Background: Identifying the preferred place of death is a key indicator of the quality of death in cancer patients and one of the most important issues for health service policymakers. This study was done to determine the preferred place of death and the factors affecting it for adult patients with cancer.Methods: In this systematic review and meta-analysis study four online databases (PubMed, Scopus, web of science, ProQuest) were searched by relevant keywords. Quality assessment of papers was conducted using Newcastle-Ottawa (NOS) criterion. Odds ratios, relative risks, and 95% confidence intervals were determined for each of the factors extracted from the investigations.Results: A total of 14,920 participants of 27 studies were included into the meta-analysis. Based on the results, 55% of cancer patients with a confidence interval [95% CI (41–49)] preferred home, 17% of patients with a confidence interval [95% CI (−12%) 23)] preferred hospital and 10% of patients with confidence interval [95% CI (13–18)] preferred hospices as their favored place to die. Effective factors were also reported in the form of demographic characteristics, disease-related factors and psychosocial factors.Conclusions: This study showed that more than half of cancer patients chose home as their preferred place of death. Therefore, guided policies need to ensure that the death of the patients in the preferred place should be considered with priority.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218680, identifier: CRD42020218680.

BackgroundProviding nursing care to patients with COVID-19 has put additional pressure on nurses, making it challenging to meet several care requirements. This situation has caused parts of nursing care to be missed, potentially reducing the quality of nursing care and threatening patient safety. Therefore, the present study aimed at explaining the factors forming missed nursing care during the COVID-19 pandemic from the perspective of nurses.MethodsThis qualitative study was conducted using a conventional content analysis approach in Iran, 2020–2021. Data were collected from in-depth, semi-structured interviews with 14 nurses based on purposive sampling. Data analysis was performed simultaneously with data collection. Graneheim and Lundman's approach was used for data analysis, and MAXQDA software was used for data management. After transcribing the recorded interviews, to achieve the accuracy and validity of the study, the criteria proposed by Lincoln and Guba were considered and used.ResultsA total of 14 nurses with a mean age and standard deviation of 31.85 ± 4.95 and working in the COVID-19 wards participated in the study. The acquired data were categorized into four main categories: care-related factors, disease-related factors, patient-related factors, and organization-related factors. The category “care-related factors” comprised uncertainty in care, PPE-related limitations, attrition from care, and futile care. The category “disease-related factors” consisted of the extension of symptoms, unpredictable peaks of the disease, and restriction on the presence of patients' companions. The category “patient-related factors” included comorbidities, elderly patients, and deterioration of infected patients. Ultimately, the category “organization-related factors” consisted of restrictions on equipment supply, lack of human resources, weaknesses in teamwork, and an unsupportive work environment.ConclusionThe results of this study showed that several reasons including factors related to care, patient, disease, and organization cause missed nursing care. By modifying the related affecting factors and considering the effective mechanisms to minimize missed nursing care, it is possible to provide better services.

Purpose: Nursing development is considered as one of the most important ways to achieve the universal health coverage and sustainable development goals in different countries. Nursing in Iran has the potential to provide services at all levels of universal health coverage. Therefore, planning for nursing in Iran needs to recognize the future challenges. This study aims to explore the future challenges of nursing in the health system of Iran from the perspective of nursing experts.Methods: In this qualitative study, 11 semi-structured interviews were conducted with nursing experts by purposive sampling in 2017–2018. Interviews were recorded and transcribed and framework analysis method was used to analysis the data.Results: The results showed that a favorable future requires planning in three areas of nursing “governance challenges” including centralized nursing stewardship, policy-making and legislation, monitoring and evaluation, and cooperation and communication with other institutions, “inadequacy of professional development with social demands” including community-based nursing, nursing upgrades with disease patterns, expanding home care, expanding care centers, and use of technology, “human resource challenges “including nursing education tailored to the needs of the community, empowering nursing managers, recruiting and retaining nurses, and specialized nursing.Conclusions: A favorable future requires a coherent nursing government, professional development of nursing based on social demands, and enhancing human resources in line with the emerging needs of the future.

Based on Bloomberg's ranking, Iran has been ranked as the 45 th country in the world in terms of effective health system. The Ministry of Health and Medical Education (MOHME) is responsible for the health stewardship and centralized sovereignty. The activities of this ministry have shown improved health status over the past few decades (Rafiei et al., 2015). Nevertheless, the health system of Iran faces major challenges. The major challenges of the health system of Iran include increasing the elderly population, increasing non-communicable diseases (NCDs), changing lifestyle, as well as increasing health costs, maintaining and increasing quality of care, and patients' place of death and

BackgroundThe unpredictable and variable nature of COVID-19 and the lack of healthcare resources has led to inadequate care for patients. This study aimed to explain the causes of missed nursing care during the COVID-19 pandemic from the perspective of Iranian nurses.MethodThis qualitative study was conducted using semi-structured interviews with 14 nurses caring for patients with COVID-19 in three hospitals in Iran. Sampling was performed by the purposive method. Data were analyzed using the conventional content analysis method. The interviews were first recorded and transcribed, and then the data were analyzed using the Elo and Kyngas method. Data management was done with MAXQDA software version 10. To achieve trustworthiness, the criteria presented by Lincoln and Guba were used.FindingsA total of 14 nurses participated in the study. The mean age of participants was 31.85 ± 4.95 years, and the mean number of years of work experience was 7.71 ± 4.44. Eleven participants were women. Among all participants, nine had a bachelor's degree and five had a master's degree. Four nurses had fixed shifts, while ten nurses had rotating shifts. The causes of missed nursing care were categorized into 4 groups. The category “unfulfilled care” comprised the reasons for forgetting care, neglecting care, arbitrary elimination of care, and compulsory elimination of care. The category of “care at improper time” consisted of interference of the care in patients' daily activities and interference with other healthcare providers' activities. The “incomplete cares” category comprised failure to complete the care period in hospital, interruption in care, and discontinuance of care after patient discharge. The last category, “incorrect care,” consisted of providing care regardless of the nursing process, providing care by unqualified professionals, and providing trial-and-error care.ConclusionThis study illustrates an understanding of the causes of missed nursing care during the COVID-19 pandemic from the perspective of nurses. The increasing demand for care caused by the pandemic and problems in the work environment has led to the failure of nurses to provide complete, correct care and sometimes miss parts of care to patients. Therefore, nursing policymakers and managers should develop and implement appropriate care protocols and instructions to minimize missed nursing care.