Journal of Education and Health Promotion

The live experience of coronavirus disease with emphasis on its psychological effects and consequences

. Morteza Omidian; . Amin Rahmati; . Seyedeh Samaneh Sepehrtaj

Volume 13, Issue 2 , February 2023, , Pages 1-5

Abstract

  BACKGROUND: The aim of this study was to investigate the living experience of coronary patientsin Shiraz and the peak prevalence of the second stage in summer. This study could further ...  Read More BACKGROUND: The aim of this study was to investigate the living experience of coronary patientsin Shiraz and the peak prevalence of the second stage in summer. This study could further examinethese experiences in broader groups in subsequent studies. Identifying the psychological causesand effects of this disease with the help of patients involved in some countries has been considered.MATERIALS AND METHODS: The method, which was used in this study, was a qualitative methodand content analysis. Participants in this study were 13 patients with COVID‑19, some of whomwere members of the medical staff. The participants were selected purposefully. The semi‑organizedinterview with the participants continued until the theoretical saturation was reached.RESULTS: After extracting the codes, researchers classify them, and then the results were examinedin more depth and categorized. About 120 extracted codes were classified into seven generalcategories; three of them were directly related to psychological issues. The other four of them wererelated to the subject of psychological effects and consequences.CONCLUSION: In general, during the interview process, it was proved that the more severe thesymptoms of the disease, the psychological experiences of confronting the disease because of itsoutbreak, and the processes of coping with it were deeper.

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Requirements for promoting help‑seeking behaviors in family caregivers of cancer patients: A qualitative study

. Behzad Hamedani; . Mousa Alavi; . Fariba Taleghani; . Malek Fereidooni Moghadam

Volume 13, Issue 2 , February 2023, , Pages 1-7

Abstract

  BACKGROUND: Caring for a family member with cancer is a challenging issue for families. Familycaregivers often need the help of supportive resources to solve problems in their care ...  Read More BACKGROUND: Caring for a family member with cancer is a challenging issue for families. Familycaregivers often need the help of supportive resources to solve problems in their care role. A deepunderstanding of the requirements of caregivers to seek help is an effective step toward their abilityto use supportive resources. This study aimed to identify and describe the requirements for promotinghelp‑seeking behaviors in Iranian family caregivers of cancer patients.MATERIALS AND METHODS: This qualitative study was conducted through in‑depth semi‑structuredinterviews with 28 participants selected using purposeful sampling method from 2019 to 2021. Aninterview guide with general questions about seeking help was used to maintain coherence in datacollection. The interviews continued until data saturation. All interviews were recorded, transcribedand analyzed through qualitative content analysis.RESULTS: The requirements of promoting help‑seeking behaviors in family caregiverswere grouped into four main categories: (1) improving social paths toward seeking help, (2)spiritual‑psychological‑cognitive empowerment toward seeking help, (3) strengthening the motivationsbehind seeking help, and (4) modifying the perception of cultural barriers to seeking help.CONCLUSION: According to the results of this study, it is expected that by identifying the requirementsof caregivers for seeking help and by health stakeholders designing comprehensive programs toaddress these needs, caregivers will be empowered to use supportive resources and provide abetter care role.

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Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives

. Fatemeh Bahrambeygi; . Sakineh Rakhshanderou; . Ali Ramezankhani; . Mohtasham Ghaffari

Volume 13, Issue 1 , January 2023, , Pages 1-13

Abstract

  BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health ...  Read More BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health literacy inthis context seems necessary. The purpose of this research was to explain the concept of hospitalhealth literacy (HHL), its definition, and the related dimensions using the qualitative research method.MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open‑ended,and face‑to‑face interviews based on the interview guide were used to elicit participants’ perspectivesbetween July 2021 and January 2022. By using the content analysis method, researchers codedtranscripts and collated these codes into sub‑categories and then merged them into the main categoryand explored the dimensions of the concept.RESULTS: A total of 23 service providers and 25 service recipients were included in the study.Analysis of qualitative data led to the identification of 6 categories and 25 sub‑categories includingcognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, medialiteracy, and emotional literacy.CONCLUSION: The findings of the present study provide a deep understanding of the conceptof HHL that could be applied to develop valid and reliable measurement tools for assessing HHLamong a variety of populations. Also, it is hoped that the present attempt can be useful to guidefuture research and interventions as well as to provide a clear base for planning, implementing, andevaluating interventions aimed at promoting individuals’ health literacy in health settings.

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Heat wave adaptation paradigm and adaptation strategies of community: A qualitative phenomenological study in Iran

. Maryam Kiarsi; . Mohammadreza Amiresmaili; . Mohammad R. Mahmoodi; . Hojjat Farahmandnia; . Nouzar Nakhaee; . Armin Zareiyan; . Hamidreza Aghababaeian

