Journal of Qualitative Research in Health Sciences
Volume:5 Issue: 1, 2016

The relationship that develops between the midwife and women is at the core of human care. However, there is a lack of knowledge about the communication features of midwifes and mothers in various situations and settings. Thus, their experience in the delivery room can be the basis for the body of knowledge in their profession and provide a clear and comperhensive concept of their relationship based on the prevailing sociocultural context.
The present qualitative content analysis was conducted on 32 participants who were selected through purposive sampling. The participants consisted of 16 midwifes and 16 mothers hospitalized in the postpartum ward of a hospital affiliated to Arak University of Medical Sciences in 2013. Data were gathered through unstructured and semi-structured interviews. Interviews were transcribed verbatim and analyzed using the conventional content analysis approach. Sampling ceased when data saturation was achieved.
The data analysis revealed 2 themes that encompassed the midwife-mother relationship. The 2 themes were communication as the essence of midwifery care and reflection of communication. Each theme consisted of clasifications and main codes.
According to the results, the concept of the midwife-mother relationship in the delivery room was identified as therapeutic alliance. The findings enhanced understanding of the meaning and dimensions of the midwife-mother relationship beyond the traditional meaning. This study offers evidence of the essence of this relationship and may go some way towards the creation of a written body of midwifery knowledge. The results can assist midwives in providing holistic and high quality care to mothers during labour, and thus, provide positive outcomes in normal child birth.

The hospital, as the most important organization in the delivery of health care services, requires effective and efficient management more than other organizations. Therefore, the skills and capabilities of hospital managers are important issues. The aim of this study was to determine the skills, capabilities, and requirements of hospital managers.
This qualitative study was conducted in Shiraz University of Medical Sciences, Shiraz, Iran, in 2015. The study population was composed of teaching hospital managers, senior managers, faculty members, and postgraduate students of Shiraz University of Medical Sciences. Sampling was conducted through purposive sampling method and continued until data saturation. In this study, interview and focus group discussion were used for data collection, and data analysis was performed using content analysis method.
The skills and capabilities of hospital manager were classified into 7 themes (communication, work experience, managerial knowledge, knowledge of the hospital, motivation and interest, systemic thinking and problem solving, individual characteristics and integrity) and 24 sub-themes. For the enhancement of these skills and capabilities, 2 themes (empowerment before and after obtaining the managerial post) and 8 sub-themes were identified.
Hospital management requires specific skills and capabilities. Decision makers and policy makers in the health sector should select hospital manager based on these skills.

Changes in diseases pattern and increase in demand have necessitated private hospitals’ involvement in the health system. The purpose of this study was to analyze the private hospital industry in order to identify its strengths and weaknesses.
This qualitative study was carried out through phenomenological approach. The study participants consisted of 17 experts and chief managers of private hospitals and were selected through purposive and snowball sampling. Data collection was conducted through semi-structured interviews. The data were analyzed using framework analysis method.
The challenges of the private hospital industry, in the format of Porter’s diamond model, included 4 main themes and 21 minor themes. The most important challenges of private hospitals were shortage of medical equipment and facilities, old hospital building and physical environment, nursing shortage, lack of job security, and poor of management skills. The strengths of private hospitals were patient satisfaction with welfare services, good relationship between healthcare personnel and patients, and observance of the patient rights charter.
Dominance of profit on the private sector's management viewpoint, lack of state financial support, limitations on signing contracts with a variety of supplemental insurances, and poor government monitoring are the major causes of problems in private hospitals. The realization of private-public cooperation in community health improvement can be expected through increased government support and the improvement of the quality and quantity of human, informational, and physical resources.

