QUALITY OF NURSING CARE IN CHRONIC HEART DISEASES: CONCEPT ANALYSIS BASED ON HYBRID MODEL

quality of nursing care as a concept is subjective، multidimensional، ambiguous، neutral، related disease and depended on health care system and in the whole world is focused on improving and promoting this concept in chronic diseases. The purpose of this study was to clarify the concept of quality care in the context of chronic heart diseases and also to obtain a clearer understanding of its meaning attributes antecedents، sequences and empirical referents in nursing. In this study، we analyzed the concept of quality nursing care as used in literature and as described by participants. The three phases of a hybrid concept analysis are theoretical، fieldwork، and analysis. In the theoretical phase، full text of 110 articles in the pubMed، CINAHL، Elsevire and BlackweL databases were evaluated for the years 1990 to September 2011. Because of the stakeholder-specific nature of quality، perceptions of six participants including patient، nurse and cardiologist of the concept، were elicited in the fieldwork phase via semi structured interviews. Interviews were tape recorded and transcribed verbatim then qualitative content analysis was used to analyze both theoretical and fieldwork phase data. In the final step of combining the two previous stages، the overall analysis was performed. Based on review of literature، the following operational definition was proposed: the continuous process to provide safe and patient - centered care that based on t he therapeutic relationship and evidence-based nursing and rely on nursing theory، ethics and expertise، that along، family participation and cardiac rehabilitation team، and the ongoing management، leads to health promotion، cost effectiveness، comfortable transition and peaceful death. The antecedents of quality nursing care represented as factors; a: organizational، b: nursing unit، c: patient environment، d: Service attributes pointed. The consequences of this concept may be described as، a: Health، b: functional ability، c – satisfaction nurse/patient، d: Cost effectiveness، e: desirable processes. The results of this study suggest that consistent and evidence-based management of disease، improvement patient knowledge of their condition and providing psychosocial care، has important role in improving the quality of nursing care in chronic heart disease. The results can also be used effectively in developing quality of nursing care assessment scales and theory.