Journal of Education and Health Promotion

The experience of Saudi respiratory therapists dealing with COVID‑19 patients: A qualitative study

. Ziyad F. Al Nufaiei; . Reem H. Alluhibi; . Sama N. Almoshaigeh; . Raghad M. Alzahrani; . Wed O. Baaqeel; . Raid M. Al Zhranei; . Ali S. Al-Shareef; . Genevieve P. Zipp

Volume 13, Issue 2 , February 2023, , Pages 1-10

Abstract

  BACKGROUND: Healthcare professionals have fought hard to restrain the COVID‑19 pandemicby providing high‑quality care for their infected patients, but in doing so they have developedfears ...  Read More BACKGROUND: Healthcare professionals have fought hard to restrain the COVID‑19 pandemicby providing high‑quality care for their infected patients, but in doing so they have developedfears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratorytherapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation.The study sought to describe the experiences and coping strategies of Saudi RT managing patientswith COVID‑19.MATERIALS AND METHODS: The study utilized qualitative research methods, specifically employinga phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact withCOVID‑19 patients were selected after they agreed to participate in this study. The study followeda one‑on‑one semi‑structured interview process using the Zoom platform. This qualitative datacollection technique focuses on the participants’ lived experiences and feelings to discover sharedpatterns. The data were analyzed via an inductive approach.RESULTS: Six themes were found in the RT perceptions including stress while treating COVIDpatients, managing the fear of catching of Covid 19, feelings towards COVID‑19 patients, challengesfaced by female RTs, workplace experiences, and excessive workload.CONCLUSIONS: RTs feelings dramatically changed throughout the COVID‑19 pandemic. All theRTs have developed a self‑copying style that has helped them improve their psychosocial behaviorto face the pandemic. During the outbreak, frontline RTs’ positive and negative emotions intertwinedand coexisted. Negative emotions predominated in the beginning, while good feelings emergedgradually. Self‑coping methods and psychosocial development were significant factors in RTs mentalhealth while caring for COVID‑19 patients.

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Pregnant women’s experiences of well‑being in high‑risk pregnancy: A qualitative study

. Kobra Mirzakhani; . Abbas Ebadi; . Farhad Faridhosseini; . Talat Khadivzadeh

Volume 13, Issue 1 , January 2023, , Pages 1-9

Abstract

  BACKGROUND: Physical changes in high‑risk pregnancy (HRP) can lead to changes in mood andsocial relationships and negative effects on women’s well‑being. Individuals in different ...  Read More BACKGROUND: Physical changes in high‑risk pregnancy (HRP) can lead to changes in mood andsocial relationships and negative effects on women’s well‑being. Individuals in different socioculturalcontexts have different perceptions of well‑being. Yet, there is limited information about perceptions ofwell‑being in HRP. This study aimed to explore the Iranian women’s experiences of well‑being in HRP.MATERIALS AND METHODS: This qualitative study was conducted in 2019–2020 through directedcontent analysis based on the conceptual framework of well‑being in HRP. Participants were 26women with HRP purposively recruited from public and private healthcare settings in Mashhad, Iran.Face‑to‑face semistructured interviews were held for data collection until data saturation. Data wereanalyzed through directed content analysis proposed by Elo and kyngäs (2008) and were managedusing the MAXQDA (v. 10) program.RESULTS: Well‑being in HRP had seven attributes in the five main dimensions of physical,mental‑emotional, social, marital, and spiritual well‑being. The seven attributes of well‑being in HRPwere controlled physical conditions, controlled mood, emotions, and affections, perceived threat,self‑efficacy, and competence for multiple role performance, maintained social relationships, meaningseeking and relationship with the Creator, and positive marital relationships.CONCLUSION: The present study provide an in‑depth understanding about well‑being in the Iranianwomen with HRP. It is a complex and multidimensional concept with physical, mental‑emotional,social, marital, and spiritual dimensions. Comprehensive multicomponent interventions are needed topromote well‑being among women with HRP and designed the guidelines to provide woman‑centeredcare.

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Exploration of the primary needs of health care services for earthquake victims in the west of Iran

. Mahnaz Solhi; . Shakiba Zahed; . Abbas Ostadtaghizade; . Hadi Darvishi Gilan

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

Abstract

  BACKGROUND: Natural disasters always have significant effects on social infrastructures, livingconditions, and health care systems. This study aims to explain the needs of victims in ...  Read More BACKGROUND: Natural disasters always have significant effects on social infrastructures, livingconditions, and health care systems. This study aims to explain the needs of victims in the west ofIran for primary health care services.MATERIALS AND METHODS: This thematic content analysis and qualitative study was donefrom September 2020 to June 2021 in the west of Iran. Participants were selected using purposivesampling method. The data were extracted through semi‑structured interviews with 17 earthquakevictims and then examined through thematic content analysis.RESULTS: By analyzing and coding the data, the primary needs of victims post an earthquake in thewest of Iran were classified into four main categories) health services, mental health, social health,and health management (and 14 subcategories.CONCLUSION: Regarding the primary needs (health services, mental health, social health, andhealth management), establishing a headquarters to meet the immediate and special health careneeds seems to be required. It was recommended to create institutions for monitoring and supportingthe health care needs at the level of the community and even policymaking, as well as guidingearthquake‑stricken areas such as the eco‑village.

