Search

Background: Examining the privacy experiences of mothers in neonatal intensive care units (NICUs) can play a crucial role in bolstering patient privacy safeguards and elevating the overall quality of health care. However, our understanding of mothers' experiences regarding privacy issues they may face after their infants' hospitalization in the NICU is limited. Aim: This study aimed to investigate the experiences of mothers concerning privacy within NICUs to contribute valuable insights for improving infant care and privacy protection. Design: A qualitative content analysis using a conventional approach was conducted. A total of 18 participants, with diverse sociodemographic backgrounds, were interviewed using open‐ended questions. Qualitative content analysis was undertaken for data analysis. Setting: The study was conducted in the NICU of an urban teaching hospital in Iran. Results: The study identified four main themes: 'understanding of privacy', 'fluctuating respect for privacy', 'efforts to maintain privacy' and 'privacy barriers'. Participants viewed privacy as multidimensional, influenced by cultural and religious factors. Respect for privacy varied, with instances of both adherence and violation. Mothers employed strategies to preserve privacy, emphasizing the importance of their infants' privacy. Privacy barriers included hospital attire, the physical space of the NICU, inhomogeneous human resources and insufficient supervision and training. Conclusion: This study, the first of its kind in the NICU context, provides valuable insights into maternal experiences of privacy. Integrating these insights into practice and future research can contribute to creating more empathetic and privacy‐respecting NICU environments. Relevance to Clinical Practice: Health care providers can use these findings to enhance support for mothers, potentially reshaping physical spaces and communication practices within NICUs. [ABSTRACT FROM AUTHOR]

Background: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. Methods: An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women's experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. Discussion: This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. Ethical code: IR.TUMS.FNM.REC1400.200. Plain English summary: Intimate partner violence is the most common form of violence against women, with a higher prevalence in Asian and Eastern Mediterranean countries, including Iran. The period after childbirth is a stressful and anxiety-provoking event due to the increased physical, psychological, social, and economic needs of parents, leading to intimate partner violence. Studies show that women who experience violence after childbirth face many physical, sexual, and emotional problems. Additionally, it will have a negative impact on their baby. Many factors can lead to intimate partner violence, among which psychological factors are among the most important. Therefore, we decided to perform a study in two phases with the aim of determining the prevalence and factors related to intimate partner violence. In the first phase, we will study Iranian women who have a one-year child living in southern Tehran city and ask them to complete questionnaires related to intimate partner violence. In the second phase, we will conduct an interview with women who have experienced violence after childbirth to obtain more information about the factors involved. [ABSTRACT FROM AUTHOR]

The Islamic Republic of Iran has different policies in economic, social, cultural, and international aspects since the Islamic Revolution in 1979. This new political economy has had many socioeconomic challenges for the Iranian people since its emergence. Recently, the government of Iran has focused on the Iranian banking system, especially the problem of a high rate of NPLs, and their relationships with the current socioeconomic problems of Iran. The purpose of this research is to explain the political economy behind the non-performing loans (NPLs) of the Iranian banking system. This research has a qualitative design as a content analysis of Iranian officials’ disclosures by triangulations of the country's leadership, governmental powers, and Iranian economic-politic pundits for 1961-2023. Our findings show that NPLs in the Iranian banking system have five feeding pillars: the government’s anomalies, foreign policies, economic identity, social anomy, and geographic demography of Iran. These pentagon pillars of the political economy increase socioeconomic pressure on Iranian banking systems to spend low-quality lending towards the government’s socioeconomic strategies. However, the political economy significantly disturbs the country’s small markets and fuels social crises. The results provide insights about why Iran doesn’t have a steady economic development yet. [ABSTRACT FROM AUTHOR]

