جستجوی مقالات مرتبط با کلیدواژه « Case study » در نشریات گروه « پزشکی »

The postpartum period is a critical and important stage for protecting, providing quality care, and developing the health of the mother and newborn. One of the postpartum cares that nurses play an important role, in helping the mother to start and continue breastfeeding. Providing comfort during this period facilitates the mother's adaptation. In this regard, Kolcaba comfort theory is very useful. The purpose of this case study is an application of Kolcaba comfort theory in the postpartum period to promote effective breastfeeding.

In this case study in 2022, The client is a 19-year-old, Caesarean section delivery, primi para, Baby boy with 3350 gr weight, who came to the health center to receive mother and child health services.  she complained about her inability to breastfeed her baby and her physical problems and with a state of anxiety and concern, she constantly asked about the inability to breastfeed  and her own diet during this period. This study was conducted based on the Kolcaba theory which the mother's comfort needs were identified and interventions were provided in the form of a nursing process .in order to evaluate the quality of breastfeeding, Infant Breastfeeding Assessment Tool was used before and after the interventions. .

The mother's needs were diagnosed according to the taxonomic structure in four fields: physical, psychological, cultural, social, and environmental needs and various interventions were implemented according to the nursing process. The results indicated the effectiveness of interventions based on comfort theory in order to meet needs finally, promoting breastfeeding was effective. The infant's breastfeed evaluation score was increased after the intervention.

Complex sociotechnical systems, such as automotive industry, require a proper macro-ergonomic approach to design and implement the work system at micro-ergonomic level. The purpose of this study was to develop and validate effective macroeconomic factors to improve productivity, health and safety of employees in the automotive industry based on Holden & Karsh model.

At the first step, relevant documents were reviewed, and then experts were interviewed to identify macro-ergonomic factors. The identified factors were categorized into four groups based on Holden & Karsh’s model. In the follow-up phase of the study, then, the content validity of the factors was calculated using Delphi technique in the form of an expert panel. Finally, validity acceptance was assessed using mean content validity index, and agreement between experts was evaluated using modified kappa coefficient

28 main factors were identified and categorized into four subgroups, including personnel, unit /department, organization and environment factors. 19 main factors were selected as the effective macro-ergonomic factors to improve employee’s productivity, health, and safety. The content validity index and the modified kappa coefficient were calculated as 0.901 and 0.90, respectively.

Macro-ergonomic factors identified in this study can be considered to improve employee’s productivity, health, and safety in the automotive industry. These factors can be used as specific context-based criteria for an ergonomic evaluation in the automotive industry, or even be generalized to other industries, organizations and companies.

Primary health care system provides appropriate prevention and primary mental care services only for rural population. Therefore, the Community Mental Health Center (CMHC) was developed to provide mental health services in urban areas. The present study aimed to outline the performance, achievements, and challenges of CMHC in Tabriz, Iran.

This was a qualitative pilot study with in-depth interview approach. The outcomes, implications, and challenges of CMHC in Tabriz city were evaluated from 2015 to 2019 using three methods, including conducting in-depth interviews with two executive managers, holding focus group discussion (FGD) with managers and mental healthcare providers, and collecting mental health care indicators from the patients’ health records. After evaluating the challenges, appropriate recommendations to improve mental health services in urban areas were presented.

A total of 17 specialists and general medical doctors collaborated in this study. During the study, 1053 initial visits and/or screenings and 2313 patients with psychological disorders were identified and recorded. Moreover, a total of 988 mental training sessions were held for patients and their families. Five main themes, including the necessity for establishment and objectives, implementation process, achievements, challenges, and recommendations, were identified during in-depth interviews and FGDs.

It seems that CMHC is an appropriate strategy and model for providing basic mental health services, especially in metropolitan cities. Longitudinal studies with a randomized controlled trial design as well as cost-effectiveness evaluation studies are required to confirm CMHC in the Iranian context.

Professional management plays a key role in increasing hospital productivity. Manager succession planning is the process of identifying, training and developing people with the necessary competencies to take on the key management jobs of the organization, which ensures the long-term success of the organization. The commitment and support of the hospital's senior managers is a prerequisite for the success of the manager succession planning. The purpose of this study was to identify the characteristics of a succession planning manager in the hospital.

This qualitative case study was conducted in 2018 at Hasheminejad Hospital in Tehran. The research population consisted of hospital managers and employees. Sampling was done purposefully and with maximum variation continued until data saturation (45 people). Semi-structured individual interviews were used to collect data along with document analysis. Content analysis method was used for data analysis using MAXQDA 11 software. Ethical issues such as informed consent, voluntary participation, participants’ anonymity, information confidentiality and researchers’ objectivity in data collection, analysis and reporting were all considered.

Fourteen characteristics for a succession planning manager were identified and grouped into three main themes of value, psychological and behavioral characteristics. The manager's value characteristics include not having love of position, honesty, human dignity and mutual trust; Psychological characteristics include resilience, forecasting, optimism, self-efficacy and organizational utilitarianism. Finally, behavioral characteristics include communication transparency, organizational involvement, managerial support, meritocracy and managerial stability. These characteristics of a succession planning manager facilitate the succession planning in a hospital.

Health policymakers and senior managers should strengthen these characteristics (value, psychological and behavioral) in health care managers in order to institutionalize succession planning in healthcare.

Nursing profession and field, as a scientific field, needs a scientific basis of which nursing models were and still are. One of the prominent models in nursing is Orem's self-care model. Therefore, this study was conducted with the aim of applying the nursing process based on the Orem self-care model in patients with tibia fractures.

In this case study, the nursing process of a patient with tibia fracture admitted to Ba'ath Hospital in Hamedan city in 2019 was presented. In the stage of nursing research and recognition, data collection was done based on the "Orem self-care model survey form". Nursing diagnoses were compiled and care goals were determined and nursing measures were taken to achieve the goals. Data analysis was presented using a table.

The findings showed that cases of self-care deficiencies and patient self-care needs decreased after nursing measures based on the Orem self-care model. The findings led to 7 nursing diagnoses and 42 care goals.

Using Orem's self-care model as a framework for diagnosis, choosing the appropriate action and evaluating the results was very useful. It is suggested that nursing theories be applied in all departments and on different patients.

Considering the complications of pregnancy such as abortion, preeclampsia, preterm delivery and intrauterine death, identifying mothers who are at risk of pregnancy complications can help control and improve pregnancy outcomes. The goal of this perinatal care study was to achieve good pregnancy outcomes that considered maternal health and good fetal outcomes.

In the present case-control study, 400 pregnant women who were referred to the prenatal clinics of Motahari Hospital in Urmia in the second half of 1398 and the first half of 1399, as well as mothers who were in the first 3 months of pregnancy, were selected and included in the study. They were divided into two groups of 200. The case group consisted of 200 mothers with a serum PAPP-A level of less than 0.4 and no aspirin. The control group also included 200 mothers with serum PAPP-A levels higher than 0.4. Pregnancy complications including preeclampsia, gestational hypertension, placental abruption, fetal growth restriction and intrauterine death were compared between groups.

 The results of this study showed that preeclampsia due to PTL (Preterm Labor) (P = 0.001) and also due to IUFD (Intrauterine Fetal Death) (P = 0.049) had a significant relationship with low serum PAPP-A, while Low serum PAPP-A level was not significantly associated with preeclampsia, IUGR (intrauterine growth restriction) and gestational hypertension.

Measurement of serum PAPP-A alone  cannot predict pregnancy complications such as preeclampsia, IUGR, and preterm delivery, and it seems that should be considered along with other clinical and paraclinical indices that are useful in predicting these complications in pregnant mothers.

