fatemeh pashaei sabet

Patient education (PE) is a fundamental patient right and an essential tool for improving health outcomes and enhancing patient satisfaction. However, barriers to effective PE exist, and understanding these obstacles is crucial for addressing them.

This study aimed to conduct a systematic review of the barriers to PE in Iran.

A systematic review was conducted to analyze published articles on the barriers to PE in Iran, available in both English and Persian. The search was performed across multiple databases, including PubMed, Science Direct, and ProQuest, and academic search engine of Google Scholar, and Iranian databases such as MagIran, SID, IranDoc, and IranMedex, covering the period from January 1, 2000, to January 1, 2022. Specific keywords such as "barrier", "education", "learning", "client", "Iran" and "patient" were employed, resulting in a total of 185 articles related to the topic. Ultimately, 47 studies were included in the review.

The review encompassed 47 studies, comprising 32 descriptive, 9 qualitative, 3 intervention, and 3 review studies. The findings identified five categories of barriers: environmental barriers, nurse-related barriers, patient-related barriers, managerial barriers, and educational barriers removal.

Educating patients presents challenges due to various barriers. To address these obstacles, it is imperative for managers to support nurses by providing necessary resources, adequate funding, dedicated nursing personnel, suitable infrastructure, and training in innovative teaching techniques.

Childbearing is an important component of population science and the field of social issues. In recent years, there has been an increasing need for a deeper understanding of people's desire to have children. Also, it is necessary to identify the direct and indirect influencing factors of these conditions. This study aimed to explain the challenges related to childbearing from the perspective of married women aged 15-49.

The current qualitative study was conducted in 2023 using conventional content analysis. The research setting was where people lived and worked in Khalkhal city. A purposive sampling method was used, following the principles of maximum diversity. After obtaining informed consent, individual and semi-structured interviews were conducted and recorded with 24 women of reproductive age. Data collection continued until saturation was reached. The five-step method of Granheim and Lundman (2004) was used to analyze the data.

According to the analyzed interviews conducted with married women of reproductive age, four main categories in the field of childbearing were derived. These categories include economic challenges (financial problems and problems providing housing and life necessities), personal and family factors (maternal career challenges, parental mental and physical problems, individualism and avoidance of parental concerns, gender and desired number of children, and inadequate family support), social and cultural factors (unguaranteed future, adoption of social modeling, lack of child-rearing facilities and ineffective and inadequate childbearing policies) and labor phobia during childbirth (unpleasant experience and difficult childbirth and pregnancy experience). The most important challenge in childbearing was economic issues with the most recurring concept in the interviews.

The adoption of social modeling from society and the norm of low childbearing rate in society, economic and social issues on the one hand, and women's individualistic tendencies and avoiding child-rearing concerns on the other hand, lead families to low childbearing. This requires the adoption of policies and facilitating strategies to improve childbearing behavior. The results of this study can provide a small picture of the current state of willingness and unwillingness to have children in society and serve as a guide for officials in short-term, medium-term, and long-term planning to increase childbearing desire

Emergency medical services (EMS) play a crucial role as the first line of defense during emergencies and disasters. Given the current impact of climate change, EMS will need to employ innovative strategies to cope with changing conditions. This scoping review investigates how EMS can adapt to climate change in pre-hospital emergencies.

In this study, peer-reviewed studies and texts on adaptive strategies of pre-hospital emergency systems published in 2023 were reviewed. Accordingly, online databases, including Web of Science, PubMed, Scopus, and Google Scholar as a search engine were searched. The selected keywords were as follows: “Medical technician,” “paramedic,” “ambulance,” “climate change,” “global warming,” “adaptation,” “mitigation,” and “resiliency” (and synonyms).

No wide-ranging study has been conducted on the adaptation strategies of EMS against climate change and this is the first study in this field. In this study, elements and adaptation strategies against climate change were investigated. Extracting these cases and using them to improve the readiness and resilience of the pre-hospital emergency system will be effective against this phenomenon.