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Exploring the effective elements on the personal and professional development among health‑care providers: A qualitative study

. Shervin Farahmand; . Elaheh Malakan Rad; . Fatemeh Keshmiri

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

Abstract

  BACKGROUND: A new domain of “personal and professional development” was introduced as a corecompetency of health‑care providers. This study aimed to explore the experiences ...  Read More BACKGROUND: A new domain of “personal and professional development” was introduced as a corecompetency of health‑care providers. This study aimed to explore the experiences of learners andfaculty members about what competencies or skills were essential for the professional developmentand success of health‑care providers.MATERIALS AND METHODS: This is a qualitative study using an inductive content analysis approachin 2019–2020. In the present study, 58 academic faculty members participated by purposeful samplingincluding ten associate professors (17.24%) and 24 assistance professors (41.37%), in addition to23‑year medical residents (20.65%) and 4th‑year nursing students (20.65%). Individual and groupinterviews were conducted. Data were analyzed by the inductive content analysis approach introducedby Graneheim and Lundman.RESULTS: The qualitative data were classified in 953 open codes and eight categories, which werefurther divided into four main categories: “socio‑emotional skills,” “life‑long learning skills,” “copingskills,” and “well‑being strategies.”CONCLUSIONS: The present results showed socioemotional and coping skills affect interpersonaland professional interactions that contributed to their improved health‑care providers’ capabilities.Participants also considered lifelong learning as influential in developing professional capabilitiesand keeping their knowledge and skills up‑to‑date for accountability to duties. Moreover, usingwell‑being strategies protects the mental and physical health of health‑care providers. These skillsare synergistic, and their combination can have a significant role in improving the personal andprofessional capabilities.

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A reproductive health‑care program for surrogate mothers: A mixed methods study

. Marjan Goli; . Shahnaz Kohan; . Seiied Mahdi Ahmadi Oloonabadi; . Ziba Farajzadegan; . Zeinab Heidari

Volume 12, Issue 7 , August 2022, , Pages 1-8

Abstract

  BACKGROUND: Surrogacy has become an alternative family formation option for women who areunable to carry a pregnancy. There is no comprehensive care program despite the different nature ...  Read More BACKGROUND: Surrogacy has become an alternative family formation option for women who areunable to carry a pregnancy. There is no comprehensive care program despite the different nature ofthis pregnancy. The present study aimed to develop a reproductive health‑care program for surrogatemothers within the cultural and social context of Iran.MATERIALS AND METHODS: In the present sequential exploratory mixed methods study, firstthrough a qualitative approach surrogate mothers, care providers, and policy makers of reproductivehealth services were selected purposefully. Data were collected by using the in‑depth semi‑structuredinterviews and analyzed. A care program draft was designed by integrating results of the qualitativestudy and reviewing the literature and guidelines, then appropriateness of each proposed care wasassessed by a two‑Rounds Delphi technique (RAM), and the final reproductive health‑care programfor surrogate mothers was developed.RESULTS: The surrogate mothers’ reproductive health needs were summarized in four maincategories: surrogate mothers’ extra care, educational training, psychological support, and protectingagainst surrogacy`s social and familial consequences. The reproductive health‑care program forsurrogate mothers were developed in four sections: prepregnancy health screenings and legalcounseling; special care during embryo transfer until pregnancy confirmation; psychological supportand prenatal care of surrogacy until delivery and follow‑up postpartum care.CONCLUSION: Women face many challenges in surrogacy and need special care such as legalcounseling, reproductive health care, and psychological support. Implementation of this care programseems to help improve the reproductive health of these mothers.

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Strategies for sharing pedagogical knowledge in clinical education in adapting to the impact of COVID‑19

. Khaironnesa Ramazanzade; . Mohsen Ayati; . Farshid Abedi; . Hossein Shokohifard

Volume 12, Issue 3 , March 2022, , Pages 1-6

Abstract

  BACKGROUND: The extent and complexity of knowledge in the field of medicine necessitate modern education systems. Rational performance in the education system depends on the synergy of ...  Read More BACKGROUND: The extent and complexity of knowledge in the field of medicine necessitate modern education systems. Rational performance in the education system depends on the synergy of educators through knowledge sharing as the basis of education. The aim of this study was to investigate the knowledge‑sharing strategies in clinical education and its changes during the COVID‑19 pandemic.MATERIALS AND METHODS: The content analysis was conducted in 2019 at Birjand University of Medical Sciences. Twenty‑seven clinical instructors with enough experience and knowledge in the field of clinical education were chosen based on purposive theoretical sampling. Data collection was done by semi‑structured interviews, which continued until data saturation. The interviews were recorded, transcribed, and read several times to obtain a whole understanding. Next, the meaning units and initial codes were identified, and then, they were classified into subcategories and categories. To ensure the trustworthiness of the data, Lincoln and Guba criteria were considered.RESULTS: The results of the study include five pedagogical knowledge‑sharing strategies: “peer‑helping, clinical education workplace,” “use of cyberspace,” “student mediation,” “working teams,” and “scientific communities.” Coronavirus pandemic was identified as the “facilitator” and the “culturalization factor” of knowledge sharing. In addition, “lack of shared knowledge management,” “lack of compliance with needs,” and “dispersion of content” were considered as barriers to the efficiency of pedagogical knowledge sharing during the coronavirus pandemic.CONCLUSIONS: Sharing knowledge in a clinical education setting could continue by various strategies. The results can be used in planning for the professional development of professors.

