Point Of Data Saturation Research Articles

The Ethical Dilemmas Faced by Senior Nurses in the COVID-19 ICU: A Phenomenological Study

Working with hi-tech life-supporting machines in the midst of rapid changes in regulations and settings has raised dilemmas among senior nurses who must inevitably work with fresh-graduate nurses during the COVID-19 pandemic. Staffing limitations in nursing, in terms of both quality and quantity, where the nurses must be dressed in hot personal protective equipment suits, have added a conflict in the intensive care unit. This research sought to reveal the reality in the ICU setting during COVID-19 based on nurses’ narratives of their experiences and feelings working in the COVID-19 ICU. This research was conducted in the COVID-19 ICU of one of the public hospitals in Riau Province. The purposive sampling technique was used to choose intensive care unit nurses. In-depth recorded phone interviews were performed from June to July 2022. The total number of participants joining this research until the researcher reached a data saturation point was five. This research used Colaizzi’s phenomenological method to uncover the meanings behind patients’ stories. The majority of participants were female, and there was only one male nurse. Sixty percent of the nurses had Bachelor’s degrees, and the remaining 40% had nursing diploma degrees. Four participants (80%) were government employees, and one (20%) was a freelance daily worker. The participants had been working for eight years on average. Five themes emerged: 1) work motivation, 2) COVID-19 protocol, 3) the competencies of nursing volunteers, 4) family roles, and 5) professional ethical dilemmas.
 Keywords: ethics, dilemma, nurses, COVID-19, intensive care unit

Exploring Caregivers' Perspectives and Perceived Acceptability of a Mobile-Based Telemonitoring Program to Support Pregnant Women at High-Risk for Preeclampsia in Karachi, Pakistan: A Qualitative Descriptive Study.

Very little is known about the perspectives of the caregivers on the use of telemonitoring (TM) interventions in low-middle-income countries. Understanding caregivers' perspectives on TM interventions is crucial, given that caregiving activities are correlated with the social, emotional, and clinical outcomes among pregnant women. This study aims to explore caregivers' perspectives and perceived acceptability of a mobile phone-based TM program to support pregnant women at high-risk for preeclampsia. A qualitative description design was used to conduct and analyze 28 semi-structured interviews with a diverse group of caregivers. The study was conducted at the Jinnah Post Graduate Medical Center, Karachi, Pakistan. The caregivers were identified through purposive sampling and additional caregivers were interviewed until the point of data saturation. The conventional content analysis technique was used to analyze digital audio recordings of the caregiver interviews. All caregivers embraced the proposed mobile phone-based TM program because they perceived many benefits, including a reduction in caregivers' anxiety and workload, increased convenience, and cost-effectiveness. However, the caregivers cited several caveats to the future implementation of the TM program including the inability of some women and caregivers to use the TM program and the poor acceptance of the TM system among less educated and non-tech savvy families. Our study recommends developing a TM program to reduce the caregiver stress and workload, designing a context-specific TM program using a user-centric approach, training caregivers on the use of the TM program, sensitizing caregivers on the benefits of the TM program, and developing a low-cost TM program to maximize access.

Spiritual Care in Action for Oncology Patients in the uMgungundlovu and eThekwini Health Districts, KwaZulu-Natal, South Africa: A Qualitative Study.

Globally the inclusion of spiritual activities has been well adopted into nursing care. Empirical work related to the inclusion of spiritual activities in nursing within the South African context particularly within the oncology setting is sparse. Being diagnosed with cancer can be unsettling because of the severity and vigorous treatment that one has to endure. Spiritual activities could be used as one of the coping strategies for cancer patients in times of spiritual distress. Strengthening spiritual care by including spiritual activities into daily nursing care could be beneficial to the patient and the institution. This study aimed to explore spiritual activities that could strengthen spiritual care in oncology nursing practice. The research study followed a phenomenological qualitative descriptive design. The study population consisted of professional nurses working in the oncology units for more than 6 months. Four health care institutions were purposively selected. Data was collected through individual in-depth interviews and field notes. Ten professional nurses were recruited at the point of data saturation. Data analysis followed inductively using content analysis enrolling steps from Elo and Kyngas. The findings revealed the nurse's willingness to embrace spiritual care in action into their daily nursing care. Three subthemes: holding patient's hands, hospital policy for patient visits, and music therapy outline how patients are comforted by nurses. Nurses are integral in the provision of spiritual care for cancer patients from diagnosis up until the end of life. The essence of spiritual activities gives patients a distraction and an escape from their pain and predicament thus improving their quality of life. The findings provide policy makers with an indication that patients do not only need medical and physical care but spiritual care in their nursing care plan.

