The contribution of the nursing profession to the establishment of social justice: A grounded theory study.

BACKGROUND: Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention. OBJECTIVE: This study aimed to identify and explain the processes of the nursing profession's participation in establishing social justice in healthcare system. RESEARCH DESIGN AND METHODS: This qualitative study was conducted using the grounded theory method. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss' 2015 method. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS: The "Professional Dynamics in the Path of Justice" was the study's core category. This theory is the result of nine main categories: "inefficient professional authority," "social justice, a neglected component in education," "clinical concerns, barriers to nurses' presence in society," "individual input reserves to facilitate social justice," "inadequate maturity of the profession in the path of equity in health," "promoting justice in clinical practice," "a tendency to community-oriented profession," "use of personal approaches for justice promotion," and "emerging justice-expanding nursing." These categories cover the underlying factors, strategies, and outcomes of the nursing profession's participation in establishing social justice process in healthcare. CONCLUSION: The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended.

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.

Social justice in health system; a neglected component of academic nursing education: a qualitative study.

BACKGROUND: In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the main factors for teaching the concept of social justice in the nursing curriculum. METHOD: This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data. RESULTS: Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education. CONCLUSION: Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators, specially training in the area of ethical ideology and social justice.

Factors Affecting Nurses' Impact on Social Justice in the Health System.

BACKGROUND: Social inequities in health systems are threats to global health. Considering the important role of nurses in establishing social justice, identification of factors affecting nurses' participation in this area can contribute to the development of social justice. OBJECTIVE: This study aimed to identify factors affecting nurses' participation in establishing social justice in the health system. RESEARCH DESIGN AND METHODS: The study was conducted using conventional qualitative content analysis approach. Purposive sampling was used to select 14 participants in 2019. The data were collected through semi-structured interviews and analyzed concurrently with data gathering. PARTICIPANTS AND RESEARCH CONTEXT: In total, six faculty members, five nursing managers, and three clinical nurses from three different universities were interviewed. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS: Four main themes were found, including inadequate professional authority, insufficient attention to social justice in the area of education, clinical concerns as barriers to professional presence in society, and reflection of personality traits in the profession. These are the main factors affecting nurses' participation in establishing social justice in the health system. DISCUSSION: Authorities need to take effective steps to establish social justice through reforming the health system's policy-making and power-acquisition domains, promoting nurses' involvement in social factors in health issues, and adding professional values as a part of nursing curriculum. The clinical practice environment can also be helpful through providing quality, safe, and cost-effective services. In addition, fair and efficient recruitment process for new nurses can contribute to the establishment of social justice in the health system. CONCLUSION: Macro-level managerial factors such as policy, education, and clinical environment, along with personal factors, play a significant role in the participation of nursing profession in establishing social justice.

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.

Comparative study of virtual and traditional teaching methods on the interpretation of cardiac dysrhythmia in nursing students.

INTRODUCTION: Due to the importance of correct interpretation of electrocardiogram (ECG) in the quality of healthcare delivery, new educational methods are increasingly being implemented and evaluated. In this regard, the purpose of this study was to compare the traditional and virtual teaching methods on the interpretation of cardiac dysrhythmia in nursing students. METHODS: The present study is a quasi-experimental research with pretest and posttest design. Sixty nursing students in the seventh semester from schools of nursing in Urmia and Khoy cities were randomly assigned to two virtual and traditional education groups. Students' knowledge was measured by a researcher-made 30-item test. RESULTS: The mean and standard deviation of the students' scores in the traditional education group was 11.20 ± 4.41 and 14.40 ± 4.62 and in the virtual group was 11.30 ± 2.74 and 18.43 ± 4.68, pre- and post-training, respectively. Paired t-test showed a significant difference between the mean score of pretest and posttest in both types of training (P < 0.001). According to the results of independent sample t-test, there were no significant differences between the two groups before the training (P > 0.05). However, in the posttraining period, there were significant differences between traditional and virtual education groups (P < 0.001). CONCLUSION: Considering the results of this study, which shows the positive effects of virtual education method on nursing students' knowledge about cardiac dysrhythmia, this method can be used as an alternative or complementary method to the traditional education.