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The psychosocial challenges of mothers of children with thalassemia: A qualitative study

. Majedeh Nabavian; . Fatemeh Cheraghi; . Farshid Shamsaei; . Lily Tapak; . Ahmad Tamaddoni

Volume 12, Issue 1 , January 2022, , Pages 1-7

Abstract

  BACKGROUND: Caring for the children suffering from thalassemia is a stressful experience withvarious aspects making the mothers face various challenges. Thus, the present study aimed ...  Read More BACKGROUND: Caring for the children suffering from thalassemia is a stressful experience withvarious aspects making the mothers face various challenges. Thus, the present study aimed to explainthe psychosocial challenges of mothers with thalassemia children based on their lived experience.MATERIALS AND METHODS: In this qualitative study, which was conducted using thephenomenological method, 14 mothers with thalassemia children were selected from two thalassemiatreatment centers in Hamadan and Babol (Iran) in 2020 using the purposive sampling method. Datawere collected using in‑depth and semi‑structured interviews and were analyzed by van Manen’sphenomenological methodology.RESULTS: In the first stage of data analysis, 534 initial codes were extracted, which were reducedto 290 by comparison and integration. The primary themes turned into 24 secondary themesafter clustering. By comparing the secondary themes, three main themes (i.e., “psychologicaldistress,” “bodily burnout,” and “mothers’ need to empathy and support”) with 7 secondarythemes (i.e., “emotional exhaustion,” “mental strain,” “social stigma,” “acute psychosomatic reactions,”“long‑term psychosomatic consequences,” “expectation of family support,” and support needs outsidethe family) were extracted.CONCLUSION: The results indicated that mothers with thalassemia children experience severalchallenges in various aspects. Therefore, they require care interventions and psychosocial support.

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Health‑care workers’ experience of stressors and adaptation strategies for COVID‑19: A qualitative research

. Vajihe Atashi; . Shahla Abolhasani; . Atefeh Afshari

Volume 12, Issue 1 , January 2022, , Pages 1-7

Abstract

  BACKGROUND: The mental health of health‑care workers with their unique role in respondingto the COVID‑19 pandemic is strictly essential. Hence, to react effectively to the pandemic, ...  Read More BACKGROUND: The mental health of health‑care workers with their unique role in respondingto the COVID‑19 pandemic is strictly essential. Hence, to react effectively to the pandemic, it isessential to collect further data on the stressors and adaptation strategies. The aim of this study isto explain the health‑care workers’ experiences of stressors and adaptation strategies used duringthe COVID‑19 pandemic outbreak.MATERIALS AND METHODS: A qualitative content analysis approach was employed in thisstudy, with semi‑structured in‑depth interviews. Nineteen health‑care workers participated in thestudy by purposeful sampling method. The study setting included selective educational hospitalsthat admitting patients infected with COVID‑19. The data were analyzed using content analysismethod.RESULTS: Stressors were classified under four major categories: idiopathic, i.e., arising fromunknown causes, individual and familial, stressful work environment, and socially imposed stressors.The adaptation strategies were classified under inactive and active adaptation strategies.CONCLUSIONS: The stressors include the stresses arising from the unknown nature of the disease,stressful work environment, individual and familial stresses, and the socially imposed stresses. Theadaptation strategies include inactive and active adaptation strategies. Identification of these factorscan help workers and management to effectively react to the pandemic.

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Psychological distress Management in Iranian emergency prehospital providers: A Qualitative study

. Maryam Azizi; . Reza Bidaki; . Abbas Ebadi; . Abbas Ostadtaghizadeh; . Abbasali Dehghani Tafti; . Ahmad Hajebi; . Azizeh Alizadeh; . Hamid Reza Khankeh

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

Abstract

  INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medicalcare in threatening conditions are more at risk of displaying psychological distress presentations ...  Read More INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medicalcare in threatening conditions are more at risk of displaying psychological distress presentations indisaster situations. Problem‑solving strategies are essential for effective and efficient managementof event position. Therefore, the present study aimed to explore psychological distress promotionin Iranian EPHP.MATERIALS AND METHODS: A qualitative content analysis study was conducted based on 24semi‑structured interviews. A purposeful sampling method was applied until reaching data saturation.Interviews were transcribed verbatim, and then, data condensing, labeling, coding, and definingcategories were performed by the qualitative content analysis recommended by the Landman andGraneheim approach.RESULTS: Based on the experience of study participants, two main themes with six categoriesdeveloped. The main themes included emotion‑based management and problem‑based managementwhen confronting with incidence scene.CONCLUSION: The main problems of EPHP in confronting with incidence and disasters scenesare psychological distress which some rescuers have emotional reactions while some others whoare more resilience and experience manage this problem in the form of problem‑based approach.It is recommended these practical strategies to be taught to less experienced rescuers for avoidingemotional‑based reactions and better management of disaster scene.

