Showing 43 results for Iran
Vahideh Rahimimehr ,
Volume 15, Issue 1 (3-2022)
Abstract
Environment design has profound effects on mental, physical health, and behavior patterns. One of the architectural environments is medical centers that have changed in recent decades in developed countries. As purely physical and indoor environments have been replaced by indoor and outdoor environments. Outdoor gardens include healing gardens. Studies on traditional Iranian gardens show that these gardens are healing gardens. Outdoor gardens include healing gardens. Studies on traditional Iranian gardens show that these gardens are also healing gardens, so this study tried to investigate the healing criteria of therapeutic gardens in Iranian gardens from the perspective of traditional medicine to incorporate the attitudes of designing therapeutic environments in Iran towards the teachings of traditional medicine. In this comparative study, the method of data collection is documentary so that first, the impact of nature on man from the perspective of traditional medicine has been studied and then the criteria of healing landscapes in the Iranian garden have been studied from the perspective of Iranian traditional medicine using the sources of medical history and related articles. It seems that the general criteria for healing gardens in Iranian gardens are per the principles of traditional medicine and using the medical advice to patients can be more precisely designed for therapeutic gardens and used the Iranian garden model for design medical centers Because the criteria for the therapeutic gardens are general But according to the advice of traditional medicine practitioners can be more precise design according to the patients' temperament differences.
Elham Malekzadeh,
Volume 15, Issue 1 (3-2022)
Abstract
After September 1931 and the end of World War II, the Pahlavi government turned its attention to the villages and the implementation of the second development plan, followed by rural health programs. With the formation of the Health Corps in 1954, as the seventh principle of the Shah and the Nation Revolution, all physicians and pharmacists in the service of the conscription system were asked to take charge of medical-health services in rural areas of the country.
The present article uses archival documents and library resources in a descriptive-analytical manner to answer the question: Was the Health Corps in Iran a result of indigenous action or the result of the second Pahlavi government's development plans with US recommendations in support of Third World countries? The results of the research indicate that the historical nature and examples confirming the patient's defiance and their treatment were rooted in the historical past of Iran. The creation of the Health Corps and its acceptance by the villagers, due to its indigenous and Iranian nature, was acceptable in the historical memory of Iranians. However, the process of international interactions and the development policies of the country and the government's reform, along with taking advantage of US support opportunities, expanded within the framework of the principles of the White Revolution in Iran and led to extensive activity. This, as the present article claims, explains the indigenous practice of this measure.
Alireza Monajemi , Amir Hassan Mousavi,
Volume 15, Issue 1 (3-2022)
Abstract
Medicalization, in the sense of expansion of medicine in different aspects of human life and ultimately the transformation of medicine into a tool of social control and domination, is a common interpenetration in the literature. This concept, since its inception in the mid-twentieth century, has been an exclusive critique of modern medicine, meaning that branch of medicine based on biomedical paradigm. In this article, we argue that the conceptual shortcoming of this view and the reduction of medicalization to only one medical paradigm, lead to appear medicalization in the new outfit in the name of demedicalization and with more harmful aspects. By focusing on biomedical paradigm or biomedicalization, we neglected other types of medicalization like paramedicalization or CAMization, meaning expansion of Complementary and Alternative Medicine in different aspects of human life. This negligence makes the space to misuse of medicalization for more medicalizing issues. In the following, Iranian Traditional Medicine has been examined as one of the examples of CAM. By presenting historical examples, in the contrast of common understanding of many medical sociologists, we showed that medicalization is not an exclusive concept around modern medicine and its root go back hundreds of year, not just the last hundred year and not only in the western world.
Katayoun Fekripour , Azadeh Heidarpour,
Volume 15, Issue 1 (3-2022)
Abstract
Stress and psychological problems arose with the advent of urbanization. Ancestors generally knew disease as the result of interaction with external factors, including gods, demons, and spirits. The Iranians considered the disease created by the devil and the Mesopotamians considered the disease as a result of wrath of the gods on the sick person for various reasons. This study tries to show the knowledge of Iranians and Mesopotamians about mental illnesses and tries to answer these questions: What information about the treatment of mental illnesses has reached us through the ancient texts of the ancient Iranians and the tablets of the Mesopotamians? And was there also a difference between a physician and a psychiatrist? What similarities and differences can be seen in ancient Iranian texts and Mesopotamian tablets about these contents? In Iranian texts, we are a little familiar with the topic of psychiatry, but the Mesopotamian tablets, which are older, provide us with more details about mental illness. What is certain is that they did not know enough about mental illnesses because they were unfamiliar with brain function; As a result, they resorted to magic and sorcery to cure it. Psychotherapists had a high position in the Iranian and Mesopotamian society and were considered a clergyman. They worked with the physician to treat many ailments. This is a historical- descriptive research, and the subject matter has been gathered in a library way.
