The Effect of Simulation-Based Education on Patient Training Correct Inhaler Technique of Nursing Students: A Randomized Controlled Trial.

Introduction: Teaching inhaler techniques to nursing students is crucial. Objective: This study aimed to investigate the effect of simulation-based education on patient training correct inhaler technique in nursing students. Methods: This is a single-blind, randomized controlled trial in which nursing students are randomly allocated into two groups of control (n = 41) and intervention (n = 40). The students' mean score of correct inhaler technique was measured before and one week after intervention, using checklists of inhaler techniques. Results: The mean score of control group was significantly lower than the intervention group (p < .001). The results also revealed that there was no significant difference in students' level of confidence regarding the ability to educate patients on inhaler techniques before the intervention, while all students were shown to have higher levels of confidence in this term after the intervention. Conclusions: Simulation is an effective way to train nursing students in the correct inhaler techniques.

The effect of evidence-based nursing education on nurses' clinical decision making: A randomized controlled trial.

Introduction: Nurses are the largest group of health-care providers and their clinical decisions have an essential role in patients' clinical condition. Evidence-based nursing has been proposed as a health-care method based on the latest findings and evidence. Therefore, we aimed to determine the effect of evidence-based nursing education on dialysis nurses' clinical decision-making. Material and Methods: This single-blind experimental study conducted in 2021 at dialysis wards of teaching hospitals affiliated to Urmia University of Medical Sciences. In this study, a total of 60 dialysis nurses were recruited using convenience sampling and allocated to two groups of intervention (n = 30) and control (n = 30). Data were collected at three time points of before, 1 week after, and 1 month after the intervention using a demographic questionnaire and the Lauri and Salantera Clinical Decision-Making Questionnaire (LSCD-MQ). Nurses in the intervention group received 12 sessions of evidence-based nursing education, while nurses in the control group received no intervention. Results: The results showed the mean score of clinical decision-making had a significant decreasing trend over time (p < 0.001) so that it decreased significantly 1 week after the intervention (72.83 ± 4.90) compared with before the intervention (69.5 ± 67.34) in the intervention group. Moreover, participants' decision-making moved toward analytical decision-making. The results also indicated there was a significant difference between the baseline mean score of clinical decision-making and the postintervention mean scores obtained 1 week (p = 0.025) and 1 month (p = 0.001) after the intervention. However, this difference was not found to be significant in the control group (p = 1.000). Conclusions: The study results indicate the positive effect of evidence-based education on nurses' clinical decision-making. Therefore, nurses are recommended to apply evidence-based education methods to improve their level of clinical decision-making. Health officials are also recommended to hold in-service evidence-based workshops to update nurses' knowledge.

Effect of spiritual intelligence training on nurses' skills for communicating with patients - an experimental study.

BACKGROUND: Since poor communication with the patient has a negative impact on the quality of nursing care, taking the necessary measures to strengthen the relationship with the patient seems necessary. This study was conducted to determine the effect of spiritual intelligence training on nurses' skills for communicating with patients. MATERIALS AND METHODS: This experimental study with the control group and the pretest-posttest design was conducted on 70 nurses working in Imam Khomeini Hospital, Mahabad, in 2019. Randomized stratified sampling was used to recruit participants. Then, participants were randomly assigned to the two groups of control and intervention. The demographic information form and the patient-nurse communication skill questionnaire were used to collect the data. For the intervention group, 7 spiritual intelligence training sessions were held as a workshop in 2 months. Two weeks and a month after the intervention, both groups completed the questionnaires. Data were analyzed with the SPSS software version 17.0. RESULTS: The findings showed that the mean communication skill scores in the intervention group before training were 44.71 ± 7.62, which significantly increased to 66.22 ± 8.43 2 weeks after training. Bonferroni multiple comparisons showed the mean communication skill scores significantly increased before, 2 weeks later and in the follow-up phase in the intervention group (P < 0.001). CONCLUSION: Spiritual intelligence training is effective in improving the communication skills of nurses. It is recommended that the prepared content can be provided to in-service training units; consequently, nurses can improve their communication skills by individual and group learning.