Volume 12, Issue 11 , December 2022, , Pages 1-17

Abstract

  BACKGROUND: Heat wave adaptation is a new concept related to experiencing heat. The presentstudy aims at investigating a conceptual definition, that is, the mental framework of heat ...  Read More BACKGROUND: Heat wave adaptation is a new concept related to experiencing heat. The presentstudy aims at investigating a conceptual definition, that is, the mental framework of heat waveadaptation and its strategies.MATERIALS AND METHODS: A phenomenological study was performed to explain the mentalconcept. At the same time with the data collection process, data analysis was also performed usingColaizzi method. Semi‑structured interview method and purposeful sampling with maximum varietywere used. Interviews were conducted with 23 different subjects in the community. The accuracy ofthe data was guaranteed using Lincoln & Guba scientific accuracy criteria.RESULTS: The two main themes of the adaptation paradigm as well as its strategies were dividedinto the main categories of theoretical and operational concepts, as well as personal care measuresand government measures. Under the category of individual measures, we obtained “clothing,nutrition, building, place of residence and lifestyle,” and under the category of governance actions,the “managerial, research, health, organizational” subcategories were obtained.CONCLUSION: According to the results of the conceptual‑operational definition, heat wave adaptationis an active process and an effort to reduce the adverse effects of heat waves on individual andsocial life, and striking a balance that will not only result in individual awareness and actions thatwill lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in thecommunity. On the one hand, heat waves could not only be regarded as a threat or danger, but canalso become an opportunity for the development of a community through identification and smartmeasures, and for adaptation, the community must take it as a risk. The community should have aplan in advance, apply the necessary rules and training, and use the new facilities and rules wherenecessary. This practical concept definition includes the main features of heat wave adaptation.

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The challenges of strategic management of the wastage produced due to earthquake in Kermanshah and Varzaghan-Ahar: A qualitative study

. Sadegh Kazemi; . Mehdi Mokhtari; . Aliakbar Vaezi; . Ibrahim Salmani; . Mohammad Hassan Ehrampoush; . Abbas Ali Dehghani Tafti; . Hossein Fallahzadeh; . Mojtaba Fattahi Ardakani

Volume 12, Issue 11 , December 2022, , Pages 1-10

Abstract

  BACKGROUND: Strategic management of the wastage produced due to earthquakes has facedmany challenges over the recent decade. Thus, the present study seeks to identify and explain thechallenges ...  Read More BACKGROUND: Strategic management of the wastage produced due to earthquakes has facedmany challenges over the recent decade. Thus, the present study seeks to identify and explain thechallenges in earthquake wastage strategic management.MATERIALS AND METHODS: The present qualitative study has been steered through a contentanalysis approach and conducted using semi‑structured interviews and a purposive selection of 17professors, experts, and managers experienced in the field of waste management in Kermanshahand Varzaghan‑Ahar earthquakes over 2020‑2021. Besides, the interviews were initially categorizedusing MAXQDA18 software.RESULTS: Analysis of the experiences and perception regarding the changes in strategicmanagement of wastage produced due to Kermanshah and Varzaghan‑Ahar earthquakes revealed418 codes, 97 subcategories, 33 categories, and 8 main categories including management andleadership, organizational culture, planning, organizational learning, employee management, rulesand regulations, resource management, and procedure management.CONCLUSION: Strategic waste management has not been implemented in a coherent, integrated,and well‑planned manner in the cases of the Kermanshah and Varzaghan‑Ahar earthquakes. Thechallenges of strategic waste management turned out to be due to various reasons which will resultin many issues in achieving the goals and selecting the suitable method for resource and proceduremanagement should they not be managed well. Hence, policymakers, managers, and executors inthe field of crisis management and waste management in disasters ‑specifically earthquakes‑ musttake the necessary measures to remove these barriers.

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Factors affecting nonadherence to treatment among type 2 diabetic patients with limited health literacy: Perspectives of patients, their families, and healthcare providers

. Nasrin Pourhabibi; . Roya Sadeghi; . Bahram Mohebbi; . Elham Shakibazadeh; . Mojgan Sanjari; . Azar Tol; . Mehdi Yaseri

Volume 12, Issue 10 , November 2022, , Pages 1-13

Abstract

  BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This ...  Read More BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This study aimed to determine factors affecting nonadherence to treatment among diabetic patientswith limited health literacy from the perspectives of patients, their families, and healthcare providers.MATERIALS AND METHODS: This qualitative study with a content analysis approach was conductedon 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment,as well as their families and healthcare providers using a purposive sampling method, in Kerman cityin 2021. Interviews were conducted using a semistructured interview guide with a broad, open‑endedquestion to provide a general history of the disease separately. The interviewer asked participantsto identify the perceived barriers to treatment nonadherence. Each interview lasted 45–60 min.MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data.RESULTS: Four major themes emerged from the patients’ perspectives as “financial problems,”“individual factors,” “problems related to medication availability,” and “healthcare providers’ poorpractices.” Two major themes were classified from the perspective of patients’ families as “financialproblems” and “Individual factors,” and four major themes were identified from the viewpoint ofhealthcare providers including “financial problems,” “individual factors,” “scarcity and medicationavailability,” and “poor practice of the healthcare provider.” These mentioned barriers were confirmedregarding treatment nonadherence among study participants.CONCLUSION: Study findings revealed different factors of treatment nonadherence among diabeticpatients with limited health literacy. Therefore, these factors should be considered in tailoringpromotive educational and supportive interventions. Considering the importance of adherence totreatment patients, planning empowerment family‑based interventions focusing on health literacyimprovement seems necessary.

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Educational challenges of family caregivers of vegetative state patients for home care preparedness: A qualitative content analysis

. Aliakbar Keykha; . Monir Ramezani; . Shahram Amini; . Hossein Karimi Moonaghi; . Azadeh Saki

