barriers

Labor pain is considered one of the most intense painful experiences for women. It is not only a physical pain but, if not controlled, may cause severe mental and emotional stress and adverse consequences for both the mother and the baby.

This cross-sectional descriptive study aimed to investigate the barriers to painless labor (PL) from the perspective of anesthesiologists, obstetricians, and midwives at Al-Zahra Hospital, an academic and referral center in Guilan, Iran.

Following approval from the Research Ethics Committee of Guilan University of Medical Sciences (GUMS), this study was conducted at Al-Zahra Hospital from May 2024 to June 2024. All members of the obstetrics and gynecology, anesthesiology, and midwifery departments who agreed to participate were enrolled in the survey. A checklist including demographic data and the barriers to PL in this hospital was completed.

A total of 65 out of 84 expected questionnaires were completely filled out, resulting in a response rate of 77.3%. The mean years of experience among participants were 9.91 ± 7.49. The primary barrier identified was obstetricians' concern about interrupting the delivery process (43 responses, 25%), followed by a lack of anesthesiologists (37 responses, 21.5%). The least reported barrier was maternal refusal (3 responses, 1.7%).

The main barriers to PL at this hospital were the unwillingness of obstetricians to recommend PL, likely due to concerns about interference with the delivery process, and the insufficient number of anesthesiologists.

The use of personal protective equipment (PPE) is one of the most critical measures to protect healthcare staff from infections, particularly during outbreaks of infectious and emerging diseases. During the COVID-19 pandemic, the use of PPE was emphasized alongside vaccination as key strategies in preventing the spread of the virus.

This study aimed to identify the barriers to PPE use from the perspective of nurses during the COVID-19 pandemic.

This was a cross-sectional descriptive-analytical study conducted with 230 nurses working in COVID-19 wards at five AJA hospitals in Tehran between November 1, 2021, and June 30, 2022. Nurses were selected using a convenience sampling method based on predefined inclusion criteria. Data were collected through a demographic questionnaire and a researcher-made 22-item questionnaire on barriers to PPE use. The data were analyzed using SPSS 19 statistical software, employing both descriptive and inferential statistical methods.

Among the participants, 55.7% were male, 53.9% were married, and 84.8% held a bachelor’s degree. The results showed that organizational barriers were more influential than individual barriers in the decision not to use PPE, with an average score of 97 out of 100. Furthermore, factors such as age, gender, wearing glasses, and nurses’ work shifts were significantly associated with non-compliance with PPE use (P < 0.05).

Nurses identified organizational barriers as the primary reason for not using PPE. Given the critical role of PPE in preventing diseases, especially during crises like the COVID-19 pandemic, it is recommended that healthcare organizations ensure the availability of PPE and provide comprehensive training to nurses on the proper use of this equipment.

Spirituality is regarded as an essential aspect of health, and therefore, it should be incorporated into medical education to foster a holistic understanding of health and to develop fully competent medical professionals. Despite the significance of incorporating spiritual issues into medical education, there has been limited research conducted on this topic in Iran. Various barriers have hindered the implementation of spiritually enriched medical education; however, there are also some factors that facilitate this process. This study attempted to explore the facilitators and barriers of integrating spirituality in medical education through a qualitative content analysis.

This was a situation analysis designed and conducted as a directed content analysis study. The data collected from interviews with medical education experts and the review of upstream documents were analyzed, revealing findings categorized as internal and external factors. Internal factors were categorized using the McKinsey 7S framework, which includes structure, systems, strategies, skills, staff, style, and shared values. Meanwhile, external factors were classified according to the PEST model, encompassing political, economic, socio-cultural, and technological aspects.

The facilitators and barriers identified in this study encompassed a total of 100 concepts. We identified 27 internal and 16 external facilitators, while there were found 41 internal and 16 external barriers.

The findings of this study clarify the steps needed to uphold the goals and missions of medical education in the area of spiritual health. Overcoming the barriers while leveraging existing facilitators will be crucial for successfully incorporating spiritual health into Iranian medical education.

