Conventional Qualitative Content Analysis Research Articles

Comps: Content analysis of doctoral comprehensive exam policies and procedures

AbstractThe doctoral comprehensive exam is a common benchmark in counselor education doctoral programs. The current study examined policies and procedures for comprehensive exams in CACREP‐accredited counselor education doctoral programs. Using conventional qualitative content analysis, researchers analyzed CACREP‐accredited doctoral program student handbooks to determine common practices for conducting comprehensive exams.

Qualitative exploration of sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors.

Our understanding of the experiences of prostate cancer survivors regarding their sexual life and related issues remains limited. Therefore, this study aimed to explore sexual dysfunction and associated coping strategies among Iranian prostate cancer survivors. A qualitative study was undertaken. Participants were 15 Iranian prostate cancer survivors chosen using purposeful sampling. Data collection involved conducting in-depth semi-structured interviews, followed by the utilization of the conventional qualitative content analysis method for data analysis. Three themes were developed: (a) suspension of sexual life-treatment for prostate cancer significantly impacted participants' sexual lives; (b) emotional resilience and psychological coping strategies-various psychological strategies were used to tackle sexual dysfunction; (c) efforts to regain sexual function-several strategies were applied to enhance sexual performance. Our study findings provide insights into the experiences of prostate cancer survivors and subsequent shifts in their sexual dynamics and coping with the disease. Healthcare providers should actively identify patients' concerns and develop culturally tailored care strategies to address sexual challenges and improve coping among prostate cancer survivors.

Exploring factors affecting the unsafe behavior of health care workers’ in using respiratory masks during COVID-19 pandemic in Iran: a qualitative study

BackgroundThe use of respiratory masks has been one of the most important measures to prevent the spread of COVID-19 among health care workers during the COVID-19 pandemic. Therefore, correct and safe use of breathing masks is vital. The purpose of this study was to exploring factors affecting the unsafe behavior of health care workers’ in using respiratory masks during the COVID-19 pandemic in Iran.MethodsThis study was carried out using the conventional qualitative content analysis. Participants were the number of 26 health care workers selected by purposive sampling method. Data collection was conducted through in-depth semi-structured interviews. Data analysis was done using the content analysis approach of Graneheim and Lundman. This study aligns with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and was conducted between December 2021 and April 2022.ResultsThe factors affecting the unsafe behavior of health care workers while using respiratory masks were divided into 3 main categories and 8 sub-categories. Categories included discomfort and pain (four sub-categories of headache and dizziness, skin discomfort, respiratory discomfort, feeling hot and thirsty), negative effect on performance (four sub-categories of effect on physical function, effect on cognitive function, system function vision, and hearing), and a negative effect on the mental state (two subcategories of anxiety and depression).ConclusionThe findings can help identify and analyze possible scenarios to reduce unsafe behaviors at the time of using breathing masks. The necessary therapeutic and preventive interventions regarding the complications of using masks, as well as planning to train personnel for the correct use of masks with minimal health effects are suggested.

Clinical nursing competency during epidemics: a qualitative content analysis

BackgroundNurses are on the frontline for managing epidemic diseases. Different aspects of clinical nursing competencies during epidemics are important issues that need investigation.ObjectivesThe aim of this study was to determine the required clinical competencies for nurses during epidemics. Understanding these competencies could provide valuable information for health care services and nursing education organizations to prepare nurses for future epidemics.MethodsThe qualitative conventional content analysis study was conducted using semi-structured interviews with 12 nurses that were actively engaged in providing patient care during COVID-19 pandemic in Shahid Beheshti hospital in Kashan/Iran, from October 2022 to March 2023. The data analysis process was conducted according to 5 steps suggested by Graneheim and Lundman.ResultsAfter analysis, the 159 competencies were derived from interviews that were categorized to 11 subcategories, and three categories of clinical nursing skills in epidemics, knowledge of epidemics, and soft skills for nurses in epidemics.ConclusionNurses need wide range of competencies to address the professional expectations regarding providing acceptable care during epidemics. Knowing these competencies can help nursing managers to prepare nurses for crisis such as what world experienced during COVID-19 pandemic.