Factors affecting conscience-based nursing practices: A qualitative study.

BACKGROUND: Conscience is a guiding factor in nursing practice for delivering the ultimate care. In order to expand the concept of conscience-based care, factors affecting conscience in nursing practice need to be identified. OBJECTIVES: The current study assessed nurses' experiences to explore factors affecting conscience in nursing practice. RESEARCH DESIGN: This qualitative content analysis study employed purposive sampling to reach 14 nurses working at educational hospitals in Tabriz and Urmia, Iran. Data were analyzed using inductive and conventional analysis. ETHICAL CONSIDERATIONS: This research was approved by the Ethics Committee of Urmia University of Medical Science. Voluntary participation, anonymity, and confidentiality were considered. FINDING: Two themes emerged from our analysis for enhancing conscience in nursing practices, including environment of professional performance and personal factors. DISCUSSION: The two important factors for enhancing conscience in nursing practice are environment and personal factors. CONCLUSION: It is necessary to emphasize on religious beliefs, professional commitment, and communication skills in educational training structure. Also, establishing appropriate management systems will help nurses to provide moral care.

Challenges in the clinical education of the nursing profession in Iran: A qualitative study.

INTRODUCTION: Clinical education is an important part of nurse training. It provides students with the opportunity to gain useful experience and has a key role in their professional preparation. The importance of clinical education in nursing students' professional performance means that identifying the challenges in this field is crucial. AIM: The goal of this study is to identify challenges in the field of clinical nurse education. DESIGN: A qualitative content analysis study. SETTING: A faculty of Nursing and Midwifery, in Iran 2017. PARTICIPANTS: Nine student nurses, three qualified nurses and two nursing educators. METHODS: This study has been applied to various depths of interpretation. Semi-structured interviews were used to collect the data. Nine student nurses, three qualified nurses and two nursing educators were interviewed. RESULTS: The analysis of the interviews generated five categories. Two main themes were extracted as challenges in the clinical training of nursing professionals: 1. Inefficient educational structure and 2. Inefficient professional performance environment. CONCLUSION: Considering the inadequate professional performance environment and defective educational structure, designing and delivering lessons with clear goals is essential. Using objective and measurable scales for evaluating educational standards, the use of empowered instructors with high communicational skills is useful for increasing students' motivation and interest toward clinical education and solving existing challenges.

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.

Content analysis and qualitative study of hemodialysis patients, family experience and perceived social support.

BACKGROUND: Various treatments such as hemodialysis prolong the life of chronic renal failure disease patients who must tolerate many physical, emotional, social and economic difficulties. Therefore, social support is considered as a vital area of investigation for such patients. OBJECTIVES: In this qualitative research, a grounded theory approach was used and written as a content analysis form to study hemodialysis patients and family experience of perceived social support. PATIENTS AND METHODS: Three nurses, 4 general practitioners, a specialist and two family members who participated were interviewed from April to September 2012 in Urmia, Iran. Interviews were guided to divulge the perception of changes in their lives, needs for social support for disease complications, and the type of treatment process. Purposive sampling continued up to data saturation. Data analysis was performed based on Strauss and Corbin Method. Constant comparison analysis was performed until data saturation. RESULTS: The research results are shown in 3 steps. In the first step, 113 categories and four main themes from 993 first codes were explored. Social support was explored based on the implications of five general themes including "Perceived Threats Caused by Disease Complications", "Searching for Social Support", "Accessible Social Support", "Beliefs and Values", and "Perceived Social Support". CONCLUSIONS: The core variable of our research is acceptance of the reality of the conditions caused by the disease. The research finalized our knowledge about patient problems regarding social support and revealed many problems of supporting patients by Health Team Members, family members and organizations. The findings suggest that individual aspects of patient experiences must be considered if social support is to be given and Healthcare Providers have to facilitate positive health services.