The age pyramid of Iran’s population has changed in the last two decades due to a decreased fertility rate. Thus, the present study aimed to explore the facilitators and barriers of Iranian couples about childbearing in Khoy City.

In this qualitative study, semi-structured 23 interviews were conducted with 23 couples selected using the purposive sampling method. The interviews were conducted at health centers in Khoy in 2023. After obtaining consent, the interviews were recorded and continued until reaching data saturation. The data were analyzed using MAXQDA software, version 12 and the conventional content analysis method.

Of the 23 couples participating in the study, 14(60.87%) were unwilling to have children. The mean age of men and women was 41.32±2.16 and 36.84±5.37 years, respectively. The two themes extracted from the data analysis were childbearing facilitators and childbearing barriers. Also, childbearing barriers included four categories: Economic problems, concern about uncertain future, women’s employment and negative experiences of prior pregnancy/childbirth. Childbearing facilitators included three categories: Individual or family values and preferences, personal faith, and government’s supportive policies.

Considering the obtained results and the unwillingness of most of the participants to childbearing, investigating the pathology of couples’ reluctance to have children is necessary before persuading them to do so. It is suggested that health policymakers identify the reasons for couples’ reluctance to have children and, then, take measures to solve the relevant problems and apply childbearing supportive policies.

Electronic medical records (EMRs) can minimize mistakes, enhance the comprehensiveness, legibility, and overall comprehension of medical records. However, nurses' limited familiarity with advanced technology lowers their confidence in utilizing EMRs. We aimed to collect and synthesize the most credible evidence on nurses' perception of EMRs, along with the barriers and facilitators that influence their acceptance.

Searching for relevant studies was carried out across three electronic databases, namely PubMed, Scopus and ProQuest in Dec 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed in this study report. The selected studies were then analyzed narratively and organized thematically for presentation.

Out of the 4,382 articles identified through comprehensive database searches, only 19 met the criteria for inclusion and reviewed. Through the synthesis of findings, two primary themes emerged, including nurses' perceptions and experiences with EMRs and facilitators & barriers for nurses’ in utilizing EMRs.

Nurses' perspectives are shaped by their computer skills, confidence in their abilities, and training. Despite obstacles such as nurse stress, EMRs present advantages such as enhanced patient care and decreased errors. Augmenting computer competency, delivering training, and guaranteeing support are essential for effective EMRs integration, leading to enhanced healthcare provision and better patient results.

 In Ghana, several qualitative studies have explored users’ perspectives on conventional sources of sexual and reproductive health (SRH) information and factors which influence provision of and access in rural settings. However, there is a dearth of qualitative studies on healthcare provider (HCP) perspectives on factors that deter access to conventional sources of SRH information among young people in rural Ghana and innovative ways for addressing barriers. This study explored perspectives on barriers to traditional sources of SRH information and services and innovative ways of using mHealth technologies for addressing provision and access challenges among young people in rural Ghana.

 This study used a qualitative approach using in-depth interviews. Semi-structured in-depth interviews were conducted with HCPs in rural areas in three regions of Ghana between May and August 2021. Participants were selected from rural communities using the convenience snowball sampling and were interviewed via Zoom. The interviews explored the experiences and perceptions of HCPs on conventional SRH information and services and young people’s access to this information and services. The interviews were audio recorded and transcribed verbatim. Data were analysed thematically using NVivo software version 12, following the approach outlined by Braun and Clarke.

 Twenty HCPs were interviewed for this study. The participants identified different sources of SRH information and services used by rural young people. Peers or friends, health facilities, health providers, and community settings were reported as the main services and sources of SRH information. Participants reported several barriers and challenges to the provision of and access to SRH information to young people, including socio-cultural norms, religious beliefs, unfriendly health facility environments, negative health providers’ attitudes, lack of privacy and confidentiality resulting in unfriendly youth SRH services, distance, and financial challenges due to costs of transportation which limits rural young people’s access to, and use of, SRH services. All the participants indicated that in addressing provision and access barriers, the use of mobile phones could be beneficial.