Background: Healthy aging is one of the essential aspects of a health promotion program in the elderly. Aim: Exploring ethical challenges in healthy elderly care from the perspective of nurses, older adults, and families in the Iranian context. Research Design: This qualitative study was conducted using a content analysis approach in 4 health centers in northeastern Iran from 2017 to 2019. Semi-structured interviews, observation, review of elderly files, and focus groups were used to collect data. Ethical considerations: The ethics committee of the university approved this study in Iran. This study adhered to the principles of the Helsinki Declaration. Ethical principles autonomy, confidentiality, and anonymity were considered for the participants. Participants were informed about the purpose of the study and submitted written informed consent regarding their participation. Findings: The central theme was: An unfair approach to caring for healthy older adults. The three categories were as follows: Forgotten human care, disrespect, and lack of a meaningful and trustworthy relationship. The 14 subcategories highlighted the ethical challenges of healthy aging care in health centers. Discussion: The findings showed that due to nurses' unfamiliarity with the concept of healthy aging, older adults are discriminated against in care centers. Creating a standard care program for healthy older adults ensures that ethical principles are followed for these clients. Conclusion: Various individual and organizational factors lead to an unfair approach to caring for healthy elderly in health centers. The following factors can help improve the care of healthy aging and reduce ethical challenges in this area: Introducing nurses to the concept of healthy old age and its dimensions, creating a community-based approach in health centers, prioritizing health issues over health issues, Involvement of families and older adults in needs assessment-goal setting-implementation and evaluation of health services, and design of home visit programs to provide services to healthy elderly. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, the most common psychological-social pressure to which bipolar patients' families are exposed is stigma. Therefore, the present study was conducted to delve into the bipolar patients' family experiences of the outcomes of encountering stigma. Method: The study was of qualitative type. Purposive sampling was used to select the participants from the persons suffering from bipolar disorder and their families. Twenty seven of the participants were interviewed. The main data collection instrument was semi-structured interview with open questions. Additionally, the collected data were analyzed via inductive content analysis method. The accuracy and validity of the study rooted in four factors: credibility, transferability, verifiability, and reliability. Results: Data analysis led to 1,326 primary codes, which were further categorized into five main categories as the main outcomes of encountering stigma (social deprivation, emotional and sentimental excitement, objective and behavioral reflections, family solidarity threat, and separation from society) and 21 sub-categories. Conclusion: Given then irreparable outcomes of stigma for bipolar patients' family, it is necessary to take it into consideration. It is recommended to use media and also hygienic-treatment centers to educate different levels of society as to appropriate treatment with these patients and their families. [ABSTRACT FROM AUTHOR]

Student support services, especially for students who study virtually, increase satisfaction, attract new students, complete the course, and improve overall student performance. Given the importance of student support in e-learning and the fact that student support models should be specific to the culture and economic conditions and technology of their context, the present study set to design a native model of student support in e-learning for post-graduate students. To conduct the research, first a systematic search was performed to extract the existing models of student support. Through forming an expert panel and rating the models, more compatible models with the context of Iran were selected. The interview questions were then extracted from the concepts of the models who scored the most in the expert panel session. In relation to the examples of student support, interviews were conducted with 22 university teachers, education officials, and post-graduate students studying in educational branches leading to a virtual degree of medical sciences. Using content analysis of codes, sub-categories and the resulting categories were extracted from the interviews. Finally, in the expert panel session, using the (analytic hierarchy process) AHP, the categories were prioritized and the model was designed. After analyzing the content of the interviews, four main categories, namely teaching and learning, interactions and communications, empowerment, and structural support were extracted and the final model of student support was designed using the opinions of e-learning instructors. Despite relatively similar similarities between the native model of student support for e-learning students and the existing models, this model, which is designed based on the needs of students and faculty and e-learning officials, places more emphasis on teaching, learning, interactions, and communications. [ABSTRACT FROM AUTHOR]

Recognizing various aspects of the self-efficacy concept in specialized medical units such as intensive care units (ICUs) and coronary care units (CCUs) has the potential to help nurses improve their quality of care. Therefore, we conducted a qualitative content analysis study in 2018 in hospitals of the Guilan Province, northern Iran, to help explain nurses' perceptions of self -efficacy in care management within CCU wards. Thirty-four semi-structured interviews were conducted with nurses from CCUs. Using Graneheim and Lundman's (2004) analytical techniques, we extracted three main themes and nine subthemes from the data: decline in self-efficacy (e.g., time constraint, high work pressure, emotional stresses, and loss of motivation); care development (e.g., experience-based care, knowledge-based care, and personal capability); and organizational challenges (e.g., weak management and unavailable physician). Our findings suggest that decreases in nurse self-efficacy (and resulting weak care management) could be prevented by establishing clear plans and enrolling nurses into appropriate training courses. The constant development of knowledge and experience alongside supportive supervisors and physicians are also effective in improving nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Background: Medical care that has therapeutic effects without significant benefits for the patient is called futile care. Intensive Care Units are the most important units in which nurses provide futile care. This study aimed to explain the causes of futile care from the perspective of nurses working in Intensive Care Units are. Method: The study was conducted using a qualitative approach. Qualitative content analysis was used to analyze the data. Study participants were 17 nurses who were working in the Intensive Care Units are of hospitals in the north of Iran. They were recruited through a purposeful sampling method. Data was gathered using in-depth, semi-structured interviews from March to June 2021. Recruitment was continued until data saturation was reached. Results: Two main themes, four categories, and thirteen subcategories emerged from the data analysis. The main themes were principlism and caring swamp. The categories were moral foundation, professionalism, compulsory care, and patient's characteristics. Conclusion: In general, futile care has challenged nursing staff with complex conflicts. By identifying some of these conflicts, nurses will be able to control such situations and plan for better management strategies. Also, using the findings of this study, nursing managers can adopt supportive strategies to reduce the amount of futile care and thus solve the specific problems of nurses in intensive care units such as burnout, moral stress, and intention to leave. [ABSTRACT FROM AUTHOR]