Threats to the dignity of COVID-19 patients: A qualititative study.

Background: Dignity is a fundamental concept that has been threatened by the COVID-19 pandemic. Several factors threaten the dignity of COVID-19 patients, whether in palliative care departments, medical or surgery wards, intensive care units, or long-term care facilities. This threat is exacerbated by the increasing number of affected patients, the high transmission of the virus and problems such as limited resources, shortage of workforce, and ineffective communication. Recognizing the threats and challenges that currently affect the patients' dignity and managing them can help maintain the patients' dignity and increase their satisfaction. Research objective: This study seeks to explain the threats to the dignity of hospitalized COVID-19 patients. Research design: This qualitative study was conducted using conventional content analysis. Data were collected through in-depth, semi-structured, face-to-face interviews with 21 COVID-19 patients with maximum variation. Data were analyzed using Graneheim and Lundman's conventional content analysis and encoded with MAXQDA-10 software. The participants had already recovered from COVID-19 when the interviews were held. Ethical considerations: The study protocol was approved by the Research Ethics Committee of medical universities in northwestern Iran (IR.UMSU.REC.1399.345). Ethical principles were observed during the study. Findings: The analysis of the interviews revealed three main categories and 11 subcategories for the threats to the dignity of COVID-19 patients. The main categories included facing imposed conditions (five subcategories), facing unprofessional performance (four subcategories), and ineffective communication (two subcategories). Conclusion: The findings of the present study can help health officials and policymakers in taking positive steps to maintain patients' dignity by designing and implementing beneficial programs.

Effects of Reflexology on the Pain Intensity among Patients with Depression after Receiving Electroconvulsive Therapy: A Randomized Clinical Trial.

Introduction: High prevalence of psychiatric disorders and the high effectiveness of electroconvulsive therapy (ECT) have made this treatment a useful intervention. Memory impairment, headache, and muscle pain are the most important complications after ECT. This research aimed to determine the effect of reflexology on the headache and muscle pain intensity of patients after receiving ECT. Methods: This randomized controlled trial was conducted in Razi teaching hospital of Urmia, Iran. A total of 56 patients with depression receiving ECT were randomly assigned into two equal groups of control (n=28) and intervention (n=28). In the intervention group, reflexology was performed for 20 minutes at reflex points and, in the control group, only the conventional measures were taken. Pain intensity was measured with visual analogue scale (VAS) before and 1, 6, and 24 hours after the intervention. Data were analyzed using the SPSS software version 13. Furthermore, chi-square, Mann-Whitney, Wilcoxon, and repeated-measures tests were performed. Results: The mean difference in the severity of headache and muscle pain in the intervention group was significantly reduced compared to the control group. Moreover, the results demonstrated a significant difference between the mean headache and muscle pain in the two groups after the intervention. Conclusion: The results of this study showed the positive effect of reflexology on reducing the intensity of pain in patients receiving ECT. Thus, it is recommended that nurses, health care providers, and caregivers use reflexology to reduce pain in patients with depression receiving ECT.

The Effect of Peer Education on Management of Chemotherapy Side Effects in Patients with Cancer.

BACKGROUND: Chemotherapy drugs may have numerous side effects for patients. Thus, this study was conducted with the aim to determine the effect of peer education on the management of chemotherapy side effects in patients with cancer. MATERIALS AND METHODS: This randomized, controlled trial was conducted on 80 patients with cancer in 2018. They were allocated to two groups of intervention and control. The self-care education on chemotherapy side effects was provided by the peers to the individuals in the intervention group. The data collection tools included a demographic characteristics form and the Self-Care Diary (SCD). Data analysis was performed using independent t-test and Chi-square test in SPSS software. RESULTS: The results showed that the mean scores of the effectiveness of self-care behaviors were significantly higher in the intervention group compared to the control group after the intervention (p < 0.05). CONCLUSIONS: Peer education is recommended for cancer patients undergoing chemotherapy.

Comparing relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers.

