Self-report of pain is the single most reliable indicator of pain intensity. The purpose of this study was to compare patients' and nurses' ratings of patients' pain. The sample comprised 76 patients and 65 nurses in coronary care units that rated the patient's pain intensity on a 0-10 numeric rating scale. Results showed that the mean scores of nurses were lower than their patients significantly (P < 0.01). Also, nurses assessed patients' pain intensity accurately 60% of the time. Overestimations and underestimations were 12.4% and 27.6% respectively. In addition, there were positive, moderate and significant correlations between patients' and nurses' ratings (r = 0.41, P < 0.001). Underestimation of patient's pain can have negative effects if appropriate treatment is withheld. This emphasizes the importance of a systematic assessment and acceptance of the patient's self-reported of pain.

No abstract

BackgroundClinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services.MethodsThe present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire.ResultsIn the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance.ConclusionMismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.

Background and Objective:Regarding the fact that emergency ward has unique characteristics, whose uniqueness affects informed consent processes by creating specific challenges. Hence, it seems necessary to identify the process and challenges of informed consent in the emergency ward through a qualitative study to understand actual patients’ and health care providers’ experiences, beliefs, values, and feelings about the informed consent in the emergency ward. Through such studies, new insight can be gained on the process of informed consent and its challenges with the hope that the resulting knowledge will enable the promotion of ethical, legal as well as effective health services to the patients in the emergency ward.Method:In this qualitative study, research field was one of the emergency wards of educational and public hospitals in Iran. Field work and participant observation were carried out for 515 hours from June 2014 to March 2016. Also, conversations and semi-structured interviews based on the observations were conducted. The participants of the study were nurses and physicians working in the emergency ward, as well as patients and their attendants who were involved in the process of obtaining informed consent.Results:Three main categories were extracted from the data: a sense of frustration; reverse protection; and culture of paternalism in consent process.Conclusion:Findings of this study can be utilized in correcting the structures and processes of obtaining informed consent together with promotion of patients' ethical and legal care in emergency ward. In this way, the approaches in consent process will be changed from paternalistic approach to patient-centered care which concomitantly protects patient’s autonomy.

Context: Theoretical sampling is the hallmark of grounded theory methodology, but there seems to be little information accessible to researchers regarding process and guidance concerning theoretical sampling. The current study aimed to have a comprehensive and thorough review of the related studies on theoretical sampling and examine definitions, challenges, differences and applicable tips about this type of sampling to provide a comprehensive and clear picture of the sampling process and its probable challenges as well as explaining its practical aspects. Objectives: The ultimate goal of all the explorations is to provide practical sources for researchers to answer their questions about theoretical sampling.