Showing 27 results for Nursing Ethics
Tahereh Baloochi Beydokhti, Hamidreza Tolide-Ie, Ali Fathi, Mehdi Hoseini, Sedigheh Gohari Bahari,
Volume 7, Issue 3 (9-2014)
Abstract
Decision making is an important part of nurses’ responsibilities in providing clinical interventions for patients. Religion is among the moral factors that affect the performance and clinical decision making of nurses. The present study aimed to investigate the relationship between religious orientation and moral sensitivity in the decision making process among nurses.This study was a cross-sectional, analytical research that was carried out on 170 nurses working in Gonabad hospitals. Subjects were selected by census, and data were collected using the Allport Religious Orientation Scale and the Moral Sensitivity Questionnaire. Data analysis was performed using SPSS version 16.In the present study, internal religious orientation mean was 36.39 ± 4.65, external religious orientation mean was 33.77 ± 6.89 and moral sensitivity mean was 159.21 ± 14.1, and therefore internal religious orientation was higher among the nursing staff. Moreover, Pearson's correlation test showed that there was a significant, positive relationship between internal religious orientation and moral sensitivity (P = 0.01, r = 0.17). Nevertheless, no significant relationship was found between external religious orientation and moral sensitivity (P = 0.86, r = - 0.01).Based on the findings of this study, it seems that authorities need to develop and implement strategies to educate nurses on morality and spirituality, since members of this profession play an important part in the health and well-being of the community.
Aliakbar Koohi, Morteza Khaghanizade, Abbas Ebadi,
Volume 9, Issue 1 (5-2016)
Abstract
As a result of the changes made in health care systems, nurses nowadays are faced with more complicated ethical dilemmas. Therefore, they need to be familiar with ethical decision-making procedures and have the ability to perform ethical reasoning. The present study aimed to evaluate this ability in nurses and investigate its relationship with demographic characteristics in a subspecialized hospital in Tehran during 2015. This was a descriptive-analytical study, and the research population consisted of 245 qualified nurses selected by census. A demographic questionnaire and Crisham’s Nursing Dilemma Test were used to collect the data. Descriptive-analytical tests and SPSS software version 22 were used for data analysis. Based on the, the mean value of the nurses’ ethical reasoning was 40.81 ± 6.72, which is lower than the average score of the test. Furthermore, increased work experience led to a reduction in the mean value of ethical reasoning (P ≤ 0.05). Overall, single subjects scored higher in the mean ethical reasoning than those who were married (P ≤ 0.05), but no significant relationship was observed between other demographic characteristics and the mean of ethical reasoning. Due to the nurses’ low ability to perform ethical reasoning, further studies will need to be conducted on proper training methods to promote ethical decision-making in nurses. As regards the reduced ethical reasoning ability in nurses with more work experience, it is necessary to identify the reasons and devise appropriate solutions with the help of nursing managers and hospital ethics committees.
Marjan Mardani Hamooleh, Masoomeh Iranshahi, Naimeh Seyedfatemi, Hamid Haghani,
Volume 9, Issue 2 (8-2016)
Abstract
Moral distress has been identified in nursing literature as a major dilemma affecting nurses in all healthcare systems. It is viewed as an important factor threatening the integrity of nurses and ultimately the quality of patient care. The present study attempted to determine levels of moral distress among the nursing staff employed in hospitals across the city of Malayer. This was a descriptive and cross-sectional study conducted on 195 nurses of Malayer hospitals during 2015. Data were collected using a demographic questionnaire and the standard moral distress scale (MDS). Data analysis was performed by descriptive and analytical statistics using SPSS software version 18.
In this study, 88 nurses (45.1%) were found to be suffering from severe moral distress. The most important factors causing moral distress pertained to substandard care and treatment due to a shortage of health professionals and care providers (6.6±0.21), physician orders for unnecessary tests, treatments and care (6±0.12), and measures taken by staff who lacked clinical competency (5.9±0.22). Among the nurses’ demographic data, gender (P=0.001), job experience (P=0.001) and nursing ward (P=0.01) were significantly related to the level of moral distress experienced by the nursing staff. The results imply that in nursing, moral distress is a highly important and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.
Nabi Omidi, Heshmatolaah Asgari, Mohammad Reza Omidi,
Volume 9, Issue 3 (10-2016)
Abstract
Ethics is elemental in all lines of work, but more so in the nursing profession, since the ethical and responsible conduct of nurses can have an important role in promoting patient recovery. As members of a large group in the field of medical science, nurses need to be equipped with sound professional ethics in their interactions with others.
