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PurposeThis study aims to explore the perceptions of gastric cancer patients, their family caregivers, physicians, and nurses of nutritional challenges.MethodsUsing a descriptive qualitative method, this study was conducted in 2019–2020. Twenty participants (6 patients, 6 family caregivers, 3 physicians, and 5 nurses) were selected through purposive sampling. Data was collected through in-depth semi-structured interviews and examined using qualitative content analysis.ResultsData analysis revealed three categories, each with two subcategories: eating, an unpleasant experience that contains “a feeling like hyperemesis gravidarum” and “childish food excuses”; flexibility while adhering to a proper diet, which consists of “dietary dos and don’ts” and “nutritional leniency”; and nutrition with distress that contains “patient’s sense of being an extra burden” and “provision of nutrition with suffering in caregivers.”ConclusionBecause of the significant physical and psychological impact of nutritional problems on patients and their caregivers, the need to provide care and education to these patients and their families using a multidisciplinary team is becoming more important.

Purpose This study aimed to explore the communication culture in nursing care of patients with cancer. Methods This ethnographic study was conducted in 2018–2019. Data were collected through participatory observation (318 h of observing nurses, patients, and family behaviors), semi-structured interviews (8 interviews with nurses), and informal interactions. Data were analyzed using Spradley’s framework. Results The study results in five cultural components of “communication determinants,” “experimental acquisition of communication skills,” “gradual empathetic communication,” “avoidant communication with patient,” and “communication with family as caregiver.” “Communication between nurse, patient and family is an experimental, gradual and avoidant relationship” was the study’s cultural statement. Conclusion In this study, the nurse-patient communication was influenced by factors related to the patient, the nurse and the care environment, and nurses acquired communication skills experimentally. There were two patterns of empathetic and avoidant communication between the nurse and the patient. For having high-quality care, nurses’ behavioral patterns must be improved and changed in some cases. Nursing professors, managers, and nurses can use these results in training, hiring, orienting novice nurses, and empowering oncology nurses. Training communication skills to nurses and changing managers and nurses’ approach to move from task-oriented care to holistic care help improve nurses’ communication patterns.

Background Nursing internship students often lack the necessary clinical decision-making skills, confidence, and experience due to limited competence. To ensure safe and high-quality care, nursing faculty must train graduates with the self-efficacy required to make effective decisions in complex, dynamic, and high-stress healthcare environments. The handover process involves the information that plays a critical role in clinical decision-making and care planning. One of the frameworks used in handover process is ISBAR (Identification, Situation, Background, Assessment, Recommendation). The clinical supervision model serves as an educational and supportive approach aimed at enhancing self-efficacy and skills, including the use of handover. Objective This study aimed to investigate the impact of an ISBAR-based Clinical Supervision Model (CSM) during handover on clinical decision-making and self-efficacy in nursing internship students. Method This quasi-experimental, two-group (pre-test and post-test) study was conducted in selected hospitals affiliated with Isfahan University of Medical Sciences, Iran, in 2024. Participants were selected through convenience sampling and then randomly allocated to either the intervention or control group. Data were collected using the ISBAR communication checklist, the Self-Efficacy in Clinical Performance (SECP) questionnaire, the Clinical Decision-Making questionnaire, and the Manchester Clinical Supervision Scale (MCSS). The clinical supervision model and routine supervision were administered over six sessions for the intervention and control groups, respectively. Data were analyzed using SPSS version 16. Independent t-tests and chi-square tests were used to assess baseline differences between groups. Paired t-tests evaluated within-group changes in clinical self-efficacy and clinical decision-making scores. ANCOVA was applied to compare ISBAR communication scores across six time points and post-intervention clinical self-efficacy and decision-making scores, controlling for pre-intervention values. Repeated measures ANOVA assessed within-group changes in mean ISBAR scores over time, while MANOVA examined multiple, interrelated ISBAR subscale scores. A significance level of p  < 0.05 was set for all analyses. Results There were no significant differences in baseline characteristics between the intervention and control groups ( p  > 0.05). According to the within-group analysis, changes in the ISBAR communication scores over time were significant in both the intervention and control groups (p Time < 0.001), with a greater increase observed in the intervention group (p Intervention < 0.001). The intervention group demonstrated a significant improvement in clinical decision-making ( p  < 0.001) compared to the control group. Clinical self-efficacy showed significant improvement in both the control and intervention groups after the intervention ( P  < 0.05). However, between-group analysis showed that the increase was higher in the intervention group than in the control group ( P  < 0.001).) The mean score of the Manchester questionnaire in the intervention group in this study was 130.30, reflecting the high impact of implementing the clinical supervision model. Conclusion The findings revealed that the use of the clinical supervision model based on the ISBAR framework led to improvements in clinical self-efficacy and clinical decision-making, alongside the enhancement of handover skills in nursing internship students. Therefore, it is recommended that this model be utilized in the education of nursing students and newly graduated nurses to ensure safe and high-quality care.

