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Background & Aim: Motivated faculty promotes nursing students&apos educational level which leads to community health promotion. Attempts should be made to recognize and analyze motivating factors including expectations. This qualitative study attempted to clarify expectations of faculty of Tehran nursing schools on management system.

Methods & Materials: This was a qualitative study. The participants were 14 nursing faculty members of Tehran, Shahid Beheshti, Artesh, Shahed, and Baghiatallah Universities located in Tehran. Purposive sampling was used to recruit the participants. Data were collected using semi-structured interviews with the participants. Qualitative content analysis was used to analyze the data.

Results: Expectations of nursing faculty were explained in eight categories: empowerment of the faculty, organizational support, fairness, appropriate performance evaluation, providing appropriate working conditions, applying appropriate management strategies, attention to welfare and financial problems and promoting quality of education and research.

Conclusion: Understanding the expectations of the nursing faculty and trying to meet them can improve performance of the faculty. Meeting these expectations can enhance motivation and job satisfaction among the faculty.

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  Background & Aim: Breast cancer is the most common cancer diagnosed in women in both developed and developing countries. Long-term prognosis of breast cancer strongly depends on the stage of disease at diagnosis. More than three months after detecting breast symptoms by Iranian women, they go to visit a doctor. The understanding of life-threatening symptoms and the subsequent responses are differently affected by social interaction networks as well as cultural and social contexts. This study aimed to explore the role of social interactions on health-seeking behaviors among Iranian women with breast cancer symptoms .

  Methods & Materials: A qualitative study was conducted using purposive sampling method. Twenty Iranian w omen who attended the Cancer Institute in Imam Khomeini hospital at Tehran University of Medical Sciences and complained of symptoms of breast cancer were recruited to the study du ring 2012-2013. Data were collected through semi-structured and in-depth interviews. Interviews were transcribed and analyzed using conventional content analysis in the MAXqda . 

  Results: The results revealed three themes including: 1) effectiveness of social learning 2) seeking social support and 3) feedback with a supportive approach which included seven categories of informative social learning, reliable social learning, selective disclosure, seeking information, seeking emotional support , giving reassurance and social support for decision making .

  Conclusion: E ffective social learning and supportive interactions have influential role on health seeking behavior. Thus it is necessary to improve public awareness and correct clients' social beliefs about breast cancer to shorten the patients' delay .

  

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  Background & Aim: Medication errors are known as the most common preventable and life threatening medical errors. This study aimed to explore perceptions of nurses on medication errors .

  Methods & Materials: This was a qualitative study with content analysis approach. Seventeen nurses were selected purposefully from the intensive care units of Shohada hospital in khoramabad in 2012. Data were gathered using semi structural interviews with the nurses. Data were analyzed using the Lundman and Graneheim method. We used the Linclon and Gouba method to ensure a ccuracy and trustworthiness of the data . 

  Results: Four main categories and six subcategories were recognized including: 1) Management factors (inefficiency in recruitment of human power, poor physical condition and workload) 2) Inefficiency in professionalism (lack of commitment among nurses, insufficient knowledge and inefficiency in the inter professional relationship) 3) Failure in the process of drug prescription by physicians and 4) Failure in production and packaging drugs by drug companies .

  Conclusion: Training and recruiting professional and committed nurses, using electronic medical files, supervision on pharmacy companies to produce and package proper medication can reduce medication errors .

  

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  Background & Aim: The ultimate goal of self-care behavior is patients' empowerment. There are limited studies on perspectives of patients with Parkinson's disease on self-care. This study aimed to explore for the process of self-care in patients with Parkinson’s disease during 2011 to 2013 .

  Methods & Materials: This exploratory qualitative study was carried out using grounded theory method. Data were collected via semi-structured in-depth interviews and field notes. We interviewed with 12 patients with Parkinson 's disease and four family caregivers . Participants were selected from two neurology clinics. Interviews were conducted at participants' homes or nursing homes. Data were analyzed using the Corbin and Strauss (2008) approach . 

  Results: Concepts of study were identified using a micro and general analysis. The 'fear of becoming crippled' was identified as a main concern. Strategies used in response to context included 'independency', 'spiritual care', 'informed self-care' and ‘seeking treatment’. 'Striving for taking independent self-care' was the most important process. Demographic, familial and social factors had important roles in self-care processes of patients with Parkinson's disease .