“A sincere ‘how are you?’ is already a sign of acknowledgement that you're there too.” - Interview study on the support needs of adolescents and young adults (AYAs) living with a parent with cancer

PurposeParental cancer brings changes and challenges which affect the whole family. Evidence shows heightened psychosocial risk among the offspring. Research among adolescents and young adults (AYAs) facing parental cancer has mainly focused on these psychosocial problems. As a reaction, there has been an increase in research on the needs of this population, since this knowledge is crucial for developing appropriate support. Despite this increase, some AYAs are still underrepresented, namely those over eighteen years old and those who have a parent with incurable cancer. Moreover, the factors hampering or fostering access to and receipt of support addressing their needs are under-investigated. Increasing our understanding of these issues is crucial to developing more effective support interventions for these young people. Our aim was therefore to gain insight into the perceived support needs of AYAs who have a parent with cancer, including the mentioned underrepresented subgroups, and the perceived factors facilitating or hindering their use of support. MethodsWe conducted semi-structured interviews with 17 AYAs who have a parent with cancer of any type and stage, which were analyzed using conventional Qualitative Content Analysis (QCA). ResultsSix main categories emerged from the data, encompassing various subcategories: 1) Needs surrounding the time of disclosure, 2) Information needs, 3) Informal support needs, 4) Need for effective personal coping strategies, 5) Formal support needs, and 6) Contextual and medical factors affecting support needs. AYAs perceived family members, friends and teachers as important sources of informal support, but lacked contact with peers who also have a parent with cancer. They expressed a need for formal informational and emotional support from their parent's medical team, (onco)psychologists, and their general practitioner. AYAs faced barriers in accessing formal support. A proactive attitude from healthcare providers and information about available support would help them meet their needs. Furthermore, we shed new light on needs and issues in post-secondary education. ConclusionsAYAs who are living with their parent with cancer experience informational, emotional, and practical needs in multiple contexts, such as the home, school, leisure and hospital environment. They identify their informal and formal network as important key figures in addressing these needs.

Psychological Care for People with Inflammatory Bowel Diseases: Exploring Consumers' Perspectives to Inform Future Service Co-design.

There is a need to improve psychological care for people with Inflammatory Bowel Diseases (IBD), noting the high psychosocial burden of disease. This study qualitatively explored the views of people living with IBD to help inform future co-design of services that better meet the psychological needs of consumers. Adults with IBD were recruited to attend virtual focus groups to discuss what they want most in an IBD-specific psychological service. The discussions were recorded and transcribed, and data were analyzed using conventional qualitative content analysis. Draft results were summarized midway and reviewed by remaining focus groups and a final expert consumer. A quantitative dataset was created of comment frequencies. Thirty-one participants took part in the study: 10 focus groups were held with an average of three participants per group. The analysis identified 254 codes, 38 sub-categories and six categories. Five main categories were identified for an IBD-specific psychological service: People-Centered Healthcare (commented on by 90% of participants), Education and Preparation (83%), Social Connection (83%), Psychological Input (93%), and Accessible Services (97%). Results were summarized in a set of proposed clinical guidelines. The findings of this study identify important insights from people living with IBD regarding priorities for psychological services. IBD services should focus on improving education, addressing social connection, and integrating psychological input, as well as becoming more people-centered and accessible. It is hoped that IBD services consult the proposed clinical guidelines to inform co-designed service improvements.

Parenting a child with a disability: Fathers’ perceptions of the couple relationship

Parents of children with a disability experience elevated levels of stress compared to parents of typically developing children, which represents a risk for their couple relationship. Research on families where a child has a disability is principally based on mothers. More knowledge is needed about the paternal perspective. We conducted semi-structured interviews with seven fathers (aged 36–54 years) of children with a disability (primary school age to early twenties). We analyzed the material using qualitative conventional content analysis, focusing on participants’ descriptions of couple relationships. We categorized the participants’ descriptions in two main categories: Couplehood and Co-parenting. Throughout the material, partners were described as romantic partners, co-parents, and collaborators. Participants described that couple communication and emotional expression within couples were affected by parenting a child with a disability. Moreover, participants described influence by cultural masculinity norms on their involvement as partners and parents, and on the dynamic within their couple relationships. An uneven division of labor was described. A practice implication is that communication and emotional expression styles within the parental couple should be a key focus when working with families of children with a disability. The findings also suggest more active involvement of fathers in children’s health care.

