فهرست مطالب sadat seyed bagher maddah

Emergency medical services (EMS) personnel are subject to moral hazards during work, leading them to find moral distress (MD). Our literature review showed a gap in knowledge related to MD in EMS personnel. Therefore, this study investigated MD and its influential factors in pre-hospital emergency technicians.

This descriptive-analytic study was conducted in Iran in 2017. A convenience sampling method was used to select 265 technicians working in EMS from several cities in Iran. The MD thermometer was used to measure the MD in the technicians. The collected data were analyzed using SPSS software, version 20.

All the participants were male with mean age and work experience of 31.64±6.5 and 7.76±5.1 years, respectively. The mean score of MD was 4.6±1.8 (out of 10). Nearly 76% of the participants were with moderate levels of MD. A significant relationship was observed between the willingness of technicians to change or leave their job and the mean scores of MD in the participants.

EMS technicians experienced moderate levels of MD. Therefore, healthcare planners and policymakers need to pay more attention to this issue due to the complications of MD in healthcare personnel.

Among the members of the rehabilitation team, nurses play a key role in the rehabilitation process and are responsible for the specialized care of patients with disabilities. In order to provide these cares, nurses need to acquire various skills, which are important to know in order to provide quality care. Therefore, this study, through a qualitative approach, has explained the required competencies of rehabilitation nurses in caring for patients with disabilities.

In this qualitative content analysis study, 14 nurses working in Rafideh Rehabilitation Hospital (Tehran/Iran) were participated. Participants were purposively selected based on their willingness to participate in research and experience caring for patients with disabilities. Data were collected through in-depth semi-structured interviews and data analysis was based on the steps suggested by Granheim and Lundman. The correctness and robustness of the collected data were evaluated based on Lincoln and Goba criteria.

After analyzing the findings from 17 interviews, three main classes of "proficiency in providing care" with four subclasses (acquiring rehabilitation knowledge, mastering general nursing knowledge, having general and specialized skills), the main category "constructive communication with the patient" with three subcategories (cultural sensitivity, reliability, active listening) and the main category "personality characteristics" with six subcategories (resilience, honesty, ethics, patronage, participation, compassion) emerged.

The results show that the rehabilitation nurse needs to strengthen various aspects of his existence, including general and specialized knowledge and skills, the ability to communicate constructively with the rehabilitation team, the patient and the family, as well as acquiring positive personality traits in order to be able to best to fulfill their roles and responsibilities. The results of this research can help nurses to achieve the maximum level of individual competence and nursing managers to identify and select the most qualified nurses to provide care for patients with disabilities.

Inactivity plays an important role in the prevalence of chronic diseases, such as diabetes. Proper self-care behaviors, including mobility and physical activity, affect the control and prevention of complications in diabetic patients. This study aimed to investigate the effectiveness of self-care programs on mobility and physical activity in people with type II diabetes.

In this Quasi-experimental study, 40 patients with type II diabetes were randomly assigned into two groups. As the intervention, mobility and physical activity self-care program was conducted in partnership with their families in the residence. Reliability and validity levels of mobility and physical activity questionnaires in measuring self-care behaviors were checked (area related to mobility and physical activity was used (. Data collected before and after the training were compared and analyzed using the SPSS software (version 16).

The scores for mobility and physical activity were similar between the two groups before the training (P>0.05). Six weeks after the training, no significant difference was found in the mean scores of mobility and physical activity between the two groups (P<0.05).

The results showed that the self-care program was effective in changing the lifestyle of people with type II diabetes in terms of mobility and physical activity. Therefore, self-care programs are recommended for all areas of self-care behavior, especially mobility and physical activity in type II diabetes and other chronic illnesses.

Planning for the issuance of professional competency examination has been put on the agenda of professional policymakers, but the ways of evaluating and conducting examinations and its dimensions are the main challenges. The present study aimed to explain the essential dimensions of professional competency examination in Iran from academic and clinical nurses’ perspective.

The present mixed‑method study was performed at three stages, systematic review, qualitative, and quantitative stages. At the first stage, 56 articles and texts were collected from PubMed, CINHAL, Ovid, and ProQuest databases, by using the keywords, namely professional competency examination and assessment. Base on the inclusion criteria and eligibility assessment of article, six articles and one text on regulation were selected. At the second stage, the results of the literature review were approved by 20 nursing experts. Direct content analysis was used for data analysis. The results were prepared in the form of a questionnaire. At the last stage, the questionnaire was given to 2209 clinical, academic, nurse managers, and nurses.