  Conclusion: The process of self-care in patients with Parkinson’s disease depends on the context and severity of the signs and symptoms. Health care providers especially nurses can support patients with Parkinson's disease in achieving maintain independence in self-care. In addition, attention to self-care behaviors with focus on person as self-care agent can considerably increase control and management of life .

  

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Background & Aim: Teamwork (between obstetricians and midwives) is one of the main pillars of success in the provision of appropriate services in the maternity wards. Therefore, this study aimed to identify the factors influencing teamwork in a maternity ward in a public hospital in Tehran, Iran.

Methods & Materials: In this qualitative study, nine midwives and four obstetricians were selected through purposive sampling. Data were collected through semi-structured interviews from an affiliated hospital of Tehran University of Medical Sciences in 2013-2014. Data were analyzed using conventional content analysis.

Results: Two themes including the teamwork barriers (four categories) and facilitators (three categories) were extracted from the data analysis. The main categories of teamwork barriers were the underlying issues (inter-professional conflicts, legal issues, and salary and financial issues), individual problems (physical problems, negative personality characteristics and domestic problems), lack of skills (lack of abilities and motivation, educational weakness and lack of experience) and the external management system (inappropriate policy making and planning, hierarchical structure, lack of team evaluation and lack of justice). The main categories of teamwork facilitators were the internal management of team (good leader or manager, appropriate workplace climate, values clarification of the team members’ practices, and proper implementation of regulations), cooperation, collaboration and empathy (help and cooperation and empathy and support), and essential personal qualities for teamwork (good communication and good personality characteristics).

Conclusion: In this study, the teamwork barriers and facilitators in the maternity wards were comprehensively identified at different levels. According to the results, interventions can be designed and implemented to enhance teamwork.

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Background & Aim: Error always occurs in the health system and it can lead to irreparable consequences. Therefore, error prevention must be taken into account by the health systems. Detection of factors contributing to error is a key factor for the prevention of error. Hence, the aim of this study was to explore factors contributing to nursing error in emergency department.

Methods & Materials: This study was conducted using a qualitative approach. 17 emergency nurses participated in this study. Semi-structured interview was used to collect the data. Sampling was started as the purposive sampling and continued until the saturation of data was reached. Data were analyzed using the Elo & Kyngas (2008) qualitative content analysis approach. To achieve trustworthiness, participants were selected with maximum variation in terms of age, gender, work experience, and educational background.

Results: The analysis of data led to the emergence of 500 open codes and four categories including the predisposing factors of nurse-related error, predisposing factors of organization-related error, predisposing factors of error related to the culture of emergency department and predisposing factors of patient-related error.

Conclusion: Factors contributing to nursing errors in emergency department were very wide and multifactorial. Identifying the factors contributing to error is a first step to prevent errors. For reducing nursing error, nursing managers should pay special attention to the contributing factors of error identified by this study and implement interventions to reduce and mitigate these factors.

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Background & Aim: Culturally sensitive care is an essential component of professional development process and one of the predictive factors of nurses’ cultural competency. This care is the most important approach to improve the quality of nursing care in culturally diverse groups. The current study aimed to explore the consequences of culturally sensitive care in pediatric nursing.

Methods & Materials: This study is a qualitative study using conventional content analysis. 25 nurses and 9 parents were purposefully selected with maximum variation sampling from the pediatric wards of three referral teaching hospitals in Tabriz and Tehran in 2015-2016. Data were collected through in-depth interviews and field notes and simultaneously analyzed using MAXQDA software version 10.

Results: The consequences of culturally sensitive care in pediatric nursing emerged in two categories: justice-based care (with three subcategories: the lack of cultural bias, culture-based communication and effective participation) and cultural satisfaction (with two subcategories: reduced cultural stress and safe care). Culturally sensitive care prevents misunderstandings and improves nurse-child/parents communication and leads to parents’ honesty to share information and express cultural needs. The expression of cultural needs decreases stress levels in parents and children and results in safe care by reducing intractable traditional treatment.