Mohammad Hossein Eftekhari, Alireza Parsapour, Ayat Ahmadi, Bagher Larijani, Neda Yavari, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
Defensive medicine is performing actions that have no medical indication and benefit for the patient (positive defensive medicine) or refraining from performing risky actions that have a medical indication and benefit for the patient (negative defensive medicine). These actions are carried out by the physicians with the sole motive of protecting themselves against complaints or tensions such as the protest of the patient or colleagues and usually cause physical, psychological, or economic harm to the patient or the institution that pays the treatment fee, such as insurance organizations. It can have consequences in terms of the quality of care and the efficient use of limited health resources. Factors such as the physician’s concerns about lawsuits and proceedings may lead to defensive behaviors. This study presented suggestions for the management and prevention of such behaviors, including three main categories related to the strategies for the reformation of the patient complaint handling system, social strategies for the management and prevention of defensive medicine, and managerial-organizational strategies. These strategies are based on the findings of a mixed-methods research including an unsystematic review of resources and a qualitative study conducted using semi-structured interviews. The results have been discussed by the Medical Ethics Committee of the Academy of Medical Sciences of Iran.
Farzad Zakian Khoramabadi, Alireza Parsapour, Bagher Larijani, Amirhossein Takian, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
The right to access health services as a part of fundamental human rights, affected by the conditions and facilities of governments and the international status, has always faced challenges. Despite the clarity of the general policies and upstream documents in the Iranian health system regarding the need to provide immigrants and refugees with health services and Iran’s membership in the relevant conventions, the implementation of the provisions of these documents is not consistent and complete for various reasons, including the inadequacy of laws related to immigrants and refugees and the incorrect implementation of some existing laws. The first draft of the ethical guidelines for providing health services to immigrants was prepared by the research team using the results of a review of relevant documents as well as a qualitative study and finalized according to the opinions of the participants in a panel of experts. In this draft, after explaining the values and ethical principles governing the provision of services to Afghan immigrants, the suggested guidelines and assignments were presented to the main stakeholders involved, including the policymakers and macro planners of the health system, institutions and centers providing health services, professionals and health service providers, professional organizations, civil society activists, media and non-governmental organizations, and medical research and education authorities and researchers.
Zahra Kheiry, Iraj Nabipour, Neda Mehrdad, Abtin Heidarzadeh, Afshin Ostovar,
Volume 16, Issue 0 (11-2023)
Abstract
At first, education was the university’s only goal; nevertheless, scientific progress in the twentieth century added research to the universities’ missions. The industry sector’s knowledge-based technologies added a third mission to universities and brought the university into new fields. The fourth-generation universities provided a more comprehensive view by considering the four elements including university, industry, government, and civil society and the next generation (the fifth generation) of universities also considered the environment in addition to these four elements. The present study examined the optimal conditions and requirements for new-generation medical universities (third- to fifth-generation universities). This review study extracted 187 scientific documents from domestic and foreign databases and after screening, 56 documents were selected for the study. Finally, the propositions relevant to the objective of the study were extracted and categorized using content analysis. This study identified 17 optimal conditions for transitioning to new-generation universities. Moreover, 41 requirements were extracted and listed for achieving these conditions, each under its corresponding condition. New-generation universities are known as borderless and accountable universities. Thus, the communication and exchange of knowledge, capital, and value with institutions outside the university at the local, national, and international levels as well as accountability to the needs created at these levels are the main principles of new-generation universities. Given the unique structure of the Iranian health system and the infrastructure for communicating with society, by fulfilling other requirements, this structure can facilitate the transition to new-generation medical universities.