Based on findings of the review literature, essential dimensions of the professional competency examination included a central theme of the client’s needs with four categories. At the second stage, the Professional Competency Examination dimensions were approved by experts. At the third stage, a comparison of findings indicated that clinical nurses emphasized more on cardiopulmonary resuscitation, client safety, and implementation of procedures, while academic nurses emphasized on the client’s needs, client education, and clients’ physiological integrity.

The client’s need is the most important dimension in the professional competency examination. The nurses will be successful in providing care if they can identify the clients’ needs and provide care plans based on client needs and priorities.

Recovery of children does not appear on its own after cochlear implantation. Coherent, thoughtful, and comprehensive rehabilitation is needed to achieve complete success. The purpose of this study was to identify the types of rehabilitation interventions for children with cochlear implants that have been performed in Iran.

A scoping review study was conducted. An electronic search was carried out both in English and Persian. In English, the following keywords were used: cochlear implantation, child, cochlear implants, auditory rehabilitation, deaf, hearing loss, comprehensive, interventions, rehabilitation, and telerehabilitation and a combination of them in ProQuest, PubMed, Science Direct, and Scopus databases, Web of Sciences, Medline and Embase. Persian electronic search was conducted in the Scientific Information Database (SID) of Jihad Daneshgahi, Iran Journals Database (MagIran), and Islamic World Science Citation Database (ISC). Searches were done using articles published until September 25, 2020, and a total of 902 articles were found, of which 14 were directly related to the purpose of the study. Interventional studies were included in the study, and the quality of studies was measured using the Structured Effectiveness Quality Evaluation Scale.

The results showed that using music and rehabilitation equipment, different methods of speech therapy and auditory training, story-based instruction, creative play, family-centered instruction, and occupational therapy are interventions in cochlear implant rehabilitation. Speech therapy accounts for 54% of the rehabilitation share. The mean number of rehabilitation sessions was 26. These interventions were all somehow effective in children with cochlear implantation; the longer the training duration, the better the results.

The process of cochlear implant rehabilitation in children is multi-professional; auditory training and speech therapy possesses the highest share of rehabilitation. Therefore, it is recommended to develop speech therapy centers in Iran.

Collaborative learning encourages students to work with peers and leads to the development of problem-solving and communication skills, and the transfer of knowledge learned in the classroom to be used in the clinical setting. This study aims to explain the role of collaborative learning experiences of nursing students in the field of clinical training.

In this qualitative study, 20 nursing students who experienced specialist clinical training were selected using object-based sampling. The data were collected using semi-structured and focus group interviews. The interviews were transcribed verbatim and the relevant themes were extracted and categorized using content analysis.

The results revealed that group interactions lead to useful experiences in clinical works. It was also shown that collaborative learning affects the clinical success of nursing students. The participants stated that group work in clinical settings is the most important learning experience in the training course. While contributing to learning development, group participation helps the students to deal with the assigned tasks more efficiently and support each other by sharing their knowledge and establishing friendly relations. The themes derived from the data included 1) peer support, 2) clinical reasoning, and 3) group capabilities.

Collaborative learning is an important factor in improving clinical work. The results of the present study underlined the weakness of educational programs in terms of collaborative learning. Therefore, educators and education professionals are recommended to support the development of a suitable context for active and collaborative education and learning.

In medical ethics, privacy is one of the main aspects of patient rights. Since the outcomes of respecting privacy as one of the dimensions of patient's rights are not clear, this study was performed to explore outcomes of observance for patient privacy in hospital.

This study was conducted with qualitative research approach and contractual content analysis method. Participants included 20 patients hospitalized in the internal and surgical wards of Tehran's hospitals who were selected based on purposeful sampling. Data was collected using semi-structured interviews. Then data was analyzed based on conventional content analysis method and using the MAXQDA 10 software.

Analyzing the interviews with patients, 56 primary codes, 13 subcategories and 4 themes were extracted, which indicated the perception of participants for consequences of observance for privacy. These themes included: preservation and promotion of the dignity of the patient, compromise with the existing situation, health development and satisfaction.

The results of this study showed outcomes of observance for patient’s privacy. With the treatment team's awareness of these consequences, the patients' expectations are respected, which leads to the provision of favorable health care and patient satisfaction.

The unique characteristics of each emergency situation and the necessity to make prompt decisions cause emergency medical services (EMS) staff’s ethical conflicts and moral distress.

This study aimed to explore EMS staff’s experiences of the factors behind their moral distress.

