Background: Improving the self-efficacy of cardiac patients is one of the pressing necessities that must be considered in the healthcare system. Meeting this urgent need requires comprehensive educational programs. Objectives: Therefore, the present study aimed at exploring the impact of empowerment on the self-efficacy of patients with ischemic heart disease who had been hospitalized in Imam Khomeini Hospital affiliated to Lorestan University of Medical Sciences. Methods: This clinical trial was carried out in 2018 on patients with ischemic heart disease who had referred to Imam Khomeini Hospital in Pole Dokhtar, Lorestan province, Iran. A total of 56 patients were randomly chosen and assigned to the control and experimental groups. The standard chronic disease self-efficacy scale (CDSES) was used for data collection. The empowerment program was presented in three 45-minute sessions, and the data were analyzed by SPSS version 23 using covariance, independent t test, and descriptive statistical tests. Results: The results of the independent t test revealed no significant difference in the mean scores of self-efficacy between the two groups before the intervention. However, after the intervention and at the first and second phases of control, the mean score of selfefficacy was higher in the experimental group than in the control group. Moreover, the results of covariance analysis established that while self-efficacy promoted in the experimental group, it did not change in the control group. Conclusions: Empowerment training can promote self-efficacy in patients with ischemic heart disease, which, in turn, can facilitate their treatment process and ultimately enhance the health system efficacy.
Background: In nursing, it is important to ensure the evaluation of students’ clinical competency and using a valid and reliable evaluation system is necessary. The aim of this study was to design a clinical competency evaluation system for nursing students in medical-surgical wards and determine its validity and reliability. Methods: This cross-sectional study was conducted on the nursing students who were spending their practicum courses at the medical-surgical wards. First, the educational objectives and applicable evaluation tools were determined. Then, three tools of: Direct Observation of Procedural Skills (DOPS), Mini Clinical Evaluation Exercise (Mini-CEX), and Clinical Work Sampling (CWS) were determined as appropriate tools. Finally, the evaluation system was designed and its validity was confirmed using content validity index (CVI) and content validity ratio (CVR). Reliability of the tools was calculated using Cronbach's alpha coefficient. Results: CWS tool had CVI = 0.91 and CVR = 0.93, DOPS tool had CVI = 0.98 and CVR = 0.94, and Mini-CEX tool had CVI = 0.93 and CVR = 1. These results indicated desirable validity of the designed evaluation system. In addition, all items had appropriate CVR. Reliability was also higher than 0.7. Significant difference was found between the results of students’ evaluation using the School's current evaluation method and the designed evaluation system. From the perspective of teachers and students, the designed evaluation system was accepted. Conclusion: The designed evaluation system had high reliability and validity. Its application satisfied the majority of teachers and students. Therefore, it can be used as a useful evaluation system for assessing clinical competencies in medical-surgical wards.
Background: Discriminative nursing care is one of the most important challenges in the field of ethical care and the rights of patients. Experiencing discrimination has negative impacts. Objective: The aim of this study was to explore the process of the development of the discriminative nursing care. Methods: Sampling was begun purposefully and gradually continued, according to the obtained codes and categories, using theoretical sampling until data saturation. Data collection methods included semi-structured interviews, observations, and field notes. In this study, 13 clinical nurses and 5 patients in Iran were selected from public hospitals. The inclusion criteria were willingness to participate, having adequate experience about the considered phenomenon, and being able to discuss the subject. Data analysis was performed simultaneously to data collection using the method of Corbin and Strauss 2008. Results: Five categories were extracted. The categories include: “context,” “causal conditions,” “phenomena,” “strategies,” and “outcomes.” Each of these categories contained subcategories with specific characteristics. The context was classified into “nurse's characteristics” and “patient's characteristics. “”Complete conflict” and “hatred” were extracted from the category of causal conditions. The causal conditions and context led to “discriminative nursing care” phenomena. The two strategies were “avoiding the patients” and “robotic care.” Outcomes were located in a spectrum ranging from “annoyance and discomfort” to “imposition of costs.” Finally, the categories were connected together and the meaning of “care in the context of the sense of interaction with the patient” was theorized. Conclusions: It is important to provide nursing education on the development of discriminative nursing care and its associated complications. Nurses should understand the nature, components, and the process of discriminative care. Understanding discrimination improves the action of nurses.
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