مجله پژوهش پرستاری ایران
پیاپی 33 (تابستان 1393)

Performance appraisal is an important responsibility of health care system and increases employee’s morale and productivity. The aim of this study is to explore nurses'' perceptions of justice in Performance appraisal. This qualitative study was conducted in Tehran in year 2012. Nurses were selected purposively from an educational hospital of Shahid Beheshti University of Medical Sciences. For data gathering، 5 focus group sessions، involving 10 to 7 nurses at each session، were held by using semi-structured interview and continued until the data reaches saturation. Data were analyzed using framework analysis. Four major themes and 14 subthemes were emerged from the analysis of textual data. These themes were organizational context (discrepancies nursing standards and nursing duties، lack of appropriate incentives for nurses، the lack of an appropriate institutional framework، lack of a clear nursing job description، and the gap between educational theory and practice)، performance appraisal structure (inefficient systems of laws and regulations introduction، subjective appraisal، overall appraisal form، discontinuation in appraisal)، performance appraisal process (lack of strict supervision of the authorities، unfair appraisal، and lack of respect for the persons dignity) and performance appraisal results (lack of proper feedback and little attention to meritocratic). Participants believed nurse performance appraisal system facing with multiple problems that are affected justice in performance appraisal. It seems to achieve the ultimate goal of performance appraisal، improved quality of patient care، change and revision is necessary.

Improvement and progress of each organization depending on the staff and situations improvement. Knowledge is a base of the knowledge oriented organization and excellent staff can make knowledge to the excellent services and products. To have an excellent organization we need to knowledgeable، motivated and excited personnel to have an excellent organization. This motivation and knowledge along with self believe can cause the bright results. To achieve to this results we need to convergent، satisfaction، general identification and cultural strategies that these strategies are in the professional excellence and including productivity، active، efficient، independent and knowledge oriented personnel. Therefore it is necessary to clear the professional excellence process systematically. This research aimed to explain the process of the professional excellence of nurses، assisted by «Grounded» Theory. This qualitative study was carried out on the basis of «Grounded Theory» of Corbin & Strauss copy in 2008. Participants in this study were among nurses and from different ranks. Participants were selected based on assigned indicators، «Snowball Sampling Method» and theoric. Data are collected through in depth semi-structural interview. In this study، nineteen interviews were held with fifteen participants. Upon the analysis of the data and doing constant comparisons for the purpose of conceptual accumulation، 1450 primary codes، 35 primary category،8 sub category and 3 themes were derived in the frame of a conceptual model that consisting of extra role professional behaviors، strategic professional insight، and the professional talents management. The research results imply to the differences between excellence nurses behaviors’ and their specific characteristics. Emerge of the extra role behaviors need to abet and prod. The role of the managers is important in this situation. They should deduct the appropriate policy and strategies for emerging of the extra role behaviors in nurses and improve quality of care services. With application of the nursing professional excellence model in medical centers، we can insure the quality of care services and commitment to continual improvement of the nursing services.

Nurses must be able to define parameters of their roles based on views of care recipients because awareness of the parents'' perception of hospitalized children of caring behaviors is very important and it can produce significant results and provide useful information. This study aimed to explore mothers'' perceptions of nurse caring behaviors. This study is a qualitative research with content analysis approach. Fourteen mothers of hospitalized children in pediatric ward of Yazd hospitals selected by purposive sampling and data were collected via semi-structured individual interviews. Data was analyzed by using qualitative content analysis. Data analyses led to emerge of the main theme «confidence building behaviors» that its sub-themes include: calming presence، mother absorption in caring، valuing، constructive communication. Due to the main theme of the study “confidence building behaviors”، it seems paying attention to confidence attracting in caring behaviors and planning and implementation of caring plan based on this aim is necessary for pediatric nurses.

The knowledge of nursing is an essential part in nursing practice. Nursing knowledge، over the years influenced by philosophical thought، and has been changed a lot. The main aim of this article is، exploring the development of nursing knowledge in the age of postmodernism. To find relevant sources، library studies and review the books available databases include (CINHAL)، (Blackwell)، (Proquest)، (science direct)، (Ovid)، (Magiran)، (web of science)، (pub med) from the Tehran University of Medical Sciences Electronic Library and available book in the faculty of nursing library were searched by keywords (postmodernism) (knowledge development)، (science development)، (nursing knowledge) (nursing science) separately and in combination in the title، abstract and keywords. (36) Full Article and (10) relevant books from 1990 to 2012 were used as the source. Development of nursing knowledge is obvious in research methodology، intuition، and health care service. All these are because of postmodern bases such as pluralism، relativism، met narrative، and discourse. Being aware of development of nursing knowledge provide a new vision for professionals in nursing that lead to professional progress and promotion in nursing practice.