Hossein Riazi, Somayyeh Abedian, Hamid Moghaddasi,
Volume 16, Issue 0 (11-2023)
Abstract
In summary, this project was carried out in the following steps: reviewing the literature, determining the ethical and legal aspects of the implementation of the electronic health records, reviewing the existing laws and regulations in Iran, identifying the shortcomings and localizing the ethical and legal aspects of implementing electronic health records in Iran, and providing operational suggestions. By reviewing the literature, a list of ethical aspects of electronic health records was extracted and analyzed. Moreover, through reviewing the laws and regulations, it was shown that in the last decade, numerous and diverse laws have been passed in the field of electronic health, especially regarding electronic health records, and there is no serious legal gap in this field in the country. However, certain serious problems were observed including non-implementation or incomplete implementation of some existing laws and regulations, lack of sufficient technical and executive regulations and determining the examples of deviation from the goals of the laws and regulations or their correct implementation, and lack of implementation guarantee for some laws and regulations. Based on the studied documents, the current state of electronic health records in Iran was investigated from legal and ethical aspects, and operational suggestions were presented for its reformation and promotion.
Ali Hasan Rahmani, Ms Elahe Banafshe, Atefe Kamrani, Ms Azam Moridi, Ms Zohreh Yeganeh,
Volume 16, Issue 1 (3-2023)
Abstract
A professional and educated midwifery workforce is essential to provide high-quality maternal and newborn care. Midwives’ awareness and knowledge of professional rules and regulations would be necessary for correct practice. Accordingly, this study aimed to investigate midwives’ awareness and knowledge of the professional rules and regulations in Iran. In this systematic review study, the PICO guidelines were used to find the relevant articles through searching MeSH terms in Irandoc, SID, Scopus, EMBASE, Cochrane, Magiran, and PubMed databases up to September 7, 2023. The JBI checklist was used to assess the quality of the articles. This systematic review investigated 14 cross-sectional studies with a total of 2161 participants. The results demonstrated that midwives in Iran do not have a satisfactory level of awareness and knowledge about the professional rules and regulations. Based on the results, much more focus is required to enhance the awareness and knowledge of midwives about the professional rules and regulations. The results of this study can be used for developing educational programs on midwifery professional rules and regulations as a necessity for providing high-quality maternal and newborn care
Fatemeh Bahmani, Mahshad Noroozi, Narjes Kolahchi, Mostafa Ghanei,
Volume 16, Issue 1 (3-2023)
Abstract
Emerging biotechnologies contribute significantly to societal well-being by influencing social, economic, and health fields. Attitudes toward biotechnologies differ, in various situations and over time, based on new understanding and evidence. One issue always emphasized in the ethical evaluation of emerging technologies is their dangerous and problematic aspects for human life and well-being. Simultaneously, ethical assumptions can influence ethical decision-making toward employing these technologies, including liberty, technological optimism, determinism, the lifecycle, power, the form of life, technology neutrality, ambiguity, uncertainty, dual-use transformative potential, and the challenges that will be raised by them. For the ethical assessment of emerging technology, six principal methodologies are employed. The "principles-based approach" focuses on obtaining the intended goals rather than determining specific requirements, laws, standards, and obligations and avoids checklist design. The ethical principles raised by the principles-based approach are presented in this article, including risk-cost-benefit, adherence to individual rights, sustainability, naturalness, precautionary, trajectory, responsible stewardship, public beneficence, justice and fairness, democratic deliberation, and intellectual freedom.Finally, by presenting a conceptual model in applying the principles above in forming biotechnologies, eighteen operational recommendations are presented to facilitate the ethical evaluation and monitoring of emerging biotechnologies in the policy-making process in Iran.
