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      Challenges of Cooperation between the Pre-hospital and In-hospital Emergency services in the handover of victims of road traffic accidents: A Qualitative Study Translated title: Desafíos para la cooperación entre los servicios de emergencias prehospitalarias e intrahospitalarias en la entrega de víctimas de accidentes de tránsito: un estudio cualitativo Translated title: Desafios para a cooperação entre os serviços de emergências pré-hospitalar e intrahospitalar na entrega de vítimas de acidentes de trânsito: um estudo qualitativo

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          Abstract

          Objective.

          To take a deep look at the challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents.

          Methods.

          This is a qualitative study and the method used is of content analysis type. Semi-structured interviews were used to collect the data. Through purposive sampling, fifteen employees from ambulance personnel and hospital emergency staff were selected and interviewed. They expressed their experiences of cooperation between these two teams in the handover of traffic accident casualties. The interviews were transcribed verbatim and content analysis method was used to explain and interpret the content of the interviews.

          Results.

          Three major categories were derived from the analysis of interviews: Shortage of infrastructure resources (Shortage of equipment, Shortage of physical space, and Shortage of manpower); Inefficient and unscientific management (Shaky accountability, Out-of-date information based activities, Poor motivation, and Manpower low productivity); and Non-common language (Difference in understanding and empathy, and Difference in training and experience).

          Conclusion.

          The obtained results of this study suggest that the careful planning of resources, the promotion of managerial practices as well as empowerment program of the staff, healthcare managers and policymakers can take a pace forward in order to enter into a hearty coordination between these two services for the attention of victims of road traffic accidents.

          Resumen

          Objetivo.

          Examinar los desafíos para la cooperación entre los servicios de emergencias prehospitalarias y hospitalarias en la entrega de víctimas de accidentes de tránsito.

          Métodos.

          Estudio cualitativo con análisis de contenido. Se utilizaron entrevistas semiestructuradas para la recopilación de los datos. Se seleccionaron y entrevistaron quince personas de los equipos de atención prehospitalaria y del servicio de emergencias de un hospital a partir del muestreo intencional. Los participantes expresaron sus experiencias de cooperación entre estos dos grupos en la entrega de víctimas de accidentes de tráfico. Las entrevistas se transcribieron textualmente y se utilizó el análisis de contenido para explicar e interpretar el contenido de las entrevistas.

          Resultados.

          Emergieron tres categorías principales : Escasez de recursos de infraestructura (equipos, espacio físico y de personal); Gestión ineficiente y no científica (responsabilidad inestable, actividades basadas en información desactualizada, motivación deficiente, y baja productividad de personal); y Lenguaje no común (diferencia en comprensión y empatía, y diferencia en capacitación y experiencia).

          Conclusión.

          Los resultados obtenidos en este estudio muestran dificultades con la planificación de los recursos y la promoción de las prácticas de gestión, así como la necesidad de un programa de empoderamiento del personal. Se deben formular políticas para poder avanzar en el mejoramiento de la coordinación de los servicios en la atención a víctimas de accidentes de tráfico.

          Resumo

          Objetivo.

          Examinar os desafios para a cooperação entre os serviços de emergências pré-hospitalar e hospitalar na entrega de vítimas de acidentes de trânsito.

          Métodos.

          Estudo qualitativo com análise de conteúdo. Se utilizaram entrevistas semiestruturadas para a recopilação dos dados. Através da amostra intencional se selecionaram e entrevistaram quinze pessoas das equipes de atenção pré-hospitalar e do serviço de emergências de um hospital. Os participantes expressaram suas experiências de cooperação entre estes dois grupos na entrega de vítimas de acidentes de trânsito. As entrevistas se transcreveram textualmente e se utilizou a análise de conteúdo para explicar e interpretar o conteúdo das entrevistas.

          Resultados.

          Emergiram três categorias principais : Escassez de recursos de infraestrutura (equipamentos, espaço físico e de pessoal); Gestão ineficiente e não científica (responsabilidade instável, atividades baseadas em informação desatualizada, motivação deficiente, e baixa produtividade de pessoal); e Linguagem não comum (diferença em compreensão e empatia, e diferença em capacitação e experiência).

          Conclusão.

