نشریه پرستاری ایران، جلد ۳۳، شماره ۱۲۳، صفحات ۷۳-۸۳

عنوان فارسی ضرورت‌ها و الزامات بخش آنژیوگرافی کودکان از منظر تیم مراقبتی: یک مطالعه کیفی
چکیده فارسی مقاله زمینه و هدف: آنژیوگرافی اطفال برای تشخیص و درمان ناهنجاری‌های قلبی مادرزادی در اطفال به صورت گسترده در دو دهه گذشته استفاده شده است. به منظور ارتقاء و بهبود محیط مراقبت ویژه کودکان توجه به تجارب و نظرات پرستاران شاغل در محیط مراقبت ویژه کودکان از اهمیت به سزایی برخوردار است. هدف تحقیق حاضر، تبیین ضرورت و الزامات بخش آنژیوگرافی کودکان از منظر تیم مراقبتی بود. روش بررسی: این پژوهش به شیوه رویکرد تحلیل محتوای کیفی در سال 2018 انجام شد. مشارکت کنندگان 20 نفر شامل نه پرستار، چهار رادیولوژیست و هفت پزشک قلب بودند که به روش هدفمند از بخش آنژیوگرافی بیمارستان هاجر شهرکرد انتخاب شدند. مدت مصاحبه‌ بین 35 تا 60 دقیقه بود. جمع‌آوری داده‌ها و مصاحبه‌ها تا اشباع داده‌ها انجام شد. جمع‌آوری و تجزیه تحلیل داده‌ها چهار ماه طول کشید. جهت تحلیل داده‌ها از روش تحلیل محتوای کیفی قراردادی استفاده شدبه منظور اطمینان از صحت یافته‌های پژوهش از چهار معیار 1- اعتبار یا مقبولیت 2- قابلیت اعتماد یا همسان بودن 3- قابلیت انتقال 4- تأیید پذیری استفاده شد. یافته‌ها: از تحلیل داده‌ها سه طبقه حساسیت بخش، ضرورت کاربرد صحیح تجهیزات تخصصی، و ضرورت آموزش و مهارت آموزی به دست آمد. طبقه حساسیت بخش با سه زیرطبقه ویژه بودن بیماران، استریل بودن محیط آنژیوگرافی، و لزوم آشنایی با بخش مشخص شد. طبقه تجهیزات تخصصی با دو زیرطبقه گران بودن تجهیزات، و ضوابط مدیریت نگهداشت تجهیزات تخصصی، به دست آمد. طبقه ضرورت آموزش و مهارت آموزی با دو زیرطبقه نیاز به مهارت‌های دانشی و نیاز به مهارت‌های ارتباطی مشخص شد. نتیجه‌گیری کلی: سه یافته مهم این مطالعه ضرورت آشنایی و ضرورت کاربرد صحیح تجهیزات تخصصی و ضرورت آموزش و مهارت آموزی، همچون گنجینه‌ایی طلایی است که کلید آن در دست مدیران و مسئولان بیمارستان است. آموزش تیم مراقبتی در بخش آنژیوگرافی امری یکباره نیست بلکه فرآیندی مستمر است. از جمله مهارت‌های مورد نیاز کار در بخش آنژیوگرافی داشتن دانش کافی و توانایی ارتباط صحیح با بیمار و همراهان، و توانایی استفاده صحیح و مناسب از تجهیزات تخصصی در بخش است که می‌توان با برگزاری دوره‌های آموزشی ارتباط و مشاوره، برگزاری کلاس‌های آموزشی تجهیزات تخصصی، آمادگی‌های لازم برای کارکنان این بخش فراهم کرد.
کلیدواژه‌های فارسی مقاله بخش آنژیوگرافی، کودکان، تیم مراقبتی

