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Yarahmadi S, Soleimani M, Gholami M, Fakhr-Movahedi A, Madani SMS. Ageism and lookism as stereotypes of health disparity in intensive care units in Iran: a critical ethnography. Int J Equity Health 2024; 23:114. [PMID: 38831276 PMCID: PMC11149295 DOI: 10.1186/s12939-024-02180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/17/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The intensive care unit presents structural complexities, and the prevailing power imbalance between patients and staff can lead to health disparities. Hence, unveiling the underlying factors that give rise to and reinforce these disparities can contribute to their prevention. This study aims to shed light on the stereotypes linked to ageism and lookism, which perpetuate health disparities within the intensive care unit setting in Iran. METHODS This critical ethnographic study employed Carsepkan's approach and was carried out in intensive care units in the west of Iran from 2022 to 2023. The data collection and analysis were conducted through three interconnected stages. In the initial stage, more than 300 h of observations were made at the research site. In the subsequent stage, a horizon analysis was performed. Conversations with 14 informants were conducted in the final stage to enrich the dataset further. Then the analysis process was carried out as in the previous step to uncover an implicit culture of health disparity. To verify the validity and reliability of the study, credibility, conformability, dependability, and transferability were all taken into account. FINDINGS The ageism and lookism stereotypes emerged from seven main themes; youth-centric; negative ageism; age-friendliness; age-related priority; centered care for pediatric patients and families; appearance-centeredness; and a contradiction between belief and behavior. CONCLUSION This critical study showed that ageism and lookism stereotypes permeated the intensive care unit's culture. These stereotypes have the potential to influence equality dynamics, as well as to foster and support health disparity in the intensive care unit.
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Affiliation(s)
- Sajad Yarahmadi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohsen Soleimani
- Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mohammad Gholami
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Fakhr-Movahedi
- Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Baykal D, Çömlekçi N, Can G. "I don't Want to Die Alone" Nurses' Perception of Ageism: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:812-827. [PMID: 37210657 DOI: 10.1177/00302228231177761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The aim of the study was to learn the perceptions and thoughts of nurses with whom older patients interact constantly. In this research, semi-structured interview was used. In a research hospital in Istanbul between March-June 2019, 16 volunteers were included in the study. Researchers led individual semi-structured interviews regarding nurses' perceptions, how they overcame those challenges, and need and expectations aging care (dying patients). All interviews were analysed using thematic analysis methods and synthesized into major themes. The research was planned based on the 32-item checklist (COREQ) guideline. Nurses (N = 16) reported three themes: (i) ageing perceptions (ii) care for dying patients, (iii) expectations and five subthemes emerged in this study. It is understood that nurses have a positive perception of ageing. In addition, nurses have expectations from the state (financial support, gerontology service etc.) and society (respectful, understanding etc.) to reduce the difficulties they experience while caring for dying patient.
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Affiliation(s)
- Dilek Baykal
- Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Türkiye
| | - Necmiye Çömlekçi
- Department of Nursing, Faculty of Health Sciences, Bartın University, Bartın, Türkiye
| | - Gülbeyaz Can
- Faculty of Nursing, Istanbul University-Cerrahpasa Florence Nightingale Istanbul, Istanbul, Türkiye
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Pouresmail Z, Heshmati Nabavi F, Rassouli M. Quality of services in health education nurse-led clinics: an Iranian service providers and service recipients experience. BMC Health Serv Res 2024; 24:581. [PMID: 38702707 PMCID: PMC11069198 DOI: 10.1186/s12913-024-11057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Patient education is a vital role of nurses in nurse-led clinics(NLCs). Since 2011, independent NLCs entitled health education Nurse-led clinics(HENLCs) have been established in Iran. In order for this newly developed service to be able to perform perfectly in implementation and evaluation, it should be explained based on one of the quality evaluation models. The objective of the study was to determine the dimension of service quality in HENLCs based on service providers' and service recipients' experience. METHODS This research is a qualitative study of directed content analysis type conducted between May and November 2020. Twenty-nine participants who had rich experiences in the patient education in HENLCs were interviewed in this study. Asarroodi et al.'s (2018) qualitative content analysis method was used for data analysis, and MaxQDA software was used for data management. We used credibility, dependability, and Confirmability to confirm the trustworthiness of the study's findings. RESULTS In this study service providers including managers, policymakers, decision-makers, nurses, physicians, and service recipients including patients and families participated. Seven generic categories, including (1) a competent and self-motivated nurse educator, (2) an easily accessible and comfortable environment, (3) informational-educational materials and health education equipment, (4) motivational facilities, (5) access to the health education support team, (6) organizational communication supporting the education process, and (7) receiving the patient education fee, constituted the main category of structure. Five generic categories, including (1) assessment and determination of the educational needs of the target group, (2) description of the nurse's duties, (3) teaching-learning methods, (4) patient referral, and (5) the process of preparing and publishing educational content, constituted the main category of process. One generic category called evaluation constituted the main category of outcome. CONCLUSION Based on the results of this study, it is suggested to managers to pay attention to the dimensions of the quality model of Donabedian (SPO) in setting up and developing the performance of HENLCs, it is recommended that future quantitative studies based on the categories formed in this study evaluate the observance of the dimensions of structure, process and outcome.