Barriers and Facilitators Affecting the Uptake of COVID-19 Vaccines: A Qualitative Perspective of Frontline Nurses in Namibia.

Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses. A qualitative, explorative, descriptive, and contextual research strategy was employed. A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically. Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake. The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines.

Clinicians' Perceptions of an Artificial Intelligence-Based Blood Utilization Calculator: Qualitative Exploratory Study.

According to the US Food and Drug Administration Center for Biologics Evaluation and Research, health care systems have been experiencing blood transfusion overuse. To minimize the overuse of blood product transfusions, a proprietary artificial intelligence (AI)-based blood utilization calculator (BUC) was developed and integrated into a US hospital's electronic health record. Despite the promising performance of the BUC, this technology remains underused in the clinical setting. This study aims to explore how clinicians perceived this AI-based decision support system and, consequently, understand the factors hindering BUC use. We interviewed 10 clinicians (BUC users) until the data saturation point was reached. The interviews were conducted over a web-based platform and were recorded. The audiovisual recordings were then anonymously transcribed verbatim. We used an inductive-deductive thematic analysis to analyze the transcripts, which involved applying predetermined themes to the data (deductive) and consecutively identifying new themes as they emerged in the data (inductive). We identified the following two themes: (1) workload and usability and (2) clinical decision-making. Clinicians acknowledged the ease of use and usefulness of the BUC for the general inpatient population. The clinicians also found the BUC to be useful in making decisions related to blood transfusion. However, some clinicians found the technology to be confusing due to inconsistent automation across different blood work processes. This study highlights that analytical efficacy alone does not ensure technology use or acceptance. The overall system's design, user perception, and users' knowledge of the technology are equally important and necessary (limitations, functionality, purpose, and scope). Therefore, the effective integration of AI-based decision support systems, such as the BUC, mandates multidisciplinary engagement, ensuring the adequate initial and recurrent training of AI users while maintaining high analytical efficacy and validity. As a final takeaway, the design of AI systems that are made to perform specific tasks must be self-explanatory, so that the users can easily understand how and when to use the technology. Using any technology on a population for whom it was not initially designed will hinder user perception and the technology's use.

Identifying the Potentials, Challenges, and Barriers to the Application of New Communication Technologies in the Field of Health with a Focus on Rare Patients: A Qualitative Study

Introduction: Advances in new communication technologies have created a good environment for the provision of various services. Due to the importance of using new communication technologies in health care, this study was conducted to identify opportunities, threats, strengths, and weaknesses of these technologies in the field of health with a focus on rare patients. Method: This qualitative study was conducted with the participation of 40 experts and specialists in the field of communication and health, and a number of rare patients. The sampling method was snowball sampling and semi-structured interviews continued to the point of data saturation. To collect data, notes were taken and the interviews were recorded and transcribed. For accurate data analysis, MAXQDA (version 12) was used. Results: The results of this study on opportunities, challenges, threatening factors, and strategies of using new communication technologies in the field of health led to the formation and identification of 379 initial codes, including 45 categories, which finally 4 themes of opportunities, threats, strengths, and weaknesses were extracted. Conclusion: New communication technologies, regarding their potentials, could facilitate the advancement of health communication and provide better digital solutions for rare patients, who face various challenges in their treatment period and social life, as well as mental and psychological concerns and the need for information. It is recommended to determine the potentials, difficulties, and barriers associated with employing new communication technologies and then, plan, establish standards and rules, and employ these technologies accordingly

Exploring socioeconomic inequality in educational management information system: An ethnographic study of China rural area students.