BACKGROUND: Death anxiety is one of the most common problems among women with cancer, which can affect the useful treatment process. With regard to the superior role of spiritual well-being over other aspects of health, the present study is aimed to compare the relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers. METHODOLOGY: This was a descriptive-correlational study. Research statistical population included Iranian women with cancer at major hospitals in Isfahan, Iran. 160 research samples were selected through convenience sampling method based on inclusion criteria using a demographic questionnaire, spiritual well-being scale (Paloutzian et al.) and death anxiety scale (Templer). Research data were analyzed through SPSS 22 using independent t-test, Pearson's correlation, and analysis of variance at significance level 0.05. RESULTS: The study findings indicated a significant inverse relationship between death anxiety and spiritual well-being (at 0.05) in both groups. As a result, people with higher spiritual well-being would experience less anxiety about death. In addition, the relationship between death anxiety and spiritual well-being in women with gastric and colorectal cancers was stronger than those with breast and cervical cancers. CONCLUSION: Spiritual well-being is of effective factors of death anxiety among women suffering from cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities for these women. Furthermore, paying attention to the spirituality by nurses may shield against individual difficulties.

Effects of Foot Massage on Severity of Fatigue and Quality of Life in Hemodialysis Patients: A Randomized Controlled Trial.

BACKGROUND: Despite the advances in treatment, fatigue is a common symptom experienced by many patients undergoing hemodialysis, and is associated with poor health-related quality of life. The aim of the present study was to explore the impact of foot massage with chamomile oil and almond oil on the severity of fatigue and quality of life of Hemodialysis patients. METHODS: In these four parallel groups controlled clinical trial, 120 male patients under hemodialysis were randomly assigned to foot massage groups and control (30 in each group) from June 2016 to April 2017 in Urmia, Iran. foot massage using either chamomile oil, almond oil or no oils was provided to patients undergoing hemodialysis for two months. The primary outcome measures were the Fatigue Severity Scale (FSS) and secondary outcomes included quality of life using the Short-Form Quality of Life for Renal Patients questionnaire (KDQOL-SF). Data were analyzed using ANOVA, Tukey's and paired t-test in SPSS the (Version 16) at the significance level P<0.05. RESULTS: The mean FSS scores after the implementation of foot massage in all intervention groups were significantly lower than the control group (P=0.005). Mean KDQOL-SF scores after the intervention in all intervention groups increased compared to the control group, but this increase was not statistically significant (P=0.34). CONCLUSION: Foot massage appears to be effective in reducing fatigue and improving quality of life in patients undergoing hemodialysis. Further studies are needed to confirm and extend these results. Furthermore, involvement of patients' companions as family caregivers in massage therapy can lead to continuation of this effective intervention at home. Trial Registration Number: IRCT2016121731438N1.

The Effect of Peer Education on Knowledge, Comprehension, and Knowledge Application of Patients Regarding Chemotherapy Complications.

BACKGROUND: The aim of the present study was to determine the effect of peer education on the level of knowledge, comprehension, and knowledge application of patients regarding chemotherapy complications. MATERIALS AND METHODS: This study was performed on 80 patients with cancer undergoing chemotherapy in 2018. The participants were selected through convenience sampling and randomly allocated to the two groups of control and intervention (40 participants per group). Before the intervention, the participants in both groups completed a demographic characteristics form and the Educational Needs Assessment Questionnaires. Then, the peer education intervention was designed based on the educational needs of the patients regarding chemotherapy complications for the intervention group. Peer education was performed face-to-face and individually during two chemotherapy sessions. The questionnaires were re-administered to both groups 2 weeks after the end of the second chemotherapy session and data analysis was performed using independent t-test, Chi-square. RESULTS: The means of knowledge (t78 = 19.74, p < 0.001), comprehension (t78 = 17.27, p < 0.001), and knowledge application (t78 = 14.84, p < 0.001) were significantly increased after peer education in the intervention group compared to the control group. The difference in the means of knowledge (t39 = 17.40, p < 0.001), comprehension (t39 = -18.53, p < 0.001), and knowledge application (t39 = -13.94, p < 0.001) after peer education, compared to before the intervention, was significant in the intervention group. CONCLUSIONS: Peer education can lead to increased level of knowledge, comprehension, and knowledge application of patients in terms of chemotherapy complications.