 This study highlights several barriers and challenges that deter provision of, and access to, SRH information and services for young people in rural Ghana. The findings indicate the use of innovative mobile health (mHealth) technologies may be one solution to some of the barriers and challenges.

Childhood cancer is significant due to its high prevalence and its impact on the entire family, resulting in various psychological, social, economic, and communication challenges for the families.

The aim of this study was to explore the barriers and facilitators to pediatric oncology social work practices in Iran.

This qualitative study used a content analysis method and involved 19 pediatric oncology social workers. We used a purposeful sampling method until data saturation was reached. Data were collected through semi-structured interviews and field observations and then analyzed.

This study demonstrated that the factors influencing social workers' practice include personal characteristics and interpersonal communication at the micro level, while barriers mainly consist of cultural, social, economic, organizational, and structural dimensions at the macro level.

In order to better support children with cancer and their families, policymakers and health system managers need to give special attention to the status of social workers. Strengthening support systems and addressing the challenges they face can be effective in protecting the professional practices of these caregivers.

 Addressing perinatal health inequities is the joint responsibility of professionals working for local governments, the medical, social, and public health sector. Cross-sectoral collaboration between these professionals is challenging. For such collaborations to succeed, a transition, ie, a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. We investigated facilitators and barriers for cross-sectoral collaborations, when addressing perinatal health inequities in the Netherlands. Additionally, we studied how cross-sectoral collaborations can be facilitated by action research.

 We used interview and questionnaire data of the Healthy Pregnancy 4 All-3 (HP4All-3) program, which resulted from action research in six Dutch municipalities. All interviews were coded using open codes related to facilitators and barriers for cross-sectoral collaboration and categorized into three subgroups: structural, cultural, or practical. The answers to the questionnaire were analyzed and summarized quantitatively.

 We conducted 53 interviews with a total of 81 professionals. The most important ingredients for cross-sectoral collaborations mentioned by the interviewees were: (1) structural: having a solid network with a clear overview of professionals working in the different sectors, (2) cultural: having a joint vision/goal, and (3) practical: short lines of communication and timely sharing of information. A total of 85 professionals filled in (parts of) the questionnaire. Two-thirds to over 80 percent replied that the HP4All-3 program had an added value in building cross-sectoral collaborations.

 Our research shows that cross-sectoral collaborations in the context of perinatal health are hampered by structural, cultural, and practical barriers. Analyzing facilitators and barriers at these three levels helps to identify bottlenecks in cross-sectoral collaboration. Action researchers can be of great advantage in facilitating collaboration, as they can offer an open setting for reflection and instigate a sense of urgency for building collaborations.

In today's world, due to intense competition and the rapid pace of production, exploiting knowledge and converting it into economic returns has become a critical management issue for academics and capital owners. Commercialization activities can impact the educational and research programs of universities, potentially leading to resistance against them.

The current study was conducted to identify the challenges of the commercialization process in health science research.

This qualitative study was conducted between June and December 2022 in Tehran province, Iran. Data were collected using semi-structured interviews with 22 key individuals, including university management and technology experts, as well as CEOs and experts from knowledge-based companies, selected through purposive sampling. The interview guide was designed based on four in-depth interviews, theoretical foundations, and comparative study findings. The obtained data were analyzed using the conventional content analysis method in MAXQDA 10 software.

The challenges of the commercialization process for health sciences research results were categorized into six main themes and 16 sub-themes. The main themes identified in this study were rules and regulations, societal culture, university management and infrastructure, human resources, financial systems, and organizational cooperation with industry.

Policymakers, especially senior health managers, can create a suitable platform for the optimal use of resources and the expansion of targeted relationships between universities and industries by incorporating economic insight into academic services. By compiling relevant laws and guidelines, optimizing resource management, achieving financial independence for universities, and increasing the productivity of health research, the high costs associated with the commercialization of academic research projects can be reduced.