A qualitative study on the health system-related needs in women survivors of rape

BackgroundRape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape.MethodsIn the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method.ResultsAfter analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”, and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”.ConclusionsOverall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

Perceptions of Medical Staff on COVID-19 Vaccination: A Qualitative Analysis

Background: The COVID-19 pandemic has caused almost unimaginable damage to the lives, health, and economies of many countries. Alongside health and behavioral control measures, vaccination has been considered the most successful method to control the COVID-19 epidemic. Although vaccination is an effective way to reduce and eliminate diseases, its effectiveness depends on the willingness of the population to receive the vaccine. The purpose of this study is to explore the perceptions of medical staff on COVID-19 vaccination through qualitative content analysis. Objectives: This study aims to explore the perceptions of medical staff on COVID-19 vaccination through qualitative content analysis. Methods: A qualitative study employing a content analysis approach was conducted at Khoy city hospitals in Iran. The researchers explored the perceptions of 16 medical staff members who were among the first group to receive the vaccine in 2021 - 2022. Health staff of various ages, genders, and professions including doctors, nurses, midwives, pharmacists, laboratory staff, and radiologists were included in the research. Sampling was purposeful, and data collection utilized face-to-face semi-structured individual interviews. Data analysis followed the method of “conventional qualitative content analysis.” Results: Data analysis revealed three main categories and seven sub-categories as follows: “Conflicting feelings” (confidence or doubt, hope or worry, complications and benefits), “continuing to fight against COVID-19” (responding to social/professional responsibility, encouraging people to accept the vaccine), and “getting rid of COVID-19” (return to normal life, reduction of mortality). Conclusions: The medical staff expressed a desire to receive the COVID-19 vaccine to continue fighting the disease and eliminate it, but they also had conflicting feelings about receiving it. The perceptions of healthcare workers about healthcare issues serve as a reliable source of knowledge for the public and play a crucial role in deciding whether to accept or reject critical health interventions. Therefore, health policymakers dealing with epidemic diseases should prioritize creating scientific and psychological support for acceptance among healthcare workers, who serve as a reference for the public.

Targeted Care in Comatose Patients with Head Injury: A Qualitative Content Analysis

Background: Brain injury and coma after trauma are major health problems all over the world as the hemodynamic indicators of patients fluctuate and their clinical conditions deteriorate. Consequently, the demand for professional care will increase. Accordingly, this study aimed to explain the experiences of people caring for comatose patients with head injury. Methods: The present study was conducted using a conventional qualitative content analysis approach. The participants were selected through purposive sampling and the sampling process continued until data saturation. A total of 17 nurses and 3 head nurses working in the intensive care units (ICUs) of Sabzevar University of Medical Sciences in 2022 participated in the study. Results: Data analysis led to the identification of three main categories and nine subcategories including clarification of needs (understanding patients’ needs based on symptoms, intensive vision, application of care knowledge), continuous care to facilitate transition (skilled and quality care, progress monitoring, continuity in care and teamwork), and empathic support (living in the patient’s world, therapeutic relationship, and conscience-oriented actions. As a result, "targeted care" was detected as the main theme of the study. Conclusion: According to the results of the current study, in order for nurses to perform targeted care to get patients out of critical situations as quickly as possible, first a detailed examination is required to identify the patients’ needs and problems. Then, continuous nursing care with comprehensive support should be provided to the patients. The results of this study can instill motivation in care and improve its quality, ultimately leading to patient-centered nursing and treatment.

Difficulties and challenges experienced by nurses in eldercare institutions in Albania: A qualitative content analysis.

The global and Albanian populations of elderly people are steadily increasing. It is estimated that the number of elderly adults requiring care in Albania will rise from 90.9 thousand to 130.4 thousand by 2030. Despite the envisaged increase in the number and life expectancy of the elderly population in Albania, which will result in an increased demand for nursing care, little is known about the difficulties and challenges that nurses face while providing care for elderly Albanian individuals. To explore the difficulties and challenges nurses experience while caring for elderly people in Albanian eldercare institutions. The study employed a qualitative design using purposive sampling of 20 nurses in 8 eldercare institutions who participated in face-to-face semi-structured interviews. The audio-recorded interviews were transcribed and subsequently subjected to analysis using Graneheim and Lundman's qualitative conventional content analysis. Data analysis was supported by the qualitative data analysis software MAXQDA 2020. The reporting of this study followed the consolidated criteria for reporting qualitative research (COREQ) checklist. Five key categories emerged from data analysis: (1) professional difficulties, (2) educational difficulties, (3) relationship challenges, (4) increased mental stress, and (5) participation in advocacy. This study showed that nursing staff experienced many barriers, challenges, and unmet needs when implementing care for elderly people in long-term care facilities. The findings indicate that nurses working in eldercare institutions faced significant challenges in caring for elderly people. Nurses need more legal, financial, educational, and emotional support. The study indicates that more organizational and national support is necessary for nursing staff to care for elderly people in eldercare Albanian institutions properly. Eldercare institution leaders need to recognize the importance of their role in overcoming the barriers and providing adequate support for their staff in caring for elderly people.