Volume 12, Issue 9 , October 2022, , Pages 1-10

Abstract

  BACKGROUND: Patients with a vegetative state (VS) are completely dependent on caregivers inall physical aspects of their lives. Caring for such patients comes with a great deal of difficulty ...  Read More BACKGROUND: Patients with a vegetative state (VS) are completely dependent on caregivers inall physical aspects of their lives. Caring for such patients comes with a great deal of difficulty forfamily caregivers. As a result, family caregivers must be fully trained and prepared for this role. Thepresent qualitative study was conducted to investigate the educational challenges faced by familycaregivers of VS patients for home care preparedness.MATERIALS AND METHODS: The present qualitative study was conducted through the conventionalcontent analysis method from August 2020 to September 2021 in two provinces of Iran (Sistan andBaluchestan Province; and Razavi Khorasan Province). Fourteen family caregivers of patients in a VSwere included in the study. Semi‑structured and in‑depth interviews were employed to collect data.The Graneheim and Lundman method was utilized to conduct the data analysis using MAXQDA2020software. Data collection continued until data saturation and the identification of main categories.RESULTS: As indicated by the data analysis, three categories of “unmet educational needs,”“confused caregiver,” and “searching for practical knowledge” which included 19 sub‑categoriesdescribed the experiences of family caregivers of patients in a VS concerning challenges they wentthrough in preparation for patient care at home. Participants’ experiences revealed that despite theinadequacy of educations provided by health‑care providers on knowledge and skills required byfamily caregivers, they were committed to caring for the patient and trying to acquire the requiredknowledge.CONCLUSION: Results indicated that inadequate education and the lack of family caregivers’contribution to caring for the patient in the VS during their stay in the hospital impedes their acquisitionof adequate knowledge and skill to care for patients at home. Therefore, healthcare systempolicymakers should be planning to eliminate the educational barriers faced by family caregiversand expand the educational activities of hospitals’ homecare centers to provide educational supportof family caregivers after the patient’s discharge.

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Identifying the factors affecting on interaction of faculty member: A meta‑synthesis

. Mojgan Mohammadimehr; . Jamal Haji

Volume 12, Issue 9 , October 2022, , Pages 1-9

Abstract

  BACKGROUND: The ability to interact and communicate effectively is one of the factors affecting theperformance of faculty members, which is considered one of their basic competencies. ...  Read More BACKGROUND: The ability to interact and communicate effectively is one of the factors affecting theperformance of faculty members, which is considered one of their basic competencies. The purposeof this study was to identify the factors affecting on interaction of faculty member with student andcolleague, through the synthesis of literature.MATERIALS AND METHODS: The research method was qualitative with a meta‑synthesis approach.Meta‑synthesis was performed with Sandelowski and Barroso method. After the research of databasesin the period 1995–2021, 259 studies were collected and finally 48 sources were selected and wereincluded in the analysis phase. Coding method was used to analyze the data.RESULTS: Analyzing the findings of previous researchers and synthesizing the results, 155 codes,18 subcategories, and 6 categories were identified and validated through kappa coefficient. Thecategories included “emotional‑cognitive factor,” “sociocultural factor,” “communication factor,”“professional factor,” “educational factors,” and “management factor.”CONCLUSION: Based on the findings of this study and the importance of faculty members’interactions in medical universities, it is recommended that university officials and administratorsuse the results of this study to provide a suitable platform for creating and strengthening theseinteractions through holding workshops.

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Explaining the challenges of hospitals admitting COVID‑19 patients from the perspective of managers (a qualitative study)

. Seyed Saeed Tabatabaee; . Vahid Vatandoost; . Fatemeh Kokabi Saghi; . Elahe Daghighbin

Volume 12, Issue 9 , October 2022, , Pages 1-11

Abstract

  BACKGROUND: Crises are often unavoidable events that occur around the world. Hospitals playan important role in treating patients and preventing extensive injuries in times of crisis, ...  Read More BACKGROUND: Crises are often unavoidable events that occur around the world. Hospitals playan important role in treating patients and preventing extensive injuries in times of crisis, requiringadequate preparedness. In order to design a proper planning system, it is essential to be aware ofthe challenges of hospitals during a crisis. The purpose of this study was to explain the challengesof hospitals admitting COVID‑19 patients in the city of Mashhad, Iran, from the perspective of theirmanagers.MATERIALS AND METHODS: This study employed a qualitative approach, using the method ofconventional content analysis and was conducted from May to July 2020. A purposive samplingmethod was used to recruit the senior managers of hospitals admitting COVID‑19 patients in Mashhad.The interviews were conducted face to face, with open‑ended questions following an interview guidebased on semi‑structured questions, and continued until data saturation was reached. Data wereanalyzed using Atlas Ti software.RESULTS: After the implementation of the interviews, first 665 initial codes were extracted fromthe data, and after removing the overlapping sequences, a total of 115 codes were obtained. Threecategories (organizational challenges, extra organizational challenges, and challenges related toinformation domain), 13 sub‑categories, and 33 codes were extracted from the content analysis ofthe interviews. The main themes propounded in the field of challenges of COVID‑19 referral hospitalsin Mashhad were organizational challenges, extra organizational challenges, and information domainchallenges.DISCUSSION: The results of this study showed that the hospitals admitting COVID‑19 patients inMashhad faced many challenges. To improve the quality of services in postcrisis phase, replacinghospitals’ equipment, revising curriculums at medical universities, staff retraining, recruiting skilledhuman resources, and creating a supportive community context are necessary.CONCLUSION: For sure, the COVID‑19 crisis will not be the last one, we have to be prepared forthe bigger health crisis.

