The challenges of the Iranian nursing system in addressing community care needs

Ebrahim Ezzati; Shahram Molavynejad; Amir Jalali; Mohammad-Ali Cheraghi; Simin Jahani; Dariush Rokhafroz

doi:10.4103/jehp.jehp_1398_22

The challenges of the Iranian nursing system in addressing community care needs

J Educ Health Promot. 2023 Oct 31:12:362. doi: 10.4103/jehp.jehp_1398_22. eCollection 2023.

Authors

Ebrahim Ezzati¹, Shahram Molavynejad², Amir Jalali³, Mohammad-Ali Cheraghi⁴, Simin Jahani², Dariush Rokhafroz²

Affiliations

¹ Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
² Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
³ Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
⁴ Department of Nursing Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Health Sciences Phenomenology Association, Ministry of Health and Medical Education, Tehran, Iran.

Abstract

Background: The nursing system is one of the major and important fields of health and medicine in every country, responsible for providing nursing care and addressing medical and health-related community care needs. The aim of this study was to explain the challenges of the Iranian nursing system in addressing community care needs.

Materials and methods: A conventional content analysis method was performed in this exploratory qualitative study, and 27 participants were selected through a purposive sampling method based on the inclusion criteria. In-depth semi-structured interviews were conducted with the subjects, and data saturation was achieved in the 27^th interview. The main interviews with the participants were individual, in person, and face-to-face, conducted at different times (morning and evening) in a peaceful environment and at the convenience of the participants. The interviews were recorded by the researcher with the participants' consent. The duration of the interviews ranged from 50 to 70 minutes, given the participants' energy and time. Data analyses were done using Graneheim and Lundman approach.

Results: After conducting the interviews and the simultaneous analysis, three themes were extracted, including the challenging structure in the internal environment, the operating environment, and the social environment, with seven main categories and 26 subcategories. An inadequate number of nurses given the real needs of society, the unbalanced proportion of employed clinical nurses to the real needs of society, poor presence of nurses in community-based nursing services, insufficient attention to the optimization of the work environment, the gap between education and clinical practice in the nursing system, poor mutual accountability of the community, and policies in the health system were seven main categories in this study.

Conclusion: In general, the results showed that the Iranian nursing system faces many micro, meso, and macroscale challenges. It is necessary to plan properly to enhance the accountability of the nursing system to the current community care needs by improving the situation.

Keywords: Community health; health service needs; nursing; social accountability.