JOURNAL OF QUALITATIVE RESEARCH IN HEALTH SCIENCES
Year:2014 | Volume:2 | Issue:4|Papers Count:8

Introduction: Clinical judgement as a tool for professionals allows the nurses to play their roles and explore their opinion. This necessitates clarification of the structure of clinical judgment. It is difficult to give a unanimous definition for clinical judgement; therefore, exploration of the structure of the concept is necessary to understanding clinical judgment. The aim of this study is to explore the structure of clinical judgment of nurses.Method: This qualitative research was a grounded theory study based on purposed sampling.18 clinical nurses from Kurdistan University of Medical Sciences were interviewed. The interviews were transcribed in Microsoft Word Office, and then the data were analyzed in MAXQDA2007. Constant comparison analyses were used simultaneously with data collection.Results: The participants in study include 9 men and 9 women, with at least 3 years of experience of nursing in variable clinical settings. Final research findings could be discussed in five categories including: complexity of definition of clinical judgment, context of clinical judgment, continuum of clinical judgment, skills of nurse in clinical judgment, and achieve to professional criteria.Conclusion: Despite the complexity of the concept in the literatures and the field of research, this study could explore the structure of clinical judgment of nurses in the clinical arena. The results of this study would be used to explore nurses' clinical judgment model, based on grounded theory.

Introduction: Patient safety has long been a major concern for healthcare professionals. Today, hospitals should provide patient safety in order to gain accreditation. Among patient safety issues, medication error rate has been considered as a major indicator of healthcare quality. The different aspects of medication error are not clearly known and the nurses are the main source of knowledge in this field. Therefore, the researcher decided to study the experiences of nurses who have been faced with a medication error in order to clarify the various aspects of this phenomenon. It is through the exact identification of this phenomenon that it can be managed.Method: In the present study, a phenomenological qualitative approach was used. Participants in this study were nurses working in hospitals of Isfahan and had experienced medication error. Purposive sampling was adopted in the study and sample size was dependent on the data saturation. A total of 10 participants were chosen. Data collection was carried out through unstructured interviews and analysis through Colaizzi’s Method.Results: From the findings of this study, six main themes expressing participants’ experiences emerged. The six main themes include: The context of error, the error range, negligence, the consequence of error, concealment of error, and reporting of error.Conclusion: Nurses report their errors when they feel safe and do not see harmful results for them.Therefore, hospitals should review their policies on error reporting to ensure they actively encourage nurses to report medication errors, and to support a blame-free culture in the organization and a systembased approach to deal with the error.

Introduction: There has been an accumulation of qualitative studies in nursing, but the findings from many of these investigations have remained largely obscure, and they have had little impact on clinical practice and policy formation. As pressure increased toward ensuring an evidence-based practice across diverse contexts and disciplines and as the finding of any qualitative research will reflect a piece of the health and disease aspects, being familiar with meta-synthesis in nursing research is very important. This paper discusses the purpose, stages, application, and challenges of meta-synthesis, and strategies for their solution.Method: This review article was carried out by non-time-limited search literatures related to “meta-synthesis and nursing” keywords using PubMed, CINAHL, Proquest, Blackwell, Science Direct, SID, and Magiran databases. Finally, 57 articles were included in the range of 1984 to 2012.Results: Meta-synthesis is integrations that offer more than the sum of the individual data sets because they provide new interpretations of the findings. These interpretations are inferences derived from examining all of the articles in a sample as a collective group, presenting findings/interpretations which are not found in any of the articles. Despite existing different approaches to meta-synthesis, evidence synthesis mechanisms are not well suited to consideration of qualitative research. Moreover, qualitative meta-synthesis should not be undertaken by novices. Meta-synthesis can help nurses understand the meaning of relative phenomena and clinical decision making regarding evidence-based practice.Conclusion: The future of meta-synthesis depends on its acceptance and utility in the evidence-based nursing practice. If the results of meta-synthesis provide evidences for the clinical nursing, nursing researchers will embrace this approach more.

Introduction: Induced demand utilizes the advantage of higher information in respect to patients and too much care is presented with suspicious value. Therefore, the theory of induced demand is based on the assumption of asymmetric information between physician and patient. The patients do not have sufficient expertise to assess the level and quality of provided services. They rarely know what and how much medical care they need. In fact, due to some reasons, patients can influence the demand induction. They have unlimited wishes and desires in respect to the offered services. This article examines the role of the patient in the phenomenon of induced demand with the use of the experiences of experts of Isfahan University Medical Sciences, Isfahan, Iran.Method: The present research was a qualitative study. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard, were experienced, and were known as experts. Purposive sampling was done for data saturation.17 people were interviewed and criteria such as "reliability of information" and "stability" of data were considered. The anonymity of the interviewees was preserved. The data were transcribed, categorized, and then used the thematic analysis.Results: In this study, according to thematic analysis 5 main themes and 7 sub-themes were extracted. They include the experiences of experts about the role of patients in induced demand. The 5 main themes include incorrect demand of patient from the physician, patients’ excessive trust in the physician, patient's desire to use much more free services and without copayment, patient’s unawareness, and free access to physicians. Each of these themes includes some sub-themes.Conclusion: The results of this study on the role of patients in induced demand help the policy makers to consider patients and related factors in their strategic planning in induced demand.