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Technical competency required by postgraduate psychiatric nursing students: A qualitative research

. Effat Sheikhbahaeddinzadeh; . Tahereh Ashktorab; . Abbas Ebadi

Volume 12, Issue 9 , October 2022, , Pages 1-7

Abstract

  BACKGROUND: Technical skills result in the patient’s safety. Psychiatric nurses need to learn andapply them to provide effective and secure cares. This study explains the technical ...  Read More BACKGROUND: Technical skills result in the patient’s safety. Psychiatric nurses need to learn andapply them to provide effective and secure cares. This study explains the technical competencyrequired for postgraduate psychiatric nursing students.MATERIALS AND METHODS: This conventional qualitative content analysis study is part of a largerstudy on the clinical competency of postgraduate psychiatric nursing students performed in Iran in2020. A qualitative study was conducted at universities holding master’s degree courses in psychiatricnursing. Participants were instructors and postgraduate psychiatric nursing students, psychiatricnurses, psychologists, and psychiatrists selected by purposeful sampling method. Sampling continueduntil data saturation was achieved. Data were collected through a semi‑structured individual interviewand were analyzed by conventional qualitative content analysis.RESULTS: The “technical competency” has two subcategories of “specialized knowledge” (includinggeneral nursing knowledge, psychiatric nursing knowledge, and basic knowledge of psychology)and “application of knowledge in practice” (including clinical experience, skills of psychiatric nursinginterventions, educational skills, and research and evidence‑based practice skills).CONCLUSION: The psychiatric nursing student learns and operates knowledge of psychiatricnursing, psychology, education, and research, besides improving their knowledge of general nursing.

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Factors influencing professionalism among nurse educators: A qualitative study

. Bharat Pareek; . Kiran Batra

Volume 12, Issue 8 , September 2022, , Pages 1-8

Abstract

  BACKGROUND: Nurse educators require to exhibit specialized behaviors that demonstrate the beliefsof the nursing profession. The aim of the study is to explore the factors influencing ...  Read More BACKGROUND: Nurse educators require to exhibit specialized behaviors that demonstrate the beliefsof the nursing profession. The aim of the study is to explore the factors influencing professionalismamong nurse educators in the selected nursing educational institutes of Indian States.MATERIALS AND METHODS: Qualitative approach was adopted where multiple focus groupdiscussions were planned and conducted. The study was carried out among nurse educators fromthe Northern Indian states. Thematic analysis, using the argumentative interactions approach wasused. The consolidated criteria for reporting qualitative research (COREQ) guide were followed.RESULTS: Three types of factors, that is, individual (micro‑level), organizational (meso‑level), andexternal professional occupational (macro‑level) were explored, where individual factors emerged ashaving a strong positive impact on nurse educators’ professionalism as compared to other factors.Poor organizational infrastructure, privatization of educational institutions, and other related factorswere reported as having a negative influence on nurse educators’ professionalism.CONCLUSION: Most of the educational institutions included in the present study, lacked basicinfrastructure/facilities for the professional development of nurse educators and professionalism.

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A qualitative approach to identify clinical uncertainty in practicing physicians and clinical residents

. Shoaleh Bigdeli; . Hamid Reza Baradaran; . Shirin Ghanavati; . Seyed Kamran Soltani Arabshahi

Volume 12, Issue 7 , August 2022, , Pages 1-10

Abstract

  BACKGROUND: Clinical decision‑making is not only stressful to physicians, but also to patients andeven their companions. Thus, managing uncertainty in clinical decision‑making is ...  Read More BACKGROUND: Clinical decision‑making is not only stressful to physicians, but also to patients andeven their companions. Thus, managing uncertainty in clinical decision‑making is essential whichrequires knowing its origins. Therefore, this study aimed to understand determinants of uncertaintyin clinical decision‑making from the perspective of clinical physicians.MATERIALS AND METHODS: This is a qualitative study which is done during October to November2020. An in‑depth interview is performed with 24 specialists of clinical groups including obstetrics,surgery, internal medicine, and pediatrics, working in teaching hospitals affiliated to Iran Universityof Medical Sciences. All the interviews were recorded, transcribed and analyzed according to thesteps suggested by Graneheim and Lundman. The interviews were analyzed through comparativemethod. Then, the interviewer created initial codes, categories, and key concepts and sent them tofourteen physicians for member check.RESULTS: According to the participants’ view, determinants of uncertainty in clinical decision‑makingconsisted of three themes: individual determinants, dynamics of medical sciences, and diagnosticand instrumental constraint. Individual determinants can be related to the physician or patient. Thedynamics of medical sciences could be explained in two categories: variation of medical science andcomplexity. Diagnostic and instrumental constraint category could be also explained in subcategoriessuch as lack of efficient diagnostic tests and unknown etiology.CONCLUSION: To curb uncertainty, the more accessible way is considering interventional programswith a focus on individual determinants related to physicians, such as strengthening doctor–patientrelationships, and considering related mandatory retraining courses to reduce insufficient knowledgeof physicians.

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Exploring Challenges of Access to Non‑Communicable Disease (NCD) Prevention, Treatment and Care: A Qualitative Study on People Living with NCDs (PLWNCDs) in West Bengal, India

. Sutapa Biswas; . Debayan Podder; . Sweety Suman Jha; . Prachi Kathuria; . Bobby Paul