This qualitative study was conducted on 14 EMS staff using the conventional content analysis. Data were collected through unstructured and semi‑structured interviews. Each interview was started using general questions about moral issues at workplace and barriers to professional practice. The five‑step content analysis approach proposed by Graneheim and Lundman was used for data analysis.

The factors behind EMS staff’s moral distress were categorized into 13 subcategories and 5 main categories. The main categories were staff’s lack of knowledge and competence, inability to adhere to EMS protocols, restraints on care provision, ineffective interprofessional communications, and conflicts in value systems. The subcategories were, respectively, inadequate knowledge and experience, working with incompetent colleagues, artificial services, working in unpredictable situations, lay people’s interference in care provision, resource and equipment shortages, barriers to early arrival at the scene, obligatory obedience to the system, poor interprofessional interactions, inadequate interprofessional trust, refusal of care, challenges in obtaining consent, and challenges in telling the truth.

EMS staff experience moral distress at work due to a wide range of factors. Given the negative effects of moral distress on EMS staff’s physical and mental health and the quality of their care services, strategies are needed to prevent or reduce it through managing its contributing factors.

Privacy is one of the basic human needs and one of the most important nursing concepts of care ethics. Several definitions have been proposed for it, since the cultural norms and values of each society and the specific position of each individual in the community are effective in defining and determining its scope. Therefore, in order to provide proper cultural care, it is important to examine the privacy of patients. Therefore, this study aimed to investigate the viewpoints of hospitalized Patients to Respecting Privacy.
The present study was carried out with qualitative content analysis method on 20 patients hospitalized in internal and surgical wards of governmental hospitals of Tehran in 2017. Data collection was based on Purposive sampling and using semi-structured individual interviews. In interviews; hospitalized patients reported experiences with respect to their privacy during hospitalization. The interviews were recorded and handwritten and analyzed on the basis of qualitative content analysis.
The analysis of hospitalized patient's experiences with respect to privacy in the hospital resulted in the extraction of five Category and 10 subcategory. The privacy implications included the dynamics of privacy, physical privacy, information privacy, psycho-social privacy and Religious spirituality privacy.
The findings of this study showed that privacy of hospitalized patients has different dimensions and care should be taken to all aspects of it. According to the findings of this study, we can conclude that privacy policies should be provided according to the patient's perspective in the health care system.

Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses’ daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses.
This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi‑structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim.
Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1) individual competencies (knowledge, experience, emotional intelligence, and loving children), (2) ethical imprinting (responsibility, reflection, empathy, and ethical beliefs), and (3) an environment that nurtures moral values (organizational, spiritual, family, and cultural environments) as facilitating factors.
The promotion of nurses’ competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.

Context: Considering the stressful conditions of life and social difficulties, an important question is why are some people can show positive adaptation and avoid mental health disorders, while others cannot? The present study aimed at reviewing the national studies on the correlation between resilience and mental health.
Evidence Acquisition: In this systematic review, all national articles published in international and national databases were searched without restrictions, using the following keywords: “Resilience OR Resiliency” AND “Mental health” OR “General Health” and their combinations. The Persian equivalents of these words were also used in Persian language sites. Finally, based on PRISMA guidelines, 15 studies were selected. The results of these studies were combined using the random effects model of meta-analysis.
In the present research, 16 correlation studies were examined without time limits, and with a sample size of 3157. Overall, a positive correlation was found between resilience and mental health in the national studies (r = 0.48). The results showed that the correlation between resilience and mental health was lower in the population of school and university students than among other populations (r = 0.39, compared to r = 0.54). The analysis based on geographical division indicated that the highest correlation between resilience and mental health existed in the fifth area (r = 0.83), and the lowest correlation was found in the fourth area (r = 0.35).
By providing cognitive, behavioral and emotional responses in stressful situations, resilience can maintain and improve mental health.

Cardiovascular patients need information to preserve and promote their health, but not all of them have the necessary motivation to seek relevant health knowledge..
The present study analyzed experiences of patients, family caregivers, and healthcare providers to explore the motivating factors that cause cardiovascular patients to seek important health information..
Patients and This study was conducted using a qualitative approach and conventional qualitative content analysis method. Thirty-six people, including 18 cardiovascular patients, 7 family caregivers, and 11 healthcare providers (from multidisciplinary backgrounds) participated in the study. The data were collected through semi-structured interviews and purposeful sampling and continued until data saturation. Data collection and analysis proceeded simultaneously and with constant comparison; this study was carried out from May 2012 to May 2013..
During the analysis process, three main themes were extracted that characterized participants’ experiences, perceptions, and motivations to seek health information. The themes were “Optimizing quality of life, “Desire for personal rights to be respected,” and “Gaining confidence through consultation.”.
Our findings showed that, through seeking information, patients try to achieve well-being and realize their personal rights as well as their right to security. They should also be encouraged to enhance their quality of life by using the Knowles’ learning theory to formulate their needs and learning priorities..

Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents.The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure,Barriers related to the profession and Barriers related to managerial issues. Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries.

Type II diabetes, can be controlled by medical treatment and self care behaviors, however the patients often fail to comply with self care behaviors. Concerning the role of family in supporting patients’ self care behaviors, the aim of this study is to determine the effect of a family –centered education of self care behaviors based on family- centered empowerment model on patients with type II diabetes.Methods and materials:The quasi-experimental design carried out on 40 patients with type II diabetes who were randomly assigned to intervention and control groups. The education of self care behaviors in four domains (nutrition, physical activity and exercise, medications, complications and foot care) for intervention group and their families was performed. Data were collected by a valid and reliable questionnaire. The scores of self care behaviors before and after the education were measured. Data were analyzed by the SPSS16 software.

Prior to education, there was no significant difference between self-care behaviors scores in both intervention and control groups (p>0/05). After education, self-care behaviors of the intervention group in total scores and also in all domains were increased and statistically were significant (p <0/05), while there was no significant change in the control group.

The findings showed that this education method improved self -care behaviors among patients with type II diabetes. These results can be used in the other chronic diseases and different levels of nursing care.

Stroke is an unexpected major life incident that effect on physical functioning and can lead to changes in lifestyle and inability to manage self care, work or leisure. To explore the everyday life situation as experienced by stroke survivors, and their family caregivers, this study was conducted 3-6 month after stroke. Twelve stroke survivors and thirteen family caregivers were interviewed and a qualitative content analysis was conducted to analyze data. The results were categorized into two central themes that were identified as; (1) Being challenged by changes in everyday life situation including; the struggle with physical dysfunctions, inappropriate daily plan for leisure activities, changes in mood, being faced with economical problems and being worried about changing roles (2) striving to cope with new conditions including; trying to preserve self-worth, seeking to support from spirituality, learning and re-learning and regaining independency. Physical dysfunction was the major concern for both the survivors and their family caregivers in their everyday life situation. This problem led to, and forced them, to be dependent on others. Training is needed to teach stroke survivors and their families strategies of how to cope with and overcome ongoing challenges of everyday life after stroke and to re-organize their lives and improve skills of the survivors to deal with the new situation at home. A daily plan for spending their time and leisure activities would ease this work. More investigation will be needed to clarify the process of life after stroke to cover this gap

Transferring research-based knowledge into practice would help to maximize the quality of health care. However, the role of knowledge producers and the organizational roles related to knowledge transfer have been largely ignored. This study was accomplished with the aim of describing the organizational activities needed to transfer the findings of nursing research from the viewpoint of nurse educators in Iranian Universities of Medical Sciences.Patients and This descriptive study was carried out with participating 279 nurse educators of medical sciences universities. Data were collected using Knowledge Translation Self-Assessment Tool for Research Institutes (SATORI). Nursing faculty members evaluated the organizational activities of transferring the knowledge of nursing research at the “medium” level and for the domains of “the question of research” and “promoting the use of evidence” at a “weak” level and in the domains of “knowledge production” and “knowledge transfer” at a “medium” level. Organizational activities related to the knowledge transfer of nursing research are demonstrably low (medium at best). It is recommended that in each faculty and with the participation of all faculty members, the research transferring procedure should be assessed and all necessary changes needed to improve the research transferring procedure should be implemented.

In recent years a variety of system models for providing community based health care services for the elderly has been envisioned and implemented in the developed countries which meet the special care needs of different groups of elders. In Iran as a developing country, a considerable percentage of old people live in the society need to receive specialized care and health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as: existing and available resources and facilities (financial and human resources); social and cultural issues and characteristics of each groups of elders(healthy elders, frails,home bounds, …)  seem to be necessary. At the development phase of the care model in this study Ellowing methodological triangulation must be considered: 1) Comprehensive review of current and related literature, 2) Conduction of an ethnographic study on a number of Tehranian elders and their families, 3) Seeking opinions of a group of experts on this issue using nominal group technique, and analysis as well as synthesis of the collected data were employed to develop a community based care system for elders. The preliminary results of employing this care system and examination of expected outcomes such as promoting quality of life and expectancy in elders reflects the efficiency of this system, although further complementary studies and particularly cost benefit analysis are strongly recommended.