The present study was a descriptive survey of the relationship between professional ethics and the efficiency of nurses. Study population consisted of the nurses employed in Imam Hospital and Mostafa Khomeini Hospital in Ilam. Sample size was determined at 134 using the Cochran formula, and 126 completed the professional ethics and efficiency questionnaire. The validity of the questionnaire was confirmed by experts, and its reliability was established by Cronbach's alpha test. Subsequently, the main hypothesis and the eight sub-hypotheses were examined.
The subjects consisted of 89 males and 37 females, of which 50 percent were aged between 20 and 35, 42% between 36 and 50, and 6% between 51 and 60 years. In terms of education level, 7 subjects had high school diplomas, 18 associate degrees, 42 were undergraduate and 59 graduate students and higher. The findings showed a significant correlation (0.002) between professional ethics and the efficiency of nurses. Results of the Pearson’s correlation test confirmed the relationship between accountability, honesty, fairness, loyalty, respect for others, and the efficiency of the nurses employed in Imam and Mostafa Khomeini Hospitals, Ilam. No significant correlation was found, however, between the components of superiority and sympathy in nurses and their efficiency.
Considering the relationship between professional ethics and the efficiency of the nurses in these two hospitals, it is recommended to improve their performance through continuous training and promotion of nursing ethics.
Somayeh Mohammady, Fariba Borhani, Mostafa Roshanzadeh,
Volume 9, Issue 5 (1-2017)
Abstract
Nursing is an ethical profession and nurses are responsible for patient care. In providing healthcare services, patient right is an important issue to consider. However, not only the awareness the patient right is important but also moral sensitivity to ethical decision-making is crucial. This study aimed to determine the relationship between moral sensibility and attitude towards patients' rights. A descriptive-analytic study was used and 194 nurses working in intensive care units in hospitals affiliated to medical university of South Khorasan province were selected by convenience sampling method. The data collected through a questionnaire consisting of three parts: 1) demographics 2) the moral sensitivity questionnaire (Korean version), and 3) a questionnaire survey of nurses' attitudes towards the patients’ rights. Data collected by the software SPSS version 16, and were analyzed descriptive and analytical statistical tests.
The results showed that there is a significant direct relationship between average moral sensibility and nurses' attitudes towards patients’ rights (r= 0.6, P=0.03). The average nurse's ethical sensitivity has been reported 3.05±0.68 0f the total score (0-4). The average attitude towards the patients’ rights was 4 ± 0.8 of the total score (1-5). The relationship between moral sensitivity whit the years of service and age of the participants was significant (P<0.05). There was also a significant relationship between the attitudes of nurses towards patients' rights with gender and years of service (P<0.05). In conclusion it is necessary to provide more moral education to increase nurse’s moral sensitivity towards patients’ rights. It should be noted that due to the fact that moral sensitivity and attitude towards patients' rights increases with the number of years of service the article suggests that considering more experienced nurses in the teams would result a more morally sensitive care for the patients.
Shahrzad Ghiyasvandian, Afagh Sedighiyani, Anooshirvan Kazemnejad, Iraj Iranshahi,
Volume 9, Issue 6 (3-2017)
Abstract
One of the major challenges in healthcare system is to train staff with strong commitment to the organizational mission. The key variables that have a significant impact on the performance of the organization is communication satisfaction. In fact, organizational communication has influential affect on different aspects of the organization including, professional commitment. This study was conducted to determine the relationship between communication satisfaction and organizational commitment among nurses.
In a descriptive-correlation study, 300 nursing staff in hospitals from Tehran University of Medical Sciences were selected through random cluster sampling in 2015. Data were collected by organizational communication “Downs and Hazen” and organizational commitment of “Allen and Meyer” questionnaires. Data were analyzed using chi square test and SPSS 16 software.
In Result, 7.2% of nurses were satisfied with their organizational communication and 1.7% of nurses had organizational commitment. There was a significant correlation between organizational communication satisfaction and organizational commitment (p<0.001). The mean and standard deviation of organizational communication Satisfaction (91.396 ±2.39) and for Organizational Commitment respectively (47.488±9.33) was. also there was a significant correlation between organizational commitment and age, education and shift, but it was not correlated with sex, marriage status and organizational post. Likewise, communication satisfaction had significant correlation with job position and job experience, but hadn’t significant correlation with other demographic variables. Also, the regression model showed that with one point increase of organizational communication satisfaction are added. /189 to the score of organizational commitment.
In conclusion, considering the existence of significant positive relationship and also linear regression result, satisfaction of organizational communication is as predictive variable for organizational commitment. Therefore it seems that the optimization of organizational communication managers and officials could increase the commitment of nurses in hospitals and to increase their effectiveness.