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial.

OBJECTIVES: Coronary angiography can be stressful for patients and anxiety-caused physiological responses during the procedure increase the risk of dysrhythmia, coronary artery spasms and rupture. This study therefore aimed to investigate the effects of peer, video and combined peer-and-video training on anxiety among patients undergoing coronary angiography. METHODS: This single-blinded randomised controlled clinical trial was conducted at two large educational hospitals in Iran between April and July 2016. A total of 120 adult patients undergoing coronary angiography were recruited. Using a block randomisation method, participants were assigned to one of four groups, with those in the control group receiving no training and those in the three intervention groups receiving either peer-facilitated training, video-based training or a combination of both. A Persian-language validated version of the State-Trait Anxiety Inventory was used to measure pre- and post-intervention anxiety. RESULTS: There were no statistically significant differences in mean pre-intervention anxiety scores between the four groups (F = 0.31; P = 0.81). In contrast, there was a significant reduction in post-intervention anxiety among all three intervention groups compared to the control group (F = 27.71; P <0.01); however, there was no significant difference in anxiety level in terms of the type of intervention used. CONCLUSION: Peer, video and combined peer-and-video education were equally effective in reducing angiography-related patient anxiety. Such techniques are recommended to reduce anxiety amongst patients undergoing coronary angiography in hospitals in Iran.

Threats to nurses' dignity and intent to leave the profession.

BACKGROUND: It is essential to pay attention to and respect the dignity of nurses to maintain them in their profession while they deliver skilled nursing care. Little is known, however, about how a sense of dignity influences the practitioner. OBJECTIVES: The purpose of this study is to describe nurses' experiences of threats to their dignity occurring within clinical settings, which generates an intention to leave clinical practice. RESEARCH DESIGN AND METHOD: The study was performed using qualitative content analysis. The participants were 21 clinical nurses with work experience who were employed across a range of clinical posts. Data obtained from the semi-structured interviews were analyzed and interpreted using a content analysis approach. Ethical considerations: The study was approved by the Ethics Committee of Tabriz University of Medical Sciences and was guided by the ethical principles of voluntary enrolment, anonymity, privacy, and confidentiality. FINDINGS: Within data analysis, three main themes and nine categories were extracted as follows: (1) lack of professional pride (physician's dominance, intangible nature of nursing, and negative attitude toward clinical nurses); (2) oppressive work environment (high workload, disrespect, discrimination, and lack of support); and (3) suppression of progressivism (lack of appreciation and attention to meritocracy). DISCUSSION: Almost all of the participants have experienced some degree of disrespect and violation of dignity. In general, attempts made by the participants to show their objection to the threats and to support and protect their dignity have not been effective and in fact made them more inclined to leave the clinical work. CONCLUSION: According to the views of nurses themselves, identification of the factors threatening nurses' dignity can be one of the appropriate solutions for the broader and deeper investigation of this phenomenon and can help promote and support nurses' dignity and their retention within the profession.

The Effect of Group Discussion-based Education on Self-management of Adults with Type 2 Diabetes Mellitus Compared with Usual Care: A Randomized Control Trial.

OBJECTIVES: We sought to determine the effect of group discussion-based education on the self-management capability of patients with type 2 diabetes in Iran. METHODS: This randomized control trial was conducted on 90 patients with type 2 diabetes. Participants were allocated randomly into one of two groups; intervention and control. The intervention group received the group discussion-based education while the control group received routine care only. The Lin's self-management questionnaire was completed at baseline and three months post-intervention. RESULTS: Statistical analysis, including the use of independent t-test, identified that in comparison to the control group, significant increases were observed in the scores of self-organization (t =11.24, p < 0.001), self-adjustment (t = 7.53, p < 0.001), interaction with health experts (t = 7.31, p < 0.001), blood sugar self-monitoring (t = 6.42, p < 0.001), adherence to the proposed diet (t = 5.22, p < 0.001), and total self-management (t = 10.82, p < 0.001) in the intervention group. CONCLUSIONS: Sharing experiences through group discussions and receiving instructive feedback can improve the ability to self-manage diabetes.

