The framework for developing nursing specialist roles in the health care system of Iran

Community-based nursing: a concept analysis with Walker and Avant's approach

BACKGROUND

Community-based nursing in recent years has received much attention from nursing schools in different countries as a suitable solution in response to existing and future problems and challenges, but there is yet no comprehensive and correct understanding of this concept and considering its importance, the present study was conducted to the aim of analyzing the concept of community-based nursing.

METHODS

Concept analysis was done using Walker and Avant's 8-step approach. Nursing dictionary, Persian dictionary, research articles, journals and conferences articles, dissertations, thesis, books, and other sources related to the concept of research were investigated through search engines and available databases using the keywords of nursing, community-based, concept analysis and Walker and Avant from 1990 to 2023. Finally, 54 articles related to the concept were reviewed and analyzed.

RESULTS

The results showed that community-based nursing has attributes such as individual-oriented/ family-oriented/ community-oriented, social partnership with the communities and stakeholders, social justice, and group and interprofessional cooperation, the community as the main activity setting, providing services based on cultural diversity, providing services according to the context, conditions and community needs, caring for individuals and families with health problems throughout life, responding to the community needs, community-based experiences and facing real-life issues in the context of community, using a problem-based and service-based approach, providing context-based care and considering factors affecting health. In this regard, borderline and related cases (community health nursing, community-oriented nursing, population-based nursing, and public health nursing) were also presented to clarify the concept. Antecedents of community-based nursing included: determining the position of community-based nursing, making infrastructure and structure, the partnership between university, hospital and community, identifying all settings, the presence of educators proficient in education, survey of community needs, having knowledge, communication and community-based skills, expanding the role of the nurse, stakeholders' attitude towards community-oriented nursing and management and financial support. Consequences of community-based nursing included: competence development in nurses, solving community-based nursing challenges, meeting the health needs of individuals, families and communities, social justice, and increasing access to health care services.

CONCLUSION

The results of this study can provide an objective and understandable image of the use of community-based nurses and their education in practice. Conducting more quantitative and qualitative studies about community-based nursing is also recommended.

What is the mind map of the hospital's future changes in a developing country like Iran? A qualitative study

BACKGROUND

Hospitals have a vital role in the future of health systems with upcoming structure, resources, and process changes. Identifying the potential aspects of change helps managers proactively approach them, use the opportunities, and avoid threats. This study presents a mind map of future changes in Iranian hospitals to develop a base for further related studies or prepare evidence for interventions and future-related decisions.

METHODS

This study is a qualitative-exploratory one, conducted in two phases. In the first phase, in-depth and semi-structured interviews were conducted to identify future hospital changes over 15 years. The interviews were analyzed using the content analysis method and MAXQDA 2018 software and holding two expert panels to develop the mind map using the 2016 Visio software.

RESULTS

In the first phase, 33 interviews led to 144 change patterns. In the second phase, a mind map of changes was drawn according to experts' opinions with ten categories: structure and role, knowledge management and research, service delivery, health forces, political and legal, economic, demographic and disease, technological, and values and philosophy, and environmental.

CONCLUSIONS

Many changes affecting hospitals rooted in the past continue to the future, but the point is the increasing intensity and speed of changes. Healthcare systems need a systematic approach to monitoring the environment to be updated, agile and proactive. These monitoring systems are essential in providing evidence for Macro-level decision-makers.

Diplomatic activities of Iranian Nursing Organization: A qualitative study

BACKGROUND

Nursing organizations play an important role in fulfilling the professional demands of nurses. The Iranian Nursing Organization (INO) is also using diplomatic activities in this direction.

AIM

This study was conducted to explain the diplomatic activities of INO.

METHODS

A descriptive qualitative study was conducted using conventional content analysis. A purposive sampling approach was used. Data were collected via in-depth, unstructured, face-to-face interviews with 21 nurses at various INOs in different cities from March to July 2020. The data collection process continued until data saturation. Interviews were analyzed using Graneheim and Lundman's (2004) guidelines. The MAXQDA software (v. 10) was used.

FINDING

The results showed that the diplomatic activities of INO comprise professional (three categories), social (two categories), and diplomacy in power network (two categories).

CONCLUSION

INO carries out diplomatic activities at organizational, national and international levels and pursues its professional nursing goals through diplomacy. INO also uses social diplomacy and political diplomacy to influence decision-makers in the community and network of power.

Factors affecting the emergence of diplomacy in Iranian nurse managers: a qualitative study

AIM

To explore the factors affecting the emergence of diplomacy in Iranian nurse managers.

BACKGROUND

Today, with the development of complex health systems, diplomacy in health care can take place at organizational, national and international levels.

INTRODUCTION

Diplomacy's role is to convince others peacefully to achieve goals. Diplomacy in nursing can facilitate professional development and direct policy and decision-making process towards the development of a healthcare system.

METHODS

The study used a qualitative descriptive approach. The sampling method was purposeful, and data were collected via in-depth, unstructured and face-to-face interviews with 16 participants. The interviews were digitally recorded, transcribed verbatim and analysed through conventional content analysis based on Graneheim and Lundman's work.

RESULTS

In total, 212 codes were generated, which were grouped into three main categories, namely paradigmatic socio-political changes (two subcategories), nurses' dissatisfaction with their status in healthcare system (two subcategories) and multidimensional development of the nursing profession (four subcategories).

DISCUSSION/CONCLUSIONS

Socio-political changes, development of the nursing profession and nurses' dissatisfaction with the health system have led to the emergence of diplomacy roles in nurse managers, the recognition and development of which can improve the effectiveness of nurse managers in policymaking.

IMPLICATIONS FOR NURSING & HEALTH POLICY

The recent COVID-19 pandemic outbreak has demonstrated the urgent need to use diplomacy to solve health problems and adjust or develop policymaking at the national and international levels. Strengthening their role in diplomacy, nurse managers can play an important role as diplomats at various levels of policymaking and in health crisis management.

Intensive care nurses' experiences during the COVID-19 pandemic: A qualitative study

BACKGROUND

Because of the COVID-19 pandemic, health care systems worldwide are working under challenging conditions. Patients, who are seriously ill, require intensive care admission. In fighting COVID-19, nurses are frontline health care workers and, as such, have a great responsibility providing needed specialized patient care in intensive care units (ICU). However, working conditions and emotional factors have an impact on the quality of the care provided.

AIM

The purpose of the present study was to explore and describe the experiences and perceptions of nurses working in an ICU during the COVID-19 global pandemic.

STUDY DESIGN

Qualitative research was undertaken, using an empirical approach and inductive content analysis techniques.

METHODS

The selected population consisted of ICU nurses from a tertiary teaching hospital in Spain. Data were obtained via semi-structured videocall interviews from Apr 12th to Apr 30th, 2020. Subsequently, transcribed verbatims were analysed using the template analysis model of Brooks.

FINDINGS

A total of 17 nurses comprised the final sample after data saturation. Four main themes emerged from the analysis and 13 subthemes: "providing nursing care," "psychosocial aspects and emotional lability," "resources management and safety" and "professional relationships and fellowship."

CONCLUSION

Providing health care by intensive care nursing professionals, during the COVID-19 pandemic, has shown both strong and weak points in the health care system. Nursing care has been influenced by fear and isolation, making it hard to maintain the humanization of the health care.

RELEVANCE TO CLINICAL PRACTICE

Implications for practice include optimizing resource management (human and material), providing psychological support, and adequate training for ICU nurses, as well as high-quality protocols for future emergency situations.