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Aims: To describe intensive care unit nurses' experiences of moral distress during the COVID‐19 pandemic, and their recommendations for mitigative interventions. Design: Interpretive description. Methods: Data were collected with a purposeful sample of 40 Canadian intensive care unit nurses between May and September 2021. Nurses completed a demographic questionnaire, the Measure of Moral Distress—Healthcare Professionals survey and in‐depth interviews. Quantitative data were analysed using descriptive statistics. Qualitative data were categorized and synthesized using reflexive thematic analysis and rapid qualitative analysis. Results: Half of the nurses in this sample reported moderate levels of moral distress. In response to moral distress, nurses experienced immediate and long‐term effects across multiple health domains. To cope, nurses discussed varied reactions, including action, avoidance and acquiescence. Nurses provided recommendations for interventions across multiple organizations to mitigate moral distress and negative health outcomes. Conclusion: Nurses reported that moral distress drove negative health outcomes and attrition in response to moral events in practice. To change these conditions of moral distress, nurses require organizational investments in interventions and cultures that prioritize the inclusion of nursing perspectives and voices. Implications for the Profession: Nurses engage in a variety of responses to cope with moral distress. They possess valuable insights into the practice issues central to moral distress that have significant implications for all members of the healthcare teams, patients and systems. It is essential that nurses' voices be included in the development of future interventions central to the responses to moral distress. Reporting Method: This study adheres to COREQ guidelines. Impact: What Problem did the Study Address?: Given the known structural, systemic and environmental factors that contribute to intensive care unit nurses' experiences of moral distress, and ultimately burnout and attrition, it was important to learn about their experiences of moral distress and their recommendations for organizational mitigative interventions. Documentation of these experiences and recommendations took on a greater urgency during the context of a global health emergency, the COVID‐19 pandemic, where such contextual influences on moral distress were less understood. What Were the Main Findings?: Over half of the nurses reported a moderate level of moral distress. Nurses who were considering leaving nursing practice reported higher moral distress scores than those who were not considering leaving. In response to moral distress, nurses experienced a variety of outcomes across several health domains. To cope with moral distress, nurses engaged in patterns of action, avoidance and acquiescence. To change the conditions of moral distress, nurses desire organizational interventions, practices and culture changes situated in the amplification of their voices. Where and on Whom Will the Research Have an Impact on?: These findings will be of interest to: (1) researchers developing and evaluating interventions that address the complex phenomenon of moral distress, (2) leaders and administrators in hospitals, and relevant healthcare and nursing organizations, and (3) nurses interested in leveraging evidence‐informed recommendations to advocate for interventions to address moral distress. What Does this Paper Contribute to the Wider Global Community?: This paper advances the body of scientific work on nurses' experiences of moral distress, capturing this phenomenon within the unique context of a global health emergency.Nurses' levels of moral distress using Measure of Moral Distress—Healthcare Professional survey were reported, serving as a comparator for future studies seeking to measure and evaluate intensive care unit nurses' levels of moral distress.Nurses' recommendations for mitigative interventions for moral distress have been reported, which can help inform future interventional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background. Universities have established a system of periodic evaluation and accreditation in order to manage the quality of education, enhance their physical resources and educational equipment, and improve their human resources. This study aimed to conduct an analysis of second-generation institutional accreditation standards for medical sciences universities from the experts' perspective. Methods. The present research was a qualitative study with an inductive approach conducted at Tabriz University of Medical Sciences between the years 2019- 2022. The sampling method was purposeful, and data were collected through semi-structured interviews with 34 managers, officials of development offices, and experts involved in the accreditation programs of educational institutions. As for study validation, the four criteria of Guba and Lincoln (i.e., credibility, dependability, confirmability, and transferability) were used. As for data analysis, MAXQDA 20, a software program designed for computer-assisted qualitative and mixed-methods data analysis, was used. The interview texts were analyzed using the content analysis method. Results. The results of the content analysis identified 204 initial codes, 9 subcategories, and 2 main categories (the strengths and weaknesses of the content). The subcategories of strengths included standardization, improvement of educational processes, development of assessment areas, restructuring of educational structure, benchmarking global experiences, and transparency in criteria. The subcategories of weaknesses included structural weaknesses, lack of validity, and ambiguity in criteria. Conclusion. The process of analyzing the content of accreditation standards for educational institutions periodically and obtaining regular feedback will lead to the enhancement of the standards and the realization of activities, ultimately resulting in the improvement of educational quality and the dynamism of the community. [ABSTRACT FROM AUTHOR]