Volume 12, Issue 7 , August 2022, , Pages 1-9

Abstract

  BACKGROUND: People living with noncommunicable diseases (PLWNCDs) are oftendisproportionately affected due to adverse interaction with socioecological and biological factors.Hence, ...  Read More BACKGROUND: People living with noncommunicable diseases (PLWNCDs) are oftendisproportionately affected due to adverse interaction with socioecological and biological factors.Hence, it is imperative to learn from their lived experience to gain a greater understanding ofinteractions as well as explore their priorities and needs in accessing care and identify areas ofpriority action through multistakeholder engagement.MATERIALS AND METHODS: The qualitative study with grounded theory approach wasconducted between October and December 2020. An online key‑informant interview with the healthpolicymaker, virtual group discussion with eight PLWNCDs, and in‑depth telephonic interviewswith five PLWNCDs were conducted, after obtaining informed consent using interview guide,developed, and validated by the experts. Data collection continued till data saturation was achieved.Transcripts generated from the interview recordings were coded using hand‑code technique andanalyzed thematically.RESULTS: Challenges faced by PLWNCDs in accessing care were lack of empathy and supportfrom health‑care professionals, stigma, financial hardship, and hospital overcrowding. Caregiversemphasized on the felt need to involve civil society organizations (CSOs) in raising awareness towardnoncommunicable diseases (NCDs) at family, community, and policymaking levels. The need forhome‑based NCD care and rehabilitation centers was voiced by the PLWNCDs. Impediments towardeffective implementation of NCD policies were adoption of a “top‑down” approach, poor awarenessabout government health insurance schemes, skewed distribution of empanelled hospitals in andaround cities, nonavailability of qualified health‑care professionals in underserved areas, aggravatedallocation‑utilization disparity during COVID‑19 pandemic, and lack of robust information technologyinfrastructure to support access to telemedicine services.CONCLUSION: The collective role of governments, CSOs, and health‑care providers, along withmeaningful involvement of PLWNCDs, would help to create an enabling environment for overcomingthe challenges of access to care and thus achieve universal health coverage.

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Exploring the reproductive health needs of men in the preconception period: A qualitative study

. Zeinab Rabiei; . Mohammad Shariati; . Naser Mogharabian; . Rahim Tahmasebi; . Ashraf Ghiasi; . Zahra Motaghi

Volume 12, Issue 5 , June 2022, , Pages 1-9

Abstract

  BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive healthassessment is conducted in the preconception period, the chance of a healthy pregnancy ...  Read More BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive healthassessment is conducted in the preconception period, the chance of a healthy pregnancy can increase.This qualitative study aimed to explore men’s reproductive health needs before conception in Iran.MATERIALS AND METHODS: This research was a qualitative study conducted in Bushehr city, Iranto explore men’s reproductive health needs from April 2021 to November 2021. 30 semistructuredinterviews were conducted with married men, women, healthcare providers, and specialists individuallyin the health centers. The sampling method used in this study was purpose‑based with maximumvariety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzedusing directional content analysis. MAXQDA software version 12 was used to facilitate data analysis.RESULTS: From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. Thethemes included evaluation and health promotion recommendations. It consisted of 10 categories:reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation,social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation,physical examination, lifestyle evaluation, and mental health evaluation. Health promotionrecommendations included five categories: nutritional recommendations, stress management,avoiding harmful behaviors, protective measures against harmful exposure, and need for education.CONCLUSIONS: Our results showed that men need a comprehensive evaluation of reproductivehealth and recommendations to improve their health in the preconception period. Our study findingscan inform healthcare providers to increase men’s participation in reproductive health.

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What do parents of children with autism spectrum disorder think about their quality of life? A qualitative study

. Samaneh Abolkheirian; . Roya Sadeghi; . Davoud Shojaeizadeh

Volume 12, Issue 5 , June 2022, , Pages 1-9

Abstract

  BACKGROUND: Living with children with autism spectrum disorder (ASD) can affect differentaspects of parents’ physical and mental health and quality of life. This study aimed to ...  Read More BACKGROUND: Living with children with autism spectrum disorder (ASD) can affect differentaspects of parents’ physical and mental health and quality of life. This study aimed to identify parents’perceptions of their quality of life and factors influencing such perceptions and investigate how theycope with difficulties in their daily lives.MATERIALS AND METHODS: This study was conducted using a qualitative research design to gaininsight into how children with ASD may influence their parents’ quality of life. A total of 31 parentsand school counselors were selected by the snowball sampling method in autism schools in Tehranin the academic year 2018–2019. Semi‑structured interviews were used to collect the data. Eachinterview was held based on a preprepared guideline by the researchers. In‑depth questions werealso asked as needed. Finally, the data were analyzed using the content analysis approach.RESULTS: The participants reported a variety of difficulties and crises to cope with in their dailylives. The factors reported to decrease the quality of life were categorized into six main themes and20 subthemes. The main themes included “family interactions,” “parenting,” “daily living,” “health,”“financial issues,” and “community‑related.”CONCLUSIONS: Due to the diversity and multilevel factors affecting the quality of life of parentshaving children with ASD, it is essential to adopt a comprehensive approach with the participationof all stakeholders in the development, design, and implementation of future interventions.

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Metamotivation in medical students: Explaining motivation regulation strategies in medical students

. Ali Norouzi; . Maryam Alizadeh; . Dean Parmelee; . Saharnaz Nedjat; . Saiideh Norouzi; . Mohammad Shariati

Volume 12, Issue 5 , June 2022, , Pages 1-8

Abstract

  BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical ...  Read More BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical studentsmanage their motivational states. This study aim to identify the motivational strategies of medicalstudents as they use the metamotivational process to monitor and control their motivational states.MATERIALS AND METHODS: This qualitative study uses directed content analysis of the narrativeresponses of 18 medical students to draft an in‑depth and semistructured interview protocol which wereconducted through WhatsApp due to social distance restrictions of COVID‑19. Data were collected,encoded, and analyzed using deductive content analysis approach descripted by Elo and Kyngäs.RESULTS: Seven main themes were extracted as the motivational strategies of medical studentsincluding “regulation of value,” “regulation of situational interest,” “self‑consequating,” “environmentalstructuring,” “efficacy management,” “regulation of relatedness,” and “regulation of situationalawareness.” In this study by identifying new strategies, we provide a broader framework ofmetamotivational strategies in the field of the progression of learners in medical education.CONCLUSION: Medical students use a variety of strategies to regulate their academic motivation. Tosustain and improve the motivation of medical students, identifying and strengthening metamotivationalstrategies is the first step.