There is currently enough systematic literature presents about socioeconomic inequalities across different disciplines. However, this study relates socioeconomic inequality (SEI) to rural students educational management information systems (EMIS) in different schools in China. The dynamic force of information technology could not be constrained in the modern techno-based world. Similarly, the study was qualitative and ethnographic. Data were collected through an interview guide and analyzed with thematic scientific analysis. Ten male and ten female students were interviewed based on data saturation point. The purposive sampling technique was used for the rural school and students’ selection. This study summarizes the findings and brings together in-depth emic and etic findings based on new Marxist conflict theory, exploitation, and domination power lens. The study found that SEI creates disparities among EMIS. Household income inequality has influenced on educational achievements of rural areas’ students. Gender-based SEI was not present among students. Family wealth and SES-based exploitation are present regarding EMIS among male and female students. Household wealth is significant for the EMIS. The study put forward a recommendation to the policymakers that exploitation could be overcome among students if the government provides equal opportunities for access to the EMIS.

An Analysis of Covid-19 Global Pandemic and Sri Lankan Aboriginal Community with Special Reference to Bourdieusian Approach

It seems that Sri Lankan aboriginal community had to go through significant hardships during the Covid-19 outbreak. This particular research was conducted in Rathugala aboriginal village in Monaragala district mainly as a qualitative research. The whole research was driven by four major objectives; investigating the social burdens that Rathugala aborigines had to undergo in the pandemic outbreak, the efficacy of the government-sponsored redressing mechanism towards the Rathugala aborigines, the coping strategies employed by Rathugala aborigines to face the unexpected pandemic and its consequences and understanding aforesaid factors through a Bourdieusian perspective. A sample comprising 20 respondents (N=20) was selected under the purposive sampling and sample size was determined by the data saturation point. Data analysis was predominantly carried out as a thematic analysis with a Bourdieusian Approach. The research revelations are as follows; Closing the entrances to the aboriginal village seemingly brought most of the income earnings of the Rathugala aborigines to a halt. Subsequently, it caused the proliferation of the decades-old chronic poverty in Rathugala aboriginal village. Some aboriginal youth have been involved in illegal means of income-earning for their survival as government subsidizing was late and not systematic. The lack of social capital in the Rathugala aboriginal community has made them more deprived of gaining social support from outside of their community. Being aborigines has created a pathetic social perception in the mindset of both the general public and state officials and it might have been a barrier for Rathugala aborigines in the pandemic time when gaining state support.

Resilience-building Inquiry Among High Professional Profile Nurses: A Descriptive Qualitative Study

Nurses experience stress and face adversities during their professional career, which is a leading cause of professional dropouts and nursing shortages around the globe. Resilience among nurses has an important role in overcoming adversities and facing professional challenges. Nurses learn to cope with adversities and develop resilience through professional experience. To explore the resilience-building process among high professional profile nurses working as clinical and educational experts in a semi-government institute. This study employed a descriptive qualitative design. It was conducted from January 2019 to July 2019 after the IRB approval. Purposive sampling was used to recruit study participants. Data was collected through semi-structured interviews until the data saturation point was reached. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was done to analyze the data. The process through which nurses develop resilience during their professional career took place in three main phases: challenges and stresses faced during their nursing career, coping process utilization, and capacity building. These phases are supported by motivation and professional commitment. The core theme was the resilience-building among nurses during their nursing careers. Pakistani nurses are managing those stresses that have been resolved in developed countries. There is less external motivation to work in nursing; rather, Pakistani nurses are motivating themselves through self-realization and self-motivation strategies. The important pillars of resilience-building are family support, toughening up, spirituality, self-motivation, and commitment. Resilience among novice nurses should be strengthened and developed through resilience-building interventions.
 Keywords: resilience-building, inquiry, high professional profile, nurses, exploratory, descriptive, qualitative study.

Factors Contributing to English as a Foreign Language Learners’ Academic Burnout: An Investigation Through the Lens of Cultural Historical Activity Theory