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New financial management system for Iran public health sector: A qualitative study

. Masoud Abolhallaj; . Mehdi Jafari; . Hesam Seyedin; . Masoud Salehi; . Arefeh Pourtaleb; . Keyvan Rahmani; . Seyede-Elahe Hosseini

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

Abstract

  BACKGROUND: Financial management system acts as a driving force and the first important principleof health sector reform. This study aimed to prepare a framework for new financial managementsystem ...  Read More BACKGROUND: Financial management system acts as a driving force and the first important principleof health sector reform. This study aimed to prepare a framework for new financial managementsystem in Iran health sector.MATERIALS AND METHODS: This qualitative study was conducted by content analysis approachand 15 key informant participants selected through purposive sampling consisted of three minsters ofMinistry of Health and Medical Education (MOHME), three vice‑chancellors in the Center of ResourceDevelopment and Management, Two members of the Health Assembly of the Islamic Consultative,four Medical Sciences university’s presidents, and three managers in Budgeting and performanceMonitoring Center of MOHME in 2017. Data were collected through semi‑structured interviews andthey were analyzed using Atlas T6 software.RESULTS: Six main themes were emerged as follow: “legal reform,” “removing barriers to set upaccrual accounting,” “cost price calculation,” “operational planning and budgeting,” “human resources’organization, recruitment, and moderation,” and “financial system output utilization (managementaccounting techniques) as the base for evidence‑based policymaking and decision‑making practices.”CONCLUSION: Any efforts for improving the current situation and reducing of mentioned limitationscould be useful in providing required space for future phases of reforms and calculation of unit cost,operational budgeting, and management of cost and productivity. This can be achieved through anintegrated system of recording and producing standard and accrual financial information. Furthermore,changing the accounting process and the financial system that complies with one single encodingin the country is a key issue.

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Utilizing “Positive deviance inquiry” to explore factors influencing child health: A qualitative study

. Rupali Sabale; . Barsha Gadapani Pathak; . Rukman M. Manapurath

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

Abstract

  BACKGROUND: India is a lower middle‑income country with one of the fastest growing economiesin the world. Despite improvements in its economy, it has a high child mortality rate, ...  Read More BACKGROUND: India is a lower middle‑income country with one of the fastest growing economiesin the world. Despite improvements in its economy, it has a high child mortality rate, with significantdifferences in child mortality both between and within different states. In this research, we tend toexplore factors as to how a particular child’s growth is optimal. With this aim, we utilized positivedeviance inquiry to study the factors influencing under five child’s health.MATERIALS AND METHODS: This qualitative study was carried out in Naigoan, an urban healthsetting of metropolitan city with 37 sample size between July 2020 and September 2020. It consistedof total 16 in‑depth interviews (IDIs), 3 focus group Discussion (FGDs), and 7 key informantinterviews (KIIs) which were performed by predesigned guides.RESULTS: Various themes evolved with the interviews; however, triangulation of the concept (fromFGDs, IDIs, and KIIs) occurred with the following themes: satisfaction among mothers for health‑careservices, community participation, family support, and new interventions.CONCLUSION: Mothers’ satisfaction to health‑care services, community participation, family support,and innovations by the health‑care providers are the influencing factors in promoting child’s health.Further research can be conducted to understand the in‑depth understanding of each factor.

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Causes of nonadherence to treatment in people with myocardial infarction: Content analysis

. Yaghoub Nadery; . Parvaneh Khorasani; . Aram Feizi; . Soroor Parvizy

Volume 11, Issue 8 , September 2021, , Pages 1-6

Abstract

  BACKGROUND: Nonadherence with the medication regimen in patients with heart disease canlead to treatment failure. The purpose of this study was to identify the causes of nonadherence ...  Read More BACKGROUND: Nonadherence with the medication regimen in patients with heart disease canlead to treatment failure. The purpose of this study was to identify the causes of nonadherence inpeople with myocardial infarction.MATERIALS AND METHODS: This study is a qualitative conventional content analysis. Data werecollected through semistructured interviews. Thirteen individual interviews and a focus group wereconducted with nurses, patients, and doctors. Data were analyzed using conventional content analysis.RESULTS: Four main themes were identified, which are organizational‑managerial causes andfactors (drug‑related problems, educational system‑related problems, weak performance of hospitals,and problems related to insurance companies); sociocultural causes and factors (factors relatedto cultural problems and factors related to social problems); causes and factors related to careproviders (skill problems of care providers and functional problems of care providers); and causesand factors associated with caregivers (factors related to social characteristics of the patient, factorsrelated to patient characteristics, and factors related to the patient’s belief).CONCLUSIONS: Many individual and organizational factors affect nonadherence, which can bereduced by fundamental changes.

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Why people are becoming addicted to social media: A qualitative study

. Maryam Chegeni; . Parvin Mangolian Shahrbabaki; . Mahin Eslami Shahrbabaki; . Nouzar Nakhaee; . Aliakbar Haghdoost

Volume 11, Issue 4 , May 2021, , Pages 1-6

Abstract

  BACKGROUND: Social media addiction (SMA) led to the formation of health‑threatening behaviorsthat can have a negative impact on the quality of life and well‑being. Many factors ...  Read More BACKGROUND: Social media addiction (SMA) led to the formation of health‑threatening behaviorsthat can have a negative impact on the quality of life and well‑being. Many factors can develop anexaggerated tendency to use social media (SM), which can be prevented in most cases. This studyaimed to explore the reasons for SMA.MATERIALS AND METHODS: This qualitative study was conducted using content analysis. Atotal of 18 SM addicted subjects were included through purposive sampling. Data were collectedthrough semi‑structured interviews and analyzed using the Lundman and Graneheim qualitativecontent analysis method.RESULTS: The main category of “weakness in acquiring life skills” was extracted with three themes: “problemsin socializing” (including communicating and escaping loneliness), “problems in resiliency” (includingdevastation in harsh conditions and inability to recover oneself and “lack of problem‑solving skills”(includingweaknesses in analysis and decision making and disorganization in planning).CONCLUSIONS: Weakness in life skills plays an important role in individuals’ addiction to SM andformation of the health‑threatening behaviors. Since SMA can affect behavioral health, policymakersmust adopt educational and preventive programs to increase the knowledge and skills of individualsin different societies in the modern world.