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Affiliation(s)
- Zohre Pouresmail
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maryam Rassouli
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Liu X, Wang D, Gu C, Bao H, Luo Y. Perceived Ageism in Health Care: A Hybrid Concept Analysis. J Appl Gerontol 2024:7334648241248297. [PMID: 38631909 DOI: 10.1177/07334648241248297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Identifying perceived ageism is a critical step in eliminating ageism. This hybrid concept analysis aims to describe the concept of perceived ageism in health care. In the theoretical phase, a scoping review was conducted. In the field phase, semi-structured interviews were conducted with nine community-dwelling older adults. In the final analytical phase, results from the theoretical phase were integrated with those from the fieldwork phase. The perceived ageism in health care includes four dimensions: self-internalization (self-denial, a sense of unease, and passivity of behavior in seeking health care), interpersonal interaction (perceived negative perceptions, neglected attitudes, and unfair care behaviors), organization system (perceived strangeness caused by unfamiliar technology, unsupportive environment, and inadequate resources), and procedure policy (perceived uniformity of healthcare process and lack of targeted practice policies). Research related to this concept has contributed to developing measurement tools for assessing perceived ageism in healthcare practice and subsequent research.
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Affiliation(s)
- Xinyi Liu
- Third Military University/Army Medical University, Chongqing, China
| | - Dan Wang
- Third Military University/Army Medical University, Chongqing, China
| | - Chunyan Gu
- ShuangBei Community Health Service Center, Chongqing, China
| | - Haoying Bao
- Third Military University/Army Medical University, Chongqing, China
| | - Yu Luo
- Third Military University/Army Medical University, Chongqing, China
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Salarvand S, Farzanpour F, Gharaei HA. The effect of personalized mobile health (mHealth) in cardiac rehabilitation for discharged elderly patients after acute myocardial infarction on their inner strength and resilience. BMC Cardiovasc Disord 2024; 24:116. [PMID: 38373888 PMCID: PMC10877866 DOI: 10.1186/s12872-024-03791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Given the importance of promoting self-care and quality of life for discharged elderly patients after acute Myocardial Infarction(MI), It is necessitated we conduct interventions to promote these items. This study was conducted to determine the effect of mHealth-Cardiac rehabilitation (CR) on the inner Strength and resilience of elderly patients with MI after discharge from the hospital. METHODS The present study was a randomized controlled trial that was conducted on 56 Elderly patients with myocardial infarction were discharged from the heart departments. In the intervention group after the patient's discharge, the patients were contacted twice a week for one month and the necessary training and support were given online. To gather data, the Mini-Mental State Examination (MMSE), the demographic and clinical characteristics questionnaire, the inner strength scale (ISS), and the Connor-Davidson Resilience Scale (CD-RISC) were completed pre- and post-intervention. The data analysis was done by SPSS16. RESULTS This study showed the mean resilience and inner strength scores before and after the intervention in the control group had no statistically significant difference(P˃0.05). There was a significant increase in the mean resilience and inner strength scores in the intervention group after the intervention (P ≤ 0.001). CONCLUSION The results of this study showed that mHealth as a kind of telenursing nursing has a significant effect on both variables of inner strength and resilience of post-discharge elderly patients after acute myocardial infarction. This means that using mHealth for these patients could increase the inner strength and resilience of the elderly discharged after myocardial infarction. Therefore, through using this method, elderly patients' self-care ability and quality of life could be increased.