Hossein Mahmoodian, Haseli Sara,
Volume 11, Issue 0 (3-2018)
Abstract
Ethical approach is one of the most important features of medical staffs expected to be used. One of the most important diseases that have been allocated to high moral challenges is HIV/AIDS. Nurses should provide standard care to these patients in their professional careers. In this descriptive study, 136 nurses working in the internal and surgical wards of one of the hospitals in Shiraz were selected through a cross-sectional questionnaire in 2015.Frequency of compliance with ethical values of nurses toward HIV/AIDS patients within various aspects showed that in total 40.4% of nurses in the observance of moral values has unsatisfactory performance, 33.1% relatively good performance and 26.5% has optimal performance. (P-value: 0.018)The mean score of different dimensions to separate parts of questionnaire showed no significant difference in dealing with AIDS patients among nurses according to different ages, sex and working years. The mean score of the separation of education in the respect of client/patient and keep his human dignity significantly differ between Diploma, B.S and M.S. Findings showed poor compliance with ethical code among nurses toward HIV/AIDS patients. Due to importance of ethical approach towards patients especially this vulnerable group of patients, regular educational program in relation to AIDS patients, in order to improve the quality of services, is recommended.
Talieh Khalifi, Naimeh Seyedfatemi, Marjan Mardani - Hamooleh, Hamid Haghani,
Volume 11, Issue 0 (3-2018)
Abstract
Spiritual health (SH) is a supernatural force and endeavor to achieve perfection and peace of mind in life.When it is endangered, a person experiences loss of meaning in life. In nursing, caring services and SH are related to each other. It is necessary to promote the SH of nurses so that patients will receive better care. The study aim was the effect of spiritual education on SH of nursing students. In this quasi-experimental study, 76 of undergraduate nursing students were selected using random simple sampling method and divided into experimental group (EG) and control group (CG) (n= 38) with random allocation method. Educational intervention was done for the EG for a period of 4 weeks, a 60-minute session per week, but no intervention was performed for the CG. Four weeks after the intervention, the post-test was taken in 2 groups. Data were collected using the SH scale by Paloutzian and Ellison. Independent t-test didn’t indicate any difference before the intervention in the mean score of SH in 2 groups (t=-0.49, p=0.62), while in the post-test, the independent t-test indicated the mean score of SH was higher in the EG than in the CG (t=-2.14, p<0.03). After the intervention, there was a significant increase in the SH (t=-4.39, p<0.001) in the EG. The paired t-test indicated no difference in the SH in the CG compared to the pre and post-test (t=-0.25, p<0.79). Spritual education influenced SH of nursing students. It is recommended that spiritual education be considered as one of the strategies for promoting SH in students.
Marjan Mardani - Hamooleh, Masoomeh Ahmadi, Naimeh Seyedfatemi, Hamid Haghani,
Volume 11, Issue 0 (3-2018)
Abstract
Empathy is considered an essential prerequisite for a nurse to effectively care for a patient. Also, spirituality is an important component in nurse-patient relationships. The aim of this study was to determine the relationship between empathy and spiritual attitude among nursing students. In this descriptive and correlation study, the samples consisted of 272 nursing students that were studying in 3 Medical Sciences Universities in Tehran, 2017. Samples were selected through convenience sampling method. Data were collected by demographics’ data form, validated and reliable scales of empathy and spiritual attitude. Data were analyzed by descriptive and analytical (Pearson Coefficient, Independent T test, and ANOVA) statistics. The students had a mean empathy score of 106.982 ± 14.65 that this was more than median scores of scale (60). Furthermore, they had a spiritual attitude score of 115.79 ± 15.8 that this was more than median scores of scale (86). Findings indicated that a significant relationship between empathy and spiritual attitude among nursing students (r=.265, p=.0001). Gender, educational level, interest in nursing, work status, and the average score of the previous term had significant relationships with empathy (P < 0.05). Interest in nursing and work status had significant relationships with spiritual attitude (P < 0.05).Research findings support the hypothesis of association between empathy and spiritual attitude. Since empathy has a significant relationship with spiritual attitude, it seems that nursing students’ empathy will increase by promoting their spiritual attitude.
Mehri Seyedjavadi, Raheleh Mohammadi, Arezo Mirzayee, Maryam Mirzayee,
Volume 12, Issue 0 (3-2019)
Abstract
Nursing ethics is one of the most basic aspects of nursing profession, which nurses are required to follow the principles receiving nursing care with confidence by patients. This study was conducted to determine the level of moral development of nurses and its contributing factors. This descriptive, analytic study was performed in 2017, study samples were 310 nurses working in educational hospitals of Ardabil University of Medical Sciences. Samples were selected by convenience method. The data was collected using a Kohlberg’s nursing dilemma test. The questionnaire included six scenarios: newborn with anomalies, forcing medication, adult's request to die, new nurse's orientation, medication error, and uninformed terminally ill adult. The data was analyzed by IBM SPSS 18 using descriptive and analytic tests. In this study, 51 nurses (16.45%) were in the pre-conventional level, 101 nurses (32.58%) in the conventional level, 132 nurses (42.58%) at the post-normal level and 26 nurses (8.38%) at the level of clinical considerations. Moral thinking mean score was 42.58 ± 5.6 and the mean score of the clinical considerations was 21.53 ± 4.3. The present study showed that the majority of nurses are in the post conventional and conventional level; but this is less than 50% of all nurses, which shows that the level of moral development of nurses is in the moderate level. It requires further investigation of the causes and related factors and more efforts for improving it.