During the shift from face-to-face to online emergency classes due to the COVID-19 pandemic, learners of English as a Foreign Language (EFL) were under constant pressure to familiarize themselves with the once-in-many-generations learning context. Based on the cultural-historical activity theory (CHAT), this qualitative study investigated factors contributing to EFL learners’ academic burnout at Open University, Vietnam. The interviewees were seven students, two teachers, and two administrators recruited using a theoretical-based sampling technique. The data consisted of iterative rounds of interviews which lasted approximately 60 min each until the data saturation point was reached. The content analysis revealed six factors that impacted EFL learners’ physical and psychological exhaustion, including prolonged online learning time, privacy concerns and cyber-bullying, teachers’ role, institution’s role, and support community outside the classroom. Also, teachers’ insufficient preparation for online teaching and students’ academic misconduct during exams were factors that created EFL learners’ academic cynicism. Finally, participation in social networking sites’ extracurricular activities, participation checking, and cheating in exams affected the last dimension of academic burnout, the sense of academic achievement. Based on this study, the authority, administrators, and teachers can take a more proactive role in supporting students in curbing their academic burnout during this unprecedented pandemic. The authors also hope that this study can lay the foundation for further humanistic research into the EFL learner’s psychological world in online classes, particularly when each student’s social and cultural background is considered.

Perceived barriers and facilitators of physical activity in adults living in activity-friendly urban environments: A qualitative study in Sri Lanka.

BackgroundDespite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in such environments need to be identified. The aim of this study was to explore the barriers and facilitators for physical activity, as perceived by adult urban dwellers in activity-friendly environments in Colombo District, Sri Lanka.MethodsA qualitative study using in-depth interviews was conducted among adults aged 20–60 years living in an urban area which has been recently re-designed for recreational and rejuvenating purposes in Sri Lanka. Recruitment targeted varying socio-economic status and risk of non-communicable diseases; and was continued until the data saturation point was reached. Interviews were conducted in homes, primary healthcare units and fitness centres, and were transcribed verbatim and analysed using framework analysis.ResultsA total of 31 eligible and consenting adults were interviewed. Of the reported barriers to physical activity, lack of time was very common. Other frequently reported barriers included unpleasant experiences following exercise and misconceptions about exercise, whereas physical environmental factors, weather and road safety were reported less frequently. All participants reported at least one facilitator for engaging in exercise. Expectations of preventing diseases, improving health, physical fitness, psycho-social wellbeing, optimising body functions and increasing lifespan were frequently cited as reasons to be active, while social factors such as positive attitudes of family members and the influence of peers were found to be motivating.ConclusionsThe study showed that while participants valued the health benefits of physical activity and refurbished activity-friendly urban environments, these were not sufficient to support them to overcome key perceived barriers to being physically active.

A qualitative investigation of the perceptions of complementary and alternative medicine among adults in Hawaiʻi

BackgroundComplementary and alternative medicine (CAM) is defined as a group of diverse medical and healthcare practices outside of conventional medicine modalities. The use of CAM is steadily increasing despite gaps in the scientific evidence supporting its use and the challenges of its regulation and integration into conventional healthcare practices. In this context, perceptions concerning CAM become important. The purpose of this study is to identify the perceptions of CAM among adult residents of Hawaiʻi.MethodsTwo researchers conducted audio-recorded interviews at the University of Hawaiʻi Mānoa (UHM) campus. Participants were over the age of 18, spoke English fluently, and self-identified as Hawaiʻi residents. Interviews were conducted to the point of data saturation and audio recordings were transcribed verbatim. Researchers collaboratively developed a codebook and used NVivo 12 to analyze transcripts. New codes were added as required. Inter-rater reliability was determined by calculating Cohen’s kappa coefficient. Key themes were identified by both researchers individually and then discussed and evaluated together.ResultsParticipants were mostly female, white, and affiliated with UHM. Perceptions were categorized as positive, negative, and neutral. The majority of participants had positive perceptions of CAM with few reporting negative perceptions. The positive perceptions were related to CAM’s perceived effectiveness, the desirability of CAM compared to conventional medicine, and CAM’s ability to foster well-being. Negative perceptions were attributed to the lack of scientific evidence and ineffective outcomes of CAM use. Neutral perceptions of CAM related to its safety and natural characteristics.ConclusionsThe study found mainly positive perceptions of CAM among Hawaiʻi residents. Use of CAM is on the rise despite CAM lacking robust empirical evidence demonstrating efficacy across various medical conditions. With insufficient data and understanding of current medical literature, CAM users place themselves at risk for harmful herb-herb and herb-drug interactions. These findings have implications for healthcare providers of both conventional medicine and CAM traditions.