A Grounded theory study of the intention of nurses to leave the profession.

Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

A Grounded theory study of the intention of nurses to leave the profession / Estudo utilizando a Teoria Fundamentada sobre a intenção das enfermeiras de abandonar sua profissão / Estudio utilizando la Teoría Fundamentada sobre la intención de las enfermeras de abandonar su profesión

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

RESUMO Objetivo: este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. Método: o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. Resultados: segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. Conclusão: os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los.

RESUMEN Objetivo: este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. Método: el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. Resultados: según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la organización: en busca de una salida". Conclusión: los hallazgos de este estudio proporcionan información útil sobre las necesidades de las enfermeras para superar las intenciones de abandonar el cuidado de cabecera. La identificación de este proceso puede ayudar a reconocer los problemas emergentes y ofrecer soluciones para resolverlos.

A qualitative exploration of facilitators and inhibitors influencing nurses' intention to leave clinical nursing / Análise Qualitativa dos Facilitadores e Inibidores que Influenciam a Intenção dos Enfermeiros de Abandonarem a Enfermagem Clínica / Análisis Cualitativo: Facilitadores e Inhibidores Influyentes Sobre Voluntad de Enfermeros Para Abandonar la Enfermería Clínica

Abstract OBJECTIVE The aim of this study was to determine the barriers and facilitators shaping the development of an intent to leave the nursing profession, from the perspective of Iran's clinical nurses. METHOD The study was completed using qualitative content analysis And included 21 Participants who were clinical nurses with a variety of work experience across a range of clinical posts. Semi-structured interviews were used to collect data and data obtained from the interviews were analyzed and interpreted utilizing a content analysis method. RESULTS During data analysis, 2 main themes, 5 categories and 12 subcategories were extracted as follows. Facilitators include: (I) spoiled identity (weak social status and violation of dignity), (II) frustration (feeling subordinate including a lack of appreciation), and (III) experience of hard labor (job stress, hard work and shift work). Inhibitors include: (I) positive management behaviors (rewards and support systems), and (II) being valuable (spiritual satisfaction, the efficient presence and professional capabilities development). CONCLUSION Based on the findings, it can be concluded that managers can prevent nurses from leaving clinical nursing by providing appropriate activities for them and increasing their motivation and satisfaction.

Resumo OBJETIVO Este estudo teve como objetivo determinar as barreiras e facilitadores que definem o desenvolvimento de uma intenção de abandonar a profissão de enfermagem, sob a perspectiva de enfermeiros clínicos do Irã. MÉTODO O estudo foi realizado através da análise de conteúdo qualitativo e incluiu 21 participantes que eram enfermeiros clínicos com vasta experiência de trabalho em uma variedade de cargos clínicos. A coleta de dados foi realizada através de entrevistas semiestruturadas, e os dados obtidos com as entrevistas foram analisados e interpretados através do método da análise de conteúdo. RESULTADOS Durante a análise dos dados, 2 temas principais, 5 categorias e 12 subcategorias foram obtidos como indicado a seguir. Os facilitadores incluem: (I) identidade debilitada (status social vulnerável e violação da dignidade), (II) frustração (sentimento de subordinação, incluindo falta de reconhecimento) e (III) experiência de trabalho árduo (estresse ocupacional, trabalho árduo e trabalho por turnos). Os inibidores incluem: (I) gestão de comportamentos positivos (recompensas e sistemas de apoio) e (II) ser útil (satisfação espiritual, eficiência e desenvolvimento de habilidades profissionais). CONCLUSÃO Com base nos achados, pode-se concluir que supervisores responsáveis podem impedir os enfermeiros de abandonarem a enfermagem clínica, delegando-lhes atividades pertinentes e aumentando sua motivação e satisfação.

