چكيده لاتين :
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.