Dignity of Nursing Students in Clinical Learning Environments

As an important professional value, dignity has always been an ethical concern in nursing education and practice. However, the dignity of nursing students in clinical environments has remained a little-discussed topic. This study aims to explore and describe nursing students' dignity in clinical learning environments. This study is a qualitative descriptive work in which data were collected via semi-structured, in-depth, individual interviews and subsequently analyzed according to conventional content analysis. Based on the inclusion criteria of the study, nursing students were selected from different departments of university hospitals in the south of Iran from October 2019 to December 2020 (n = 21). Sampling continued to the point of data saturation. This study has been approved by the institutional review board of the university. Two themes emerged from the data collected in the interviews: trust-based relationships and formation of professional identity. The findings of the study show that nursing students need to be supported by their instructors and perceive that the personnel and patients believe in their ability. In an effectively supportive, trust-based atmosphere, these factors can contribute to maintaining nursing students dignity. Also, showing respect for their personal identity, projecting a positive image of nursing, and giving them authority to perform executive and clinical tasks in hospital departments play a major role in the formation of nursing students' professional identity and development of their dignity. Accordingly, it is recommended that in cultural contexts and clinical learning environments, more attention should be given to nursing students' dignity.

Experiences of Urinary Incontinence Management in Older Women: A Qualitative Study.

IntroductionOlder women have various experiences regarding the management of urinary incontinence depending on the societies they live in and their cultural backgrounds. The present study aimed to determine older women's experiences in urinary incontinence management.MethodsThe present qualitative study employed a conventional content analysis approach and was conducted in Iran from 2019 to 2020. In this research, the data were collected through face-to-face unstructured in-depth interviews with 22 older women suffering from urinary incontinence selected via purposeful sampling. The interviews were continued until reaching the data saturation point. Data analysis was performed simultaneously with data collection. The interviews were recorded, transcribed, and analyzed through Graneheim and Lundman style content analysis, and data management was done using the MAXQDA software. In order to achieve the accuracy and validity of the study, the Four-Dimensions Criteria (FDC) by Lincoln and Guba, namely credibility, dependability, conformability, and transformability, were considered and used.ResultsThis study was conducted on 22 older women suffering from urinary incontinence with the mean age of 66.54 ± 5.76 years. The acquired data were put in four main categories of “resilience” with three subcategories, “change in lifestyle” with six subcategories, “attempt for treatment of the condition” with three subcategories, and “receiving support” with two subcategories.ConclusionThe study results indicated that the older women suffering from urinary incontinence were resilient against the condition, had changed their lifestyles to manage the condition, and sought treatment. In addition, receiving support from the family and the society played a significant role in the follow-up and management of the condition. The present study findings can help healthcare team members focus on urinary incontinence, design care programs for older women with this condition, and improve their quality of life. Furthermore, focusing on young and middle-aged women's health, providing them with the necessary training for taking care of the genitourinary system, and raising their awareness for preventing urinary incontinence during old ages can be helpful. Moreover, increasing the healthcare team's sensitivity and following the patients up can help diagnose, manage, and treat the condition before exerting adverse impacts on their quality of life.

Potentials and Challenges for Cycling Tourism as a Sustainable Model of Transportation for Tourist Destination Promotion– Case Study in Ella-Sri Lanka; An Exploratory Study

Presently, lots of countries have initiated sustainable approaches to destination development. As result, cycling is also promoted due to the enormous environmental benefits it offers to ensure a smokeless tourism industry. Accordingly, this study aims to identify the potential and challenges of cycling tourism as a sustainable mode of transport for destination promotion. Further, the study explores the challenges of promoting cycling along with the tourists' perception. Ella-Sri Lanka was chosen as the main study location, and for in-depth analysis, the scenario study employed a qualitative approach. Purposive sampling and semi-structured interview techniques were applied for the data collection and at the data saturation point, 20 cycling tourists' responses were recorded for data analysis. The thematic analysis method was used for data analysis. Findings associated with the benefits of cycling were divided into four main themes economic, social-cultural, environmental and health, and other benefits. Additionally, tourist perception and the related challenges were categorized under three themes namely, safety and security-related issues, product, and process-related issues, and infrastructure facilities. Finally, implications for developing a more participatory policy approach towards sustainable destination development are highlighted considering the cycle renters, tourist guides, travel agents, accommodation providers, tourist services and facility providers, local authorities, government, and other relevant stakeholder groups involved in the tourism sector.