Background and Purpose: Recognizing the importance of self-management in older adults with multiple chronic conditions (MCCs) is crucial for their quality of life. This qualitative study explored the factors linked to self-management among older adults with MCCs., Materials and Methods: The present study was conducted in three stages: an integrated review, qualitative interviews, and Delphi. The search used electronic databases including Web of Science, PubMed, Scopus, Magiran, SID, and Iranmedex. The results of 33 studies that met the inclusion criteria were analyzed using conventional content analysis. A data matrix was formed; and purposeful sampling was conducted among older adults with MCCs, family caregivers, and specialists. The data were collected through semi-structured interviews. Data analysis of 29 interviews was conducted simultaneously with data collection using oriented qualitative content analysis and the Elo and Kyngäs approach. Three rounds of Delphi were conducted via email correspondence with a group of 30 experts to develop and validate the proposed variables., Results: The factors that influence self-management can be categorized into various categories. Biological factors, cognitive factors, co-morbidities, socio-economic factors, health-related behaviors, mental health, interactions with healthcare teams, Family relationships, medical facility resources, employee empowerment, health policy development, and cultural influences., Conclusion: Self-management in older Iranian adults with MCCs is a complex and multidimensional phenomenon. By identifying the relevant factors, it is possible to design operational plans that promote self-management among the older adult population and are tailored to fit the specific needs of Iranian society., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sadeghi, Mohammadi Shahbolaghi, Hosseini, Fallahi-Khoshknab and Ghaedamini Harouni.)

Background: Sexual harassment in the workplace is a common event with negative consequences for victims. Working conditions become unstable because of sexual harassment, and workplace insecurity causes psychological distress and physical problems, as well as a reduction in the quality of care. Therefore, the current study sought to investigate the effects of sexual harassment in the workplace on Iranian nurses. Materials and Methods: This qualitative study used conventional content analysis with a descriptive-explorative approach to investigate the consequences of sexual harassment in Iranian nurses (n = 22). The purposeful sampling method was used. Semi-structured and in-depth interviews were used to collect data. Maximum diversity in terms of age, sex, work experience, level of education, marital status, and type of hospital and ward was observed in order to obtain rich information. The Guba and Lincoln criteria were used to improve the study's trustworthiness and rigor, and the Graneheim and Lundman method was used to analyze the content. Results: Two hundred and twenty-seventh number codes, one main category, four subcategories, and eighteen primary categories were extracted from the data in this study. The main category of "loss of individual and social identity: the consequences of sexual harassment in nurses" is divided into four subcategories: "psychological trauma," "detrimental effects of work," "physical problems," and "disintegration of warm family relationships." Sexual harassment had a greater psychological impact on victims. Conclusion: Sexual harassment has a number of negative consequences for nurses' personal and professional lives and can impose a significant burden on the healthcare system due to decreased productivity and loss of active labor. Therefore, it requires increased attention and focus. [ABSTRACT FROM AUTHOR]