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Factors affecting emergency evacuation of Iranian hospitals in fire: A qualitative study

. Ali Sahebi; . Katayoun Jahangiri; . Ahmad Alibabaei; . Davoud Khorasani‑Zavareh

Volume 11, Issue 4 , May 2021, , Pages 1-9

Abstract

  BACKGROUND: Fire is one of the most important threatening factors for hospitals and needs specialattention. The present study was conducted to explain the factors affecting hospital ...  Read More BACKGROUND: Fire is one of the most important threatening factors for hospitals and needs specialattention. The present study was conducted to explain the factors affecting hospital emergencyevacuation following fire based on hospital administrators’ experiences.MATERIALS AND METHODS: This was a qualitative study conducted employing the content analysisapproach. Participants included 22 hospital administrators in Tehran, Lorestan, Kurdistan, and Ilamprovinces. The participants were purposefully selected and included until reaching principle of datasaturation. Data were collected through in‑depth semi‑structured interviews from November 2019to August 2020 and analyzed by the content analysis method.RESULTS: Factors affecting hospital emergency evacuation during fire were categorized into fivemain categories and 17 subcategories including response to incident (five subcategories of fire nature,emergency evacuation, service provision, coordination and communication; and collaboration andcompanionship), human factors (two subcategories of individual characteristics and competencies),hospital preparedness (three subcategories of planning, safety and security; and informationmanagement system), environmental factors (two subcategories of hospital design and infrastructure;and weather condition), and finally ethical values (five subcategories of human dignity, trust, altruism,responsibility and accountability; and empathy).CONCLUSION: The results of this study indicated that during fire in Iranian hospitals, several factorsin addition to available standard guidelines affect the emergency evacuation process that need tobe considered. Hospital emergency evacuation during fire is a complex process and necessitates afull and high‑level hospital preparedness, so using the results of this study can be used to developand practice evacuation plans and improve the hospital preparedness.

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Explaining the perception of spiritual care from the perspective of health personnel: A qualitative study

. Zohre Khalajinia; . Hoda Ahmari Tehran; . Akram Heidar

Volume 11, Issue 2 , February 2021, , Pages 1-8

Abstract

  BACKGROUND: Spiritual care is one of the important and essential aspects of healthcare. Theimpact of spirituality on healing, health‑related states, and the ability to cope and adapt ...  Read More BACKGROUND: Spiritual care is one of the important and essential aspects of healthcare. Theimpact of spirituality on healing, health‑related states, and the ability to cope and adapt to the diseaseis undeniable. Thus, this study is aimed to explain the perception of the spiritual care of patients byhealth‑care providers.MATERIALS AND METHODS: The present study was performed with a qualitative approach using contentanalysis by the conventional method in hospitals of Qom University of Medical Sciences. The data werecollected through in‑depth semi‑structured interviews with 11 participants through a purposeful samplingmethod and analyzed simultaneously. The consistency of the data was confirmed by the participants.RESULTS: Data analysis provided four main categories as follows: “Observing the patient’s rights”with subcategories of respect, right to choose, preserving the patient’s privacy, proper communicationwith the patient, “professionalism” with subcategories of responsibility, acceptance of mistakes,development of technical skills and knowledge, “supportive behaviors” with subcategories of payingattention to emotional and psychological needs and “Strengthening the patient’s religious dimension”with subcategories of honoring religious beliefs and providing healthcare along with trust in God.CONCLUSIONS: According to the study findings, spiritual care from the perspective of health‑careproviders was explained as attention to emotional and psychological needs, reverence for patients’religious beliefs, respect for human dignity, and sense of responsibility.

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Evaluating the responsiveness of higher education system in relation to social determinants of health

. Rahele Samouei; . Kamal Heidari; . Sakineh Saghaeiannejad; . Sedigheh Karami; . Pejman Aghdak

Volume 10, Issue 10 , October 2020, , Pages 1-8

Abstract

  BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinantsof health (SDH), higher education system must be responsive in training knowledgeable ...  Read More BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinantsof health (SDH), higher education system must be responsive in training knowledgeable students andfaculty members. Therefore, this study was carried out to determine the responsiveness of highereducation system in relation to the SDH.METHODS: This is a content analysis study carried out using qualitative approach. Semi‑structuredinterviews were used to gain access to the knowledge of experts in the fields of health care, education,and SDH. Sampling was carried out until data saturation was achieved during which 15 experts wereselected using purposeful sampling method with highest possible variety. Data were categorizedusing qualitative content analysis approach.RESULTS: In total, 11 themes and 43 categories of codes were identified in semi‑structuredinterviews with experts. A total of two approaches were identified for the training of responsivestudents including educational–research approach and cultural–social approach; five approacheswere identified for the development of faculty members including cognitive development, executivedevelopment, evaluation, promotion and incentives, and revisions; two approaches were identified forprovision of theoretical and practical education including education in a real and active environmentand structural education; and finally, two approaches were identified for evaluation of students andfaculty members in regard to their responsiveness to society’s health needs and SDH includingcontent and operational approaches.CONCLUSION: In general, the results of the current study indicate the need for the higher educationsystem to use educational, research, and society‑based approaches in real and social environmentsalong with an incentive system and use of evaluation for responsiveness to society’s health needsand SDH. These results can be useful for the health‑care system and the higher education system.