Resumen OBJETIVO Estudio objetivando determinar obstáculos y facilitadores condicionantes del desarrollo de la intención de abandonar la profesión de enfermería, en la perspectiva de enfermeros clínicos de Irán. MÉTODO Se aplicó análisis cualitativo de contenidos. El estudio incluyó 21 participantes, todos ellos enfermeros clínicos con variada experiencia laboral en el campo de la enfermería clínica. Datos recolectados mediante entrevistas semiestructuradas, posteriormente analizados e interpretados por método de análisis de contenido. RESULTADOS Durante el análisis de datos fueron establecidos 2 temas principales, 5 categorías y 12 sub categorías, a saber. Los facilitadores incluyen: (I) identidad damnificada (status social debilitado y violación de la dignidad), (II) frustración (sentimiento de subordinación incluyendo falta de reconocimiento), y (III) percepción de alta carga laboral (estrés laboral, trabajo duro y turnos de trabajo). Los inhibidores incluyen: (I) comportamientos positivos de gestión (sistemas de recompensas y soporte), y (II) sentirse valorado (satisfacción espiritual, presencia eficiente y desarrollo de capacidades profesionales). CONCLUSIÓN En base a estos hallazgos, puede concluirse en que los gestores pueden prevenir el abandono de la profesión de los enfermeros clínicos brindándoles actividades apropiadas para ellos e incrementando su motivación y satisfacción.

Towards an understanding of clinical nurses challenges that leads intention to leave

Abstract Objective: Clinical nursing is the most important feature of the nursing profession and similar to the global community. The study objective was to identify and describe the challenges and why Iranian nurses leave their profession. Methods: Qualitative methods were applied to describe nursing practice challenges through in-depth and semi-structured interview of 16 Iranian nurses with 2 to 15 years of work experience in 2014 by asking: “Please tell me about your challenges at work and why nurses are leaving the nursing profession?” Obtained data were analyzed using conventional content analysis. Results: Analyzed data revealed four thematic categories as 1) unfriendly workplace, 2) lack of opportunity for professional advancement, 3) work stress, and 4) ethical issues. Conclusion: Recognizing nursing challenges in clinical setting can help faculty in academia and administrators in healthcare institutions to develop policies to reduce pitfalls and prevent attrition.

Experiences of Iranian Nurses that Intent to Leave the Clinical Nursing: a Content Analysis.

INTRODUCTION: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. METHODS: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. RESULTS: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I) Entry routes into nursing (implicitly entry, targeted entry), (II) Defects in dignity (lack of professional vision toward the nurses, social status of nurses), (III) Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement), and (IV) Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours). CONCLUSION: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field.

A qualitative exploration of facilitators and inhibitors influencing nurses' intention to leave clinical nursing.

OBJECTIVE: The aim of this study was to determine the barriers and facilitators shaping the development of an intent to leave the nursing profession, from the perspective of Iran's clinical nurses. METHOD: The study was completed using qualitative content analysis And included 21 Participants who were clinical nurses with a variety of work experience across a range of clinical posts. Semi-structured interviews were used to collect data and data obtained from the interviews were analyzed and interpreted utilizing a content analysis method. RESULTS: During data analysis, 2 main themes, 5 categories and 12 subcategories were extracted as follows. Facilitators include: (I) spoiled identity (weak social status and violation of dignity), (II) frustration (feeling subordinate including a lack of appreciation), and (III) experience of hard labor (job stress, hard work and shift work). Inhibitors include: (I) positive management behaviors (rewards and support systems), and (II) being valuable (spiritual satisfaction, the efficient presence and professional capabilities development). CONCLUSION: Based on the findings, it can be concluded that managers can prevent nurses from leaving clinical nursing by providing appropriate activities for them and increasing their motivation and satisfaction.

Coping Strategies to Hinder Intention to Leave in Iranian Nurses: A Qualitative Content Analysis.

BACKGROUND: Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. METHODS: A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. RESULTS: Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). CONCLUSION: Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares.