Bridging the gaps in patient education through aesthetic-based education: A concept analysis study.

BACKGROUND: Aesthetics is a branch of philosophy that has been entered into the philosophy of education for a long time. Reviewing the concept of aesthetics in education, we can see the components that can cover a number of challenges in the field of patient education. Focusing on the conceptual dimensions obtained from the analysis of this concept, the aim is matching the resulting conceptual categories with the gaps in the field of patient education. MATERIALS AND METHODS: Using a scoping review, we reviewed the literature dealt with different dimensions of aesthetic-based education. Walker and Avant's concept analysis approach was used to inductively analyze the content obtained from the review of literature. The data were divided into three general groups of antecedents, attributes, and consequences of the aesthetic-based education concept, and the final conceptual model was defined. Interdisciplinary comparisons between educational and medical sciences were made to match the concept of aesthetic education with the field of patient education to cover its issues. During the scope review process of the texts, after screening the articles, 17 articles selected to enter the concept analysis stage. RESULT: Concept analysis phase showed that the main conceptual categories of antecedents of aesthetic-based education are aesthetic-based intrapersonal competencies and aesthetic capacities of educational setting. The attributes include aesthetic-based educational content and teaching methods including unity in diversity, combination with art and being based on empathy. The consequences include subliminal learning and constraint-free learning. These conceptual dimensions can cover four important issues in patient education including patient satisfaction, pedagogical competences of health educators, patient centeredness, and empathetic relationship. CONCLUSION: Applying aesthetic concept in the patient education process can bridge part of the gaps in this process. So, this study can be an introduction to future innovative models based on aesthetic paradigm in the field of patient education.

Entering aesthetic concept into the field of patient education: A protocol for an interdisciplinary study to develop a conceptual model.

BACKGROUND: According to the significance of patient education, new conceptual models are constantly required to promote pedagogical competences of health educators. In the field of educational sciences, aesthetic-based education is known as one of the effective types of curriculum planning which has shown many positive pedagogical outcomes. Thus, the researcher's assumption is that, the concept of "aesthetic education" could be transposed from educational sciences to health sciences in order to develop a new formula in the patient education process. The purpose of this study is to explain methods in detail, to develop an aesthetic-based patient education conceptual model through the concept derivation strategy. MATERIALS AND METHODS: 1. Scoping review and inductive data analysis using Walker and Avant's approach to achieve conceptual categories of the concept "aesthetic education." 2. Semi-structured qualitative interviews and directed content analysis to extract the main categories of the concept "aesthetics in the patient education process." 3. Drawing an aesthetic-based patient education conceptual model by allocating new conceptual components to each general step of the patient education process, including needs assessment, goal setting, implementation, and evaluation. 4. Modified Delphi technique to validate the final conceptual model. RESULTS: The first phase will represent the main categories and subcategories of attributes, antecedents, and consequences of "aesthetic education." The second phase will show the main categories and subcategories of attributes, antecedents, and consequences of the new concept named "aesthetic-based patient education." In the third phase, it is expected to achieve a new conceptual model representing the components of aesthetics in the general steps of the patient education process. The fourth phase will propose the final validated conceptual model. CONCLUSIONS: The provided study protocol can be a road map to developing derivative models through concept derivation strategy in health sciences.

Organizational Climate of the COVID-19 Intensive Care Units: A Qualitative Content Analysis Study.

Introduction: To manage the psychological consequences of providing services in the COVID-19 intensive care units (ICUs), it is necessary to identify the experience of nurses from the organizational climate. The current study was conducted to explain the nurses' experience of the organizational climate of the COVID-19 ICUs. Methods: This qualitative study was conducted in three teaching hospitals affiliated to Isfahan University of Medical Sciences. 17 individual and semi-structured interviews with 12 nurses working in three selected COVID-19 centers were included in the data analysis. The participants were selected by purposive sampling and interviewed in one or more sessions at a suitable time and place. Interviews lasted for 45 to 90 minutes and continued with conventional content analysis until data saturation. Data analysis was done using conventional content analysis of Graham and Leideman model. Guba and Lincoln criteria (including validity, transferability, consistency, and reliability) were used to ensure reliability and accuracy. Results: The results of data analysis were classified into 82 primary concept codes and 10 sub-categories in the form of 3 categories: "positive climate of attachment and professional commitment", "emotional resonance in the work environment" and "supportive environment of the organization". Conclusion: This study led to the identification of nurses' experiences of the organizational climate during the COVID-19 which provides appropriate information to nursing managers to create a favorable organizational climate and increase the quality of work-life of nurses.

An explanation on the process of production to the utilization of patient education media in chronic diseases in Iran: Protocol for a grounded theory study.

BACKGROUND: Chronic diseases are always considered one of the most critical challenges of the health system in any country. Patient education on self-care is one of the basic strategies in controlling the disease process and minimizing complications in patients with chronic diseases. It seems that in the process of patient education, from the preparation of materials to their delivery to the final user, many problems prevent the proper and practical education. The study aims to explain the process of production to the utilization of patient education media in chronic diseases in Iran. MATERIALS AND METHODS: This study employs a grounded theory (GT) methodology and the data will be analyzed by Strauss and Corbin method. Participants in this study include groups involved in the field of patient education, including policymakers, managers at all management levels, clinical, educational, and public health service providers (physicians, nurses, medical librarians, medical, and nursing professors, NGOs in the field of patient education, physiotherapists, nutritionists, and psychologists) as well as service receivers such as patients, their family, and caregivers whom will be all selected through theoretical as well as snowball sampling method. The interview method will be semi-structured and will not be ceased until the data is saturated. CONCLUSIONS: It is anticipated that in this study, the pros and cons of the process of production to utilization of patient education media will be identified and appropriate solutions to improve this process will be provided.

The Safe Coping Strategy of Nurses Working in the Care Units of Patients with COVID-19: A Qualitative Study.

Background: Nurses are in direct contact with patients with COVID-19 and have faced much tension with the rapid spread of coronavirus. This study aimed to explore the safe coping strategies of nurses when facing the COVID-19 pandemic. Materials and Methods: In this qualitative study, data were collected from September 20 to December 20, 2020, in Isfahan (Iran) through individual semi-structured interviews with 12 nurses working in the five referral centers for patients with COVID-19. Informants were selected via purposeful sampling and interviewed in one or several sessions at the appropriate time and place. The interviews continued until data saturation. All interviews continued until no new data were added to the continuous content analysis. Data analysis was performed using conventional content analysis based on Graneheim and Lundman's approach. We used Guba and Lincoln's criteria (including credibility, transferability, conformability, and dependability) to guarantee trustworthiness and rigor. Results: Safe coping strategies for nurses were discovered in two categories of "wise liberation" and "care," and six subcategories. "Wise liberation" consisted of four subcategories: "living in the moment," "accepting the inner and outer world," "life enrichment," and "building opportunities." "Care" contained two subcategories: "caring for others" and "caring for oneself." Conclusions: Discovering safe coping strategies for nurses could set the stage for special educational-therapeutic interventions so they can better understand their experiences and take advantage of the best coping strategies.

Strategies for Improving Nurses' Performance Regarding Cardiovascular Patient's Adherence to Treatment Regimen: Content Analysis.

Background: Patient adherence to the treatment regimen is an important goal of treatment; finding appropriate strategies to improve treatment adherence is a nursing challenge. This study aimed to explore strategies to improve nurses' performance to enhance cardiovascular patients' adherence to treatment regimens. Materials and Methods: This is a qualitative content analysis study that was performed in an educational hospital of the Urmia University of Medical Science. Data were collected through semi-structured individual and group interviews. Sixteen individual interviews were conducted with nurses, patients, and physicians. A focus group was conducted with the presence of six nurses and nursing managers. Data were analyzed by conventional content analysis using MAXQDA 2020. Results: After analyzing the interviews, five strategies were explored; these strategies include: follow-up of the patient after discharge (systemic and organizational follow-up, educational follow-up, counseling follow-up, and motivational follow-up), sending reminders for necessary cases to the patients (risk reminders, care reminders); improving patient education methods (modern and up-to-date education, conventional and routine education), improving support services (home care services, social support, Psychological support), and optimizing the structure and processes of the hospital (making structural changes, making process changes). Conclusions: Much needs to be done to improve patient's adherence to treatment. Nurses are at the forefront of this work. In this study, we introduced ways to improve nurses' performance in order to increase patient adherence.

Causes of nonadherence to treatment in people with myocardial infarction: Content analysis.