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.

Skin-to-skin contact between mother and newborn is an important care in maternal and newborn health and promoting breastfeeding. This study aimed to determine the barriers of implementing the SCC guideline at birth from the perspective of midwives working in hospitals in Yasuj.Iran.

A descriptive-cross-sectional study was conducted with the participation of 88 midwives working in two hospitals of Yasuj 2024. Data were collected through interviews with a questionnaire consisting of two sections of demographic characteristics and questions related to seven areas of barriers to implementing the SCC guideline. Its validity was measured with the Content Validity Index. Data analyzed with descriptive statistics including frequency tables, central and dispersion indices and using SPSS version 16 software.

The age of the midwives was at least 25 and at most 59 years with a mean of 35.91 ± 8.482 and the work experience in the maternity hospital was at least 1 and at most 26 years with a mean of 6.672 ± 6.86. From the perspective of 48 people (54.5%), SCC in the hospital was not performed according to the guidelines. The frequency of midwives' knowledge barriers was 4 (4.5%), human resource barriers was 35 (39.8%), environmental barriers was 4 (4.5%), content barriers of the guideline was 2 (2.3%), maternal and newborn safety barriers were 15 (17%), cultural barriers were 5 (5.7%), and managerial and supervisory barriers were 17 (19.3%).

The main barriers were human resource, managerial and supervisory, maternal and newborn safety respectively.

 Due to the type and nature of hospitalized psychiatric patients, nurses encounter many ambiguous and complex clinical situations that require intuitive decision-making. The present study was conducted to determine the use of intuition and its barriers and facilitators among psychiatric nurses.

 This study adopts a descriptive cross-sectional design and employs 123 nurses using convenience sampling in 2022. Demographic characteristics, the use of intuition in clinical practice, and the barriers and facilitators of intuition in clinical practice questionnaires were used for data collection.

 The results of this study showed that the mean (SD) of intuitive decision-making among psychiatric nurses was 58 (13.07) out of a range from 25-125. The use of intuition had a statistically significant correlation with age and work experience in the psychiatry ward. The use of intuitive decision-making has a statistically significant difference in gender, work shift, and education level. The biggest barrier to the use of intuitive decision-making among psychiatric nurses was “The limitations of nursing role which restrict the use of intuition in the clinical setting”. The most common facilitator in the use of intuition among psychiatric nurses was “having experience and clinical knowledge leads to the use of intuition in patient care”.

 Given the low level of the use of intuition and the important role of intuitive decision-making in the quality of nursing care, nursing managers should provide some strategies for reducing the barriers to the use of intuition among nurses.

Gaining insight into the obstacles holding women from engaging in physical activity during pregnancy is crucial for planning future interventions to enhance their physical activity during this period. This research aims to identify barriers to physical activity among pregnant women using an explanatory sequential mixed-methods approach. The study protocol is explained in this article.

This research employs an explanatory sequential mixed-methods design. The project will be implemented in two separate phases. In the first phase, a quantitative cross-sectional study will be conducted on 358 eligible pregnant women aged 18-45 years living in Babol City, Iran. Quantitative data collection will involve using the barriers to physical activity during pregnancy scale (BPAPS) and questionnaires gathering demographic and obstetric data. The qualitative investigation will employ individual semi-structured interviews utilizing a content analysis approach. Ultimately, incorporating qualitative data will inform the interpretation of quantitative findings.

The results will be presented in alignment with the study objectives. Initially, the mean score of BPAPS and its subscales, along with the correlation between demographic and obstetric variables, will be reported. Subsequently, the qualitative phase will encompass the reporting of categories and the main themes. Finally, the quantitative phase findings will be interpreted, incorporating insights gained from the qualitative phase.