Conclusion: According to the findings of this study, it is suggested that effective culturally sensitive interventions in pediatric wards should be included in in-service courses and nursing curriculum.

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Background & Aim: Pedestrians are the most vulnerable road users. In many cases, pedestrian-vehicle crashes are often the result of their risky road crossing behaviors. So, this qualitative study aimed to explore the reasons for risky road crossing behaviors among young people.

Methods & Materials: The current study was designed as a qualitative content analysis. Twelve males and females who had a car-accident were purposefully selected with maximum variation sampling. Data were collected and analyzed by semi-structured individual interviews.

Results: Conformity with the masses including “conformity with peers and conformity with the public space of society”, and anomie emerged as the most important social reasons for young pedestrian’s risky road crossing behaviors.

Conclusion: According to the results of this study, young pedestrian’s risky road crossing behaviors are affected by conformity with the masses and peers and as well as anomie so that risky behaviors have been commonplace and inevitable and a part of their lifestyle.

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Background & Aim: The physiologic childbirth program in Iran is an emerging program that needs to be evaluated like any other program to improve its quality and process. Evidence suggests that the implementation of the physiologic childbirth program faces some challenges. The present research aimed to explore the challenges of the physiologic childbirth program from the perspective of service providers.
Methods & Materials: This qualitative research was carried out through a content analysis method in two mother-friendly hospitals of Ahwaz and Mashhad in 2016-2017. Data were collected through semi-structured interviews with 17 physiologic childbirth service providers. The content analysis method of Elo and Kyngas was used for qualitative data analysis.
Results: Data analysis led to five main categories: low motivation of midwives in performing physiologic childbirth; barriers related to manpower; medical interventions in physiologic childbirth; challenges from the environment and facilities; and educational barriers.
Conclusion: Different challenges in interaction with each other create a complex environment in which the implementation of physiologic childbirth program becomes more difficult. Therefore, policymakers, authorities, doctors, midwives and mothers need to work in a coordinated way to resolve the mentioned challenge.
 

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Background & Aim: Concerns over limited equipment and resources particularly in the intensive care units have raised the issues of medical futility, futile treatment, and futile care. Considering that there is no consensus in the definition of the concept of futile care, this study aimed to explore the concept of futile care, especially in terms of clarifying it with the concept of futile treatment.
Methods & Materials: This is a qualitative study conducted using the conventional content analysis approach. In this study, 22 nurses, eight medical specialists, four medical ethics specialists, and one sharia specialist, were purposively recruited with the consideration of maximum variation. Data were collected using individual, in-depth, semi-structured interviews.
Results: The main theme of the study was “care is never futile: care as goal”. This theme is consisted of four main categories including: 1. care as an indispensable service; 2. care as an ongoing process focused on human existence; 3. care as a sacred and essential process in Islam; 4. the necessity for differentiating between care and cure: futile treatment instead of futile care.
Conclusion: Although, in some cases, and depending on the circumstances, medical interventions may be futile, care is never futile. According to the findings of this study, the terms medical futility and futile care cannot be used interchangeably because interchangeable use of these terms can devalue the nature of care. Thus, it is necessary to use the term of “futile treatment” instead of “futile care”.
 

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Background & Aim: Creating and maintaining a safe environment is an important part of care in psychiatric wards. The results of previous studies indicated that some features of the physical environment facilitate the ward’s safety. The experiences of people who are most likely to be present in these environments can be the best source for identifying these features. Therefore, this study was conducted to explain patients’ and employees’ perceptions toward the features of a safe physical environment in psychiatric wards.
Methods & Materials: In this exploratory qualitative descriptive study, seven patients at discharge time and nineteen employees working in psychiatric wards were interviewed about their experiences in psychiatric wards and 84 hours of field observation was done. The data were analyzed using a qualitative content analysis approach according to the method proposed by Graneheim and Lundman.
Results: The results showed a safe physical environment in psychiatric wards meant “having an accident-free environment”. This theme was abstracted from two main categories included “Accidents prevention through design” and “having a natural life environment”, which, according to the experience of the staff, is required to balance the two. The subcategories of “having the design of accidents prevention” were “eliminating or modifying accident-causing objects”, “wards based on the characteristics of the patients” and “conditions for facilitating staff performance” and the subcategories of “having a natural life environment were “meaningful activities", “healthy and pleasant conditions” and “preserved privacy”.
Conclusion: According to the results of the study, it is necessary to create a physical environment free of accidents and at the same time to meet the daily needs of patients in order to prevent physical and psychological damage to patients and staff in psychiatric wards.
 