Background: Given the impact of politico-economic sanctions on the pharmaceutical supply chain, this study aims to identify practical strategies to improve the resilience of the Iranian supply chain in pharmaceutical procurement under politico-economic sanctions. Methods: This is a qualitative content analysis study conducted in 2018. Semi-structured interviews were conducted using snowball sampling, and saturation was achieved after 18 interviews. Guba and Lincoln's criteria, namely credibility, confirmability, transferability, and dependability, were considered to ensure the validity and transparency of the study. A five-step framework analysis was applied to analyze the data using MAX QDA10. Results: The results led to the identification of nine main themes and 26 subthemes as strategies to improve the resilience of the pharmaceutical chain. According to the thematic map, some of these strategies have an extra-sectoral character: 'insurance organizations', 'strengthening relations with other countries', 'mechanization of the distribution system', and 'suppliers and manufacturers'. At the same time, some inter-sectoral strategies can help the pharmaceutical chain maintain its resilience: 'healthcare management and policy', 'exploiting local potential', 'pricing', and 'integrated health information systems.' As a strategy, 'Medical community and consumers' also plays a crucial role in this regard. According to the subthemes, revisions of health management, more supervision, privatization, clinical policies, strategic purchasing, improvement of the referral system, inter-sectoral cooperation, support of indigenous medicines, rational pricing, insurance system, improvement of medical coverage, and development of electronic prescription should be considered by health systems. Sufficient support for indigenous medication and supervision of the distribution system should be considered by the pharmaceutical industry, taking into account the cooperation between consumers and patients. Conclusions: Integration of the pharmaceutical supply chain and modern technologies, more attention to business complexity, economic development, intense competition, rapid changes in customer needs, and appropriate relationship between manufacturers, distributors, prescribers, and insurance organizations as purchasers should be considered by policymakers to improve supply chain resilience. [ABSTRACT FROM AUTHOR]

Statement of the Problem: According to the report of the World Economic Forum in 2019, Iran is not in a good position in terms of tourism competitiveness. Existing statistics also do not show a significant annual number of foreign tourists visiting Iran. On the other hand, human resources and how to manage and develop them today is one of the key factors in the success of tourism use as a factor in sustainable economic development and increasing employment opportunities, earning income and profits from tourism operations in any region. Purpose: The purpose of the present study was to identify and prioritize human resources development strategies in the Isfahan tourism industry. Method: This study was applied in terms of the purpose and survey in terms of the implementation method. In this study, the qualitative content analysis method was used to identify and extract strategies for human resource development of the tourism industry. Then, by distributing a questionnaire among 20 experts in the field of tourism and analyzing it, these strategies were prioritized using the TOPSIS method. Results: The research findings showed 11 strategies in 3 dimensions of executive, educational, and incentive strategies. According to the results of the TOPSIS method, strategies for providing public education, enriching and targeting internship courses, designing retraining courses and continuous development of professional skills, preparing and compiling a map of human resource competencies in the tourism industry, and developing and monitoring of public and private scientific centers in the tourism industry in the province were the most important strategies for the development of human resources in the tourism industry in Isfahan province. Innovation: In this study, for the first time, human resource development solutions in the tourism industry of Isfahan province were identified and classified using the qualitative content analysis and were prioritized using the TOPSIS technique. [ABSTRACT FROM AUTHOR]

Objectives: Women confront many problems after self-immolation, so the purpose of this study was to explore the challenges facing women survivors of self-immolation in the Kurdish Regions of Iran. Method: This study used a qualitative approach and conventional content analysis. Data were collected through semi-structured interviews with 19 Kurdish women who attempted self-immolation in Iran. They were sampled through purposeful sampling and snowball sampling. The Lincoln and Guba criteria were used to strengthen the research. Results: The results of data analysis were categorized into five main categories: 1—psychological problems, 2—lack of social and legal supportive structures, 3—incomplete treatment, 4—poor self-care, and 5—social problems. These categories consist of 19 subcategories. Conclusion: Having been rescued from self-immolation, the women confront many challenges returning to normal life. Reducing these women's problems and paving the way for their return to life requires multi-dimensional and community-based interventions. Therefore, all social organizations and institutes can cooperate and each of them paves part of the way. [ABSTRACT FROM AUTHOR]

Background: In order to achieve the goals of the healthcare system, nursing managers are required to comply with ethical principles in decision-making. In complex and challenging healthcare settings, it is shown that the managers' mere awareness of ethics does not suffice and managers need to be sensitive toward making ethical decisions. Aim: To explore nursing managers and their sensitivity toward ethical decision-making by analyzing their related experiences. Method: The current study has been conducted in Iran in 2017 through a qualitative content analysis approach. Nineteen nurse managers were selected purposefully from different hospitals in Tehran. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Ethical considerations: The research was approved by the ethics committee of Tarbiat Modares University, Tehran, Iran. Participants were informed about the purpose of the study and submitted written informed consents regarding their participation. The principle of autonomy, confidentiality, and anonymity was taken into account in data collection. Results: Fifteen subcategories, three categories (assertiveness, commitment, and insight), and one theme of excellent decision-making were the results of data analysis. Discussion: Findings showed that nursing managers' sensitivity to ethical decision-making allows them to make the best decision by insight, commitment, and assertiveness. Making a morally excellent decision ensures that ethical principles are followed in the healthcare system. Conclusion: Considering that most managers are committed to making ethical decisions, it is required to develop the scope of their insights even further using a professional management and ethical principles training program. Also, by addressing some of the ethical barriers at personal and organizational levels, the assertiveness in managers can be improved, which in turn can facilitate their ethical decision-making. [ABSTRACT FROM AUTHOR]