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Key educational and research factors affecting the future of medical education discipline in Iran: A qualitative study

. Atiye Faghihi; . Mohammad Hoseini Moghadam; . Nikoo Yamani

Volume 10, Issue 10 , October 2020, , Pages 1-8

Abstract

  CONTEXT: Along with the evolutions of medical sciences education, the importance of medicaleducation discipline has gained more attention for keeping up with these evolutions. Therefore,paying ...  Read More CONTEXT: Along with the evolutions of medical sciences education, the importance of medicaleducation discipline has gained more attention for keeping up with these evolutions. Therefore,paying attention to policymaking regarding the development of this discipline and its position inuniversities is very necessary.AIMS: This study has been done with the aim of investigating key educational and research factorsaffecting the future of medical education discipline in Iran.SETTINGS AND DESIGN: This is a qualitative study with directed content analysis approach,which has been conducted in eight medical sciences universities having medical educationdepartment (Tehran, Iran, Shahid Beheshti, Isfahan, Mashhad, Shiraz, Tabriz, and Kerman) in2018–2019.SUBJECTS AND METHODS: A total of 25 participants (professors, students, and graduates) ofmedical education discipline were selected by purposeful sampling and with maximum diversity. Datawere collected through semi‑structured interviews. Interviews were analyzed using MAXQDA software.RESULTS: After analyzing the data, a number of 1561 initial codes were obtained, of which 914 codeswere extracted after removing repetitious codes and merging similar codes. Finally, the obtainedresults from content analysis were classified into two main categories including key educational andresearch factors and ten subcategories.CONCLUSIONS: Among the most important key educational and research factors affecting the futureof medical education discipline, it can be mention to the role of the discipline curriculum and needto revise it, the need to monitor the graduates and their status , globalization, the role of medicaleducation centers and departments, and the role of theses. It is recommended that future studiesinvestigate other key factors affecting the future of the discipline.

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Qualitative study of social determinants of child marriage in Kurdish regions of Iran: Evidence for health promotion interventions

. Javad Yoosefi Lebni; . Mahnaz Solhi; . Farbod Ebadi Fard Azar; . Farideh Khalajabadi Farahani

Volume 10, Issue 9 , September 2020, , Pages 1-11

Abstract

  INTRODUCTION: One of the most thought‑provoking problems in the world is child marriage that isaffected by various factors. Therefore, the purpose of this study is to identify the ...  Read More INTRODUCTION: One of the most thought‑provoking problems in the world is child marriage that isaffected by various factors. Therefore, the purpose of this study is to identify the social determinantsof child marriage in Kurdish regions of Iran.MATERIALS AND METHODS: This qualitative study was conducted using conventional contentanalysis approach. The participants of the study were 30 Iranian‑Kurdish women married under theage of 18 who were selected through purposeful and snowballing sampling. Data collection wasconducted through semi‑structured interviews and face‑to‑face interviews and continued until thesaturation of concepts was achieved. Graneheim and Lundman method was used to analyze thedata, and Guba and Lincoln criteria were used to strengthen the research.RESULTS: In general, findings include 5 categories and 17 subcategories: 1 – economicfactors  (financial problems and economic benefits); 2  –  sociocultural factors  (social customs,cultural beliefs, community encouragement, social learning, gaining prestige, and social support);3 – individual factors (physical characteristics, personality traits, lack of awareness of the damagingconsequences of early marriage, and fear of the future); 4 – family factors  (dysfunctional family,weak awareness of parents, and harm prevention); and 5 – structural factors (high demand, limitedaccess to educational services, and the lack of supportive social and legal structures).CONCLUSION: By raising the level of awareness and attitude of girls and their families aboutthe consequences of early marriage, creating the culture of correcting cultural beliefs and socialmisconceptions, passing appropriate laws, and the use of local and national media to prevent childmarriage, this social harm can be reduced.

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Hospital managers’ skills required and onward challenges: A qualitative study

. Farideh Moradi; . Razie Toghroli; . Jaffari Abbas; . Arash Ziapour; . Javad Yoosefi Lebni; . Amin Aghili; . Nadya Baharirad, Mohammad Mohseni; . Ali Soroush

Volume 10, Issue 9 , September 2020, , Pages 1-7

Abstract

  INTRODUCTION: The qualification of managers in terms of management skills is one of the mostimportant factors in the continuous success of each organization, and utilizing such skills ...  Read More INTRODUCTION: The qualification of managers in terms of management skills is one of the mostimportant factors in the continuous success of each organization, and utilizing such skills can havea positive contribution in the effectiveness of the organization while improving the performance ofthe employees in line with the objectives and goals of the organization. The study's primary objectivewas to examine the necessary skills of the hospital managers and their capabilities to manage thechallenges in providing health care facilities to their patients and employees.MATERIALS AND METHODS: This study is a qualitative that deep interviews were performed with22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and thesample size was 22 individuals. The interviews were analyzed by a MAXQDA software applicationafter transcription.RESULTS: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptiveskill, the human relations skill, work experience, and personal characteristics were among the skillsnecessary for hospital managers. Some of the challenges facing the hospital managers includedrapid changes in the policies, the limitations of financial resources, and lack of proportion betweenthe educational and occupational spheres.CONCLUSION: Because of their existential philosophy and differences with other service sectors,managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is veryimportant. Therefore, in order to meet the satisfaction of those receiving services, decision‑makersand policy‑makers must think twice when selecting and appointing hospital managers and evaluateand appraise this group in terms of abilities and skills necessary for managing such an importantservice section.

