فهرست مطالب عاطفه واعظی

The ever-increasing speed of changes in today's world has led to the emergence of an era called uncertainty, and an environment full of opportunities and threats has made the current complex systems a precursor. One of the challenges of accurate and big planning for the future is the uncertainty inherent in the future and rapid changes in various fields in health. A powerful tool that predicts future competitive environments and develops long-term strategy even in environments with the greatest uncertainty is the scenario planning tool. Scenarios are descriptions of future situations and possible events in those situations so that a person can move from their current situation to a planned future. Scenario writing is not only a planning tool, but also an effective learning tool. Thinking about scenarios helps us to understand the logic of development, to recognize driving forces, trends and challenges. Drivers are a set of future-shaping forces that affect different futures globally or locally. Proponents perform the task of advancing and solving challenges simultaneously. For its development and sustainability, nursing education needs drivers so that it can maintain its existence in a turbulent age. Drivers are the main factors consisting of several processes that cause change in a studied area. Nursing education in the country, while having many challenges and crises, has diverse and somewhat unknown capacities. Drivers and trends that, if identified and applied, can overcome some of the existing challenges. Therefore, the current research tries to identify the key factors and the main drivers involved in nursing education and then by designing the desired and probable scenarios in the future, it provides a framework for policy making and flexible planning according to the conditions. Therefore, the current research was carried out with the aim of scenario planning the future of nursing education in Iran.

This research was conducted with an exploratory nature and with the aim of knowing the leading futures in the field of nursing education in Iran in the undergraduate course. In the first stage, in order to identify drivers and trends, qualitative interviews with nursing professors of Iran and Delphi universities were used. Sandelowski and Barroso's seven-step method was used for synthesis. In the second step, a semi-structured interview was used. The participants were selected in a goal-based way from nursing professors who had managerial experience in nursing education. Interviews were conducted by phone and in person. The Shannon entropy method was used to analyze the content of the codes. In the third step, the Delphi method was used to confirm and evaluate the drivers identified. 30 people, including nursing specialists (members of nursing board and teaching assistants and managers of nursing departments in all nursing schools of medical sciences universities of the country) participated in the research by means of targeted sampling. A report of the drivers and trends obtained from the previous stage along with a summary of the research method and research objectives was sent to the members. For evaluation, scoring was used in the form of 0 to 5. This process continued in three consecutive rounds of e-mail and face-to-face visits. Then, using a panel of experts, the influence and uncertainty of the identified trends were scored. In the next step, using influence/uncertainty diagrams, the key axes for writing the scenario were determined. Scenarios were designed by Scenario Wizard software version 11/4 and strategies were presented. The validity of the scenarios was examined from the four perspectives of feasibility, internal consistency, usefulness and differentiation. All four conditions were acceptable according to the experts.

In the meta-synthesis stage, after internet search, 723 articles were reviewed, among which nine articles were used for the final analysis. At the end of this stage, the researcher identified 127 codes, which according to the purpose of the research and also based on the semantic proximity and the only verbal difference between some codes, the codes were merged and brought under a common title. Finally, 24 codes were identified. In the next step, considering the concept of each of these codes, they were categorized into a similar concept. In order to evaluate the quality, the results were given to one of the experts to be evaluated by the Kappa index. Using SPSS version 16 software, at a significance level of 0.05, this coefficient was obtained as 0.83, which shows the appropriate reliability of the codes. In the interview phase, 17 nursing professors (2 professors, 6 associate professors, 6 assistant professors, and 3 instructors) with an average clinical experience of 16 ± 1.2 years and an average managerial experience of 6 ± 3.1 years were interviewed. A total of 23 interviews were conducted with an average of 25-30 minutes. 15 of the interviews were conducted over the phone and the rest of the interviews were conducted in person. In this step, 356 codes were obtained. The findings of the content analysis were categorized using Shannon's entropy, and the results were entered into the next step for agreement and confirmation. In the third step, the experts agreed on 6 drivers and 31 trends. With five key uncertainties, the scenario was designed in three optimistic, intermediate and pessimistic assumptions. According to the size of the matrix and its dimensions (15 x 15), four problem-oriented, ethical, maintaining the status quo and closed educational system scenarios were reported for nursing education in Iran.

In the current study, four different scenarios were designed. Ultimately, each of these scenarios is believable and each has the potential to be realized, but which one will happen depends on today's plans. Scenarios have no prescription for the future itself, but rather a short film of the possibilities that may occur. This research is an analysis of the reliable results of our current possible actions. Further researches can obtain indicators for these scenarios. The application of future planning methods such as scenario in Iran's national health system can be considered as a warning system for awareness of opportunities and threats before the crisis. In order to improve the future of nursing education in Iran, it is recommended to form an expert working group with technical skills of scenario planning for more coordination in the strategic planning of specialized and sub-specialized fields and to formulate a comprehensive plan for the correct implementation of future planning projects. The manager or decision maker of the health field can see the serious part of the consequences of different decisions in the form of future scenarios of experience and future failure points right now.