Background: Working in pediatric oncology is highly stressful and exhausting for social workers. Evidence acknowledges the development of compassion fatigue and burnout as a result of being continuously in this field. Objectives: This study was aimed to explore how pediatric oncology social workers alleviate compassion fatigue and burnout. Methods: The present qualitative study was performed using a content analysis method. A total of 19 social workers participated in this study who were providing services for children with cancer and their families in public and specialized children's cancer hospitals in Iran. A purposeful sampling method was applied, until reaching data saturation. Data were collected using semi-structured interviews and were analyzed by qualitative inductive content analysis. The trustworthiness of the study was supported by considering the creditability, transferability, dependability, and conformability. The study lasted from 2015 to 2017. Results: Four main categories including sense of being worthy, self-care, professional growth, and establishing boundaries were extracted from the experiences of social workers which was identified "resiliency of social workers" as a key concept. The contributing factors demonstrated the strategies was used by social workers to protect themselves from CF and BO. Conclusions: As a result of this study, through recognizing the strategies to resilience in pediatric oncology social workers and enforcing its contributing factors, the health-care system, social workers, and the patients would all benefit. The results of this study can be used as the basis for future research in this field. [ABSTRACT FROM AUTHOR]

Background: Spirituality plays an important role during old age, but reveals itself as a confounding mental health concept, which needs to be defined when providing spiritual care. The purpose of this study was to explore factors promoting Iranian older adults' spirituality.Method: In a qualitative content analysis approach, we searched for the factors promoting spirituality among a selection of Iranian older adults. Totally, 22 people aged above 60 years old were interviewed using open-ended questions. The recorded interviews were then transcribed, and a coding process was applied based on a qualitative, conventional content analysis.Results: Three key factors were found to promote the spirituality among the older adults: 1) insight in personal belief, 2) spiritual socialization, and 3) peace of mind. Traditional dimensions, the cultural surroundings, and participants' religious beliefs were apparent in each of the categories.Conclusion: Society's role in making the seniors spiritual role models was very important; moreover the hereafter life on religious grounds seemed to be another important factor in reaching for high levels of spiritual and mystical perfection. Educational interventions based on the elders' needs for spiritual empowering by health care professionals especially with regards to their spiritual based social interactions and reaching peace of mind, will comprise a major part of wellness approaches. [ABSTRACT FROM AUTHOR]

Aims and objectives To understand the challenges faced by patients with heart failure. Background Heart failure is a clinical syndrome that is increasing across the globe. People affected with it encounter various problems that reduce their quality of life and well-being. Therefore, identifying the challenges faced by patients with heart failure is necessary for health care and treatment plans. Design This study was performed using the qualitative research approach and content analysis method. Methods Data were collected using semistructured interviews and notes in the field of 21 Iranian participants, namely 12 patients with heart failure, three cardiologists, three nurses and three members of patient family. The data were analysed using Lundman and Graneheim qualitative content analysis. Results The results of this study were revealed in the form of a theme: 'sliding context of health' in which the following three categories 'perceived threat of health and life', 'the struggle between doubt and certainty' and 'in the downward slope of quality of life' reflect the experiences of patients faced with heart failure. Conclusions The findings of this study showed that it is necessary to identify the challenges of facing heart failure, in order to support and educate patients with heart failure. Patients do not take care of themselves based on the fact that these challenges affect them psychologically and physically, and as such, the new situations are often misunderstood, thereby resulting in frequent recurrence of symptoms, mandatory hospitalisations and reduced quality of life. Relevance to clinical practice Nurses, as the first line of health care, play an important role in identifying problems and supporting patients with heart failure. By acquiring knowledge and listening to the complaints of patients, interventions can be developed to improve their situation. [ABSTRACT FROM AUTHOR]

