title: A grounded theory of humanistic nursing in acute care work environments.
abstract: BACKGROUND
  Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment.
  
  
  OBJECTIVE
  To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting.
  
  
  METHODS
  Data were collected from interviews and observations in 2009-2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. Participants and research context: In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals.
  
  
  RESULTS
  The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation-education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others' needs, resulting in "success and accomplishment" of nurse/nursing manager and patient/family.
  
  
  CONCLUSIONS
  This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated.
authors.affiliation: Lorestan University of Medical Sciences, Khorramabad, Iran; Tarbiat Modares University, Tehran, Iran.
authors.forename: Mojgan
authors.identifier: http://orcid.org/0000-0001-7051-1605
authors.initials: M
authors.lastname: Khademi
authors.forename: Eesa
authors.initials: E
authors.lastname: Mohammadi
authors.affiliation: Tarbiat Modares University, Tehran, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Vanaki
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D066296:Grounded Theory; D006808:Humanism; D006801:Humans; D007492:Iran; D008297:Male; D009726:Nurses / Q000523:psychology*; D009729:Nursing / Q000592:standards*; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D036301:Qualitative Research; D017132:Workplace / Q000523:psychology / Q000592:standards
keywords: Grounded theory; humanistic nursing; nurses; professional values; rights violation