In the year 1995, the novel hospital administration plan (fee for service) was presented. Based on this plan, a percentage of specific revenues are allocated as a fee to the hospital staff. This plan was implemented in hospitals for 20 years. In early September 2104, the new guideline entitled the performance-based fee was designed with the aim of eliminating the deficiencies in the previous plan and implemented in hospitals in Isfahan, Iran. Therefore, the present study was performed with the aim of studying the strengths of the performance-based scheme in selected teaching hospitals of Isfahan in 2014.
This was a qualitative study. In-depth interviews were used to collect data. The study participants consisted of 11 middle managers and executive managers of university hospitals and university headquarters, faculty members, and hospital officials. The subjects were selected through purposive sampling method. All interviews were recorded and transcribed verbatim. The duration of the interviews varied between 30 to 60 minutes. Data analysis in this research was based on thematic analysis.
In this research, the 4 main strengths of "defining and developing appropriate guidelines, improving the monitoring system, improving the management information system, and organizing the fee payment system" were obtained.
The results of the present study revealed the 4 main strengths of the performance-based scheme. Thus, in order for the health system to be effective, the strengths of the performance-based plan must be evaluated and used to reduce the dissatisfaction of hospital staff.

Presently, in many countries, certain groups of nurses are allowed to prescribe medicine. Despite the increasing attention of the world to nursing prescription and emphasis of the World Health Organization (WHO) on its implementation in regional countries, a review of literature indicated that there is no evidence of nursing prescription in Iran. Thus, this study aimed to assess the necessity of nursing prescription from the perspective of the Iranian nursing policymakers.
This descriptive qualitative study was performed through interviews with 14 nursing policymakers. The participants were selected through purposive sampling method. Semi-structured interviews were used to collect data. Interviews were conducted after coordination with participants and in their workplace. All interviews were recorded using a digital voice recorder. Interviews were simultaneously transcribed verbatim and analyzed using conventional content analysis through inductive approach. The coding was performed using MAXQDA software. To achieve the accuracy and reliability of the data, the Lincoln and Guba authenticity criteria were used.
Analysis of the recorded interviews resulted in the extraction of the 3 main categories of "the right to health and individual’s requirements", "the current situation of the clinical setting", and "nursing prescription outcomes".
The views and perspectives of nursing policymakers indicated that due individuals’ right to health and need for health care services, and also the positive outcomes that may result from nursing prescription, the necessity of its implementation is felt. However, there are challenges to its implementation that require the relevant authoritie's efforts to resolve them.

Brain death is one of the greatest crises experienced by families who are faced with the decision of organ donation. Families of brain dead patients are faced with many psychological problems. Thus, the experiences of intensive care unit (ICU) nurses regarding the psychosocial status of family members of organ donating patients were studied in the present study.
This qualitative study was conducted through phenomenological approach. The study participants consisted of 8 nurses of ICUs in Kerman, Iran, who were selected through purposive sampling. Subjects were assured of confidentiality of data and were able to leave the study any time they wished. Data were collected through open and semi-structured in-depth interviews until data saturation was achieved. All interviews were recorded, transcribed verbatim, and analyzed using Colaizzi's method.
Through analysis and integration of codes, 3 main codes and 13 secondary codes were extracted. The main code of unknowns consisted of the secondary codes of ambiguity, anxiety, unknowns, and the reaction of family members. The main code of understanding the family’s critical situation contained the secondary codes of fear of remorse, the chances of recovery, others’ lack of approval, and obsessive thoughts. Moreover, the main code of understanding the cultural, social, and religious aspects consisted of the secondary codes of altruism, religious beliefs, growing up in difficult circumstances, interests and expectations, and emotional relationships.
The psychological problems of families of brain dead patients can be managed through the elimination of the unknown, understanding the critical situation of the family, and understanding their cultural, social, and religious status. In this way, these difficult stages can be passed in greater psychological tranquility.

Physical activity and exercise play an important role in the health of individuals within a society, including children and adolescents. Thus, the aim of this study was the exploration of the role of the background factors of family, peers, school, and media in the internalization of sports culture in children and adolescents.
This qualitative study was conducted using content analysis method. The study population included experts in the field of child and adolescent sports (12 university professors of physical education, 4 heads of physical education of Iranian schools, 3 professors of education sciences who had a sport-related field of study, 4 professors of sport sociology, and 2 professors in the field of culture and sport). The subjects were selected using purposive sampling method. Data were collected through interviews. Data from the 25 semi-structured interviews were analyzed through Graneheim and Lundman approach to content analysis.
Data from the 3 main categories of family and peers, school, and media were classified into 10 subcategories. The main category of family and peers consisted of the subcategories of emotional support by parents and peers, cognitive support by parents and peers, parents’ economic support, cooperation and participation of parents and friends, and competition with peers. The main category of school contained the subcategories of activities supported by facilities within the school, and out of school activities. The main category of media was classified into the subcategories of techniques used to attract, exercise training, and support models.
In the present study, it was found that family and peers, school, and the media have an important role in the internalization of sports culture in children and adolescents. Therefore, it is recommended that these groups attempt to develop this culture through relying on supportive, facility, and educational roles.