Patients' Perspectives on Discontinuing Buprenorphine for the Treatment of Opioid Use Disorder.

Buprenorphine and other medications for opioid use disorder (OUD) are recommended as standard of care in the treatment of OUD and are associated with positive health and addiction-related outcomes. Despite benefits, discontinuation is common, with half of patients discontinuing in the first year of treatment. Addressing OUD is a major clinical priority, yet little is known about the causes of medication discontinuation from the patient perspective. From March 2021 to April 2022, we conducted qualitative interviews with patients who had discontinued buprenorphine for the treatment of OUD within the past 12 months. Eligible participants were selected from 2 Veterans Health Administration Health Care Systems in Oregon. Coding and analysis were guided by conventional qualitative content analysis. Twenty participants completed an interview; 90% were White and 90% were male, and the mean age was 54.2 years. Before discontinuation, participants had received buprenorphine for 8.3 months on average (range, 1-40 months); 80% had received buprenorphine for less than 12 months. Qualitative analysis identified the following themes relating to discontinuation: health system barriers (eg, logistical hurdles, rules and policy violations), medication effects (adverse effects; attributed adverse effects, lack of efficacy in treating chronic pain) and desire for opioid use. Patient description of decisions to discontinue buprenorphine could be multicausal, reflecting provider or system-level barriers in interaction with patient complexity or medication ambivalence. Study results identify several actionable ways OUD treatment could be modified to enhance patient retention.

The Mental Well-Being and Inclusion of Refugee Children: Considerations for Culturally Responsive Trauma-Informed Therapy for School Psychologists

Refugee children displaced by war suffer incredible amounts of physical and psychological trauma during and post-displacement. War is not partial to children, and they are subjected to as much extreme violence as adults. This paper explores the mental health of refugee children following war and was guided by the research question: What are the mental health experiences of refugee children displaced by war situations? A secondary data analysis was conducted on publicly available documentary short films and instructional videos on psychological therapy with refugee children and families. The data were analysed through Qualitative Conventional Content Analysis (QCCA). Three major categories emerged regarding the well-being of refugee children: (1) children are not spared from war trauma, (2) children live in perpetual fear and anxiety, and (3) war-related violence ignites aggressive behaviours in children. To increase positive mental health outcomes, school psychologists need to implement trauma-informed therapy that focuses on decreasing psychosocial reactions to war. Culturally responsive therapy is recommended as it places indigenous ways of being at the centre of the healing process.

Bichronous scientific writing course for medical faculty during Covid-19: a SWOT analysis experience

IntroductionWriting and publishing scholarly articles in international peer-reviewed journals can be a challenging undertaking for medical and healthcare professionals in universities, especially in non-English speaking countries. Surprisingly, very few faculty members report receiving guidance on scientific writing. To encourage more faculty engagement in professional development courses aimed at enhancing their writing abilities, we have revamped scientific writing courses to incorporate bichronous (a combination of asynchronous and synchronous) teaching methods.MethodsAfter forming a team, we performed a SWOT (strengths, weaknesses, opportunities, and threats) study of the medical faculty’s present programs and proposed alternatives to prior course issues. In this interventional study, fifty-nine eligible medical educators selected by purposeful sampling underwent a two-and-a-half-month bichronous scientific writing course from March to August 2021. The perspectives of the participants were evaluated through a SWOT analysis. The data were collected through online semi-structured interviews, and data collection continued until data saturation was achieved (40 participants). Data were then coded and analyzed based on conventional qualitative content analysis principles.ResultsOur planned blending sequence and e-feedback increased the medical faculty’s drive to learn, self-confidence, and autonomy while improving their writing skills. Poor ICT and network infrastructure hindered course adoption. Due to the course’s time and the faculty’s own online teaching, many battled with computer vision syndrome, self-discipline, and distractions. Our participants struggled with self-discipline and distractions, so setting a daily time limit may help them concentrate.DiscussionGiven the faculty’s demanding professional lives, this designed course provided a learning opportunity for many that would not have been feasible otherwise.

