoint of the students (3.24 ± 1.17). CONCLUSION: Based on the results of the study, the status of the doctoral course in medical education at Isfahan University of Medical Sciences was assessed as appropriate by the subjects of the study including the heads of department, faculty members, and graduates. It was not, however, acceptable according to the students. Based on the results, it is suggested that evaluation be done continuously and measures are taken to correct the weaknesses and enhance the strengths.

Generational characteristics of general medicine students in Iran.

BACKGROUND: Purpose: The success of any educational system depends on the fitness of the curriculum components with the characteristics of its audience. The students of the present generation are different from the previous ones due to the changes resulting from the changes that have taken place in society, media, technology, and communication as we entered the 21th century. Hence, this study was conducted to identify the characteristics of MD students in universities of medical sciences in Iran. MATERIALS AND METHODS: This qualitative study was conducted on 32 MD students among 7 universities of medical universities of Iran. The participants were selected through purposive sampling method, and the data were collected via semi-structured interviews after getting informed consent. Then, the data were analyzed using conventional content analysis method. RESULTS: Technology as a Double-Edged Sword, in digital age, Quick access, Reasoning the basis of acceptance. Evaluation ambiguity, Seeking independence,get involved in problems, desirable teaching qualities, my favorite teacher, features of content, Role models traces,my favorite teacher, The rest are unchanged. CONCLUSION: MD students are interested in using various teaching methods and technologies, applying methods that are similar to their future job and learning by doing; they also tend to use visual materials and shortening the time and memorizing content. They prefer professors who love to teach and are good role models for them. What motivates them is to be involved in the classroom, to be active, to be respected, and not to be ignored.

Exploring the occupational health needs of oncology nurses: A qualitative study.

BACKGROUND: Although the work environment of oncology nurses is highly complex and challenging, their occupational health needs are scarcely studied. This study aimed to explore the occupational health needs of oncology nurses. MATERIALS AND METHODS: This qualitative descriptive study was conducted in 2018-2019. The participants consisted of 52 oncology nurses and 11 other key informants. They were chosen from eight cancer treatment centers in different cities of Iran. Data were collected through semi-structured individual interviews and analyzed using conventional content analysis. RESULTS: The occupational health needs of oncology nurses were grouped into three main categories included needs for self-care, development of professional competency, and a safe and healthy work environment. CONCLUSION: The work environment of oncology nurses needs to be optimized in terms of physical, psychological, organizational, and sociocultural conditions. Furthermore, the necessary measures should be taken to encourage oncology nurses to implement self-care, thus creating the preparedness to face the challenges of the workplace by developing their professional competencies.

Occupational stressors in oncology nurses: A qualitative descriptive study.

AIM AND OBJECTIVES: The present study aims at exploring oncology nurses' perceptions regarding work-related stressors. BACKGROUND: Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work-related stressors from the oncology nurses' perspective. DESIGN: Qualitative descriptive study. METHODS: Fifty-two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi-structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study. RESULTS: The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person-job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources). CONCLUSION: It is necessary to find measures attenuating work-related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health. RELEVANCE TO CLINICAL PRACTICE: The results of this study can help improve nursing work conditions, attenuate work-related stresses in nurses and introduce efficient interventions reducing occupational stressors.

Oncology Nurses' Needs Respecting Healthy Work Environment in Iran: A Descriptive Exploratory Study.

OBJECTIVE: The work environment of oncology nurses is often unpleasant due to the complexities of cancer treatment and care. Yet, there is limited information about their perspectives on healthy work environment (HWE) and their HWE-related needs. This study aimed to explore oncology nurses' HWE-related needs. METHODS: This descriptive exploratory qualitative study was conducted in 2018-2019. Participants were 52 nurses and 11 oncology specialists, nursing instructors and managers, and occupational and environmental health experts, who had the experience of promoting nurses' work conditions. They were recruited from eight teaching specialty cancer treatment centers in different cities of Iran (Tehran, Isfahan, Mashhad, Shiraz, and Babolsar). Data were collected via semi-structured interviews. Data were analyzed via conventional content analysis. RESULTS: Oncology nurses' HWE-related needs were grouped into the four main categories of physical-structural improvement, mental health improvement in work environment, organizational improvement, and sociocultural improvement. CONCLUSIONS: A wide range of physical-structural, mental health, organizational, and sociocultural improvements should be made to oncology nurses' work environment in order to fulfill their HWE-related needs. Health-care managers can use the findings of the present study to create HWE for oncology nurses.

The effects of swallowing exercise and non-nutritive sucking exercise on oral feeding readiness in preterm infants: A randomized controlled trial.