Trauma is one of the major non-communicable diseases of this century and one of the main problems threatening public health. Trauma injuries are the leading cause of disability and mortality in all countries. This study aimed to explore and understand the challenges of early rehabilitation care in multiple trauma patients from the experience of a multidisciplinary care team using a qualitative research method.  This study was conducted with the qualitative research approach using qualitative content analysis. Participants were seven nurses, two doctors, three physiotherapies, and two occupational therapists in inpatient wards and outpatient trauma were interviewed. Data were collected through semi-structured interviews with a purposive sampling continued until data saturation. Analysis of data collected concurrently with data for comparison was done. First, for depth descriptions of the participant statements, 800 codes were extracted and finally, for the analysis, and constant comparison, two main themes of the lack of holistic care and support structure were extracted. The results showed that comprehensive and rehabilitation-based care was essential to achieve important care goals in this group of patients. Understanding the challenges of early rehabilitation care in multiple trauma patients will help health policymakers that solve these problems and help improve the health of this group.

One of the most common care interventions performed by nurses is drug therapy and medication errors are the most common type of medical error in medical centers. The aim of this study was to determine the frequency of medication errors and their related factors in Kashan Shahid Beheshti Hospital staff.

This descriptive-analytical study was performed in Shahid Beheshti Hospital of Kashan University of Medical Sciences in 2016. To collect the data, four hospital wards were selected randomly at first and the researcher-made questionnaire with 29 open-ended questions and a 20-question checklist were used to investigate drug errors. The data collection tool was completed by the observer while accompanying and observing the nurse in charge of the medication. Descriptive and inferential statistics were used for data analysis. The data were analyzed by SPSS software version 16.

In this study, a total of 65 nurses were observed in four departments of internal medicine, surgery, intensive care and emergency for 301 doses of medication. The highest frequency of medication errors according to the types of errors were incorrect time (41.74%), wrong medication (18.88%) and wrong technique (14.23%). The highest number of medication errors according to the drug administration stage were in drug administration (20.02%) and then in drug preparation (5.04%) and finally in drug prescription (2.94%).

According to the results of the present study, it can be concluded that medication errors are common in nurses. Therefore, it is necessary to educate the fundamentals of medication properly considering all safety considerations.

The pre-hospital emergency care system plays a very important role in the transmission of injuries to medical centers. One of the effective factors in reducing mortality is the timely presence of the treatment team and their rapid transfer. Today, these casualties are transported both aerial and terrestrial. The purpose of this study was the comparison of time indicators of air and land emergency with international standards in the injured trauma resulting from accident in Qom province in 1395

This research is descriptive-analytic. In this study, a total of 8,500 randomized traumatic missions registered in year 95 in the emergency department, 4715 injured persons were selected by census air and ground emergency. The data were collected using a checklist including demographic characteristics of injuries and dispatch distances. One-variable T-test and SPSS software version 18 were used to analyze the data.

The mean time of arrival to the accident site in the road and air emergency was 11.45 ± 7.21 and 21.53 ± 7.65 minutes, respectively. The average time to arrive at the accident site in the road emergency was significantly lower than the standard time ]14 minutes] ]P <0.05]. But this duration in the air emergency was significantly higher than standard time ]17 minutes] ]P <0.05]. The average stopping time at the scene in the road and air emergency was 28.02 ± 13.88 and 12.68 ± 6.8 minutes, respectively. The mean stop time at the scene in the air emergency was significantly lower than the standard value ]20 minutes] ]P <0.05]. Due to the lack of a universal standard for time scene variable for road emergency, no significant level was reported. The mean transfer time in road and air emergency was 17.68 ± 10.58 and 23.43 ± 17.28 minutes, respectively. The mean transfer time in the air emergency was significantly higher than standard ]9 minutes] ]p <0.05]. Due to the lack of a universal standard for transmission time for road emergencies, no significant level was reported.

The time to arrive at the accident site in the road emergency and the emergency stop time was less than the standard time standard, but the time to arrive at the accident site and the duration of the transfer in the emergency room was more than standard time..

