---

Background & Aim: Nurses can support the patients’ rights advocacy, if they are informed of these rights. Furthermore in order to exercise and protect of these rights, the working environment should be appropriate.

Methods & Materials: The aim of this descriptive analytical study was to explore the nurses’ awareness of patients’ rights in Tehran teaching hospitals and the facilitators of observing theses rights from their perspective. To achieve this, 517 nurses were selected using multi stage stratified sampling method. Data were gathered utilizing a researcher made questionnaire with 3o statements regarding patients’ bill of rights, and an open question about patients’ rights facilitators at the end.

Results: The findings indicated that overall nurses had a high level of awareness regard patients’ rights. In addition nurses mentioned 17 factors as facilitators of patients’ rights practice. These were classified to three groups: organization related, personnel related and client/ patient related factors. The most frequent items were in the group of organization related factors.

Conclusion: Despite of nurses’ high awareness of patients’ rights, observing these rights in practice needs many other requirements. These requirements should be recognized and identified. This can be the first step for finding proper solutions by all health care providers and policy makers as well.

---

Background & Aim: Patient satisfaction has been recognized as a key indicator of health care quality which is used by accreditation agencies to monitor quality of care in hospitals. A high proportion of health caregivers are nurses. The services provided by nurses are significantly influential in satisfaction of patients. The aim of this study was to assess patients&apos satisfaction from nursing care in hospitals of Iran University of Medical Sciences in 2010.

Methods & Materials: In this cross-sectional study, we recruited 200 patients from different wards (except for special wards, Emergency department, Pediatric and Psychiatric wards) at the time of discharge from hospital through multistage sampling method. Data were collected using Patient Satisfaction Instrument (PSI). Data analysis was performed using descriptive statistics, chi-square and regression analysis.

Results: Majority of patients (72%) were moderately satisfied. Patient satisfaction had a significant relationship with the type of ward (P≤0.001), and type of hospital (P≤0.001). Of demographic variables, only patients&apos level of education was significantly associated with patient satisfaction (P≤0.019).

Conclusion: In this study, patients were moderately satisfied from nursing care services. Educating hospital staff, especially nurses and encouraging them to actively participate in activities to promote patient satisfaction should be a priority for hospital management. We should also consider that in a competitive market of health and treatment care giving, institutions that put patient satisfaction as their main goal are more successful.

---

Background & Aim: Moral distress, a major issue in nursing, affects nurses in all healthcare sections. The existence of such distress and its consequent job dissatisfaction may pose a threat to nurses&apos physical and mental health, as well as their quality of life and hinder their accomplishment of individual and social goals. The aim of this study was to determine the relationship between the moral distress and job satisfaction In nurses.

Methods & Materials: This cross-sectional correlational study was conducted on 210 nurses employed in the selected healthcare centers of Tehran University of Medical Sciences in 2009. Data were collected using a questionnaire consisting demographic characteristics, the Corley&aposs moral distress scale, and the Minnesota Satisfaction Questionnaire. Data were analyzed using descriptive statistics and independent t-test, analysis of variance, Wilcoxon test and Pearson&aposs correlation coefficient in the SPSS v.14.

Results: According to the findings of the study, the mean of the moral distress was 1.77 out of four and the mean of the job satisfaction score was 3.17 out of 5 indicating a moderate job satisfaction among the nurses. A significant relationship was observed between the moral distress and nurses&apos job satisfaction in the present study, indicating that by decreasing moral distress, job satisfaction increases.

Conclusion: Although numerous factors govern nurses&apos job satisfaction, the observed relationship between moral distress and job satisfaction indicates that identifying and limiting factors influencing these distresses can lead to improved job satisfaction for nurses.

---

Background & Aim: Patient falling is one of the most important indicator of patient safety. Nurses have an important role in the prevention of patient falls and the improvement of patient safety standards. The current study aimed to determine the relationship between the incidence of patient falls and nurses’ professional commitment.

Methods & Materials: In this cross-sectional study,300 nurses employed in hospitals affiliated to Tehran University of Medical Sciences, were selected through a proportional stratified sampling method. Data were collected by a three-part questionnaire consisted of the demographic data, the Nurses’ Professional Commitment Scale and the reports on the number of patient falls in the past three months. Data were analyzed on SPSS software using statistical tests including Pearson's correlation coefficient, Kruskal-wallis and independent-t test.

Results: The mean score of patient falls in the past 3 months was 6±1.61(moderate) for each nurse and the mean score of nurses' professional commitment was 86±8.61 (committed).A significant and reverse relationship was observed between the incidence of patient falls and nurses’ professional commitment (R= -0.51; p<0.018).There is no relationship between nurses’ demographic characteristics and patient falls.

Conclusion: Despite the lower incidence of falls in the patient under the supervision of the committed nurses, its prevention entails taking into account all factors that influence this phenomenon besides improving professional commitment.

---

Background & Aim: White lie is one of the inevitable challenges that creates an ethical dilemma during the patient care process. White lie remains an abstract concept in caring process. The aim of this study was to analyze the concept of white lie in the caring process using a hybrid model.
Methods & Materials: A hybrid model of concept analysis including three phases was used in this study. In the theoretical phase, different databases including PubMed, CINAHL, Scopus, Science Direct, Google scholar, SID and Magiran were searched for finding relevant articles published in 1980-2018. The keywords were truth, white lie, care and deception (in Persian and English). In the fieldwork phase, semi-structured in depth interviews were conducted with nurses. In next step, by combining the two previous stages, the final analysis was performed.
Results: In the theoretical phase, the attributes of the concept were determined, including “harmlessness”, “without personal motivation” and “use in compulsion situations”. In the fieldwork phase, three main categories such as “the sweetness of the bitter truth”, “harmless sentences to prevent harm” and “temporary relief to balance the situation” were identified from the data analysis. By merging the concepts extracted from the theoretical and fieldwork phases, “white lie in the patient care process” was defined as “an ethical decision without personal motivation, which is chosen in unstable situations to prevent predictable harms to the patient in facing the bitter truth”.
Conclusion: Although a definition of white lie was developed based on the above three phases, the further development of this concept requires a deeper look at the Iranian-Islamic culture. Therefore, further research is recommended in other medical centers in the country.