Rescuers' psychological competence, particularly their motivation, can improve the cardiopulmonary resuscitation outcomes. Data were collected using semistructured interviews with 24 cardiopulmonary resuscitation team members and analyzed through deductive content analysis based on Vroom's expectancy theory. Nine generic categories were developed: (i) estimation of the chance of survival; (ii) estimation of self-efficacy; (iii) looking for a sign of effectiveness; (iv) supportive organizational structure; (v) revival; (vi) acquisition of external incentives; (vii) individual drives; (viii) commitment to personal values; and (ix) avoiding undesirable social outcomes. When professional rescuers were called to perform cardiopulmonary resuscitation, they subjectively evaluated the patient's chance of survival, the likelihood of achieving of the desired outcome, and the ability to perform cardiopulmonary resuscitation interventions. If their evaluations were positive, and the consequences of cardiopulmonary resuscitation were considered favorable, they were strongly motivated to perform it. Beyond the scientific aspects, the motivation to perform cardiopulmonary resuscitation was influenced by intuitive, emotional, and spiritual aspects. [ABSTRACT FROM AUTHOR]

Background: The student-educator relationship in nursing is very important to the success of teaching and learning. The perceptions of students and educators of this relationship affect its success. Therefore, it is necessary to better understand this relationship. Purpose: The purpose of the current study was to explore Iranian nursing students' and educators' perceptions of student-educator relationship in clinical nursing education. Methods: In this conventional content analysis study, eight Bachelor of Nursing students and 10 clinical nursing educators from nursing and midwifery school in Mashhad (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semistructured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and their condensation and to make codes and create categories Results: Results showed that the multidimensional nature of the student-educator relationship in clinical nursing education consists of (a) dimensions related to the educator, (b) dimensions related to the student, and (c) dimensions of relationship quality. Each of these categories is composed of codes that showed the perception of participants about the nature of relationship. Conclusions: On the basis of the unique features and attributes regarding relationship perceptions in clinical nursing education identified among the participants of this study, students and educators in Iran should pay greater attention to establishing the relationship as it relates to these attributes. [ABSTRACT FROM AUTHOR]

Background: Early marriage occurs in some regions of the world. Given that early marriage can have many negative consequences for girls by affecting their physical, mental, and social health, the purpose of this study was to investigate the reasons for early marriage from the perspective of women who had experienced it in Zahedan, Iran., Methods: This qualitative research was conducted based on the qualitative content analysis method in 2020-2021. The target population included women aged 18-35 living in Zahedan who were married under the age of 18 years. Purposeful sampling was used to select the participants. In order to collect data, in-depth interviews were performed to decipher the reasons for early marriage from these women's perspectives. A total of 36 interviews were conducted from October to December 2020 until reaching theoretical saturation. Conventional content analysis was used to analyze the data and extract the relevant concepts and categories., Results: The analysis of the interviews in this study revealed three main categories:(1) "early marriage as a transcendental coercion" ( early marriage as a cultural heritage and early marriage as a control tool, girls' weaknesses and inability to resist, dominant attitudes toward gender and gender restrictions), (2) "early marriage as a solution or a kind of problem solving" (escape from undesirable family environment, escape from financial poverty, and strategic escape from an unpleasant situation), and (3) "early marriage as a voluntary act" (real agency and imaginary agency). To substantiate these findings, we presented excerpts from the interviews conducted with the participants., Conclusion: The results of this study suggest a multidimensional picture of early marriage. It seems that improving cultural conditions and empowering families and girls in various areas, including marriage, can reduce the rate of early marriage and/or at least mitigate its undesirable consequences., (© 2022. The Author(s).)

Background: Stroke is a significant and unpredictable event that affects physical and mental functions. A useful approach to returning to a normal life is to seek out health information. This study aimed to explore the experiences from health information seeking in the stroke survivors and their family caregivers., Methods: This study was carried out using qualitative content analysis. Participants included five stroke survivors and fifteen family caregivers who were selected purposively from the Rofideh Rehabilitation Center and private physiotherapy centers in Tehran. Data were collected from semi-structured interviews. Data analysis was performed using Graneheim and Lundman's method manually in Word software. Sampling was carried out in 2021., Results: Two main categories were extracted 1): adapting and learning resulting from awareness including optimization of living environment and disease management, and 2) fear and inquietude on the information way including confused and insolvent in receiving information, and doubts about the accuracy of information., Conclusion: The health information seeking created adaptability and relative stability in some stroke survivors and their family caregivers. However, in others, there was still a sense of anxiety and uncertainty. Thus, understanding health information seeking experiences helps health policymakers and administrators to provide information and training based on evidence and individual needs of the client and family., Competing Interests: None declared., (Copyright: © International Journal of Community Based Nursing and Midwifery.)