Amirhossein Mardani, Maryam Nakhoda, Ehsan Shamsi Gooshki,
Volume 17, Issue 0 (12-2024)
Abstract
Research misconduct cases reviewed by ethics committees serve as a valuable source of data for managing potential future misconduct. This study examines the reported cases within closed research misconduct files of the National Committee for Ethics in Biomedical Research of Iran, aiming to identify common manifestations of misconduct and influential factors across various activities within the research system. Documentation from 100 closed cases reviewed by the National Committee for Ethics in Biomedical Research during 2016 and 2017 was analyzed. A documentary research method and qualitative content analysis were employed. Using a directional analysis approach, the manifestations and factors contributing to misconduct in each case were extracted and categorized. Subsequently, causal relationships between the reported factors were defined. Twenty-one manifestations of research misconduct were identified, most of which involved undesirable micro-level activities, particularly the failure to adhere to ethical standards in research publication. Although negative impacts were observed at the meso level, including issues with research oversight, training in research standards and skills, journal management structures, and administrative and financial structures within universities, macro-level activities and deficiencies in research system performance—such as inadequate investment and financial resource allocation—were not addressed. Twelve causal relationships contributing to research misconduct were identified, highlighting how inadequate performance across different levels of the research system—including administrative structures for research approval and funding, research infrastructure, research evaluation, training, journal management, and oversight mechanisms—can interact and exacerbate misconduct. A key finding was the insufficient reporting of reasons for research misconduct in case documentation. Ethics committees appear to lack significant focus on analyzing the underlying causes of misconduct. Detailed and precise reporting of misconduct reasons, alongside independent studies, would provide decision-makers with valuable insights for preventing future occurrences.
Saeed Biroudian,
Volume 17, Issue 0 (12-2024)
Abstract
Conflicts of interest, particularly financial ones, pose a significant ethical challenge in the medical field. They can compromise clinical decision-making, erode patient trust, and ultimately diminish the quality of healthcare. This study reviewed ethical documents and guidelines published by the Medical Council of the Islamic Republic of Iran, including the Charter of Rights for the Medical Community. A comprehensive review of relevant scientific literature on conflicts of interest in healthcare was also conducted. The analysis revealed that financial relationships between physicians and external entities, such as pharmaceutical companies, can create conflicts of interest that negatively impact patient care. These conflicts can erode patient trust and lead to suboptimal clinical decisions. The Medical Council's ethical guidelines address these concerns by emphasizing the importance of transparency regarding financial ties and relationships. They advocate for the disclosure of such relationships to patients and the implementation of educational programs to enhance physician awareness of ethical principles and conflict-of-interest management strategies. Adherence to the ethical guidelines established by the Medical Council of Iran is crucial for effectively managing conflicts of interest in the physician-patient relationship. By prioritizing transparency, disclosure, and ongoing education, healthcare professionals can mitigate potential conflicts and maintain the highest standards of ethical conduct in patient care.
Jalal Saeidpour, Alireza Hajizadeh,
Volume 17, Issue 0 (12-2024)
Abstract
As one of the countries with the fastest growing aging population, it is predicted that more than 20% of the Iran’s total population will be elderly in 2040. It is important to address ethical considerations in providing healthcare services to aged population. This study aimed to review the evidence related to ethical considerations in providing healthcare services to the elderly in Iran. This study was a scoping review conducted using the six-step protocol of Arksey and O’Malley. The English-language, Persian-language databases and Google Scholar, were searched without time limitation. After selecting studies and extraction the data, the narrative analysis was used to analyze the data. Providing comprehensive healthcare including, preventive, diagnostic, treatment, and rehabilitation services to the elderly needs to be based on humane-Islamic principles and values accepted by society. The most important ethical considerations required are: Maintaining the dignity and eminence of the elderly in all situations, considering ethics in communication with the elderly, ensuring autonomy and independence of the elderly in relevant decision-making, paying attention to the principles of justice and benefit in healthcare interventions, empathy and cheerfulness among healthcare providers, ensuring confidentiality and privacy and protecting information, paying attention to privacy, obtaining informed consent in healthcare centers, paying attention to religious and Islamic rules in caring for the elderly, the responsibility of government and non-government institutions in preventing stigma and discrimination against the elderly, carrying out timely and ethically-based care actions, healthcare providers' adherence to teamwork and scientific and professional behaviors, supporting the elderly as a vulnerable population group in prioritizing health services, preventing conflicts of interest in elderly care, and using safe, affordable, reliable, and evidence-based healthcare services for the elderly. It is necessary to pay attention to the ethical considerations identified in this study in providing healthcare services to the elderly. So, it is recommended that policymakers, managers, and healthcare providers take actions at the levels of the ministry of health, medical universities, and healthcare centers providing services to the elderly to promote humane-Islamic principles and values.