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Telenursing: A step for care management in disaster and emergencies

. Mahdiye Nejadshafiee; . Kambiz Bahaadinbeigy; . Majid Kazemi; . Mahmood Nekoei-Moghadam

Volume 10, Issue 8 , August 2020, , Pages 1-8

Abstract

  INTRODUCTION: Unusual impacts of disasters on normal living conditions pose challenges to thehealth system. Nurses who take care of disaster victims may face situations that make decision‑makingdifficult; ...  Read More INTRODUCTION: Unusual impacts of disasters on normal living conditions pose challenges to thehealth system. Nurses who take care of disaster victims may face situations that make decision‑makingdifficult; hereon, the use of new technologies can be a useful solution. The study aimed to identifythe telenursing care during incidents and disasters.METHODS: The study was conducted at a medical science university in Iran from 2018 to 2019. Thiswas a semi‑structured interview‑based qualitative study using content analysis. Eighteen nurses,nursing teachers, and emergency medical technicians were included in the study. Data analysiswas performed using inductive content analysis and coding with MAXQDA (2010) software. TheLincoln and Guba (1985) trustworthiness criteria were used for the reliability and validity of the data.RESULTS: Telenursing in critical and supportive care was the main theme identified from dataanalysis. This theme included six main categories: (1) management of trauma, (2) technical skills, (3)care and decision‑making in stressful situations, (4) management of patients with special needs, (5)life‑saving intervention, and (6) psychological and emotional supports.CONCLUSIONS: Telenursing in disasters is the turning point of the care management of victims.In order to achieve this goal, nurses should acquire the relevant knowledge, skills, and abilities.

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Nurses’ professional competences in providing care to the injured in earthquake: A qualitative study

. Soheila Ahangarzadeh Rezaei; . Alireza Abdi; . Farzaneh Akbari; . Khalil Moradi

Volume 10, Issue 7 , July 2020, , Pages 1-7

Abstract

  BACKGROUND: Iran has experienced an increasing number of earthquake disasters in the pastthree decades. Due to nurses’ unique role as professional and volunteer responders in ...  Read More BACKGROUND: Iran has experienced an increasing number of earthquake disasters in the pastthree decades. Due to nurses’ unique role as professional and volunteer responders in times ofdisaster, more information is required regarding the capabilities they need to provide more effectivecare during the crisis. The aim of this study was to identify professional capabilities needed by nursesto provide care to the injured of earthquake.MATERIALS AND METHODS: The present study was conducted as a qualitative conventional contentanalysis, and data collection was carried out through 16 semi‑structured and in‑depth interviews withthe nurses involved in providing care to the injured in the Kermanshah earthquake. The data wereanalyzed following Graneheim and Lundman’s approach.RESULTS: Data analysis led to the emergence of 427 primary codes, 10 subcategories, and fourcategories. The four categories included clinical competence (professional knowledge and clinicalskills), personal competences (communication skills, resiliency, and creativity and innovationin providing care), ethical competence (commitment to ethics and professional responsibility),and essential skills in caring for the injured (skills in triage, psychological care skills, and skills inobservation and monitoring)CONCLUSION: The present study identified a wide range of professional capabilities required bynurses in disasters. Given that nurses do not acquire some of these specialized and technical skillsduring their education, it is recommended to enhance the professional capacity of nurses in disasters.In addition, special training programs in this field can be incorporated into the curriculum of nursingprograms and in-service nursing education.

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The need for renovating patient education in kidney transplantation: A qualitative study

. Ahmad Mahdizadeh; . Fatemeh Oskouie; . Sedigheh Khanjari; . Soroor Parvizy

Volume 10, Issue 6 , June 2020, , Pages 1-8

Abstract

  BACKGROUND: Many kidney transplant recipients lack the knowledge, abilities, and support theyneed for self‑care. On the other hand, most kidney transplant centers do not have a well‑plannedand ...  Read More BACKGROUND: Many kidney transplant recipients lack the knowledge, abilities, and support theyneed for self‑care. On the other hand, most kidney transplant centers do not have a well‑plannedand specific training program for them, and educational interventions for kidney transplant recipientshave not been adequately effective. This study aimed to describe strategies for improving patienteducation in kidney transplantation.MATERIALS AND METHODS: Data were collected through semi‑structured individual and groupinterviews with 24 patients, family members, and health‑care staff in one of the main kidney transplantcenters in Tehran. Participants were selected purposefully, and qualitative content analysis wasused to analyze the data.RESULTS: The main finding emerged from the data was the shift from current patient educationprogram to patient‑ and family‑centered education (PFCE). The strategies to achieve this goal werecategorized into four main categories including “continuous patient and family education” (pre‑ andposttransplant patient education), “facilitating the process” (using new technologies, teamworkeducation, and patient and family accessibility), “strengthening human resources” (empowermenthealth‑care team, allocation of human resources, promoting staffs’ motivation, and updatingeducational content and materials), and “monitoring and evaluation” (correcting patient educationrecording, supervising the patient education, and appropriate educational evaluation).CONCLUSIONS: Transforming from the current patient education program to PFCE seems to beessential to increase the effectiveness of patient education in kidney transplant process. To thisend, providing continuous patient and family education, facilitating the processes, strengtheninghuman resources, and monitoring and evaluation in health‑care organizations conducting the kidneytransplantation is necessary.

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Quality of training in oral health educational programs: What do primary healthcare providers think?