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Sensitizing the medical undergraduates to qualitative research: In the context of experiential learning debriefings

. Lopamudra Debasish; . Kavita Vasudevan; . Premnath Dhasaram; . Prakash Mathiyalagen

Volume 12, Issue 4 , April 2022, , Pages 1-8

Abstract

  BACKGROUND: The role of medical undergraduates is limited while interacting with the community related to issues involving human behavior. Since qualitative research seeks to build ...  Read More BACKGROUND: The role of medical undergraduates is limited while interacting with the community related to issues involving human behavior. Since qualitative research seeks to build a holistic understanding of social phenomena, we designed this project to expose them to the basics of qualitative research in a real‑world setting of experiential learning. The aim of this study is to sensitize the medical undergraduates to the basics of qualitative research and able to apply it in the context of experiential learning in the community.MATERIALS AND METHODS: In this current educational intervention, a structured teaching program was designed and applied for the first time, to our students to effectively sensitize them to qualitative research in a natural community setting, intended to provide them a solid base for experiential learning. A batch of students (n = 50) was selected by convenient sampling method who had their clinical postings with us. At first, a “session planning guide” was drawn on the plan of conduction of this program. We followed the “facilitators reference manual by research consortium on educational outcomes and poverty (RECOUP) for our teaching sessions. The framework of our study was executed in the following sequence: sensitization of the learners, exposure to structured quality experience, systematic debriefing sessions with evaluation of learner experiences, and the process and outcome feedbacks from the learners. The students were monitored by trained facilitators. The various study tools used in the structured teaching program included, the teaching sessions using the RECOUP manual, didactic lectures and short group interactive sessions to teach qualitative research and photographs and video clips to facilitate the sessions, mock demonstrations and role plays on interviewing techniques, use of case vignettes on the theme “perception of psychosis” for interviewing the community, structured debriefing guide, and various self‑reflective exercises. Learners’ perspective of community perception, debriefing sessions, and self‑reflective responses were transcribed, and manual content analysis was done to identify the codes and interpret the results.RESULTS: Majority could appreciate the uniqueness of qualitative research over the quantitative counterpart. They could enumerate the attributes of a good qualitative researcher. The debriefing exercises made them summarize their experiences and the self‑reflective exercises enabled them to identify their abilities and critique their ideas. It was a different experience to our learners as they could identify themselves with the sentiments of the community. To them, the facilitating points were the interviewing skills and confidence gained in facing the community. However, they felt time constraint for exploring the sensitive issues during the fixed posting schedule.CONCLUSIONS: The experience of learning beyond the boundaries of a classroom setting sensitized them to various community perceptions and reactions. The students perceived the qualitative methods well and could apply the lessons learnt in the facility. They also felt that this learning exposure gave them community orientation and confidence in dealing with community issues.

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The shadow of paternalism on patient‑centeredness in oncology nursing care: A barrier of health‑care promotion

. Fariba Taleghani; . Saba Farzi; . Ahmadreza Yazdannik; . Mehran Sharifi Esfahani

Volume 12, Issue 4 , April 2022, , Pages 1-7

Abstract

  BACKGROUND: Patient‑centered care (PCC) is a key component of high‑quality care. Given the different effects of cancer on patients, patient‑centeredness is very important ...  Read More BACKGROUND: Patient‑centered care (PCC) is a key component of high‑quality care. Given the different effects of cancer on patients, patient‑centeredness is very important in oncology nursing care. The aim of this study was to explore nurses’ perceptions of the patient‑centered in oncology nursing care.MATERIALS AND METHODS: This descriptive qualitative study was conducted in 2018–2020, Iran. Data collection methods included observation and semi‑structured interviews. Patient, family, and nurse behaviors were observed (total: 318 h). In addition, interviews were conducted with nurses and nursing managers (12 interviews). Data analysis was performed using Graneheim and Lundman’s approach.RESULTS: Data analysis resulted in the emergence of four themes: “Organizational structure as a barrier to the PCC,” “Lack of institutionalization of PCC in nurses,” “Understanding and paying attention to the patient as PCC,” and “Situational PCC.” The final theme of this study is “PCC in the shadow of paternalism.”CONCLUSIONS: The paternalism approach in the context of oncology nursing care has made the realization of PCC difficult. The first step to promote PCC is increasing nurses’ awareness of the impact of paternalism on patient‑centeredness. Providing patient‑centered oncology nursing care requires changing attitudes, values, and behaviors at individual, professional, and organizational levels.

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Understanding the rationales behind childbearing: A qualitative study based on extended theory of planned behavior

. Babak Moeini; . Amir Erfani; . Majid Barati; . Amin Doosti‑Irani; . Hatam Hosseini; . Mokhtar Soheylizad

Volume 12, Issue 4 , April 2022, , Pages 1-9

Abstract

  BACKGROUND: Childbearing is the most important determinant of population fluctuations and its studies are more important than other population phenomena. Many factors are associated ...  Read More BACKGROUND: Childbearing is the most important determinant of population fluctuations and its studies are more important than other population phenomena. Many factors are associated with childbearing, but individual factors associated with it have been less studied in a specific framework. The present study aimed to explore and identify the factors related to childbearing based on extended theory of planned behavior (ETPB).MATERIALS AND METHODS: This qualitative study was conducted among married women <35 years of age and married men whose spouses were under 35 years of age and lived in the City of Hamadan, Iran, in 2019. The data were collected by semistructured and face‑to‑face in‑depth interviews and continued until the data saturation was reached. Overall, 15 interviews were conducted with 17 people. The data were analyzed, using a directed content analysis approach.RESULTS: The data analysis resulted in the extraction of 28 main codes, 9 subcategories, and 4 themes, which were correspond to constructs of the theory, consisting of attitudes, subjective norms, perceived behavioral control, and social support in the field of childbearing. The main predictors were attitude toward childbearing and perceived control.CONCLUSION: The findings of this study showed that ETPB has a potential to explain the intention and behavior of childbearing. The ETPB makes it possible to understand many of the factors associated with childbearing. The results of this study could be the basis for designing appropriate data collection instrument in quantitative studies and vast surveys.