The most common complaint of heart patients is pain and chest discomfort. The delay in transmitting patients from the onset of symptoms to reaching a treatment center is one of the most important reasons for the deaths of these patients. There is a direct relationship between the early services provided by the pre-hospital emergency room with positive therapeutic outcomes and the reduction of mortality. By using telephony triangulation protocol, delayed call center experts dispatch ambulances to patients at higher risk and job misconduct. The purpose of this study was to investigate the outcome of telephony triage in patients with complaint of pain and chest discomfort in the first half of 1996 in the Qom province of Qom according to the modified protocol of New Jersey. In this descriptive-analytical study, 550 callers with 115 emergency services in the first half of 1396 were selected through a random sampling method, with a complaint of pain and chest discomfort. Data were collected using valid and reliable checklist The data were analyzed using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (Chi-square and independent tests). from 550 registered cases, 202 people were transferred to the hospital by ambulance and 347 were not sent by ambulance, and 347 of them were contacted by 196 people, and the result of the absence of ambulance was questioned. Ultimately, experts from the Qom Emergency Center in Triage suggested patients with chest pain complained of in accordance with the New Jersey protocol in the 68/39% correct and 36/31% wrong.
According to lateral findings, there was no significant relationship between sex and work shift with triage method, but there was a significant relationship between age and contact history with triage modthod. Experts at the Qom Emergency Center using the New Jersey Protocol have performed non-urgent trials by maintaining the safety of patients at a desirable level, but there is a need for careful consideration in identifying urgent cases.

Chronic renal failure is an unreversible and progressive kidney disease in the world as well as in Iran. Hemodialysis, which is the most common protective treatment in these patients, will have a significant impact on the patient's life, recognizing their feelings and expectations will play an important role in guiding the medical staff will have more effective care and support and eliminate the limitations of these patients. For this reason, this study aimed to understand and understand the concept of quality of life in hemodialysis patients. The purpose of this study was to understand the quality of life in patients with hemodialysis. In this study, one of the qualitative research methods was used as a descriptive phenomenological phenomenon. The data collection method was semi-organized interview with 10 modalization modalities from Shariati Hospital and Imam Khomeini Hospital in Tehran. Interviews focused on the question of what constitutes the quality of life of hemodialysis patients. The main concepts extracted from the experiences of the participants in the study were dialysis: an important part of life, dialysis life tensions, protectionism and adaptability. The important aspect of the life of these patients was the acceptance of life with all its limitations. The experience of living in the fence was alive with dialysis, which widened the umbrella affecting all aspects of the patient's life. Adoption of this kind of life was in the shadow of spirituality and proximity to God and the support of health care providers. These findings provide a new vision for health caregivers to better understand the problems of these patients.

Today, trauma is considered as a major cause of temporary or permanent disabilities for millions of people. Any loss of ability has considerable effects on the quality of life. One of the most important causes of disability is limb trauma. However, the quality of life with limb trauma is relatively unexplored.

The objective of this study was to explore the quality of life following limb trauma.

In this qualitative study a thematic analysis and purposive sample method was used to recruit 11 patients with a disability in the upper or lower limbs and a history of hospitalization caused by a traffic accident 6 months to 2 years earlier. Data were collected through semi-structured interviews continued until reaching saturation. The data analysis approach in this study was thematic analysis, which consists of a vigorous process of data familiarization, data coding, and theme development and revision. The trustworthiness of the results was ensured through constant comparisons, triangulation, member checks, and peer review.

Based on the participants’ experiences, three themes were conceptualized: existing with limitations, empowerment approaches in encountering disabilities, and seeking support.

The experience of living with limb disability was a limiting experience, and other person’s activities and relations could aid participants in achieving empowerment through strengthening and seeking compensatory mechanisms. More attention to the problems of patients, and more research is recommended.

The role of society and people in disaster risk management is prominent. However, using this potential and increasing the people’s role have always been a challenge. The purpose of this study was to find community-based management challenges in disaster risk reduction.
Participants and This study was conducted with the qualitative approach and in the form of content analysis. Participants were selected purposefully and by snowball sampling out of 17 professors and managers in the field of incidents and disasters. Data were recorded and collected through semi-structured interviews. The records were transcribed and then analyzed.
Results included 2 main themes of egocentrism and management helplessness (failure) and 5 main categories, including inadequate attention to the nature of the risk reduction process, inadequate community resilience, ignoring social capital, inadequate planning and training, and incorrect organization, as well as 13 subcategories.
Firstly, managers should accept the community as a major hub of the process to harness the power of community. Secondly, using capable and trained managers familiar with the concepts, literature, and challenges in the field of disasters increase participation of people in disaster risk management.