One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation). Among the 12 dimensions of safety culture, the nurses assigned the highest score to \"team work within units\" (97.3%) and \"Organizational learning-continuous improvement\" (84%). They assigned the least score to \"handoffs and transitions\"(21.1%), \"non-punitive response to errors\" (24.7%), \"Staffing\" (35.6%), \"Communication openness\" (47.5%), and \"Teamwork across units\" (49.4%). The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error.

BACKGROUND: Clinical education is the heart of professional education in nursing. The perspective of nursing students and clinical nursing educators as the main owners of teaching–learning process are of determinants affecting clinical education process. This study was conducted to explore and to describe the clinical education problems and strategies to improve it from the perspective of nursing students and clinical nursing educators. MATERIALS AND METHODS: The study was conducted using a descriptive qualitative method in 2017. Participants included 35 baccalaureate nursing students and 5 clinical nursing educators from nursing faculty of Isfahan University of Medical Sciences, Isfahan, Iran. Participants were selected using purposeful sampling method. Data were collected through semi-structured individual interviews and used qualitative content analysis for analysis. RESULTS: The 2 main categories, 7 subcategories, and 19 sub-sub categories extracted from interviews. The two categories were “challenges of clinical education in nursing with four subcategories: fear, insufficient readiness of student, incompetency of clinical educators, unpleasant atmosphere of clinical environment,” and “strategies for improving clinical education of nursing with three subcategories: the use of nursing education models and methods, improvement of communication between faculty and practice, and holding orientation stage at the beginning of training.” CONCLUSIONS: The findings show that clinical strategies, including employing experienced clinical educators, attempting to enhance the learning environment, developing the relationship between faculty and practice, participation of clinical nurses in clinical education, paying attention to entering behavior, and holding orientation stage at the beginning of training, can improve clinical education of nursing.

Medication errors among nursing students pose a threat to medication safety. Medication Error Encouragement Training and Problem Based Scenario are two innovative educational methods used in medication education. Compare the effects of Medication Error Encouragement Training and Problem Based Scenario on the knowledge and competency of medication safety among nursing students. Quasi -experimental, double-blind, two-group pretest-posttest study. This study was conducted in 2023. Participants were randomly assigned to two groups: one group received the Medication Error Encouragement Training method, while the other group was taught using the Problem-Based Scenario method. Data collection was performed using the Medication Safety Critical Element Checklist and Medication Safety Knowledge Assessment before and four weeks after the intervention. Data analysis was conducted using SPSS version 16. The Pair t-test demonstrated that the change in competency and knowledge scores of medication safety before and after the intervention was significant in both groups (P< 0.05). The results of the Mancova test indicated a significant increase in medication safety competency scores in the Medication Error Encouragement Training group compared with the Problem Based Scenario group after the intervention (P< 0.05), while there was no significant difference in medication safety knowledge scores between the two groups after the intervention (P> 0.05). The Medication Error Encouragement and Problem Based Scenario methods were effective in increasing the knowledge and competency of medication safety among students, but the effectiveness of the Medication Error Encouragement method was more pronounced in achieving safe medication administration. •Medication error can result in serious harm to patients.•Medication error encouragement and problem-based scenarios can enhance medication safety confidence among nursing undergraduates.•Medication error encouragement training is more effective than problem-based scenarios in improving medication safety competence.