The nursing education course faces challenges that can be solved with simple and low-cost measures if properly identified. Otherwise, the challenges will turn into a crisis and their solution will be difficult and costly. However, there is no tool available to examine the challenges of nursing education in Iran.

This research is a combined study that was conducted in two stages. In the first stage, the terms of the questionnaire were compiled using the qualitative interview of the study, as well as the review of authentic texts related to the topic of the research. In the next step, during a methodological study, the psychometric characteristics of the questionnaire were determined using face validity, content (CVR & CVI) and exploratory factor analysis, as well as reliability with internal consistency and stability methods.

The pool of items including 30 expressions was extracted. After determining face validity, qualitative and quantitative content validity, the number of questionnaire statements was reduced to 28 items. The result of the exploratory factor analysis of this questionnaire, three factors including "defective educational cycle", "educational structure challenge" and "overall neglect as a member of the education family", these three factors explained a total of 72.01% of the variance of the entire test. Cronbach's alpha coefficient was 0.865 and the stability through retest with intraclass correlation test was 0.8.

Considering the desired validity and reliability of the 27-item questionnaire of nursing education challenges, its use by researchers is recommended.

The Comprehensive Child Development Center was established in 2012 in the center of Isfahan province to rapidly identify and intervene in the developmental problems of children. The aim of this study was to evaluate the implementation of this program.

This was a descriptive-analytical study conducted based on the framework for evaluating public health programs established by the Center for Disease Control and Prevention of United States of America with regard to evaluation of infrastructure, process and outcome. The infrastructure’s checklist included an area of land, equipment, workforce and equipment completed with presence of researcher at the center. Process and outcome evaluation was performed for 127 registered children during 2019. A satisfaction questionnaire was completed in person or remotely by parents of 144 children referred to the center in 2019 and 2020. Data were analyzed using descriptive statistics and independent t-test, and one-way ANOVA was carried out through SPSS 16 software.

The overall compliance of infrastructure with standards was 75.42%, with the highest compliance related to the equipment and the lowest related to the specialized workforce. The degree of compliance of the process compared with the standard one varied in different dimensions. 6.30 % of the children were cured and 76.38 % quit treatment. The most common reasons for treatment discontinuation were lack of appointment (29.53 %) and long distance (18.12 %). The overall satisfaction score was 83.90 ± 14.08. The satisfaction of the parents who completed the questionnaire in person was higher than those who completed the questionnaire remotely.

The results of this study revealed that the rate of complete cure is low and the rate of treatment discontinuation is high, whose main reasons were the lack of appointment to admit children with developmental disorders and long distance. It is suggested that, in order to solve the problem, the Ministry of Health establish more centers and provide the required workforce.

Problem solving skills are at the highest level of human cognition and are considered to be the most valuable educational goals. Due to the nature of the discipline, medical students need to upgrade their problem-solving skills. This article aimed to investigate the findings of studies on the use of problem-based Learning in medical education.

In this systematic review, using the databases SID and Irandoc, Magiran and Iran Medex from and searching the Scopus, Pubmed, Web of Science databases from 1970 to 2018, Barley and extracted. Then, all articles that had inclusion criteria were studied. To increase the reliability of the study, two researchers evaluated the quality of the articles separately.

Of the 4500 original articles, 16 articles were reviewed in the final review. 15 items were quantitative and one of them was a qualitative article. The findings of the articles point to the fact that using the problem-based method in self-directed learning is effective. In this way, students analyze information and achieve the result and avoid repetition and memorization.

Use of modern teaching methods to motivate students to actively participate is necessity. Improving students' ability to access and use resources independently to improve their ability to solve problems in medical science education is one of the important issues that should be given special attention, therefore, it is recommended to use this method both in theory education and in clinical education of students.

  Indecivility is a widespread problem in today's health care. Indecisiveness and violent behavior are complicated problems in the nursing profession, which causes significant problems for nurses, patients and health organizations. The aim of this study was to explore the lived experiences of incivility among a group of Nurses. This study was conducted based on the qualitative approach, using an interpretive phenomenological method. Using purposeful sampling method, 14 participants were selected and shared their experiences regarding incivility at the workplace through individual, in-depth and semi-structured interviews. The transcribed interviews were analyzed based on the Colaizzi approach. . The lived experiences of nurses regarding incivility in workplace emerged as “Indurance in the way of destruction and humiliation”as the main theme. The extracted themes were “Obvious and latent difficulties of being a nurse” including four subthemes (insulting encounter of the patient and accompanies; non-professional interactions; organizational and professional challenges; social challenges regarding profession). The second theme was extracted as “multi-dimentional breakdown” including three subthemes (psychosocial and personal instability; negative physical responses, forthcoming professional threats and damages). Incivility behaviors among nurses can affect the quality of services provided by them. Therefore, considering factors that lead to incivility in nursing workplace is necessary.