Rehabilitation is an interdisciplinary field of study and is dependent upon the culture of the place of study, and has a significant role in the patient’s well-being and their return to work and normal life. The sequence of a phenomenon rehabilitation care and socio-cultural context in which returning veterans with spinal cord injury, traumatic health and prepare the patient to return to normal life and this community have an important role to explore various aspects of rehabilitation. Several studies have investigated spinal cord injuries that take place at home with the aim of providing more effective services. Therefore, this study aimed to explore patients with spinal cord injuries, for whom traumatic home-based rehabilitation was performed.
A qualitative study was conducted during year 2014 in Tehran's hospitals. Participants included 12 victims of traffic accidents with injuries of the spine (spinal cord injury), two family caregivers, five nurses, four doctors, two physiotherapists, and two occupational therapists in inpatient wards and outpatient trauma centers that explained the process of care based rehabilitation at home for patients with spinal cord injury. Firstly, purposive sampling was performed and was continued by theoretical sampling on the basis of codes and classes. Data were collected through individual semi-structured interviews. Data were analyzed by the conventional content analysis approach.
Data analyzes led to the emergence of four main categories including home-based rehabilitation process of patients with traumatic spinal cord injury, consisting of four main sub-categories: facilitator of recovery, limitations, seek support and challenging return to society.
Support of spinal cord injury patients at home with a team of doctors, nurses, social workers, psychologists and clergy is necessary.

Traffic accidents are the main cause of death and disability in the world and Iran. The Injuries caused by traffic accidents may result in severe limitations and worst outcomes in various aspects of lives of traffic accident injured people and their families. Therefore, understanding their experiences is very important to design better programs with regard to their treatment and returning to the society. In this regard, we conducted this study with the aim of understanding and describing the experiences of encountering with physical trauma resulting from traffic accidents.
This study was conducted with qualitative research approach, using qualitative content analysis method. The study participants had a record of upper and or lower extremity injuries caused by traffic accidents of at least 3 months and at most 2 years after the accident. They were chosen by purposeful sampling method. Data were collected through semi-structured interviews and continued until data saturation. Data analysis was carried out using content analysis method.
The study findings based on the experiences of participants were conceptualized in three main categories; experiencing some limitations, disturbances in performing professional duties, and family problems caused by trauma.
The study findings showed that injured people due to traffic accidents experience numerous constraints in different areas of their lives. Accordingly, proper interventions can be designed based on understanding these needs and experiences from participants’ own words to alleviate these problems. Finally, the study results provide a new insight to the medical team to understand these patients and their real health problems in a more realistic way.

Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life.
This study aimed to understand the experiences of return to normal life in RTA victims.
Patients and This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis.
By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life.
The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.

Road traffic injuries (RTIs) are a major public health problem and the most important cause of disability, morbidity and mortality worldwide. Early rehabilitation can play a significant role in minimizing complications, morbidity and mortality.

The aim of this study was to describe perceptions of barriers precluding provision of early rehabilitation care for RTI victims.

A qualitative content analysis was carried out on 15 nurses with at least one year experience caring for RTI victims. The nurses were selected from various wards (emergency, orthopedic, neurosurgery, and clinic) of Sina and Imam Khomeini Hospitals via targeted sampling. Data were collected through semi-structured interviews and targeted sampling until data saturation. Data were analyzed and assessed.

After continuous analysis and comparison of data, major causes precluding nurses from early rehabilitation of RTI patients were retrieved. These barriers included: (a) lack of insight, (b) lack of comprehensive care (c) excessive costs; facilitating factors included (d) training for cooperation and (e) support for coping.

The findings of this study show that the need for early rehabilitation in the hospital phase of care for RTI victims is needed. Knowledge about the barriers precluding nurses from early rehabiltiation of RTI patients and facilitators that can help health care workers and policy makers eliminate the barriers precluding early rehabilitation can help health care workers, especially nurses enable patients get over their disability and gain social and family support.