Reza Karami,
Volume 17, Issue 1 (3-2024)
Abstract
Epidemic diseases have historically posed significant threats to human societies, with the plague being one of one of the deadliest. Between 1772 and 1773, an outbreak of plague, known as Abu Chafchir or Abu Khanjar, occurred in Ottoman Iraq, inflicting severe damage on the local economy. This outbreak spread throughout the Persian Gulf and southern Iran; hence it was also referred to as the Persian plague in European accounts. This study aimed to investigate the effects of this plague on human societies and its scope from various dimensions. The study was conducted using library-based and historical methods with a descriptive-analytical approach. Persian, Arabic, and English resources were extracted from domestic databases as well as the archives of British newspapers and the digital archive of Qatar, as important foreign archives. The findings indicated that Mesopotamia was one of the important centers for the outbreak of the plague, and the Persian plague spread to neighboring countries from this region. The results also revealed that the initial attempts to implement quarantine measures in Iran were made during the Karimkhan Zand dynasty and some preventive measures were taken for the first time in response to this plague. Moreover, the transregional trades and movement of commercial and pilgrimage caravans in these areas increased the spread of this disease. This plague changed the political and economic relations of these regions with other countries and resulted in a dramatic population decline
Shiva Khaleghparast, Saied Bagheri Faradanbeh, Samaneh Karimian, Fahimeh Khosrobeigi Bozchaloei, Seyed Ebrahim Hoseini Zargaz, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
The electronic health record system (SPAS in Iran) records information related to the health of individuals in an electronic format. It is the center for collecting health information and data on outpatients and inpatients. This system records information such as the patient's full name, marital status, gender, date of admission, level of education, occupation, type of admission, and other relevant medical data. The core values and ethical requirements of SPAS include safeguarding citizens' rights, respecting individuals, observing justice and fairness, transparency, encouraging participation, and accountability. In this study, the ethical aspects of SPAS were evaluated using the model proposed by the World Health Organization (WHO) for ethical evaluation. This model emphasizes fundamental ethical principles such as human well-being and health, respecting individuals and communities, justice, and fairness. Concerning human well-being and health, SPAS can prevent unnecessary and redundant interventions and provide physicians with quick access to an accurate patient history. Furthermore, the system ensures the confidentiality of information, which is essential to respect individuals and communities. Regarding justice and fairness, the system can improve access to health services for disadvantaged and remote areas. Moreover, SPAS adheres to procedural ethical principles such as solidarity, transparency, participation, and accountability. Therefore, by critically examining the ethical dimensions of the electronic health record system (SPAS), the findings of the present study provide valuable insights for policymakers, health professionals, and regulatory organizations to ensure the ethical and efficient performance of electronic health record systems in Iran.
Amirhossein Mardani, Maryam Nakhoda, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Since research misconduct can be considered as an adaptive reaction against the limitations, pressures, and demands arising from inappropriate functions of the research system, to manage it, the activities of the research system should be investigated and traced during the path of transferring research policies (macro level) to research development programs in institutions (meso level) and research implementation by researchers (micro level). By introducing the macro-meso-micro analytical framework, this study clarified the tasks, strategies, and activities formed at three levels of the research system of medical sciences in Iran; from macro policies of research (macro) to operational plans for the development of research in universities and research centers (meso) and researchers as research conductors (micro). For this purpose, three analytical levels of the research system were explained and defined according to the assumptions of this framework. By performing a qualitative content analysis of the relevant texts, those activities that could be useful at different levels to support the research integrity were identified and presented as different strategies. The results showed that the research system, based on the existing analytical framework, is not seen as a mere macro-system without regard to the interaction of its parts, but rather a system in which there is cross-sectional influence and interaction among the components. This approach can improve the focus, clarity, and capability to study research misconduct, and by using micro, meso, and macro levels, it can trace challenges in the interactive path of various activities and functions of the research system and their intertwining.
Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Defensive medicine refers to actions taken by doctors and other medical professionals to protect themselves against potential threats and risks, particularly to prevent patient complaints or convictions in court, which is carried out in various forms including positive and negative defensive medicine. Since the primary motivation behind such actions, often viewed as morally unjustified, is to avoid legal proceedings and lawsuits, court rulings against doctors can intensify these behaviors. Reports of criminal sentences against some doctors in Iran and reactions from professional associations highlight the significance of this issue. This study examined the effects of such sentences on the healthcare system by referring to available documents and data on the widespread prevalence of defensive medicine in Iran, offering some suggestions for managing the issue. The objective of the study was to emphasize the importance of acknowledging the defensive motivations of doctors in healthcare and its influential factors, particularly the fear of criminal convictions, which can increase defensive behaviors among doctors and amplify their negative impacts on the healthcare system.