Nursing Instructors’ and Students’ Experiences of Transition from Face-to-Face Education to Virtual Education during the Coronavirus Disease 2019 Pandemic

Introduction. The coronavirus disease 2019 (COVID-19) pandemic necessitated the suspension of most educational activities and a shift from face-to-face (FTF) education to virtual education (VE). These changes were associated with new educational experiences for both instructors and students. This study aimed to explore nursing instructors’ and students’ experiences of VE during the COVID-19 pandemic. Method. This descriptive qualitative study was carried out in 2021. Participants were 21 bachelor’s, master’s, and Ph.D. nursing students and six nursing instructors purposively selected from the Faculty of Nursing and Midwifery of Tehran University of Medical Sciences, Tehran, Iran. Data were gathered through FTF or online in-depth semistructured interviews and were analyzed through conventional qualitative content analysis as proposed by Graneheim and Lundman (2004). Results. Eight subthemes and three main themes were developed during data analysis. The main themes and subthemes were VE as a double-edged sword (VE as a threat, VE as an opportunity, and necessity to improve VE), weaknesses in clinical education (reduced quality of clinical education and necessity to compensate for students’ retarded clinical learning), and reduced reliability of virtual student evaluation (cheating as a problem of virtual evaluation, stresses and tensions of virtual evaluation, and necessity to use new strategies in virtual evaluation). Conclusion. Despite the different shortcomings and challenges of VE during the COVID-19 pandemic, educational experiences gained in this period can be used to improve the quality of nursing VE in future epidemics and pandemics.

Exploring Patients' and Chaplains' Perspectives About a Spiritual Care Program in the Primary Care Setting.

Spirituality is an important component of social and cultural identity that influences health-related beliefs, decision-making, and coping behaviors. Despite the importance of addressing spirituality in healthcare, research about its impact is limited, especially in the primary care setting. This study aimed to explore patients' and chaplains' experiences of receiving or providing spiritual care in the primary care setting. We conducted an in-depth interview qualitative research study. Participants included patient informants, a chaplain, and chaplains-in-training who participated in a spiritual care program at a primary care clinic. Interviews were transcribed and coded. Conventional qualitative research content analysis was performed. Eleven interviews were conducted - 7 with patient informants, 1 with a chaplain, and 3 with chaplains-in-training. Informants reported that in their experience spiritual care increased trust in their provider, made them feel safe to ask or share anything, improved their satisfaction with care, helped sustain healthy behavior change, and improved coping with chronic illness. Participants specifically attributed these positive experiences to chaplains' ability to respect and attend to patients' spirituality, create a safe space, help patients see the connection between their spirituality and health, and help patients tap into their own spirituality as a healthy means of coping. Spiritual care, when integrated into the primary care setting, has the potential, according to the report of our informants, to help achieve important health-related objectives, such as increased trust in their providers, sustained healthy behavior change, and happiness in spite of chronic illness. Now, more than ever, when our society is hurting from mistrust of our profession secondary to disinformation and discrimination, spiritual care has an important role to play in our efforts to gain our patients' trust so that we can support their healing.

Managing Medications During “Sick Days” in Patients With Diabetes, Kidney, and Cardiovascular Conditions: A Theory-informed Approach to Intervention Design and Implementation

ObjectivesOur aim in this work was to: 1) explore barriers and enablers to patient and health-care provider (HCP) behaviours related to sick-day medication guidance (SDMG), 2) identify theory-informed strategies to advise SDMG intervention design, and 3) obtain perspectives on an eHealth tool for this purpose. MethodsA qualitative descriptive study using qualitative conventional content analysis was undertaken. Interviews and focus groups were held with patients and HCPs from January 2021 to April 2022. Data were analyzed using the Behaviour Change Wheel and Theoretical Domains Framework to inform intervention design. ResultsForty-eight people (20 patients, 13 pharmacists, 12 family physicians, and 3 nurse practitioners) participated in this study. Three interventions were designed to address the identified barriers and enablers: 1) prescriptions provided by a community-based care provider, 2) pharmacists adding a label to at-risk medications, and 3) built-in prompts for prescribing and dispensing software. Most participants accepted the concept of an eHealth tool and identified pharmacists as the ideal point-of-care provider. Challenges for an eHealth tool were raised, including credibility, privacy of data, medical liability, clinician remuneration and workload impact, and equitable access to use of the tool. ConclusionsPatients and HCPs endorsed non-technology and eHealth innovations as strategies to aid in the delivery of SDMG. These findings can guide the design of future theory-informed SDMG interventions.

