mixed method design

The cardiac care unit (CCU) is a stressful environment where nurses play a crucial role in providing critical care to cardiac patients. Consequently, missed nursing care in these units can have detrimental effects on patient outcomes. 

This study aims to develop a model for the determinants of missed nursing care in the CCUs of hospitals in Iran.

This is a mixed-method study that was conducted in 2023 in two stages. In the first stage, an initial model of the determinants of missed nursing care in CCUs was developed by combining the results of previous studies. In the second stage (quantitative phase), six questionnaires were completed by 202 CCU nurses from a teaching hospital in Rasht, Iran. To measure the missed nursing care score, job profile, work-life conflict, clinical competence, cardiac room climate, and organizational management, which included the MISSCARE survey, the work-family conflict scale (WFCS), and the competency inventory for registered nurse (CIRN). Data were analyzed using Pearson’s correlation test, independent t-test, one-way ANOVA, and hierarchical multiple linear regression analysis.

As the total score for nurses’ clinical competence increased, the total score of missed nursing care significantly decreased (β=-0.010, 95%CI; -0.014%, -0.007%, P<0.001). Also, as work-life conflict scores increased, the total score of missed nursing care increased significantly (β=-0.162, 95% CI; -0.269 %, -0.055%, P=0.003). Overall, 41.6% of the variance in missed nursing care was explained by the variables in the regression model.

Attention should be given to demographic and job-related characteristics, work-life conflicts, and clinical competencies of nurses to reduce missed nursing care in CCUs.

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.

Caregiving for trauma patients has many challenges. Inadequate knowledge of these challenges can affect the patients and worsen their conditions.

We aimed to explore the caregivers’ experiences about these challenges and problems of caring for patients with trauma emergencies.

The study adopted a concurrent triangulation mixed-method and was conducted in Shahid Rajaee Hospital, southern Iran, in 2019. Semi-structured interviews, focus groups, observation and ward document assessments were conducted with focusing on the challenges experienced by the caregivers. A checklist was used to assess the performance of caregivers and measure the indices related to the care process. Statistical results and qualitative data on the main categories were compared and integrated for data analysis.

In total,307 codes were extracted by analyzing the content of the interviews and available evidence. The codes were summarized in 20 subcategories, and six main categories were extracted as follows: lack of professional capability, uncoordinated team response, deficits in managerial commitments, inadequate work motivation, complex nature of trauma emergency, and lack of clinical communication. The quantitative results indicated that caregivers’ performance was considerably far from the expected scores and also many indices indicated a waste of time in responding to the patient needs.

Various dimensions of trauma care challenges indicate that professional capability, team coordination and communication, managerial commitments and work motivation considering the complex nature of trauma emergency wards are crucial to enhance patients' access to optimum quality care. Caregivers’ performance and quality of indices also affect the care process. Future studies are required for compiling strategies and protocols for the quality of care for trauma patients.