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Contributing factors of willingness and hesitancy regarding acceptance of COVID‑19 vaccine in primary care settings: A qualitative study in an eastern state of India

. Sweety Suman Jha; . Bobby Paul; . Rahul Das; . Biswadip Chattopadhyay; . Arista Lahiri

Volume 12, Issue 2 , February 2022, , Pages 1-7

Abstract

  BACKGROUND: For any effective vaccination strategy, the willingness of the beneficiaries and its contributing factors are important. This study was conducted among the health‑care ...  Read More BACKGROUND: For any effective vaccination strategy, the willingness of the beneficiaries and its contributing factors are important. This study was conducted among the health‑care workers (HCWs) and community members to find the perceptions regarding the COVID‑19 vaccine and understand the influencers and the barriers of vaccine acceptance.MATERIALS AND METHODS: A qualitative study was conducted from October 2020 to December 2020 in two primary care settings in an urban area. Eighteen in‑depth interviews (IDIs) after taking consent were conducted with the help of IDI guide developed and validated beforehand by the experts. IDIs were done among the ten community members and eight HCWs selected conveniently. Data collection were continued till data saturation when no new information yielded from the interviews. Thematic analysis was performed.RESULTS: All the participants were hopeful about availability of the vaccine. The key influencers identified for promoting willingness to accept the vaccine among both the groups were opinion of the health‑care providers, colleagues’ and other people’s acceptance of the vaccine, effectiveness of vaccine on other people, and perceived risk of the disease. Fear of adverse reactions was the most important barrier among all the respondents. The prevalent perception was that other preventive practices and vaccine together can only be the best solution to prevent COVID‑19 illness. The HCWs perceived that acceptance of vaccine among the community members would be good overall but apprehended some initial difficulties. Mass campaign to promote COVID‑19 vaccination and sensitization events are the need of the hour.CONCLUSIONS: Since opinion of health‑care personnel emerged as an important influencer of vaccine acceptance, mass campaign and sensitization programs spearheaded by the health‑care providers can bring about change by increasing the vaccine acceptance among the beneficiaries at large. Re‑enforcement regarding practice of preventive measures should be made among the population irrespective of the vaccination status.

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Challenges faced by nurses while caring for COVID‑19 patients: A qualitative study

. Marjan Vejdani; . Samira Foji; . Sara Jamili; . Raha Salehabadi; . Amin Adel; . Zahra Ebnehoseini; . Shapour Badiee Aval; . Ali Asghar Anjidani; . Hossein Ebrahimipour

Volume 11, Issue 10 , November 2021, , Pages 1-8

Abstract

  INTRODUCTION: In the COVID‑19 crisis, nurses are directly involved in patient care, so they facemany challenges. This study was performed to determine the challenges faced by nurses ...  Read More INTRODUCTION: In the COVID‑19 crisis, nurses are directly involved in patient care, so they facemany challenges. This study was performed to determine the challenges faced by nurses whilecaring for COVID‑19 patients in Iran in 2020.MATERIALS AND METHODS: This qualitative, content analysis was conducted in Iran on ten nursesdirectly involved in the fight against the corona epidemic, selected through a purposeful samplingstrategy. Data were collected through deep interviews consisting of open questions. All the interviewswere recorded, and immediately after each interview, it was transcribed into written form. The datawere analyzed using MAXQDA software.RESULTS: All the challenges could be classified into three main categories and 17 subcategories.The main categories were miss‑management in controlling corona conditions, mental and physicalcomplications and challenges in corona work conditions, and lack of sufficient workforce.CONCLUSION: Hospital managers and authorities play a significant role in meeting the financialneeds and requirements of nurses, and can minimize the job discrimination prevalent at medicalcenters through providing financial and nonfinancial incentives for nurses. Moreover, the findingsof the present study can help hospital managers and authorities to gain a better understanding ofthe experiences of nurses, and to take the necessary measures to obviate the challenges faced bynurses in public health emergencies.

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Reconstruction of individual, social, and professional life: Self‑management experience of patients with inflammatory bowel disease

. Seyed Mostafa Mohsenizadeh; . Zahra Sadat Manzari; . Hassan Vossoughinia; . Hossein Ebrahimipour

Volume 11, Issue 10 , November 2021, , Pages 1-7

Abstract

  BACKGROUND: Patients with inflammatory bowel disease (IBD) experience wide range of physicaland psychological problems experience. The use of strategies to improve disease management ...  Read More BACKGROUND: Patients with inflammatory bowel disease (IBD) experience wide range of physicaland psychological problems experience. The use of strategies to improve disease management bypatients is of has special importance in solving these problems. The aim of present study was todiscover the strategies and behaviors of patients to manage their disease.MATERIALS AND METHODS: The present study was conducted with a qualitative research approachand a qualitative content analysis method. The research participants included 20 patients with IBDreferred to gastrointestinal wards in 2020 in Mashhad. Data were collected through unstructuredinterviews and purposeful sampling method and continued until data saturation. Data analysis wasperformed continuously and simultaneously with data collection and comparatively.RESULTS: Data analysis provided five themes of “Improving self‑efficacy and problem‑solving skills,”“Coexistence with disease,” “Reviewing and modifying of interactions,” “Adjusting job and professionalconditions” and “Commitment to self‑care.” The combination of these concepts indicated that is themain theme in disease management for these patients.CONCLUSIONS: Reconstruction of individual, social, and professional life can improve self‑regulationand problem‑solving skills in these patients and make them a sense of control on their lives anddisease.