Evidence-based nursing is recognized as an indicator of quality in nursing practice, a basis for accountability and the gold standard of professional nursing care. The aim of this study was to explore nurses' experiences and perceptions about evidence-based nursing practice in giving care to patients with diabetic foot ulcers. A qualitative research design was adopted, and content analysis was used to analyse data. Semistructured interviews were held with 19 bachelor-degree nurses working in a teaching hospital in an urban area of Iran. During data analysis, two main themes developed: 'structural backgrounds of the organization' and 'empowerment'. Accordingly, it was concluded that successful implementation of evidence-based nursing requires the reconfiguration of the administrative structure in the hospital. In addition, it requires the support of nurse leaders to facilitate the implementation of evidence-based nursing in the practice. [ABSTRACT FROM AUTHOR]

Background & Aims: Women's empowerment is a process of the expansion in women's ability and freedom to make strategic life choices, especially empowering them for decision making about family planning and fertility desires. The study Aimed to comprehend the experiences of women about empowerment in family planning. Materials & Methods: In this qualitative study, data were gathered from 35 married women who eligible for contraception use at childbearing age. Seven focus group discussion sessions and five individual interviews were recorded and analyzed using qualitative content analysis method. Result: Analysis of data showed that four main category as a meaning of empowerment in family planning in view of participants:1- control over fertility plan 2- partnership in family planning 3- maintaining health 4- access to family planning services. Conclusion: in view of participants, with knowledge about family planning and autonomy for decision making they gain control over their fertility plan. Couples agreement in fertility desires and partner's support in implementing family planning result in a partnership for family planning. Planned pregnancy, safe and appropriate contraception methods help women to maintain their health. Access to desired contraception methods during couple counseling and well treatment of side effects occur in use of contraception methods were highly emphasized. Thus to achieve empowerment in family planning we need to be planning it in the family, society and health systems. [ABSTRACT FROM AUTHOR]

Background: Social support has an important role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore, this article aims to explain the perceived experiences of women suffering from breast cancer towards social support., Methods: In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 5 hospitals affiliated to Urmia University of Medical Sciences. The data were collected through semi-structured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim's and Lundman's approach, using MAXQDA software, version 10., Results: After completion of the analyzing process, 6 categories were appeared including "creating an empathic atmosphere by family and community," "being in relationship with others," "adaption to disease," "giving meaning to life," "satisfaction with the role of healthcare providers," and "the impact of others support in fighting with the disease.", Conclusion: According to the findings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in fighting the disease and feeling of recovery. The findings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers, and the community and even providing the required supportive care for this group of women., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Female-headed households are one of the most vulnerable groups of society that confront many problems and challenges. Therefore, the present study aimed to explore the challenges and opportunities confronting female-headed households in Iran.Methods: This qualitative study was conducted among female-headed households in Kermanshah, West of Iran, in 2019. The data were collected through Semi-structured interviews with 26 female-headed households who were selected by purposeful and theoretical sampling. Data analysis was done through conventional qualitative content analysis, and the software MAXQDA-12 was used for the management of data. The four criteria of Goba and Lincon, including credibility, confirmability, dependability, and transferability, were observed to evaluate the quality of research results.Results: After analyzing the data, 4 main categories and 13 subcategories were obtained as follows: individual problems (role overload, role conflict, end of love, psychological problems), intra-family problems (declined independence, intra-family tension, poverty reproduction and family disability), social problems (stigma of being unattended, social insecurity, social isolation, social exclusion), positive outcomes (positive self-concept, social maturity).Conclusion: Female-headed households face many challenges that can become a big threat or an opportunity. Therefore, their health improvement can be achieved through training and helping them to adapt to new and multifaceted roles, providing more economic support and helping them raise their social status. [ABSTRACT FROM AUTHOR]