Creativity Practice in Teaching and Facilitating (PDPC) Malaysia's PVMA Automotive Due Covid-19 Pandemic

The need for instructors who are creative in conducting PVMA automotive teaching process is a key requirement in this study. The world was taken aback with the Covid-19 outbreak and Malaysia recorded its first case back in January 2020. The outbreak forced all educational institutions to be closed immediate, making it hard for instructors to carry out a physical learning session. This posed as a challenge to teachers and creative teaching is seen to be a great solution especially in the PVMA (automotive) field by diversifying teaching techniques in the previous teaching and facilitation (PdPc) to the current situation by adopting blended learning via online and face-to-face interaction. Therefore, a qualitative study was conduction to collect data on creative teaching. Data were obtained through interviews submitted to experts answer the research questions and reached data saturation point by the fifth expert. Interview transcripts were analyzed using NVivo software and the open coding showed the teacher's creativity level is very high in helping students to master their learning especially in the PVMA automotive. There are five constructs found from the interview analysis namely PdPc techniques, teacher personality, knowledge, environment, motivation and thinking skills. That construct is aligned with the six elements of creativity in Stenberg's creative teaching theory namely environment, motivation, knowledge, intelligence, personality and thinking style. Therefore, this study suggests that training and experience can help teachers to develop creativity in PdPc process. The training received by the instructors should cover the latest technology used in the industry to apply the skills and knowledge to students during the teaching and facilitation process.

Covid-19: experiences of teaching-mothers in Pakistan

ABSTRACT Disasters are experienced by, and responded to, differently based on the gender of those experiencing these. The responsibilities of women, particularly mothers, are amplified during times of pressure. This study investigated the experiences of teaching-mothers in Pakistan during the Covid-19 pandemic to understand the challenges they faced as professionals and as mothers. The data were collected through in-depth interviews of 24 teaching-mothers. The study participants were identified through the snowball sampling technique. The data were collected until the point of data saturation and analysed through. The analysis indicates that teaching-mothers in Pakistan faced issues in terms of maintaining their work-life balance, managing space and resources for online teaching, and learning a new set of skills in order to teach online. These multiple challenges affected their mental health. The findings indicate a sharp division of gendered roles in Pakistan and their negative impact on the mental health of women during Covid-19. The study suggests devising organizational policies to support teaching-mothers generally and especially during crises.

Family Stability Based on the Theory of Planned Behavior: A Qualitative Study

Introduction: Family is the most appropriate place to meet human needs and the best place to support human security and psychological well-being. Accordingly, young people should be encouraged to get married as soon as they meet the requirements for marriage. They also should be trained on how to strengthen their family life. For this reason, the present qualitative study aimed to develop a family model based on the theory of planned behavior to explain family stability. Methods: The data analysis method was a rule-guided qualitative content analysis. The data were collected by conducting interviews with 19 family therapists and experts in Yazd Province in 2018. The participants were selected through purposive sampling. The questions asked in the semi-structured interviews were developed based on the theory of planned behavior dealing with issues including behavioral intention, attitudes, subjective norms, and behavioral control. The interviews continued to the data saturation point when no new information or themes were observed in the data. Then the transcripts of the interviews were typed and the related themes were extracted and coded. After coding the data, qualitative research experts were asked to determine the content validity of the codes and their related categories. Then, based on the extracted categories, a local model was developed. Results: Based on the data analysis, 4 main themes (behavioral intention, attitudes, subjective norms, and behavioral control) and 8 sub-themes (self-control, patience, luxury-seeking, self-esteem, parenting, need satisfaction, positive attitudes toward marriage, and attainment of peace) were extracted. Conclusion: Since the family is the best emotional, social, and psychological shelter for its members, this study developed a model that can be valuable for educating families who have different problems. The developed model can also be used by family therapists and professionals dealing with family issues.