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Exploring physical therapy students’ experience of peer learning in a student‑run clinic

. Susan Paparella‑Pitzel; . Ellen Zambo Anderson; . Pamela Rothpletz-Puglia; . James Scott Parrott

Volume 11, Issue 9 , October 2021, , Pages 1-8

Abstract

  BACKGROUND: Participation in a student‑run pro bono clinic (SRPBC) provides opportunities forstudents to develop professional skills, engage with the community, and provide an often‑underservedpopulation ...  Read More BACKGROUND: Participation in a student‑run pro bono clinic (SRPBC) provides opportunities forstudents to develop professional skills, engage with the community, and provide an often‑underservedpopulation with needed care.MATERIALS AND METHODS: This paper describes the results of a mixed‑method analysis of studentexperiences in an SRPBC. A survey with both Likert‑type and write‑in elements was administeredto three cohorts of students enrolled in a doctoral program of physical therapy. Students wereprompted to provide their perspective on the value of the clinic experience with respect to professionaldevelopment, academic relevancy, and personal growth.RESULTS: The analysis discovered that perspective value of the clinic in the areas of personalgrowth and academic relevancy differed by cohort. Specifically, 1st‑year students reported that theybenefitted immensely by learning from their peers, especially in the use of outcome measures.Second‑year students did not report the same benefits.CONCLUSION: The findings suggest that even though students from different cohorts work togetherin the same clinic, they may experience the clinic very differently. This observation provided the basisfor changes to the SRPBC to enhance leadership and conflict management skills of the 2nd‑yearstudents.

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Effective strategies for implementing patient‑centered care in cardiac care unit: An opportunity for change

. Firouzeh Charosaei; . Shahnaz Rostami; . Maryam Esmaeili; . Shahram Molavynejad; . Zohreh Vanaki

Volume 11, Issue 9 , October 2021, , Pages 1-9

Abstract

  BACKGROUND: Patient‑centered care (PCC) is a cornerstone for health‑care professionals toimprove the quality of care they provide to patients with cardiac disease. However, implementationof ...  Read More BACKGROUND: Patient‑centered care (PCC) is a cornerstone for health‑care professionals toimprove the quality of care they provide to patients with cardiac disease. However, implementationof PCC programs has always accompanied with unpredictable challenges and obstacles. Therefore,the present study was conducted to determine effective strategies for the implementation of PCCfrom the perspective of patients and healthcare providers.MATERIALS AND METHODS: The present research was a qualitative study using conventional contentanalysis method in one of the university hospitals of Abadan University of Medical Sciences during2019–2020. Purposive sampling was performed until data saturation was achieved. Data were collectedthrough four focused group discussions and 24 in‑depth semi‑structured interviews with 22 health‑careproviders and seven cardiac patients. Depending on the interview process and the responses of eachindividual, the sequencing of questions was different from one participant to another. Data analysis wasperformed continuously and concurrently with data collection, using a comparative method.RESULTS: After data analysis, seven subcategories and three main categories were extracted. Themain categories included structural, process, and outcome strategies. The category of structuralstrategies included subcategories of nursing care organization, application of appropriate motivationalmechanisms, and expansion of team coordination. Process strategies included three subcategories,namely, promoting communication, respectful and compassionate care, and the development ofholistic care. Finally, the outcome strategy consisted of the subcategory of patient empowerment.CONCLUSION: The practical strategies for the implementation of PCC in coronary care unit revealedin this study were at structural, process, and outcome levels. Health‑care managers and administratorscan avail themselves of the findings of the present study to promote the quality care for cardiac careunit patients and improve patient satisfaction.

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Medical interns; the neglected learners of the maternity ward learning environment

. Masoumeh Rahimi; . Fariba Haghani; . Shahnaz Kohan; . Majid Shirani

Volume 11, Issue 7 , August 2021, , Pages 1-8

Abstract

  BACKGROUND: Clinical training during internship is an important part of medical education. Thematernity ward is a clinical environment in which medical students pass their obstetrics ...  Read More BACKGROUND: Clinical training during internship is an important part of medical education. Thematernity ward is a clinical environment in which medical students pass their obstetrics and gynecologyinternship to obtain competencies in this field. The present study was conducted to explain medicalinterns’ manner of learning in the maternity ward.MATERIAL AND METHODS: The present study was conducted using a qualitative approach withthe inductive content analysis method. This study observed the maternity wards of teaching hospitalsaffiliated to medical sciences universities of Isfahan and Shahrekord. Data were collected throughobservation and semi‑structured individual interviews.RESULTS: Two main categories and seven subcategories emerged from the analysis of the data.Inadequate participation in learning opportunities included the following three subcategories: theincongruousness of the learning opportunities with the educational goals, inadequate readiness forparticipation in learning opportunities, and the overlap between learning opportunities and diminishedautonomous practice. Inadequate formal and structured education included the following foursubcategories: inadequate learning support and direction, subordinate roles and aimless presence,the pale educational role played by the attendants and senior residents, and learning through thesupport of midwifery educators.CONCLUSION: Participation in and access to learning opportunities in the maternity ward are verydifficult for interns. Interns, therefore, need to attend the maternity ward by a structured program andin the company of training supervisors or competent educators to obtain the required competenciesin pregnancy and childbirth.

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