BACKGROUND: Nonadherence with the medication regimen in patients with heart disease can lead to treatment failure. The purpose of this study was to identify the causes of nonadherence in people with myocardial infarction. MATERIALS AND METHODS: This study is a qualitative conventional content analysis. Data were collected through semistructured interviews. Thirteen individual interviews and a focus group were conducted with nurses, patients, and doctors. Data were analyzed using conventional content analysis. RESULTS: Four main themes were identified, which are organizational-managerial causes and factors (drug-related problems, educational system-related problems, weak performance of hospitals, and problems related to insurance companies); sociocultural causes and factors (factors related to cultural problems and factors related to social problems); causes and factors related to care providers (skill problems of care providers and functional problems of care providers); and causes and factors associated with caregivers (factors related to social characteristics of the patient, factors related to patient characteristics, and factors related to the patient's belief). CONCLUSIONS: Many individual and organizational factors affect nonadherence, which can be reduced by fundamental changes.

The framework for developing nursing specialist roles in the health care system of Iran.

BACKGROUND: A key step to the development of a roadmap for developing nursing specialist roles is to create its framework based on the immediate context. PURPOSE: This study aimed to create the framework for developing nursing specialist roles in the health care system of Iran. METHODS: This was a descriptive qualitative study. A purposeful sample of 81 nursing and nonnursing experts was recruited. The directed content analysis approach was used for data analysis. FINDINGS: The framework for developing nursing specialist roles in the health care system include eight main categories. These categories are role titles, prioritization of the necessary specialties, the necessary competencies of nurses at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators. DISCUSSION: Creating a context-based framework for nursing specialist role development based on the characteristics of each country is recommended.

Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards.

BACKGROUND: The aim of the present study was to determine the effectiveness of a self-care education (SCE) discharge program with telephone follow-ups in managing hypertension (HTN) in older patients. METHODS: The study was conducted on 56 older patients with HTN who had recently been discharged from the cardiac wards of hospitals in Isfahan, Iran, in 2017. Participants were randomly allocated to the intervention and control groups. The intervention was a 60-minute SCE discharge program with 4 re-educative telephone follow-ups every 2 weeks based on 4 chapters of the designed SCE program and booklet. After coding the data and entering them into SPSS software, data were analyzed for the comparison of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as frequency of managed HTN in the intervention and control groups at baseline (before discharge), and 2 and 3 months after discharge. RESULTS: Statistical tests showed no significant difference in any of the demographic and confounding variables as well as baseline BPs (P > 0.050), but at post-intervention follow-ups, after Mauchly's sphericity test, repeated measurements ANOVA showed that the effect of time (P < 0.001) and group (P = 0.043) on SBP was significant. The effect of time (P = 0.036) and group (P = 0.047) on DBP was also significant. McNemar's test showed that the frequency of managed HTN (normal BP), 3 months after discharge, was significantly higher in the intervention group compared to the control group [87.5% (n = 21) vs. 23.1% (n = 6), respectively] (P < 0.001). CONCLUSION: SCE discharge program with telephone re-educative follow-ups was effective in reducing mean BP. The use of this program as a discharged plan for older adults with HTN and comparison of readmission rates for a longer period are recommended.

Nurses' Empowerment in Self-Care Education to Stroke Patients: An Action Research Study.

BACKGROUND: Self-care needs are major problems among stroke patients. Nurses can support them through interventions such as education, a change in their attitude and emphasis on their remaining abilities. However, research has shown some weak points in the quality of care given to these patients. So the aim of this study was to improve the nurses' practice in self-care education to stroke patients. METHODS: The findings of evaluation phase showed that during action research, approaching the nurses' empowerment in self-care education to stroke patients has been set in motion. The nursing practice improvement, knowledge based practice, nurses' attitude change, ability to respond against routinization, and motivation promotion emphasize the success of change process. Facilitators and barriers of educating patients are acknowledged by the participants as a factor influencing the continuation of change. RESULTS: The lack of nurses' educating performance skills was overcome using action research and changes were made to improve the performance of nurses. CONCLUSIONS: The lack of nurses' educating performance skills was overcome using action research and changes were made to improve the performance of nurses.

Nurse-led action research project for expanding nurses' role in patient education in Iran: Process, structure, and outcomes.

BACKGROUND: Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses' role in patient education in Iran. MATERIALS AND METHODS: This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. RESULTS: A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. CONCLUSIONS: A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses' educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.