JOURNAL OF QUALITATIVE RESEARCH IN HEALTH SCIENCES
Year:2024 | Volume:13 | Issue:4|Papers Count:8

Background: Emergency medical technicians (EMTs) face complex ethical dilemmas in their frontline role, involving resource constraints, time pressure, patient autonomy, and competing obligations. This qualitative study explored the experiences of EMTs, their decision-making processes, and the potential areas for enhancing ethical practices in emergency medicine, aiming to inform targeted policies and training programs that support EMTs and improve care quality.Methods: A total of 17 EMTs from Qom province participated in this study and in-depth interviews were conducted to gather rich and detailed insights into their experiences. The interviews were transcribed and analyzed using Graneheim and Lundman’s conventional content analysis to identify common themes and patterns related to ethical challenges.Results: The findings identified five main categories of ethical challenges faced by EMTs including ethical dilemmas, professional conduct, communication and consent, ethical training and support, and organizational challenges. Within these categories, specific subcategories emerged, including decision-making challenges, conflict of interest, resource allocation, end-of-life care, dual relationships, emotional boundaries, privacy and confidentiality, breaking bad news, language barriers, and informed consent. Each subcategory shed light on the unique ethical challenges faced by EMTs.Conclusion: This study highlighted the complex ethical landscape in which EMTs operate and provided valuable insights into the challenges they face. The findings underscored the need for comprehensive ethical training, support mechanisms, improved communication strategies, and an organizational culture that promotes ethical conduct. It is essential to address these challenges to enhance the ethical practices and decision-making skills of EMTs, ultimately leading to improved patient care and outcomes.

Background: The present study aimed to explore the nutritional challenges of hospitalized cancer patients from the viewpoint of healthcare professionals.Methods: This qualitative content analysis study was conducted from June 2021 to February 2022 on a sample of nutritionists (researchers and faculty members), dietitians, nurses, and oncologists in various healthcare settings such as hospitals, private/public clinics, research centers, and universities in Tehran, Iran. Data were collected through semi-structured in-depth interviews, which continued until data saturation was achieved with a total of 16 participants. Data were analyzed using deductive-inductive content analysis to explore predefined deductive concepts from previous studies and inductive concepts from the interviews.Results: After analyzing data via open coding, eliminating similar codes, and classifying the codes with similar concepts, six main themes emerged. The identified themes included problems related to the nature of the disease and complications of treatment, carelessness about principles of cancer care, lack of awareness and education in patients and medical staff, executive shortcomings, planning and policy-making, and financial and support barriers.Conclusion: Nutritional problems of cancer patients are multidimensional and rooted in diverse challenging issues including problems related to the nature of the disease and treatment, financial barriers, manpower shortages, lack of awareness among patients and healthcare providers, shortcomings related to the healthcare management and executive issues, lack of inter-organizational cooperation, and the significant negative impact of severe economic sanctions. Solving these problems needs funding from the government, interdepartmental cooperation between medical universities, healthcare centers, and hospitals, comprehensive and evidence-based healthcare management at the national level, and international collaborations.

Background: To prepare for future personal, family, and social responsibilities, young girls need to promote and maintain their health. Since physical activity has an effective role in maintaining women’s health, the present study aimed to examine the factors affecting the physical activity of female high school students.Methods: The participants in this qualitative grounded theory study were 20 female high school students living in District 20 in Tehran in 2021. The students were selected using purposive sampling. The data were collected using individual interviews and focus groups. The collected data were analyzed using the constant comparative method with MAXQDA-10 software.Results: The results showed that psychological, individual, environmental, educational, social, economic, and family factors were effective in the physical activity of female high school students. The identified factors were used to develop a conceptual model for the factors affecting the physical activity of female students. The extracted factors were further divided into some subcategories including sports facilities, gender discrimination, community management views on sports, physical health, interests, educational facilities, knowledge and information, time management, and women’s limitations.Conclusion: The findings from the present study showed that several factors can affect the physical activity of female students. These factors should be taken into account when developing and implementing educational interventions and plans to promote physical activity in female students.

Background: School counselors are expected to induce changes in schools and to help improve and promote students’ academic, personal/social, and professional development. Accordingly, this study aimed to identify the factors underlying the efficiency of school counselors.Methods: This qualitative study was conducted using a descriptive and exploratory design. Data were collected through semi-structured exploratory interviews and analyzed using thematic analysis. The participants in the study were 13 school counseling professors and experts with research and academic experiences in school counseling. The participants were selected using purposive non-probability (judgmental) sampling and sampling continued until data saturation.Results: The findings showed that factors underlying the efficiency of school counselors included psychological skills (communication and interaction skills, trust-building and persuasion skills, motivational skills, and cognitive skills), technical skills (learning and teaching skills, problem-finding and problem-solving skills, knowledge skills, and research skills), personality traits (responsibility, adherence to human and moral values, initiative, ideation and creativity, effort and patience, risk-taking spirit, and adaptability), and management skills (planning and time management, monitoring the surrounding environment, and decision-making).Conclusion: Addressing the factors contributing to school counselors’ efficiency helps improve their professional competencies and leads to the effectiveness of counseling services offered in schools. Moreover, taking into account these factors can contribute to recruiting more qualified counselors in the educational system.