Hepatitis is a chronic disease which greatly impacts patients’ lives. Since patients with chronic hepatitis have special care needs, they experience many challenges. Therefore, the purpose of this study was to explore self-care in patients with chronic hepatitis.
This qualitative study was conducted through directed content analysis method among patients with chronic hepatitis in 2013 at Tehran University of Medical Sciences, Iran. The study participants were selected through purposive sampling and data was collected through semi-structured interviews. Content analysis was used to extract data from verbatim transcripts of the participants’ interviews.
In this study, the 4 themes of requirements in the matrix of time and place, self-care agency, the need for change in self-care, and disease outcome were extracted.
The results of this study showed that patients with hepatitis have specific vital, basic, sexual, physical, economical, and psychological-behavioral needs, and need for respect and belonging. These needs had a negative impact on self-care in patients with hepatitis.

Focused ethnography is a distinct type of sociological ethnography which particularly is predominantly used in applied health studies. Considering Due to the application of focused ethnography in clinical research and lack of Persian sources for this research methodology, this study was conducted to provide a comprehensive thorough explanation of focused ethnography based on the available resources.
This paper is a traditional review of 21 articles and 17 books in relation toon focused ethnography which have been published between 1979 and 2015. These documents have beenwere retrieved from databases including ISI Web of Science, Science Direct, and PubMed as well as relevant books using keywords of qualitative research, ethnography, and focused ethnography. and Then, they have beenwere analyzedsed in terms of major themes and common concepts. In this review, English articles, which included certain English search terms in their title or keyword section, were evaluated.
Focused ethnography investigates the relationship between cultural beliefs and health behaviors and instead of exploring large cultural groups and ethnicities focusesd on the shared behaviours and experiences of small groups. In focused ethnographic methodsstudies, data are collected through semi-structured interviews and observation combined with field notes, cultural and /personal interactions, and the use of demographic data sheets. The analysis of the data started was conducted simultaneously with data collection.
Generally, focused ethnography is a methodology to of building background knowledge in order to take the required measures to design therapeutic interventions in line with the culture of a society, and consequently, improveing public health.

In the grounded theory research methodology, one of the main concerns of researchers is how and when to use the existing literature. Followers of Glaser believe that, in grounded theory, literature should not be reviewed before the research, because this awareness causes the researcher to unconsciously influence the research. However, the followers of Strauss believe that, in grounded theory, literature review before the beginning of the research is essential.
This study was performed by an extensive review of literature in databases, such as Springer, ProQuest, Oxford Journals, Wiley Online Library, SAGE Publications, Scopus, and ScienceDirect, and also books on qualitative research method.
Literature review in grounded theory can act as an assessment device for an emerging theory and enrich it, does not necessarily need to be considered at the end of the research because it can enhance the inductive research process.
Initial literature review is not the only effective factor on the research process; the researcher's previous experiences and knowledge of the subject can also affect the emerging theory. However, researcher reflexivity, use of short notes during the research, annotation, and writing previous experiences can reduce the impact of the researcher on the study process.

Werdnig-Hoffman syndrome is a progressive neurodegenerative disease and an autosomal recessive disorder. This was a qualitative case study focusing on lived experiences of the mother of 2 children with Werdnig-Hoffman syndrome.
Case Report: The case was a 37-year-old widowed, mother of two children with Werdnig-Hoffman syndrome. The first child had died at age 5 due to breathing and swallowing issues and the second child is now 2 years old and has tracheostomy. The mother's experiences of living with children with Werdnig-Hoffman syndrome were “the disintegration of family life, observing the slow death of a children, understanding the children’s feelings, and caring for an ill child”.
The results of the present study suggest that the mother had experienced distress due to the disintegration of life, and observing the death of a child, and caring for a sick child. Financial problems, substance abuse, and the death of the spouse were due to the crippling costs and issues of the disease.