Introduction: The literature indicates that pandemics significantly impact the mental health of frontline health workers. While the effects of COVID-19 on the mental health of frontline nurses have been studied, their lived experiences remain insufficiently explored. Objective: This study aims to investigate the lived experience of nurses who were deployed to support Wuhan during the COVID-19 pandemic. Methods: This study adopted a qualitative study design. A purposive sample of fifteen nurses were recruited from a group of nurses who supported Wuhan during COVID-19 pandemic. The data was collected during May and June 2020. Data collection occurred in May and June 2020, employing semistructured interviews conducted via telephone. Interpretative phenomenological analysis (IPA) was utilized to analyze the collected data by two independent researchers. This report follows the COREQ checklist. Results: Frontline nurses supporting Wuhan likened their experience to being on a battlefield. Four superordinate themes emerged: (1) mobilization for combating COVID-19; (2) rapid adaption to a dynamic high-stress environment; (3) navigating psychological distress; and (4) the journey home. Conclusion: This study offers comprehensive insights into the lived experience of nurses deployed from other provinces to assist COVID patients in Wuhan. The findings indicate that despite facing a variety of challenges, these frontline nurses were capable of rapid adaptation and successfully fulfilled their roles. Recommendations for future preparedness in public health emergencies are provided. Additionally, follow-up research is warranted to explore the long-term effects of frontline experience on the mental health of the nurses and their family members. [ABSTRACT FROM AUTHOR]

Background & Aim : Down syndrome is a common genetic disorder in which, due to the high prevalence of developmental, anatomical, and functional disorders associated with the oral cavity, it causes problems in maintaining oral hygiene. This study aimed to investigate the barriers to students' oral health with Down syndrome from the perspective of their mothers. Method & Material : In this qualitative study, in order to explain the barriers in promoting the oral health of students with Down syndrome from the perspective of their mothers, based on goalbased sampling, 21 semi-structured individual interviews were conducted to analyze the content of the interview. We analyzed interviews by Graneheimor and Lundman qualitative approaches. Result: According to mothers' experiences, their children's disorders can be an obstacle to achieving good oral health. From the data analysis, the three main themes are "the effects of general health status, the effects of instruction and learning, problems in receiving dental health care services." Moreover, six sub-themes were extracted: "General Health, Oral and Dental malformations, Mother learning, learning of people with Down syndrome, Problems with Down Syndrome People, and Service receiving problems.” Conclusions: Given that these children's illness is an essential obstacle to receiving dental services, stakeholders in planning should pay special attention to providing dental services to these children. [ABSTRACT FROM AUTHOR]

Selection of a qualified pitcher has relied previously on qualitative indices; here, both quantitative and qualitative indices including pitching statistics, defense, mental skills, experience, and managers' recognition were collected, and an analytic hierarchy process was used to rank baseball pitchers. The participants were 8 experts who ranked characteristics and statistics of 15 baseball pitchers who comprised the first round of potential representatives for the Chinese Taipei National Baseball team. The results indicated a selection rate that was 91% consistent with the official national team roster, as 11 pitchers with the highest scores who were recommended as optimal choices to be official members of the Chinese Taipei National Baseball team actually participated in the 2009 Baseball World Cup. An analytic hierarchy can aid in selection of qualified pitchers, depending on situational and practical needs; the method could be extended to other sports and team-selection situations. [ABSTRACT FROM AUTHOR]