Background: The widespread and rapid outbreak of COVID-19 shows how a biological and epidemiological issue can affect all aspects of life, including the social domain, leading to short-term and long-term changes in the social and cultural structure of society. Accordingly, the present study aimed to illustrate the social effects of COVID-19 using the futures wheel method.Methods: This qualitative study utilized the futures wheel method. Two groups of experts participated in this study, including experts in the social field at the Institute for Futures Studies in Health and national-level experts in the field of social work. The second version of the futures wheel was implemented in three steps. The identified effects were categorized based on (1) opportunities and threats and (2) time intervals (short-term and long-term). Cases with a support rate of more than 70% were included in the futures wheel as final factors.Results: The findings of this study revealed two main layers of social effects stemming from the COVID-19 outbreak. Home quarantine, social responsibility, social distancing, social security, increased risk for vulnerable social groups, and the use of social networks were the categories identified at the first layer. The second layer included factors such as individualism, social stigma, social exclusion, domestic violence, and an increase in abortions, which threatened Iranian society in a short period.Conclusion: Threats may manifest through social protests, class disparities, and the increase in social disorders in the long run. In the short term, opportunities such as reducing the number of female-headed households and increasing intragroup social capital can also be predicted. Therefore, it is expected that the role of civil society will be strengthened in the long term.

Background: Spiritual self-care (SSC) is a multidimensional construct encompassing spirituality-based activities to promote health. It is an up-to-date approach that individuals engage in to promote ongoing personal development and well-being in health and illness. Existential spirituality, which is a key aspect of the broader concept of SSC, pertains to the way individuals find meaning and purpose in their lives, particularly during an existential crisis when a previously held worldview loses its legitimacy. In the context of cancer management, understanding the dimensions of SSC is crucial for achieving holistic health and well-being, as it addresses the spiritual and existential needs of individuals facing illness and suffering.Methods: This qualitative study aimed to explore health-promoting SSC activities among people with cancer in Iran. The study was conducted using the conventional content analysis approach guided by White’s Theory of Spirituality and Spiritual Self-Care (WTSSSC). Participants were 12 people with cancer registered with Yas Charity Support Association for Cancer Patients in Kerman, who were selected using purposive sampling. Data were collected through in-depth semi-structured face-to-face interviews with the participants. The interviews were recorded, transcribed, and analyzed using Graneheim and Lundman’s qualitative content analysis.Results: The qualitative analysis of the experiences of individuals with cancer engaging in health-promoting SSC activities revealed four themes (each with subthemes) including Representation of Artistic-Aesthetic Activities (Harmonizing with Nature and Music), Semantic Recovery (Semantic Recovery of Relationships and Embracing Novel Experiences), Hope Orientation (Promoting Hope), and Embodied Movement Mindfulness (Embodied Mindfulness).Conclusion: This study provides valuable insights into the dimensions of SCC activities in people with cancer, highlighting the importance of integrating these activities with conventional cancer treatments to promote health and well-being. Successful implementation of this holistic approach requires active support from healthcare providers.

Background: Ethical conflict is a complex concept referring to the inability to perform an ethical act or the failure to recognize the correct ethical course of action. Nursing students, similar to other healthcare team members, encounter numerous ethical conflicts during their clinical training. These conflicts encompass various aspects that underscore the significance of examining and analyzing this concept. Accordingly, the present study aimed to analyze the concept of ethical conflict in the clinical education of nursing students.Methods: This review study was conducted using a conceptual analysis approach based on the 8-step method proposed by Walker and Avant in 2023 to clarify the dimensions and characteristics of ethical conflict. A systematic search was conducted in PubMed, SID, Scopus, Embase, Web of Science, Google Scholar, and ProQuest databases using a combination of keywords including ‘nursing’, ‘concept analysis’, ‘clinical education’, ‘dilemma’, ‘conflict’, ‘nursing student’, ‘concept’, ‘clinical practice’, ‘moral’, and ‘ethical’ without time limits. After reviewing 3023 articles, 23 relevant articles were selected and included in the results section of the study. This approach facilitated the identification of the characteristics, premises, and consequences of the concept.Results: The conflict between student rights and patient rights in education represents a notable concern. One of the prominent factors contributing to moral conflicts and low-quality clinical education is the inadequate development of students’ moral competence within an inappropriate learning setting.Conclusion: By clarifying the educational rights of students and the rights of patients, educational and medical administrators would be able to manage ethical conflicts. Thus, it is recommended to explore the strategies for managing ethical conflicts by analyzing the relevant experiences through both qualitative and quantitative studies.

Background: An analysis of cancer stigma and the factors affecting it can significantly affect patients’ survival rate, willingness to receive treatment, coping strategies, and quality of life. To this end, the present study investigated the factors affecting self-perceived stigma in cancer patients.Methods: The present study adopted a meta-synthesis approach. The inclusion criteria were qualitative studies, relevant keywords in the title and abstract, and full-text articles published in English from 2000 to 2022 in Web of Science, PubMed, and Google Scholar databases. After searching and screening the titles, abstracts, and methodologies, 419 articles were extracted. Then, the duplicate articles were removed and the data from the 11 remaining articles that met the inclusion criteria were used in data analysis.Results: The findings revealed the factors affecting cancer stigma include substantive factors (cancer symptoms reflecting death and nothingness and the visible signs of cancer reminiscent of isolation and loneliness) and moderating factors (the role of false beliefs and misconceptions, fear of public judgment, and the role of the media as a promoter of stigma). The data also showed that false beliefs and misconceptions play the most important role in cancer stigma.Conclusion: Taking into account factors affecting cancer stigma can contribute to developing an effective strategy to strengthen the psychological support for cancer patients and pave the way for improving optimal and effective management of the public health system in dealing with cancer.