عنوان انگلیسی The Necessities and Requirements of the Pediatric Angiography Ward from the Perspective of the Healthcare Team: A Qualitative Study
چکیده انگلیسی مقاله Background & Aims: Pediatric angiography has been widely used for the diagnosis and treatment of congenital heart disorders in children over the past two decades. The work environment of the nurses of pediatric intensive care units is highly stressful due to various technical and medical equipment and patients with life-threatening diseases. In order to improve special pediatric care environments, attention must be paid to the experiences and opinions of the nurses employed in these units. To this end, the prioritization of the health of workplace and applying multidimensional approaches to the health promotion of the workplace are paramount. Considering the teamwork involved in patient care and treatment and increased number of beds in intensive care units, it is critical to evaluate the perceptions of physicians and nurses regarding the aspects of care in intensive care units. The improvement of the performance of pediatric critical care nurses and attention to their experiences and viewpoints are also essential in this regard. To this end, the prioritization of the health of workplace and applying multidimensional approaches to the health promotion of the workplace are paramount. The use of pediatric angiography has increased in the past two decades. In addition, the differences in the culture, environment, and education of nurses in pediatric intensive care units, along with the differences in the hospitalized patients further emphasize on the necessity of qualitative research. However, most of the studies in this regard have been performed with a quantitative approach, while only qualitative research could determine the dimensions of the perceptions of the healthcare team. To date, no qualitative studies have assessed the experiences of the healthcare team in the pediatric angiography ward. The present study aimed to elaborate on the necessities and requirements of the pediatric angiography ward from the perspective of the healthcare team. Materials & Methods: This study was conducted using the qualitative content analysis approach in 2018. The sample population included 20 subjects, including nine nurses, four radiologists, and seven cardiologists, who were selected via purposeful sampling from the angiography unit of Hajar Hospital in Shahrekord, Iran. The inclusion criteria were the nurses and physicians with one year of work experience in the angiography or cardiology ward and willingness to participate in the study, and the exclusion criterion was unwillingness to participate. The duration of the interviews was 35-60 minutes, and the recordings were performed in accordance with ethical principles. Data collection and interviews continued until reaching data saturation. Data collection and analysis continued for four months. The semi-structured, individual interviews were initiated with the nurses and physicians with an open question ("Please explain your experiences of working in the pediatric angioplasty ward."/"What challenges have you faced in performing pediatric angiography?") The interviews continued with probing questions ("Please explain further."/"Please set an example.") The obtained data were analyzed using the qualitative content analysis method. After the researcher listened to the recorded interviews several times, he was immersed in the data to obtain an overview of the interviews. All the interviews were transcribed word-for-word, so that the words containing the key concepts would be highlighted and the codes would be extracted. After extracting the concepts and codes from important sentences and paragraphs, they were classified into categories based on the similarities and differences, and the categories were reduced to a smaller number of categories based on their correlations. In order to maximize the diversity of the participants, the research units were selected from the nurses, physicians (pediatric cardiologists), and radiologists engaged in the angiography ward. To ensure the accuracy and reliability of the research findings, the four criteria of credibility, dependability, transferability, and conformability were considered. To observed ethical considerations, a letter of recommendation was obtained from the Vice-Chancellor of Research of Shahrekord University of Medical Sciences. In addition, written informed consent and permission to record the interviews were obtained from the subjects prior to participation. Results: The mean age of the nurses was 34 years, and the mean work experience in the angiography ward was five years. The mean age of the radiologists was 31.5 years, and the mean work experience in the angiography ward was three years. The mean age of the pediatric cardiologists was 45 years, and the mean work experience in the angiography ward was five years. Data analysis yielded the three categories of the sensitivity of the ward, the necessity of the proper use of specialized equipment, and the need for education and skills training. The category of the sensitivity of the ward had three subcategories of the special conditions of the patients, sterilization of the angiography environment, and the need to become familiarized with the ward. The category of the proper use of specialized equipment had two subcategories of expensive equipment and management regulations of the maintenance of specialized equipment. The category of the need for education and skills training had two subcategories of the need for knowledge skills and the need for communication skills. Conclusion: The three most important findings of this study were the need for familiarity and proper use of specialized equipment and the necessity of education and skills training, which are like a golden treasure, the key to which is in the hands of hospital managers and officials. The training of the healthcare team in the angiography ward is a gradual and continuous process. Among the required skills for practice in the angiography ward are having adequate knowledge and the ability to properly communicate with the patients and their companions and the ability to use the specialized equipment correctly and appropriately, which could be achieved through the implementation of communication and counseling training courses, training on the use of specialized equipment, and the necessary preparations for the personnel of this ward. Considering the sensitivity of the angiography ward, the criticality of the applied procedures in the ward, and important issues such as clinical governance and accreditation, special attention should be paid to educational need assessment in order to implement proper interventions by hospital managers and health planners in terms of the training and skills of the personnel.
کلیدواژه‌های انگلیسی مقاله Angiography Ward, Children, Healthcare Team

نویسندگان مقاله هایده حیدری | H Heidari
School of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran (*Corresponding author) Tel: 0989133822402 Email:heidari.h@skums.ac.ir
دانشکده پرستاری مامایی، مرکز تحقیقات مدل سازی سلامت، دانشگاه علوم پزشکی شهرکرد، شهرکرد،ایران (*نویسنده مسئول) شماره تماس: 09133822402 Email:heidari.h@skums.ac.ir

ارسلان خالدی فر | A Khaledifar
School of Medicine, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
دانشکده پزشکی، مرکز تحقیقات مدل سازی سلامت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران


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