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Affiliation(s)
- Shahin Salarvand
- Hepatitis Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Farzad Farzanpour
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Yaghoobzadeh A, Asgari P, Nasrabadi AN, Mirlashari J, Navab E. Explaining the process of formation of ageism among the iranian older adults. BMC Psychol 2023; 11:123. [PMID: 37072875 PMCID: PMC10111329 DOI: 10.1186/s40359-023-01153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Ageism is considered as one of the consequences of the industrialization of societies, which appears in various forms in different cultures. This study aimed to explain the process of formation of ageism among the older adults people. METHODS The research was conducted using grounded theory method. Data were collected from 28 participants using in-depth semi-structured interviews and field notes. Data were analyzed using open, axial, and selective coding. RESULTS Fear of loneliness and rejection striving to tackle ageism "was identified as the core category of the study. Concepts such as "family context" and "cultural context" were relevant. After identifying the strategies used by the older adults in response to the context ("maintaining integrity", "socio-cultural care" and "proper health care", "striving to tackle ageism") was the most important process in ageism by the Iranian older adults. CONCLUSION Findings of this study indicated that individual, family and social factors play an important role in the process of ageism among the older adults. These factors sometimes exacerbate or moderate the process of ageism. By recognizing these factors, various social institutions and organizations (including the health care system and the national media (radio and television)) can help the older adults achieve successful aging by emphasizing the issues related to the social aspect.
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Affiliation(s)
- Ameneh Yaghoobzadeh
- School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Parvaneh Asgari
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Jila Mirlashari
- Department of OBGYN, Women's Health Research Institute, University of British Columbia, Vancouver, Canada
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Navab
- Department of critical care and Geriatric nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, East Nosrat Street, Tohid Square, Tehran, 1419732171, Iran.
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Naderi Z, Gholamzadeh S, Ebadi A, Zarshenas L. Development and psychometric properties of the hospitalized elder abuse questionnaire (HEAQ): a mixed methods study. BMC Geriatr 2022; 22:715. [PMID: 36038844 PMCID: PMC9426014 DOI: 10.1186/s12877-022-03400-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older patients are more vulnerable and prone to abuse and neglect in hospitals and acute care settings. The present study aimed to develop and assess the psychometric properties of a questionnaire for screening abuse in hospitalized older adults. METHODS This study was conducted from October 2017 to September 2019 using the exploratory sequential mixed-methods research design. The participants were selected among those admitted to various wards of six teaching hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In the qualitative phase of the study, using the inductive content analysis method, the concept of abuse in hospitalized older adults was extracted through individual in-depth semi-structured interviews with 16 older patients and 11 family caregivers. Based on qualitative findings and a review of existing literature, an initial version of the questionnaire was developed. In the quantitative phase of the study, the psychometric properties (face, content, construct, and convergent validity; internal consistency and stability) of the questionnaire were examined. RESULTS Based on qualitative findings and literature review, a pool of 154 candidate items was defined. These items were reduced to 37 after initial refinement, qualitative and quantitative face and content validity, and item analysis. The outcome of principal component analysis further reduced the number of items to 27, which were grouped into 5 components, namely "Shortcomings in management and care facility", "Neglect of professional commitments", "Physical and psychological abuse", "Protracted treatment process", and "Invasion of privacy". The explained variance of these 5 components was 50.09% of the overall variability of the questionnaire. The convergent validity of the questionnaire was acceptable (P < 0.00, r = - 0.44). Cronbach's alpha coefficient and intraclass correlation coefficient for the entire questionnaire were 0.89 and 0.92, respectively; indicating high reliability and stability of the questionnaire. CONCLUSION The hospitalized elder abuse questionnaire (HEAQ) has acceptable psychometric properties. It is recommended to use HEAQ to screen for suspected cases of abuse of hospitalized older adults.
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Affiliation(s)
- Zeinab Naderi
- Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Sakineh Gholamzadeh
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ladan Zarshenas
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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