Introduction: The recognition of effective factors associated with HIV stigma and designing of effective interventions are the key to success of AIDS prevention and treatment. This study aimed to determine the views of AIDS patients on their illness and the stigma associated with it.Method: Due to the limited number of patients, 17 patients, who were referred to a behavioral health counselling center in 2012, were selected using purposive sampling. Data analysis was performed based on a content analysis; analysis of themes.Results: The main themes emerged within the patient’s perceived feeling toward the disease include spiritual orientation, and relating the disease to other factors and the sense of inability. The main themes of social stigma associated with the disease include the perceived internal emotions (feelings of hopelessness, and rejection and separation) and the perceived external emotions of patients (feelings of disgust and blame).Conclusion: The perceived emotions of AIDS patients express the threatening nature of the disease. The disease has strengthened their spiritual dimension and has caused them to reconsider their worship rituals by reflection on and returning to their values. The patients' perceived awareness of the stigmatization of the disease reflects the fact that these patients not only struggle with adverse health outcomes, but also face the consequences of the stigmatization of this disease. This is to the extent that the mental and social health of these patients is targeted. Therefore, further investigation of these misperceptions about the disease, and the development of training programs for the public, especially the patient’s relatives and friends, and integration of these programs with educational programs seem necessary to promote preventive behaviors.

Introduction: No doubt death and life after death and human attitude is considered as one of the main subjects in all religions. This study is aimed to determine the concept of death from academicians´ point of view.Method: This qualitative study was performed through content analysis method, and the data were collected through interviews. Sampling was conducted through purposeful sampling method.21 individuals were interviewed in Arak University of Medical Sciences for 2 months. Constant comparative analysis was utilized for data analysis.Results: Data analysis has shown that six main codes were identified; certain reality, cognition, necessity, anxiety, death memory, and death quality. In this study the theme of “Death as a spiritual and positive point of view originated from participants’ belief in resurrection” emerged.Conclusion: In this study the persons’ views about death, which originated from their belief in resurrection, were positive and spiritual. From participants’ point of view death is a stage in the evolution of mankind. Thinking of death prevents humans from committing sin and has a main role in human maturity.

Introduction: Spirituality is an important aspect of health care that has been proposed in nursing over the past decades. It is recommended as an inseparable component of holistic nursing. This study aims to explore the nurses’ and patients’ perception of spirituality in cancer care.Method: In a conventional qualitative content analysis, data was collected through purposive sampling by semi-structured deep interviews with 17 participants (10 patients and 7 nurses) in oncology units of hospitals in Tabriz, and was analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control.Results: The emergent main theme was the "spirituality raising interactions". This theme consisted of three sub-themes of "spiritual elevation in cancer care", "spiritual care barriers", and "religion-based strategies". Patients with cancer understand cancer as an opportunity for belief correction, closeness to God, and awareness of death as reincarnation. Nurses had poor skills in assessing and responding to patients' spiritual needs and there were no support from organizations and clergymen for them in addressing spiritual distress of patients. However, they were a source of energy, joy, hope, and power for patients through their empathy, compassion, and openness. Patients and nurses used strategies based on religious beliefs for strengthening their spiritual dimension.Conclusion: Spiritual care requires a patient-centered approach in communication. Communication in which the religious and spiritual beliefs of patients are considered as a valuable source of spiritual coping, and which gives them the feeling of empathy, trust, passion, and joy. For reduction of barriers, the integration of spiritual care issues in the curriculum of nursing and service training programs is recommended. Care environment must be changed for religious practices and spiritual advisors and clergymen should help patients and nurses in coping with spiritual distress.

Introduction: Test anxiety, a common phenomenon among college students, is one of the problems of educational systems. According to the Islamic religious doctrines, spiritual relationship with Allah (God) comforts the hearts and prevents anxiety. Therefore, this study was performed with the goal of exploring the experiences of the effect of Holy Quran reading on students test anxiety in Arak University of Medical Sciences, Arak, Iran.Method: In a qualitative research, 23 participants were interviewed in Arak University of Medical Sciences during 2 months. The study started by purposive sampling and as the categories evolved it was continued by theoretical sampling. The data were analyzed based on the content analysis method.Results: Data analysis has shown that the third codes of the effect of Quran reading on participants’ test anxiety were controlling test anxiety, strengthening the capacity of the individual, the effect of sounds and meanings of the Quran, and final effects of Quran reading. Moreover, “the effect of holy Quran reading on all dimensions of test anxiety and strengthening the capacity of the individual” emerged as the main theme of the present study.Conclusion: Using qualitative method, the experiences of the effect of Quran reading on students’ test anxiety were more deeply recognized in comparison to using quantitative method. On the other hand, the main theme of this study (“the effect of holy Quran reading on all dimensions of test anxiety and strengthening the capacity of the individual”) is an important finding which is completely in agreement with Allah’s speech in the Quran. Therefore, in order to benefit more from divine grace and blessing of Allah manifested by the verse of the holy Quran, Quran reading is recommended for all students, especially during exams.