Hamid Kavyani Pooya,
Volume 18, Issue 1 (3-2025)
Abstract
Education in Iran, as in the rest of the world, has a long history, and with the foundation of inclusive national governments, due to the interaction of civilizations and adaptation of scientific achievements, education and educational institutions and centers have undergone major changes and transformations. Accordingly, this study aimed to examine different methods of teaching medical sciences and transferring medical achievements to scholars and those interested in this profession in the history of Iran until the end of the Safavid era through a library-based method. Data were collected from original medical resources, travelogues, and reliable historical documents and evidence in Arabic, Persian, and English. Data were then described and analyzed using domestic databanks. The findings indicated that throughout the history of Iran, particularly in the Islamic civilization, medical education and sciences have been transferred both theoretically and practically. In modern terms, this involved lectures (theory) and clinical training (practice). Nevertheless, there have been differing opinions regarding the importance and priority of each method, and the period under study witnessed significant evolution and changes in improving the ways medical concepts have been conveyed to scholars.
Zahra Aghabeiglooei, Roshanak Saghebi, Jamal Rezaei Orimi, Morteza Mojahedi,
Volume 18, Issue 1 (3-2025)
Abstract
The history of medicine during the Safavid period (907-1135 AH) in Iran, as one of the important periods, has always been the focus of researchers. The main objective of this study was to conduct a quantitative evaluation of articles related to the “history of medicine in the Safavid period” in Iran. This descriptive-analytical, applied study was conducted using a quantitative approach. The statistical population of the study comprised all scientific productions on the history of medicine in the Safavid period indexed in domestic and international scientific databases over 22 years, from 2001 to March 2024. During the period under review, a total of 247 articles in the field of the history of medicine in the Safavid period were published with the participation of 542 authors. In terms of thematic orientation, 18.2% of the published works were on the biographies of physicians, while research, translation, and editing of medical manuscripts ranked next with 16.1%. Among universities and scientific centers, Tehran University of Medical Sciences and Islamic Azad University ranked first. Male participation accounted for approximately 60%, exceeding that of female authors, and about 68% of the works were the result of collaborative research. The Journal of Islamic and Iranian Traditional Medicine published the highest number of articles. The most common type of publication was original research articles. Content analysis showed that, despite significant growth in this research field, an excessive concentration on specific topics, such as physicians’ biographies, has limited scholarly attention to other dimensions of medical history in this period, highlighting the need for broader and more balanced research perspectives.
Samira Orujlu, Arezoo Ghavi, Leila Valizadeh, Vahid Zamanzadeh, Sadat Seyed Bagher Maddah, Parvaneh Aghajari,
Volume 18, Issue 1 (3-2025)
Abstract
Improving the quality of nursing services and enhancing ethical decision-making in clinical settings require greater attention to professional ethics. This study aimed to review and synthesize existing research on professional ethics in nursing in Iran, to organize, plan, and establish knowledge- and evidence-based decision-making, and also provide strategies for ethics-centered nursing in Iran. Iranian studies on ethics were reviewed without time limitations until June 22, 2023. Database search was conducted using keywords including "Nurse", "Nursing", "Ethics", "Professional ethics", "Nursing Care", "Codes of Ethics", "Patient Rights", "Conscience", and "Iran", as well as their Persian equivalents, combined with "AND" or "OR" operators. The included studies were analyzed utilizing the five-stage integrative review method proposed by Whittemore and Knafl. A total of 103 Persian and 59 English articles were reviewed. The results were organized into two main categories: achievements of professional ethics (encompassing knowledge, attitudes, and professional performance of nurses; nurses’ experiences with ethical care; positive outcomes of professional nursing ethics education; and the convergence of spiritual health with adherence to professional ethics and the need for an Islamic approach) and factors influencing ethical performance (including facilitators of ethical performance and barriers to adherence to professional ethics). Based on the findings, it is recommended that nursing care protocols and standards be developed, and various educational programs be conducted, including those on ethical care in emergencies and disasters, emotional and spiritual intelligence, training for clinical nursing managers, and the application of creative strategies for teaching clinical professional ethics.