BACKGROUND: Clinical education is the heart of professional education in nursing. The perspective of nursing students and clinical nursing educators as the main owners of teaching-learning process are of determinants affecting clinical education process. This study was conducted to explore and to describe the clinical education problems and strategies to improve it from the perspective of nursing students and clinical nursing educators. MATERIALS AND METHODS: The study was conducted using a descriptive qualitative method in 2017. Participants included 35 baccalaureate nursing students and 5 clinical nursing educators from nursing faculty of Isfahan University of Medical Sciences, Isfahan, Iran. Participants were selected using purposeful sampling method. Data were collected through semi-structured individual interviews and used qualitative content analysis for analysis. RESULTS: The 2 main categories, 7 subcategories, and 19 sub-sub categories extracted from interviews. The two categories were \"challenges of clinical education in nursing with four subcategories: fear, insufficient readiness of student, incompetency of clinical educators, unpleasant atmosphere of clinical environment,\" and \"strategies for improving clinical education of nursing with three subcategories: the use of nursing education models and methods, improvement of communication between faculty and practice, and holding orientation stage at the beginning of training.\" CONCLUSIONS: The findings show that clinical strategies, including employing experienced clinical educators, attempting to enhance the learning environment, developing the relationship between faculty and practice, participation of clinical nurses in clinical education, paying attention to entering behavior, and holding orientation stage at the beginning of training, can improve clinical education of nursing.

: Patient decision aid (PDA) is a tool, which helps the improvement of shared decisionmaking and is a part of the paradigm shift from physician-centered decisions to patient-centered shared decision making. In this study, we aimed to describe the process used to develop a PDA for facilitating shared decision-making about treatment in patients with inflammatory bowel disease (IBD) who need medication (corticosteroid, azathioprine, anti-TNF, and infliximab) or surgery. : The development process of PDA included: 1) The development of a prototype based on literature review and interview 2) 'Alpha' testing with patients and clinicians 3) 'Beta' testing in real conditions and 4) The production of a final version. This process took about 12 months (2019-2020). The participants were adult patients with IBD, gastroenterologists, and nurses. : The final PDA contains four important sections: 1) Introduction about IBD disease, the purpose of developing PDA, and emphasis on shared decision-making 2) Benefits and risks of main medicines 3) The success rate as well as the incidence of complications after surgery, and 4) The conclusion about patients' satisfaction with PDA to choose the treatment options. Besides, PDA evaluation in the real world setting showed that 100% of physicians (n=4) and 86% of patients (n=12) were completely satisfied with the content of the PDA and considered it applicable and useful. : This PDA can help patients participate in the shared decision-making process and select the best medical and surgical treatment methods. The feedback received from clinicians and patients showed their satisfaction with using the PDA.

Background: Family planning is a lifestyle that is selected voluntarily and is based on the knowledge, attitude and responsible decision making by couples in order to promote the health and welfare of the family and the advancement of the society. In this regard, family planning counseling plays an important role in making informed decisions if used properly and in a responsible way. Detection of individual barriers in family planning counseling based on the viewpoints of managers, employees and clients who are key participants in the healthcare service provision is a major step towards appropriate planning to modify or eliminate such barriers. Objectives: The present study was conducted with the goal of comparing managers’, employees’ and clients’ viewpoints about individual barriers in family planning counseling in health care centers in Isfahan in 2012. Patients and Methods: This was a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees and 126 clients in medical health care centers in Isfahan in 2012. The managers and employees were selected by census sampling, and the clients were recruited through convenient random sampling. The data collection tool was a researcher-designed questionnaire, which was designed in two sections of fertility and personal characteristics, and viewpoint measurement. Descriptive and inferential statistical tests were used to analyze the data. Results: The obtained results showed significant differences between mean scores of viewpoints in three groups of managers, employees and clients concerning individual barriers in family planning counseling. In addition, most of the managers, employees and clients reported individual barriers as an intermediate level barrier in the process of family planning counseling. Conclusions: Results indicate that subjects in three studied groups hold different views regarding the individual barriers in family planning counseling. This difference in the perspectives may be a factor that affects the quality of the provided services. Therefore, it is necessary for the healthcare providers to consider the main concerns of their clients regarding family planning.