Uremic syndrome is a clinical condition that is associated with physical problems are plentiful and annoyingly. Because urinary tract of chronic kidney patients is not able to exit of wastes products from the body normally، patients need shall adhere an appropriate diet. This study aimed to determine the effect of food diet training on the severity of physical problems in non-dialysis chronic kidney patients. It was a quasi-experimental before-after nonequivalent comparative group study. Eighty non-dialysis chronic kidney disease patients with Glomerular Filtration Rate of 15-60 ml/min/1. 73 m2 were recruited and assigned either to comparison or experimental groups (n=40). The experimental group received food diet training package in 2 sessions of 2 hours and the control group received only usual care. Before and after 12 weeks، patients were evaluated by a Visual Analog Scale. The data were analyzed by descriptive and inferential statistics (t-test and chi square) using SPSS-PC (v. 16). After 12 weeks of intervention، problems related to muscle pain (P=0. 04)، itching (P=0. 03)، drowsy and weakness (P=0. 001)، numbness in hands and feet (P=0. 03)، bone pain (P=0. 03) and tingling feet in intervention group than comparison group showed statistically significant difference. Awareness of non-dialysis chronic kidney patients such practices in the educational related to diet reduces of severity some of physical problems in the patients. So the nurse as a member of the medical team can many complications prevent with training and these patients also present problem to a minimum.

Chemotherapy is an important treatment for cancer، its provoke a changes in the emotional sphere and anxiety for patients. Snoezelen room had reported the anxiety reduction effect on patients but limited studies have been undertaken investigating effectiveness of Snoezelen room on anxiety in differentiating high-normal state anxiety during chemotherapy. This was a Quasi experimental، clinical study that enrolled 62 patients who received initial chemotherapy. selected convenience and randomly and divided in to two groups of intervention and control. Spielberger State-Trait Anxiety Instrument was measured A half hour before and Immediately after chemotherapy. Paired t-test، chi-square and reappeared measures ANOVA was used for data analysis. No significant differences were noticed among the 2 groups before the intervention، as effective demographic factors show (P>0. 005). A significant difference was between their anxiety in Snoezelen groups with control group (P<0. 005). This study revealed that Snoezelen room on patient will have a positive effect on anxiety during chemotherapy. Taking the importance of the nurse role in management، controlling and Improvement side effects of chemotherapy chronic this pattern of relaxation recommend a necessity to reach to better anxiety control.

In health care، work dynamic is one of the variables affecting in medication errors by nurses as a result of changing health care program، procedures and physician orders may be confused and disoriented and eventually medication error occur. This aim assessing factor analysis، validity، reliability and psychometric characteristics of “work dynamic” scale in medication errors by nurses in Iran. This study was for determine items of work dynamic in mediation errors. The scale translated by Wilde and colleagues model (2005) and assessed. Study population were nurses that working in deferent ward of teaching - therapeutic centers of shahid Beheshti University of Medical Sciences، 115 nurses were selected by convenience sampling method based on inclusion criteria. Data was analyzed using SPSS software version 18. The average age of nurses was 34. 8±7. 87 and almost them were female (n=78) and mean work experience in ward was 6. 07±4. 13. Factor analysis، rotated matrix determined 2 factors: 1) team dynamic 2) Continuous work dynamic. Also reliability using Cranach''s alpha coefficient for internal consistency showed high reliability of scale (α=0. 81) and correlation coefficient in test- retest for stability (r=0. 93). Although translations of “work dynamic” scale in nursing medication errors has satisfactory reliability and validity and can be used in the Iranian health system.

The objective of this study was to explain the perspectives of managers regarding change management in nursing and midwifery faculties. This study was conducted according to the qualitative approach; in fact، a descriptive exploratory method was applied with triangulation. Snow ball sampling method was used. Subjects composed of managers in nursing schools in Tehran and the inclusion criterion was at least 1-year experience. In qualitative phase، no variable was measured. Data were gathered by semi-structured interviews in which a guide and field notes were used. Data were saturated after observing the repetition of codes. Content analysis was used for data analysis. The trustworthiness was achieved by a prolonged field experience، member check، peer check and sharing the content with two experts in qualitative research. Ten participants (7 females and 3 males) between 38 and 54 were interviewed. 2 of them had Master degree and 8 with PhD of nursing; only 3 of them were in high-level management of their faculties. After interviews، 124 conceptual codes، 15 sub concepts and 3 core concepts were extracted. Accordingly، the concept of change management was postulated as the purpose of this study. Furthermore، its influencing factors were identified. The implication of the study is in the faculties of nursing and midwifery to use the model according to organizational culture.