• Determining the approach to child welfare in Iran by content analysis of laws and macro policies. • An approach that mainly emphasizes on the child support and protection services in Iran is child protection. • The child protection laws are more focused on punishing parents than supporting and empowering them. Nowadays, in addition to the family, society is also considered responsible for the upbringing and development of children. The degree to which governments hold parents responsible for ensuring their children's well-being through child welfare services varies among countries. In Iran, children have become a growing concern among civil society and policy makers. There have been significant changes in recent decades. Therefore, Iran's academic and political literature is required to provide an explicit definition for child welfare that facilitates comparison and identification of policies and practices. Thus, this study aimed to determine the approach to child welfare in Iran by reviewing Iran's laws and macro policies, and analysing them based on Gilbert (1997) and Gilbert, Parton, and Skivenes (2011) classification in order to provide an explicit and comprehensive definition for child welfare. To achieve this goal, Iran's national laws and macro policies (a total of 55 documents) were analysed by directed qualitative content analysis. According to the findings, child support and protection services in Iran are similar to a previous child protection approach in terms of three main categories of "problem frame", "state–parent relationship and the role of the state" and "the mode and aim of intervention", although some features of other approaches are apparent. Although there is a great emphasis on the family institution in Iran, the executive laws are more focused on punishing parents than supporting and empowering them with regard to child protection. This coercive and risk management approach is particularly evident in the new legislation. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the experiences of stigma in patients with schizophrenia spectrum disorders and their families., Methods: This qualitative content analysis study was carried out in 2016-2017 in a psychiatric hospital in Tehran, Iran. A total of 16 patients with schizophrenia spectrum disorders and their families were chosen purposefully. In order to collect the data, unstructured interviews were conducted. For the data analysis, an inductive content analysis approach was used., Results: The data analysis led to the formation of two categories, "being socially rejected" and "being oppressed by others," and nine subcategories. In being socially rejected, others do not have a desire to communicate and start or continue cohabitation with the patients and their families and stay at a distance from them with fear. In being oppressed by others, persons behave aggressively with the patients and their families, violate their rights, and humiliate and ridicule them with their incorrect judgment., Conclusions: Patients with schizophrenia spectrum disorders and their families have the unpleasant and upsetting experiences of stigma. This problem imposes pressures and extreme difficulties on them, besides the difficulties related to the nature and the symptoms of the disorder. The findings reveals the need to develop strategies to help patients and their families effectively encounter stigma., (© 2018 Japan Academy of Nursing Science.)

Background: The safety culture has recently attracted the attention of healthcare organizations. Considering the importance of the roles of nurses with regard to patient safety, their knowledge and experiences of the challenges that influence patient safety culture can facilitate the development and implementation of better strategies. The aim of this study was to explore the nurses' experiences of the challenges influencing the implementation and integration of safety culture in healthcare., Methods: A qualitative study with deep and semi-structured individual interviews was carried out using a purposive sampling method to select 23 nurses from four hospitals affiliated with a large medical university in Southeast Iran. Data were analysed using the conventional content analysis of Lundman and Graneheim., Results: Data analysis reflected the main theme of the study, "A long way ahead of safety culture". This theme includes four categories: 1) inadequate organizational infrastructure, 2) insufficient leadership effectiveness, 3) inadequate efforts to keep pace with national and international standards, and 4) overshadowed values of team participation., Conclusion: While practical strategies for creating a safety culture may seem simple, their implementation is not necessarily easy. There are several challenges ahead for cultivating an effective and positive safety culture in healthcare organizations. To keep pace with international standards, healthcare managers must employ modern methods of management in order to overcome the challenges faced by the institutionalization of safety culture and to make a difference in the healthcare system.

Treatment adherence is often an important issue in the management of hypertension. Deep understanding of adherence behavior as well as its influential factors can expand knowledge about treatment adherence among hypertensives. The aim of this study was to explore patients, their families, and healthcare providers' experiences about hypertension treatment adherence in southeast of Iran. A qualitative study was conducted to explore the experience of patients, family members, and healthcare providers (n=18) by using a conventional content analysis. The purposive sampling method was used. Data were collected through semi-structured and deep interviews. Data analysis showed that hypertensive treatment adherence in an Iranian context is like an iceberg with two subthemes. The first subtheme relates to the upper and clear part of this iceberg and it consists of two categories, including 1) healthy and 2) unhealthy regimens. The second subtheme associates with under-water and unanticipated part and it consists of four categories, including 1) the nature of disease and treatment, 2) the individual resources, 3) the healthcare organization, and 4) the socio-cultural environment. The treatment adherence features emerged in this study can be useful in designing and developing context-based hypertension interventions. Further qualitative and quantitative studies with a closer collaboration between the social, natural, and medical sciences in other Iranian populations are needed to confirm the findings. [ABSTRACT FROM AUTHOR]