Understanding health-seeking and adherence to treatment by patients with esophageal cancer at the Uganda cancer Institute: a qualitative study

BackgroundIn the low- and middle-income countries, most patients with esophageal cancer present with advanced stage disease and experience poor survival. There is inadequate understanding of the factors that influence decisions to and actual health-seeking, and adherence to treatment regimens among esophageal cancer patients in Uganda, yet this knowledge is critical in informing interventions to promote prompt health-seeking, diagnosis at early stage and access to appropriate cancer therapy to improve survival. We explored health-seeking experiences and adherence to treatment among esophageal cancer patients attending the Uganda Cancer Institute.MethodsWe conducted an interview based qualitative study at the Uganda Cancer Institute (UCI). Participants included patients with established histology diagnosis of esophageal cancer and healthcare professionals involved in the care of these patients. We used purposive sampling approach to select study participants. In-depth and key informant interviews were used in data collection. Data collection was conducted till point of data saturation was reached. Thematic content analysis approach was used in data analyses and interpretations. Themes and subthemes were identified deductively.ResultsSixteen patients and 17 healthcare professionals were included in the study. Delayed health-seeking and poor adherence to treatment were related to (i) emotional and psychosocial factors including stress of cancer diagnosis, stigma related to esophageal cancer symptoms, and fear of loss of jobs and livelihood, (ii) limited knowledge and recognition of esophageal cancer symptoms by both patients and primary healthcare professionals, and (iii) limited access to specialized cancer care, mainly because of long distance to the facility and associated high transport cost. Patients were generally enthused with patient – provider relationships at the UCI. While inadequate communication and some degree of incivility were reported, majority of patients thought the healthcare professionals were empathetic and supportive.ConclusionHealth system and individual patient factors influence health-seeking for symptoms of esophageal cancer and adherence to treatment schedule for the disease. Interventions to improve access to and acceptability of esophageal cancer services, as well as increase public awareness of esophageal cancer risk factors and symptoms could lead to earlier diagnosis and potentially better survival from the disease in Uganda.

The Lived Experience of Nurses Working in Cardiology Services with Online Continuing Professional Programs in Advancing their Specialized Clinical Practice: Phenomenology Study Methodology

Introduction: Nurses should be committed to undertake continuing professional development (CPD) courses to advance nursing practice and guarantee lifelong learning. Online CPD programs may allow nurses to fulfil the demand for specialty competency. Aim: This study focuses on utilising online (CPD) activities to develop cardiac nurses’ ability to perform advanced clinical skills. Method: The study was conducted in one of the largest accredited teaching hospitals in South Australia. The department is staffed by a specialised multi-professional team, some of whom have completed specialised cardiac post-graduation diploma courses in order to meet the complex needs of cardiac patients. To keep the team abreast of the latest developments in practice, the in-service education department at local study setting runs several CPD programs for the cardiology department via varied learning modes, such as online CPD programs, classroom learning and bedside-based learning. The nursing team maintains advanced clinical skills through online CPD, orientation programs, and in-service classroom-based courses. Regarding online CPD courses, electrocardiography interpretation and underwater sealing draining management courses are mandatory courses which all registered nurses must complete while working in medical or surgical cardiac wards. Results: The interview process was conducted in five stages: 1. Determining the type of the interview where in such types of qualitative studies the researcher should focus on the fundamental question of the phenomenological inquiry throughout the unstructured, in-depth interview process. 2. Making initial contact where the researcher established a rapport with the participant and prepared them mentally by giving them the participant information sheet. 3. Context of the interview where interviews be conducted in a quiet room in the School of Nursing in order to maintain participant privacy and anonymity, participants requested to conduct the interviews in their work setting. Nonetheless, the researcher ensured that participant privacy and anonymity was upheld. 4. Selecting the lived experience where Each participant was interviewed once. Interview duration was 15 to 30 minutes. The interviews started with a grand tour question. Grand tour questions are very broad questions asked by the interviewer at the early stage of an interview to obtain a description of the event or experience. 5. All interviews were concluded by thanking the participant and offering them the choice to have a copy of their interview transcript to verify what they had said. The researcher wrote an interview summary after listening to the interviews on the same day. The summary was prepared to help the researcher evaluate the amount of data gathered and identify whether the point of data saturation was reached. In addition, writing the summary helped the researcher reflect on the interview and gain an understanding of the participant experience Conclusion This study explained the process of data collection, describing the setting, nature of participants and process of data collection using phenomenological interview. As the human experience is complex, gathering in-depth data should be systematic to ensure that the researcher has obtained the most sufficient data to explore the essence of the experience.