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Background & Aim: Moral sensitivity has various dimensions including personal sentiments, scientific competency, and reasoning and decision making capabilities. To achieve this, some personal traits and educational preparedness are needed. The aim of this study was to determine nurses’ moral sensitivity and its relationship with demographic and professional characteristics in hospitals affiliated to Tabriz University of Medical Sciences.
Methods & Materials: This descriptive, correlational study was conducted on 198 nurses working in the medical wards of hospitals affiliated to Tabriz University of Medical Sciences in 2016. Census sampling method was implemented. Data were collected through a demographic and professional characteristics form and the Moral Sensitivity Questionnaire (MSQ). The data were analyzed by the SPSS software version 13 using descriptive statistics, T test, Pearson correlation coefficient and ANOVA.
Results: The mean score for nurses’ moral sensitivity was 4.84±0.48 (out of 7). The highest scores were related to the domains of “Interpersonal orientation” and “following the rules”. The lowest scores were related to the domains of “experiencing moral conflict” and “modifying autonomy”. There was a significant and inverse correlation between age and “modifying autonomy” (P=0.008, r=-0.193) and also between age and “following the rules” (P=0.034, r=-0.156). Moreover, there was a significant and inverse correlation between work experience and “following the rules” (P=0.009, r=-0.187).
Conclusion: Given that the nurses gained a low score in the domain of “modifying autonomy”, it is suggested that client centered care and patient’s autonomy be emphasized in developing nursing curriculum and in service training programs.
 

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Background & Aim: Creating and maintaining a safe environment is an important part of care in psychiatric wards. The results of previous studies indicated that some features of the physical environment facilitate the ward’s safety. The experiences of people who are most likely to be present in these environments can be the best source for identifying these features. Therefore, this study was conducted to explain patients’ and employees’ perceptions toward the features of a safe physical environment in psychiatric wards.
Methods & Materials: In this exploratory qualitative descriptive study, seven patients at discharge time and nineteen employees working in psychiatric wards were interviewed about their experiences in psychiatric wards and 84 hours of field observation was done. The data were analyzed using a qualitative content analysis approach according to the method proposed by Graneheim and Lundman.
Results: The results showed a safe physical environment in psychiatric wards meant “having an accident-free environment”. This theme was abstracted from two main categories included “Accidents prevention through design” and “having a natural life environment”, which, according to the experience of the staff, is required to balance the two. The subcategories of “having the design of accidents prevention” were “eliminating or modifying accident-causing objects”, “wards based on the characteristics of the patients” and “conditions for facilitating staff performance” and the subcategories of “having a natural life environment were “meaningful activities", “healthy and pleasant conditions” and “preserved privacy”.
Conclusion: According to the results of the study, it is necessary to create a physical environment free of accidents and at the same time to meet the daily needs of patients in order to prevent physical and psychological damage to patients and staff in psychiatric wards.
 

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Background & Aim: Self-care education is one of the effective ways to improve the quality of life and health in patients with heart failure. The purpose of this study was to determine the effect of applying the specific situation theory on the quality of life in patients with heart failure.
Methods & Materials: In a clinical trial study, 80 patients with class 2 or 3 heart failure, referred to 12 Farvardin hospital in Kahnooj in 2018 were included. Data collection tool included a three-part questionnaire: demographic variables, Left Ventricular Dysfunction Scale to assess patients' quality of life, and Self-care Heart Failure Index. The questionnaires were completed at the first visit and three months after follow-up. Data was analyzed using independent and paired t-test, ANOVA, Pearson correlation through the SPSS software version 20.
Results: Before the intervention, there was no significant difference in the scores of quality of life and self-care between the two groups. After the intervention, the mean score of quality of life and self-care dimensions increased (P<0.001). Regarding self-care after the intervention, the highest score was related to self-care confidence with mean and standard deviation of 21.43 and 3.30 respectively, and the lowest score was related to self-care management with mean and standard deviation of 17.45 and 5.5 (P<0.001).
Conclusion: Paying attention to the dimensions of self-care based on a specific situation theory can lead to a better understanding of these patients’ problems and appropriate planning, and in turn improvement of the quality of life. Since in this study, most of the participants were illiterate, using visual teaching aids, adjusting the schedule according to the patient's conditions and readiness, and if necessary, family involvement can have positive results. It appears necessary to consider the underlying factors in the implementation of self-care programs, especially in people with lower levels of education and income.
Clinical trial registry: IRCT20141109019862N6