A shock to the (health) system: experiences of adults with rare disorders during the first COVID-19 wave

BackgroundBefore COVID-19, people with rare diseases (RD) experienced numerous disparities in quality of life and healthcare access and quality, yet little is known about the experiences of this underserved group during the pandemic.ResultsDuring the first wave of the COVID-19 pandemic in the United States, spring and summer of 2020, 759 participants representing 231 unique RDs responded to open-ended questions about the impact of the pandemic on life with a RD, healthcare access, and coping. Qualitative conventional content analysis was used to analyze responses. Identified themes represented positive and negative dimensions of change, including a shock to the (health) system, coping with uncertainty, and the value of social support while isolated.ConclusionsLimitations in healthcare access and quality were the most frequently described as impacts of COVID-19. Other major negative impacts included exacerbation of symptoms, psychological distress, and a lack of usual social support and reliable information. However, participants also noted silver linings, especially in healthcare. For some, expanded telehealth enhanced their ability to access medical and mental health providers and RD specialists. Finally, many participants hoped that, by highlighting social and health inequities faced by people with RDs and other minorities, the pandemic would prompt greater understanding and policies that could improve the quality of life of the RD community.

Exploring medical students’ perceptions of empathy after cinemeducation based on Vygotsky’s theory

BackgroundMedical students’ empathy toward patients with Alzheimer’s is rarely found in formal medical curricula. Based on Vygotsky’s theory, watching films and reflection can be considered as effective methods to improve empathy. The present study aimed to explore medical students’ perceptions of empathy toward patients with Alzheimer after participating in an educational program by using interactive video based on Vygotsky’s theory.MethodsThis qualitative study was conducted at Tehran University of Medical Sciences in 2022. The population included all 40 medical students. Firstly, the Still Alice movie which is about the feelings of a professor who was diagnosed with Alzheimer’s disease was shown to the students. Secondly, the students reflected on their experiences of watching the movie. Thirdly, a session was held for group discussion on the subject of the movie, the patient’s feelings, the doctor’s attitude, the social environment surrounding the patient shown in the movie, and the necessity of empathy toward patients with Alzheimer’s disease. The reflection papers were analyzed using the conventional qualitative content analysis method.ResultsAfter analyzing 216 codes from 38 reflection papers, four categories, including communication with a patient with Alzheimer’s, understanding the patient with Alzheimer’s as a whole, medical science development, and the student’s individual ideology, were extracted.ConclusionReflection and group discussion after watching movie by providing opportunities for social interaction about personal interpretations will lead to active role in enhancing empathy. Based on the perceptions of the medical students, they gained a perspective to consider the patient as a whole and pay attention to establishing a proper relationship with the patient.

Designing, validation and evaluation of the expert system of “Healthy Menopause” and assessing its effect on the management of menopause symptoms: an exploratory mixed method study protocol

BackgroundMenopause is a period of women’s life that has the especial physical, psychological and social challenges. So provision of an effective, practical and affordable way for meeting women’s related needs is important. In addition, women should be able to incorporate such programs into their daily work. Considering the dearth of suitable services in this regard, this study will be conducted with the aim of designing, validating and evaluating the “Healthy Menopause” expert system on the management of menopausal symptoms.Methods/designA mixed methods exploratory design will be used to conduct this study in 3 phases. The first phase is a qualitative conventional content analysis study with purposes of exploring the women’s experience of menopausal symptoms and extracting their needs, and collecting data about their expectations from a healthy menopause expert system.. The purposive sampling (In his phase data will be gathered through interviewing menopaused women aged 40 to 60 years old and other persons that have rich information in this regard and will be continued until data saturation. The second phase includes designing a healthy menopause expert system in this stage, the needs will be extracted from the qualitative findings along with a comprehensive literature review. The extracted needs will be again confirmed by the participants. Then, through a participatory approach (Participatory Design) using nominal group or Delphi technique the experts’ opinion about the priority needs of menopaused women and related solutions will be explored based on the categories of identified needs. Such findings will be used to design a healthy menopause expert system at this stage. The third phase of study is a quantitative research in which the evaluation of the healthy menopause expert system will be done through a randomized controlled clinical trial with the aim of determining the effect of the healthy menopause expert system on the management of menopause symptoms by menopausal women themselves.DiscussionThis is the first study that uses a mixed method approach for designing, validating and evaluating of the expert system “Healthy Menopause”. This study will fill the research gap in the field of improving menopausal symptoms and designing a healthy menopause expert system based on the needs of the large group of menopause women. We hope that by applying this expert system, the menopausal women be empowered to management and improving their health with an easy and affordable manner.