. Peimaneh Hosseini Dastnaei; . Zahra Saied Moallemi; . Arash Najimi

Volume 10, Issue 3 , March 2020, , Pages 1-8

Abstract

  INTRODUCTION: Due to changes in scientific findings and assigned tasks, continuing educationand other enabling programs are increasingly critical for primary healthcare providers to ...  Read More INTRODUCTION: Due to changes in scientific findings and assigned tasks, continuing educationand other enabling programs are increasingly critical for primary healthcare providers to keep themup‑to‑date in delivering oral health services. Planning these educational courses based on actualPHCPs’ needs is fundamental to provide effective ones. The purpose of this study was to elucidatethe experiences and needs of PHCPs regarding the quality of the oral health training provided incontinuing education and other enabling courses.SUBJECTS AND METHODS: A qualitative study with content analysis approach was conducted inNajaf‑Abad, Isfahan, Iran, in 2017. Data were gathered through in‑depth semi‑structured interviewswith 19 primary healthcare providers. The sampling was started with purposeful method and continuedthrough snowball method. Qualitative data were coded and analyzed using MAXQDA (VER 12).RESULTS: Factors affecting the quality of oral health training were categorized into three themes andnine subthemes, including instructor’s related factors (knowledge, skills, and relevant experiences),educational content  (content relevance, content innovation, and content update), and teachingmethods and educational tools (fitting educational contents, covering learners’ needs, and consideringavailable possibilities).CONCLUSION: Instructors with inadequate level of knowledge, skills, and relevant experiences aswell as inappropriate selection of educational content, teaching methods, and educational tools, wererecognized as affecting factors on the quality of oral health training and effectiveness of continuouseducation and enabling programs.

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Sexual health education issues (challenges) for adolescent boys in Iran: A qualitative study

. Fariba Askari; . Khadigeh Mirzaiinajmabadi; . Mahmood Saeedy Rezvani; . Seyyed Mohsen Asgharinekah

Volume 10, Issue 2 , February 2020, , Pages 1-9

Abstract

  BACKGROUND: Sexual health education, especially in adolescents, faces excess challenges inmany cultures. Iranian adolescents, especially boys, have many educational needs in the field ...  Read More BACKGROUND: Sexual health education, especially in adolescents, faces excess challenges inmany cultures. Iranian adolescents, especially boys, have many educational needs in the field ofsexual health that have not been met due to various obstacles. The main purpose of this qualitativestudy was to explore the challenges of sexual health education for Iranian adolescent boys.MATERIALS AND METHODS: This qualitative content analysis study was conducted throughindividual semi‑structured in‑depth interviews from 45 participants (20 adolescents and 25 keyadults). Data were analyzed using inductive conventional content analysis based on the Graneheimand Lundman’s approach via MAXQDA software (version 2010) by VERBI GmbH Company, Berlin,Germany.RESULTS: In total, 2 categories and 11 subcategories emerged; including, “extrapersonal barriersto sexual health education for adolescent boys” containing seven subcategories of lack of clearpolicies, family inadequacy, social barriers, cultural heterogeneity, school inadequacy, cyber threats,and educational process inadequacy concerning adolescent sexual health education as well as“intrapersonal barriers to sexual health education for adolescent boys” comprised four subcategoriesof uncontrolled emotions of adolescence, adolescent rebellion, information and communicationweaknesses, and adolescents’ concerns about being judged by others.CONCLUSION: The findings clarify some barriers to sexual health education for adolescent boys.Therefore, it was recommended to develop community‑based educational programs to changeattitudes of families and society toward addressing the challenges of providing sexual healtheducation to adolescent boys. Moreover, it was suggested to utilize an educational program specificto adolescent boys, tailored to the Iranian culture, using the potential of religion.

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Faculty’s perspective on skill assessment in undergraduate medical education: Qualitative online forum study

. Meenakshi P. Khapre; . Harshal Sabane; . Sonia Singh; . Rashmi Katyal; . Anil Kapoor; . Dinesh K. Badyal

Volume 10, Issue 1 , January 2020, , Pages 1-7

Abstract

  BACKGROUND: India is at the nascent stage of competency‑based medical education. Facultiestrained in medical education are the main driving force for change. The present study exploresthe ...  Read More BACKGROUND: India is at the nascent stage of competency‑based medical education. Facultiestrained in medical education are the main driving force for change. The present study exploresthe perception of faculties about the current practices and problems in medical/dental/nursingundergraduate assessment, barriers to adoption of best practices, and solutions for addressing them.METHODOLOGY: A qualitative study was designed and data collected through an asynchronousonline discussion forum. A group of 31 health professionals (FAIMER fellows selected on the basisof active participation in department of medical education of respective colleges) participated in theforum. An open‑ended topic guide with prompts was designed. The forum was initiated by releaseof discussion topics (threads) at the start of the month and remained in forum throughout the month.Researchers moderated and recorded day‑to‑day events. All online forum data were coded line byline and analyzed using conventional content analysis.RESULTS: Four categories generated were: (1) Low utility of current skill assessment system dueto low validity and reliability; (2) Barrier in adopting newer assessment tool due to the absence offelt need of faculties and students, mistaken beliefs, and limited resources; (3) Poor implementationof newer assessment tools such as formatives and objective structured clinical examination withno blueprinting; and (4) Solutions proposed were regular formative assessment, criterion‑basedexamination, quality‑assured faculty development programs, and administrative support.CONCLUSIONS: Barriers in adopting newer assessment tools are related to the faculty’s perceptionand resource constraint. This can be addressed by quality‑assured faculty development programsand effective implementation of competency‑based education.

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