  Patient falls are among the most significant threats to patient safety. Nurses play a pivotal role in maintaining and improving the standards of patient safety. The work environment of nurses is among the major influential factors in this regard. The present study aimed to investigate the association between the incidence of patient falls and work environment of nurses. This correlational study was conducted on 300 nurses employed in the hospitals affiliated to Tehran University of Medical Sciences, Iran, who were selected via proportionate stratification sampling. Data were collected using a questionnaire with three sections of demographic data, work environment of nurses, and patient falls. Data analysis was performed in SPSS version 16 using Pearson’s correlation-coefficient, Kruskal-Wallis test, t-test, and frequency tables. Mean age of the participants was 32±6.17 years, and the majority were female (86.7%) and married (64%). Mean incidence of patient falls was 6±1.61 within the past three months, and the mean score of the work environment of nurses was estimated at 67.34 (favorable). A significant, weak correlation was observed between the work environment of nurses and incidence of patient falls (P<0.034; r=-0.15). Given the significant association between the incidence of patient falls and work environment of nurses, it seems essential that nursing managers adopt effective strategies to improve the working conditions of nurses through the participation of nurses in decision-making, support, and adequate staff and resources, thereby facilitating safe patient care.

Considering morality, especially in researches that have human subjects, is necessary because, with ethical breaches, the main goal of these studies is that the welfare of human beings and the attention to dignity and human dignity will not be realized. One of the clear examples for using human samples in research is research on prisoners. The purpose of this study was to review articles related to ethical principles in research on prisoners. In this systematic review three-step search was used. Using the databases SID and Irandoc, Magiran and Iran Medex from 2011 to 2017 and searching the Scopus, Pubmed, Web of Science databases from 1970 to 2017, Barley and extracted. The keywords used in Persian and English were Ethics, Research, Prisoner, Prison. Then, all articles that had inclusion criteria were studied. To increase the reliability of the study, two researcher evaluated the quality of the articles separately. The most important ethical considerations raised in the articles include informed consent, the interests of the community, the secrecy of the prisoner, and the explanation of the profit and loss of research for prisoners. Research using vulnerable groups or communities is justified only if ethical principles have been designed and implemented including informed consent, consideration of the subject's interests and secrets in order to meet the health needs and the priorities of the same group or community, and there is a reasonable probability Whether the same group or community will benefit from the results of that research.

Contribution is the main element in inter-professional relationship between the nurse and physician، requiring collaborative relationship and sharing information to reach a common therapeutic goal. the collaboration between the nurse and physician in clinical decision-making is a necessity for high-quality care in hospitals. This study aimed to determine nurses'' perspective about collaboration in clinical decision- making. This descriptive study was conducted on the nurses selected by convenience sampling and inclusion criteria in state، private and social well-fare hospitals، 2011. The data was collected by a questionnaire including demographic and nurse-physician collaboration questions، whose validity and reliability were evaluated by content validity and test re-test. Descriptive statistics such as frequency mean and standard deviation was used. The results showed that the samples (76. 5%) were females، aged between 30 and 39. 5 (58. 3%)، BSc of nursing (93. 5%)، contract employment (53. 8%) and 5-9 year record of services (50%). The viewpoint of the nurses about collaboration in decision-making was moderate (70. 8%)، good (7. 5%) and weak (14%). Based on the results، a few nurses are satisfied their collaboration with physician in decision-making. It seems that the nurse-physician contribution in therapeutic procedure got the highest point، and absence of opportunity in giving comment got the lowest score.

Moral distress is considered as an important issue in nursing. Nurses participation in ethical decision making and taking deliberate action are facing them with many ethical challenges in their work environment. Confronting those challenges can lead to moral distress.This descriptive study was conducted to determine moral distress and its contributing factors from the perspective of oncology nurses in Tehran teaching hospitals in 2011.Data collection was done through a demographic questionnaire, the Moral Distress Scale – revised (MDS-R) and a questionnaire on moral distress related factors administered to all oncology nurses with inclusion criteria.Findings showed that nurses reported a high level of moral distress overall. The highest level of moral distress was associated with giving inadequate information to patients about informed consent and carrying out a physicians’ order for unnecessary tests and treatments. A significant correlation was found between oncology nurses’ age, their work experience and employment status with moral distress. Institutional factors such as managers’ support, nurses’ autonomy and having determined duties had the greatest effect on moral distress from oncology nurses’ view. Oncology nurses commonly encounter situations that are associated with high levels of moral distress, and therefore strategies need to be developed in order to mitigate moral distress.