          Os resultados obtidos neste estudo mostram dificuldades com a planificação dos recursos e a promoção das práticas de gestão, assim como a necessidade de um programa de empoderamento do pessoal. Se devem formular políticas para poder avançar no melhoramento da coordenação dos serviços na atenção as vítimas de acidentes de trânsito.

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          Most cited references31

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          Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

          Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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            Trust, Control, and Risk in Strategic Alliances: An Integrated Framework

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              Rigour and grounded theory research.

              Grounded theory methodology is a suitable qualitative research approach for clinical inquiry into nursing practice, leading to theory development in nursing. Given the variations in, and subjectivity attached to, the manner in which qualitative research is carried out, it is important for researchers to explain the process of how a theory about a nursing phenomenon was generated. Similarly, when grounded theory research reports are reviewed for clinical use, nurses need to look for researchers' explanations of their inquiry process. The focus of this article is to discuss the practical application of grounded theory procedures as they relate to rigour. Reflecting on examples from a grounded theory research study, we suggest eight methods of research practice to delineate further Beck's schema for ensuring, credibility, auditability and fittingness, which are all components of rigour. The eight methods of research practice used to enhance rigour in the course of conducting a grounded theory research study were: (1) let participants guide the inquiry process; (2) check the theoretical construction generated against participants' meanings of the phenomenon; (3) use participants' actual words in the theory; (4) articulate the researcher's personal views and insights about the phenomenon explored; (5) specify the criteria built into the researcher's thinking; (6) specify how and why participants in the study were selected; (7) delineate the scope of the research; and (8) describe how the literature relates to each category which emerged in the theory. The eight methods of research practice should be of use to those in nursing research, management, practice and education in enhancing rigour during the research process and for critiquing published grounded theory research reports.
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                Author and article information

                Journal
                Invest Educ Enferm
                Invest Educ Enferm
                iee
                Investigacion y Educacion en Enfermeria
                Imprenta Universidad de Antioquia
                0120-5307
                2216-0280
                6 January 2019
                Jan-Apr 2019
                : 37
                : 1
                : e08
                Affiliations
                [1 ] originalShahid Beheshti University of Medical Sciences, Tehran, Iran. normalizedShahid Beheshti University of Medical Sciences orgnameShahid Beheshti University of Medical Sciences Iran
                [2 ] originalShahid Beheshti University of Medical Sciences, Tehran, Iran. email: r.khanijazani@sbmu.ac.ir. Corresponding author. normalizedShahid Beheshti University of Medical Sciences orgnameShahid Beheshti University of Medical Sciences Iran r.khanijazani@ 123456sbmu.ac.ir
                [3 ] originalShahid Beheshti University of Medical Sciences, Tehran, Iran. email: ahmadalibabaee@gmail.com normalizedShahid Beheshti University of Medical Sciences orgnameShahid Beheshti University of Medical Sciences Iran ahmadalibabaee@ 123456gmail.com
                [4 ] originalShahid Beheshti University of Medical Sciences, Tehran, Iran. email: alamdsari@endocrine.ac.ir normalizedShahid Beheshti University of Medical Sciences orgnameShahid Beheshti University of Medical Sciences Iran alamdsari@ 123456endocrine.ac.ir
                [5 ] originalNurse, Ph.D. Assistant Professor, Shiraz University of Medical Sciences, Shiraz, Iran. email: najafikalyani@sums.ac.ir orgnameShiraz University of Medical Sciences Iran najafikalyani@ 123456sums.ac.ir
                Article
                10.17533/udea.iee.v37n1e08
                7871464
                31083845
                ec5a8055-4e98-4f3d-bd70-12f096b4146b

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 08 October 2018
                : 11 February 2019
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 30, Pages: 0
                Categories
                Original Articles

                ambulances,accidents, traffic,patient handoff,personnel, hospital,health resources,emergency service, hospital resources,qualitative research,ambulancias,accidentes de tránsito,pase de guardia,personal de hospital,recursos en salud,servicio de urgencia en hospital,investigación cualitativa,acidentes de trânsito,transferência da responsabilidade pelo paciente,recursos humanos em hospital,recursos,serviço hospitalar de emergência em saúde,pesquisa qualitativa

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