Since regular physical activity during pregnancy has many benefits for maternal and fetal health, the study’s findings after its implementation can play a vital role in strategic planning to address women’s false beliefs and misconceptions regarding physical activity during pregnancy. In addition, this study will contribute to designing interventions to remove barriers to physical activity and encourage it in pregnant women, hence improving their overall health and well-being during pregnancy.

Research activities are one of the main factors of knowledge production. The present study was conducted with the aim of investigating the barriers to research from Zanjan University of Medical Sciences academic staff ' point of view in 2022.

 In the form of a cross-sectional descriptive study, a two-part questionnaire (the first part containing general questions and the second part containing 22 questions in the field of research barriers) was distributed among 104 people from Zanjan University of Medical Sciences in November 2022. In each faculty, people were randomly selected from the list of professors that was prepared by the education deputy. The data was analyzed using descriptive statistics, chi-square test and Fisher's exact test at p<0.05.

 The average age and experience of the participants were 37.74 ± 8.56 and 7.16 ± 7.30, respectively. 54.8% of the participants were male, 58.7% were committed to service and 78.8% were assistant professors. Lack of materials and equipment that do not exist in Iran and must be purchased in foreign currency, failure to provide suitable funds for researchers, and lack of coordination and cooperation between different faculties of the university to conduct joint research were mentioned by the professors as the most important barriers to research. There was a relationship between the scientific rank of the professors and their opinions about the materials and equipment needed for research (p<0.001). The employment status of the professors was significantly related with their opinions about lack of suitable funds (p=0.025).

 It seems necessary to review the approval process and research budgets, establish communication between different faculties of the university, hold workshops on statistics and research methods, and facilitate the approval process of research projects to remove barriers to research.

A crucial prerequisite for managing non-communicable diseases (NCDs) and their risk factors is communityexperiences and perceptions about the challenges of unhealthy eating. On the other hand, there is no literature on nutritionalliteracy in the city›s outskirts, which are the vulnerable parts of society. Thus, this study aimed to examine the barriers to healthynutrition for resident women in low-income areas of Mashhad.

This qualitative study used 28 women as a representative sample of the residents of marginalized areas of Mashhad inIran. Data collection was conducted using interviews between 2021 and 2022. Data analysis was done using a content analysisapproach (open and selective coding).

The most critical obstacles related to healthy eating were listed as follows: (a) low income, high expenses or expensive,(b) incorrect habits or lack of awareness, (c) food preferences, (d) lack of feeling of necessity and insufficient motivation, (e) lackof convenient access in the area, and (f) illness or physical condition. However, participants stated economic, social, and culturalissues as the main barriers to choosing healthy food among residents of low-income areas.

This study identified the main barriers to a healthy diet in marginal areas. Overcoming these obstacles can be astrategy for local and national planning to deal with NCDs.

In recent years, edible insects have often been mentioned as new and innovative food items. Food identity, culture, and traditions are a strong justification and argument for food choices. In the present study, we collected, reviewed, and summarized the findings of published qualitative studies about the cultural aspects and the main barriers to the consumption of edible insects in different geographical regions of the world. While insects are extensively employed as a source of animal feed across numerous areas in Latin America, Asia, and Africa, there exists cultural reluctance in various regions, particularly in the Western world, hindering widespread acceptance. This cultural resistance plays a crucial role in shaping the acceptability and prioritization of utilizing insects as food.  Cultural factors play an essential role in what? For example, the use of an insect species may be accepted by a region's population, but it is considered inedible in neighboring tribes. For example, In Iran, a type of cricket (mostly, Psalmocharias alhageos) is prevalent among local people in parts of Kerman Province and South Khorasan, while in other provinces, they do not consume it. The main obstacles to using insects for animal feed are customs and cultures, fear of consuming food, disgust, and disease risk factors. Therefore, there is a need for measures such as education, public policies, and cultural and marketing interventions that can lead to risk reduction, change of beliefs, cultural norms, and social acceptance. Despite persistent cultural barriers, there is a growing inclination towards altering cultural beliefs, resulting in increased acceptance and consumption of edible insects.