Burning deformities have devastating effects on a person's mental image of the quality of life and self-esteem. Parse's Theory of Human becoming considers the quality of life from the perspective of each person as one of the important goals of nursing. The aim of this study was nursing care of a patient with burning deformity of the face and limbs, which was done using the "Parse's Theory of Human becoming" as a framework.

This case study was conducted to implement the model of Parse's Theory of Human becoming for nursing care of a patient with burning deformity of the face and limbs in 2021 in Sari. The study is based on three principles of Parse's theory, including 1) creating meaning through the expression of patient values and experiences, 2) creating cooperation in rhythmic patterns in a reciprocal process with the world, such as revealing - hiding, limiting and, connecting - separating and 3) Making a change was to recreate and provide the client with a unique force.

Extracted needs and categories include: Lack of self-confidence (disorder of self-image, separation, and divorce), community outlook (isolation and withdrawal, blame, creating remorse), need for support (need for psychological support, need for financial support to continue treatment, need for support of social networks (relief committee, media ...), psychological problems (depression, PTSD, suicidal ideation, fear of rejection).

Finally, by extracting and applying concepts such as: regulating grief about normal life events, maintaining and promoting relationships with relatives and loved ones, choosing opportunities to clarify the goal, a combination of the meaning of burn deformity experience for the participant of this study evolved; In other words, the client achieved creation and change in the process of her life by taking steps to improve and using power.

Cardiovascular disease is a major cause of death, creating huge health-related costs for health care systems. A client who understands the goals of treatment and care in line with their goals and priorities, will be more involved. King's goal attainment theory has addressed this issue. This study was performed to provide a nursing process in a client with acute coronary syndrome based on King's goal attainment Model.

In this case study, a myocardial infarction client with unsuccessful coronary angioplasty and the impossibility of open-heart surgery who was referred to the hospital twice within 10 days due to complications was evaluated. Data were collected through the client's file, observation and interview with the client, family, physician and nurse. The stages of the nursing process, namely, nursing diagnosis, common goals setting and prioritization, transaction based on client preferences, and evaluation of client achievement goals by comparing before and after in the range of 2- to 2+ were performed as a qualitative analysis.

Analyzes showed that although the client did not have a clear understanding of the importance of adherence to health and treatment behaviors, he was willing to interact with the nurse in a step-by step manner. Findings led to 7 nursing diagnoses and 42 caring goals. In the evaluation, the client was able to adhere the treatment well and modify the activities of daily living.

According to the nursing process based on King's goal achievement model, the Acute Coronary Syndrome client was able to act on his prioritized goals by trying to adjust daily activities. It is suggested that the nursing process be used based on King's goal achievement model in clients with acute coronary syndrome.

Planning involves choosing the right goals and the right way to achieve them goals. University managers face a number of challenges that prevent them from achieving their goals effectively and efficiently. This study aimed to identify planning challenges and their solutions in the university.

This case study was conducted qualitatively in 2018 in 11 faculties of Tehran University of Medical Sciences. The research population included senior, middle and operational managers of the university. Sampling was done purposefully with maximum variety and continued until data saturation (91 interviews). In-depth semi-structured interview method was used along with document review for data collection. Thematic analysis method with MAXQDA11 software was used for data analysis.

Senior managers’ turnover, insufficient managers’ commitment, lack of belief in planning, lack of authority and power, failure history of previous plans, non-operational plans, incompatibility of goals with activities, lack of proper planning model, people resistance to plans, lack of a culture of teamwork, lack of effective communication between managers and employees, and lack of funds, were the most important challenges of planning. Solutions include strengthening managers’ and employees’ commitment, strengthening the culture of participation and teamwork, formulating the plans based on organizational needs, continuous training of staff, improving communication between managers and employees, and regular evaluation of the plans, internally and externally.

Poor management and leadership, poor planning, weak organizational culture, lack of attention to organizational learning and poor management of staff, resources and working processes are the main obstacles to planning for university managers.