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Background & Aim: Designing healthcare spaces and physical facilities requires the identification of the patient's family needs, and it is considered an important component of nursing theories. The aim of this study was to explain the needs of family caregivers of patients undergoing gynecological surgery for physical facilities and equipment in hospital.
Methods & Materials: This study is based on the results of the qualitative part of a large hybrid study on the development and implementation of a need-based service delivery program for the caregivers of patients undergoing gynecological surgery in 2017. The selection of participants was purposefully done with maximum variation. The study data were collected using 31 (16 caregivers, 6 nurses, 4 doctors, 3 patients and 2 service workers) in-depth interviews and observations and analyzed by the conventional qualitative content analysis using the Zhang and Wildemuth approach.
Results: Data analysis led to the development of the theme "need for physical facilities", which fell into two categories "need for proper physical structure in the hospital" with the following subcategories: "need for care facilities behind the operating room door", "need to provide welfare facilities in the hospital for caregivers", "need for welfare facilities in the surgical ward", "necessity of allocating rooms to the similar patients", and category "need for appropriate hospital facilities and equipment" with subcategories "caregiver’s need for facilities and amenities", and "caregiver’s need for facilities and amenities for the comfort of the patient".
Conclusion: The results show the importance of having a physical structure tailored to the needs of family caregivers as well as the availability of appropriate facilities and equipment in hospital. One of the limitations of the study was preventing men from visiting patients in the women’s hospital. It is recommended that the needs of male companions and the necessity of their presence according to the cultural context be studied. Also, a new architectural design is suggested to create a suitable therapeutic environment and positive effect on patients’ improvement and increase patient and family satisfaction.
 

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Background & Aim: With the increasing phenomenon of elder abuse in today's societies, understanding the facilitating and inhibiting factors related to abuse seems necessary. The purpose of this study was to explain the facilitators of elder abuse in Iranian society.
Methods & Materials: This is a qualitative study that used a thematic analysis approach to collect and analyze data in order to explain the elderly’s perceptions of the facilitators of abuse. In this study, 20 elderly people in the community were selected by purposeful sampling. The data were collected by in-depth, semi-structured and face-to-face individual interviews. The Braun and Clark’s thematic analysis was used to analyze the data.
Results: The results of data analysis led to the identification of three themes including role modeling, evacuation of failures, and cultural-familial context of the society. The third theme had three sub-themes intergenerational gap, parenting style and society’s indifference.
Conclusion: Abuse is the result of a combination of causes and factors. The elderly’ experiences suggest that abuse goes beyond a personal matter and is rooted in cultural, social, and economic practices. Today, it is not acceptance of each other and disregard for the expectations of the other party that gives rise many contradictions and abuses at the family and community level.

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Background & Aim: Covid-19 is an emerging disease that has become a health crisis in the world and affected various aspects of human’s life. Understanding the experience of patients with this disease is essential for proper and comprehensive care. The aim of this study was to explore the lived experiences of patients recovered from Covid-19.
Methods & Materials: The present study was a qualitative study with an interpretive phenomenological approach that was conducted in 2021. For this purpose, 13 patients recovered from Covid-19 were selected using the purposive sampling method based on the inclusion criteria. In-depth, semi-structured interviews were used to collect the data. The interviews were recorded. Having transcribed the interviews, the transcripts were analyzed by a hermeneutic approach using the Van Manen method.
Results: Data analysis revealed four main themes: "fear of imminent death", "living in a fence", "family worries", and "the limitations suffering".
Conclusion: Patients’ experiences of being infected with Covid-19 showed that the disease affected the physical, psychological, economic, social and family dimensions of individuals. Therefore, understanding the challenges, experiences and concerns of patients about the disease, can help executive decision-makers, healthcare providers and mental health professionals to comprehensively understand the consequences of the disease.