The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study.

BACKGROUND: Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing. METHOD: This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software. RESULTS: The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement. CONCLUSION: There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

Clinical competence in nursing: A hybrid concept analysis.

BACKGROUND: Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing. METHODS: This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined. RESULTS: The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care. CONCLUSION: CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

Nurses' Job Burnout: A Hybrid Concept Analysis.

Introduction: Job burnout can significantly affect nurses' physical and mental health and the quality of the care services they provide. Yet, there is no clear definition for job burnout in nursing. This study aimed to analyze the concept of nurses' occupational burnout. Methods: This concept analysis was conducted, using the three-phase hybrid model. In the theoretical phase, online databases, namely Iranmedex, Scientific Information Database (SID), Science Direct, MagIran, ProQuest, Web of Sciences, Scopus, and PubMed were searched to retrieve studies published from 2007 to 2018. In the fieldwork phase, twelve semi-structured interviews were conducted with nurses and head-nurses selected from teaching hospitals in Isfahan, Iran. The interviews were transcribed and analyzed through thematic analysis. In the final analytic phase, the findings of the first and the second phases were combined. Results: Based on the findings of the theoretical and the fieldwork phases, job burnout can be defined as, "a state of physical, mental, emotional, and social exhaustion resulting from the negative effects of unmanaged occupational stress and inadequate managerial and social support, which reduces interest in and motivation for work, affects care quality, and results in negative attitudes and behavior towards self, clients, and the work". Conclusion: This study provides an in-depth understanding of the concept of job burnout in the nursing context of Iran. Managers need to develop strategies for job burnout prevention and management based on its contributing factors.

Bias in clinical trials into the effects of complementary and alternative medicine therapies on hemodialysis patients.

BACKGROUND: Chronic renal failure is among the major health challenges in the world. Many clinical trials have been conducted to assess the effects of complementary and alternative therapies on hemodialysis-related outcomes. However, a number of biases may affect the results of these studies. AIMS: This study aimed to assess biases in randomized clinical trials into the effects of complementary and alternative therapies on hemodialysis patients. SETTINGS AND DESIGN: A critical review on clinical trials into the effects of complementary and alternative therapies therapies on hemodialysis patients. MATERIALS AND METHODS: This study was conducted on 114 randomized clinical trials which had been published in 2012-2017 into the effects of complementary and alternative therapies on hemodialysis patients. The Cochrane Risk of Bias Tool was employed to assess biases in the included trials. The collected data were presented using the measures of descriptive statistics, namely absolute and relative frequencies. RESULTS: Among 114 included trials, 71.05% (81 trials) had used low bias methods for random sequence generation, while 60.52% (69 trials) had provided no clear information about allocation concealment. Moreover, respecting blinding, 57.89% of trials (66 trials) were low bias. Around 60.52% of trials (69 trials) had no attrition between randomization and final follow-up assessment and 84.21% (96 trials) had apparently reported all intended outcomes. CONCLUSIONS: This study shows that 50% of randomized clinical trials into the effects of complementary and alternative therapies on hemodialysis patients have low bias. Yet, quality improvement is still needed to produce more conclusive evidence.

Hopkins Syndrome in a 14 Year Old Boy; a Case Report.

Hopkins syndrome (HS) is a flaccid paralysis resembling poliomyelitis that has been seen in some children who are recovering from an acute episode of asthma. This syndrome should be suspected based on clinical findings even before the occurrence of characteristic breathing patterns and epilepsy. We report a 14-year-old boy who had experienced an episode of HS.