The treatment process of hospitalized patients with obsessive-compulsive disorder is less studied. However, because of the complex nature of the disease, these patients require a comprehensive nursing care plan. Since nursing process based on Roy’s adaptation model is widely used to solve problems caused by chronic diseases, this study aimed to implement this model in a patient with obsessive-compulsive disorder.

This study was a case study performed on a patient with obsessive-compulsive disorder admitted in the psychiatric ward of Farshchian (Sina) Hospital in Hamadan, Iran, in 2019. Data were collected using observation, interview, and patient documentation, and they were analyzed in four dimensions based on the stages of the nursing process in Roy’s adaptation model.

Based on data from the assessment stage, manifestations of chronic maladaptive behaviors in the patient included unwanted, intrusive, repetitive thoughts and fears as the focual stimuli, family history of obsessive-compulsive disorder, parental divorce and weakness in coping mechanisms as the contexcual stimulus, beliefs of the patient's father, and psychiatric hospitalization as residual stimuli. Six types of maladaptive behaviors in four modes including inappropriate nutrition (physiological mode), reduced self-care, non-adherence to treatment, need to perform obsessive rituals, avoiding social interactions (self-concept mode), and father dependency (role function mode and interdependence mode) were identified.

Implementing a nursing process based on Roy’s adaptation model by deeply identifying maladaptive behaviors and then, promoting the use of regulate and cognitive coping mechanisms can help correct or modify maladaptive behaviors of patients with obsessive-compulsive disorder. However, achieving desirable outcomes after discharge requires long-term follow-up and support by psychiatric nurses.

Public-private partnership (PPP) in constructing and operating hospitals is a good strategy to provide high quality services to people at lower cost for the government.  However, PPP is facing several challenges. The objective of this research was to identify and explore the PPP challenges in building Moheb Yas hospital in Tehran, Iran.

A qualitative approach was used for this case study in 2018. In-depth semi-structured interviews were conducted with 24 key stakeholders, managers and employees who were involved in PPP initiative implementation using purposive and snowball sampling methods. Thematic analysis approach was used for data analysis.  

Moheb Yas hospital was built in the yard of a public hospital (Co-location PPP) by the private entity. Then, the public hospital was moved into the private hospital. The new hospital was transferred to the government after one year owing to some challenges. These challenges include an inappropriate PPP model, low government capacity and competency in PPP, low trust in private partner, difficulty in funding the project, demolishing the old building, applying for hospital licences, merging two public and private hospitals, and difficulties in equipping the new hospital with human and physical resources.

The PPP was not successful in this case. Although PPP initiatives have benefits for the health system, but, it comes with numerous challenges especially in developing countries owing to disparate goals, incentives, and management practices of public and private sectors. The research findings provide useful insights for policy makers and senior managers in health systems in similar countries about the main barriers of PPP initiatives in the health sectors.

Research is a way of developing a body of knowledge and movement toward an influential profession. A case study has been commonly used in humanistic and medical sciences, even though generally was considered an underutilized strategy in community-based nursing especially in Iran; so we decided to introduce nurse researchers with detailed issues of this research strategy in this article. Some researches reiterated case studies' appropriateness in theory generation when dealing with new phenomena, events, techniques, processes, or a complex real-life activity in a great-depth and holistic view.  Some authors criticized this research strategy as lacking scientific rigor and not addressing generalization. Therefore, it is underutilized in nursing. The purpose of this article is to demonstrate the appropriateness of the case study as a nursing research strategy and discussing methodological considerations about it.To this end, we reviewed recent literature consisting 46 references (11 textbooks of nursing research) and other articles and books on case study methodology from medical and nursing databases. The result was the extraction of the main concepts such as different case studies' applications, methods, and designs to planning, conducting and reporting a case study research as well as other issues such as sampling, data gathering, analysis, and reporting of derived results with several examples in each section and discussing considerations about this strategy. To conclude, there are possibilities in nursing clinical, administrational, and educational issues as well as preventive health care for doing case studies in nursing. Thus nurses should know case-studies' methodology and practice to be able to conduct it appropriately when necessary.