ARTICLE INFO

Article Type

Qualitative Study

Authors

Farsi   Z. (1)
Rajai   N. (*2)






(*2) Maternal-Infant Health Department, Nursing Faculty, Aja University of Medical Sciences, Tehran, Iran
(1) Research & Community Health Department, Nursing Faculty, Aja University of Medical Sciences, Tehran, Iran

Correspondence

Address: Nursing Faculty, Aja University of Medical Sciences, Kaj Street, Shariati Street, Tehran, Iran. Postal Code: 1613916151
Phone: +98 (21) 77500404
Fax: +98 (21) 77601533
n.rajai22@yahoo.com

Article History

Received:  May  6, 2019
Accepted:  September 30, 2019
ePublished:  December 21, 2019

BRIEF TEXT


… [1]. During the war, health workers, including doctors, nurses and relief workers, were among the first groups to deal with injuries and played a key role in the care, education, defense, leadership and management of the injured persons and reducing the number of martyrs and veterans [6].

... [7]. The nature of war-time care is very different from the normal situation [8]. ... [9]. In fact, during the war, high casualties, lack of facilities and time, long working hours, sleep disturbances, frequent exposure to death and pain, [10] lack of staff, confusion and uncertainty [9], out-of-office affairs [11], fear, stress, depression [12], and ambiguity, uncertainty and despair [9] can make the working conditions extremely difficult are likely to affect the quantity and quality of care provided to the injured. Therefore, health workers in critical situations, such as war, to maintain their health and increase the level of care for the injured people, in addition to providing healthcare, should be able to manage, judge in dangerous clinical situations, decide to save lives, solve complex problems, and be creative [13, 14] .... [15-28].

This study aimed at explaining the managerial competencies of health care providers to reduce the number of martyrs and veterans in the Iran-Iraq war.

This research was a qualitative study using conventional content analysis.

This research was carried out using the documentation available in the library and electronic resources in 2018-19.

Purposeful sampling was used. Over 119 written narratives were collected from 101 health care workers over eight years of the war published in various documents.

The researchers collected the print and electronic documentation by referring to the libraries and electronic resources available in the libraries of the medical, public sciences, as well as military organizations. The following keywords were used to search the information sources: war, combat, Iran, Iraq, Holy Defense, health care workers, healthcare staff, Physician/Doctor, Medicine, Nurse, Nursing, Paramedic/ medical assistant, Paramedic, rescue worker, health center/Hospital, diary/Diaries, Military Medicine, Martyrs, and Veterans in Farsi and English available in the international and national databases using google and yahoo search engine published in 1979-2017. Inclusion criteria were the texts and documents containing semantic units related to the experiences and memories of the Iran-Iraq war and narrated by a professional military or civilian health professional. Exclusion criteria were texts that contained experiences and memories other than health care. Overall, more than 119 written narratives were collected from 101 health care workers during the eight years of Iran-Iraq war published in various texts. ... [29]. Researchers began writing preliminary analysis based on their understanding of the studied texts, and continued to provide backgrounds to extract codes. In this regard, the texts were changed to semantic units and labeled with initial codes. The extracted codes were then compared based on similarities and differences and classified into themes and sub-themes. This classification was formed by organizing and grouping the passwords into semantic clusters. Researchers combined and organized these sub-themes into a smaller number of themes based on the quality of the relationship between the sub-themes. The chart and tree diagrams were used to organize them into a hierarchical structure. It should be noted that in this process, both manifest and latent content analysis was performed, until the final themes were extracted. Also, "continuous comparative analysis", as one of the main approaches to the analysis of qualitative texts was used and the extracted themes and sub-themes were regularly compared and reviewed with each other in written narratives. "Memoing" was another technique used in data analysis process. ... [30]. Data analysis continued until saturation.

The results obtained by the analysis of 952 pages of diaries written by the health care staff related to the subject (7 books). A total of 382 primary codes were extracted from the data. The main themes were "management and leadership", "resource management" and "executive management" (Table 1).

"Planning" was one of the sub-themes derived from the data. In a study by Nekoumi Moghaddam et al., which assessed the nurses' needs for crisis relief and support using qualitative method, the need for a coherent plan was emphasized [31]. … [32, 33]. Regarding "Human Resources" sub-theme, most of the participants mentioned the lack of human resources. In this regard, Nekui Moghaddam et al. also pointed to the shortage of manpower in critical situations, such as the Bam earthquake [31]. ... [34]. Considering the sub-theme "Providing Physical Resources", it has shown that in critical situations of war and during military operations, some places were considered to treat the injured cases. Studies have shown that the construction of an operating room in the region during the Iraq-Iran war had a significant impact on reducing mortality of the injured cases [11]. ... [35, 36]. Ghanjal et al. also mentioned the good readiness of the rescue and emergency stations to receive the injured cases in Walfajr 4 military operation [23]. Firouzkoohi et al. also stated in their study that nurses were not prepared to work in critical situations at the beginning of the Iraq-Iran war [22]. ... [37-40].

Similar studies are recommended to explain the experiences of healthcare workers in unusual situations using other methods, including interviews.

One of the limitations of this study was lack of interviewing to collect data and no access to participants to confirm the memories recorded in the texts.

The managerial competencies of health care providers included management, leadership, providing resources, and executive management, which have been used to reduce the number of martyrs and veterans in the Iran-Iraq war.

We are grateful to the Ajay University of Medical Sciences for their support of the research.

None.

The present study was approved by the Ethics Committee of AJA University of Medical Sciences (IR.AJAUMS.RES.1397.094).

This project was supported by Ajay University of Medical Sciences.

TABLES and CHARTS

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