INTRODUCTION: Preterm infants demonstrate problems with pharyngeal swallowing in addition to sucking problems. Oral motor intervention and nonnutritive sucking (NNS) were introduced for promoting oral feeding skills in preterm infants. NNS cannot cover all the components of oral feeding. In another hand, the swallowing exercise (SE) can accelerate the attainment of independent oral feeding in the preterm infants. The current study sought to examine if a combined program of NNS and SE compared with a program that only involves NNS would be more effective on oral feeding readiness of premature infants. MATERIAL AND METHODS: This randomized controlled trial was conducted in a neonatal intensive care unit (NICU). 45 preterm infants were recruited in three groups. In the group I, infants were provided with NNS twice a day. The group II received a program that involved 15 min of NNS and 15 min of SE, daily. Both interventions were provided 10 days during two consecutive weeks. The group III, control group, just received the routine NICU care. All infants were assessed by functional oral feeding outcome measures including postmenstrual age (PMA) at the start of oral feeding, PMA at full oral feeding, transition time (days from start to full oral feeding), PMA at discharge time and also the infant's dependency on tube-feeding at discharge time after interventions. Also, all infants were assessed via Preterm Oral Feeding Readiness Scale (POFRAS) before and after intervention. RESULTS: No significant differences were observed in the PMA mean at start of oral-feeding (P = 0.29), full oral-feeding (P = 0.13), discharge time (P = 0.45) and the mean of transition time (P = 0.14). Compared to the control group, more infants in the group II were discharged without tube-feeding (P = 0.01). The mean of POFRAS was significantly higher in both groups I and II compared to the group III (P = 0.02 and P = 0.01, respectively). This score was, however, not statistically different between the groups I and II (P = 0.98). CONCLUSIONS: Both studied interventions were superior to routine NICU care in enhancing the oral feeding readiness of preterm infants based on the POFRAS score. The studied combined program of NNS and SE, and not NNS program, could significantly increase the number of discharged infants without tube-feeding compared to control group.

Begin Again and Continue With Life: A Qualitative Study on the Experiences of Cardiac Rehabilitation Patients.

BACKGROUND: Cardiovascular diseases are a main cause of mortality worldwide. However, new diagnostic techniques and treatments have increased the rate of survival for patients with cardiovascular disease. Cardiac rehabilitation programs aim to maintain and enhance the quality of life of patients and improve the secondary prevention of coronary artery disease. Suboptimal participation in rehabilitation programs, early exit from these programs, and not achieving lasting changes are cardiac rehabilitation challenges that are associated with health issues, including the increased need for medication, repeated hospitalization, failure in the secondary prevention programs, and long waiting lists. Exploring the meaning of behavioral changes in the context of cardiac rehabilitation may facilitate the design of effective interventions that are critical to achieving the goals of cardiac rehabilitation programs. PURPOSE: This study explored the mechanisms that underlie behavioral changes within cardiac rehabilitation centers. METHODS: We used a descriptive qualitative approach, which is widely acknowledged as the best approach for eliciting in-depth descriptions of behavioral changes in the context of cardiac rehabilitation centers. Using purposive sampling, 15 men and 8 women with coronary heart disease were referred to the two cardiac rehabilitation centers participating in this study. The inclusion criteria were participation in four cardiac rehabilitation sessions and ability and willingness to participate. The data were collected using semistructured in-depth interviews, and the inductive thematic analysis method was used for analysis. RESULTS: "Trying to stay alive" and "begin again" arose as the two main themes related to behavioral change. These themes include the changes in cognition and values that lead to improvements in the process of behavioral change as a major outcome of cardiac rehabilitation. CONCLUSIONS: Using psychosocial interventions such as creating and strengthening hope and meaningful intrinsic motivation in the context of rehabilitation centers often helps deal with these challenges. "Trying to stay alive" may take place before referral to a cardiac rehabilitation center. Therefore, psychosocial nursing interventions such as motivational interviewing are designed to improve a process that may be already underway. Thus, stress and anxiety may be treated based on beliefs and emotions. The primary emphasis in cardiac rehabilitation should include changing the beliefs of the patient and motivating her or him to achieve sustainable behavioral change.

Behavioral Change Challenges in the Context of Center-Based Cardiac Rehabilitation: A Qualitative Study.

BACKGROUND: Cardiovascular disease is chronic and often a sign of long-standing unhealthy lifestyle habits. Patients need support to reach lifestyle changes, well-being, join in social and vocational activity. Thus, patient responsibility should to be encouraged to provide quality as well as longevity. Cardiac rehabilitation programs aid patients in the attainment of these objectives. However, research shows that behavioral change following the diagnosis of a chronic disease is a challenge. OBJECTIVES: We sought to determine behavioral change challenges in patients with cardiovascular disease to improve intervention programs. PATIENTS AND METHODS: Using a descriptive qualitative approach, we collected the data using 30 in-depth semi-structure interviews. Thematic analysis was conducted to identify themes from the data. RESULTS: Three sources of behavioral change challenges emerged regarding the nature of cardiac disease and the role of the individual and the family in the recovery process. These challenges acted at two levels: intra- and interpersonal. The intrapersonal factors comprised value, knowledge and judgment about cardiovascular disease, and self-efficacy to fulfill the rehabilitation task. Family overprotection constituted the principal component of the interpersonal level. CONCLUSIONS: Behaviors are actually adopted and sustained by patients are so far from that recommended by health professionals. This gap could be reduced by identifying behavioral change challenges, rooted in the beliefs of the individual and the family. Therefore, culturally-based interventions to enhance disease self-management should be considered.