Fatemeh Jafarinahlashkanani, Zainab Eydivandi, Marzieh Shafiei, Elham Maraghi, Mehrnaz Moradi Kalboland,
Volume 13, Issue 0 (3-2020)
Abstract
The observance of professional ethics standards’ is inherent nature of nursing profession. Observance of ethical standards by them will be an effective factor in improving performance of patient care and affecting the quality of health care. This study was conducted to determine the facilitating and Inhibitory factors of professional ethics from the perspective of nurses. This cross-sectional descriptive study with the participation of 367 nurses in Masjed-e-Soliman hospitals was performed in 2019. The data collection tool was a questionnaire of facilitating factors in the three dimensions of management, individual, and patients and inhibitory factors in three dimensions of management, environmental, and individual care; design, validity, and reliability of the questionnaire was reported by Dehghani. Data analysis was analyzed using SPSS version 22 and statistical tests. From the nurses' point of view, facilitating factors to follow ethics were: sufficient personnel in proportion to the number of patients (64.6%) in the managerial dimension, proper interpersonal relationship between colleagues and other treatment teams (60.3%) in the individual dimension;. appropriate treatment of patients with nursing staff (59.1%) in the patient dimension. The most important inhibitory factors were: lack of attention to the ability and skills of personnel during the division of labor (71.2%) in the managerial dimension; crowded and busy wards in environmental dimension (69.6%); shortage of time in the individual and care dimension (66.4%). In this research, most important facilitating and inhibitory factors for following professional ethics standards in nurses was evaluated. Due to the necessity of observing the standards of professional ethics in nursing performance, the managers of health care organizations can observe the current situation by conducting periodic studies in the field of professional ethics from the perspective of nurses and patients.
Mahrokh Keshvari, Negar Farajzadeh, Mohsen Shahriari, Mohammad Azadmanesh, Aliasghar Jamalinasab,
Volume 17, Issue 0 (12-2024)
Abstract
Nursing and midwifery professors play a crucial role in transmitting societal norms, providing cultural experiences, shaping students' behavior, beliefs, and attitudes, and cultivating moral virtues. As significant influencers on students' moral development during their academic journey, careful attention to this aspect is essential. This study aimed to elucidate the ethical challenges encountered by faculty members within the Faculty of Nursing and Midwifery. This qualitative study employed content analysis. Purposive sampling was utilized to select 23 faculty members from the Faculty of Nursing and Midwifery at Isfahan University of Medical Sciences, with data collection spanning eight months. Data were collected through semi-structured interviews and analyzed using conventional qualitative content analysis. Continuous and comparative data analysis revealed three primary categories of ethical challenges perceived by faculty members: discrimination and injustice, low professional commitment, and unprofessional behavior.
· Discrimination and injustice: This category encompassed three subcategories: disparities in rule implementation across faculties and groups, unfair financial compensation, and inequitable distribution of academic units and points.
· Low professional commitment: This category included two subcategories: educational underselling and non-adherence to established rules by faculty members.
· Unprofessional behavior: This category comprised two subcategories: unhealthy competition among faculty members and inappropriate student evaluations.
The experiences of faculty members in this study highlighted the presence of numerous challenges, with ethical issues significantly impacting their performance and motivation. The identified ethical challenges primarily revolved around discrimination and injustice, low professional commitment, and unprofessional behavior. Given the pivotal role of faculty members in teaching ethical principles and actively addressing ethical challenges, it is imperative for administrators and officials to acknowledge these concerns and implement strategies to mitigate these issues.
Nayereh Baghcheghi, Zahra Maddah,
Volume 17, Issue 0 (12-2024)
Abstract
With the increasing elderly population and the growing demand for home healthcare and end-of-life care services, nurses are facing expanded duties and responsibilities. This intensification of responsibilities can expose them to significant ethical challenges. This study aimed to investigate the ethical issues nurses encounter in providing end-of-life care at home for elderly patients. This review study involved a comprehensive search of databases including PubMed (Medline), Google Scholar, ISI Scopus, ProQuest, Science Direct, SID, IranDoc, IranMedex, and Magiran. The keywords used were: nursing ethics, ethical challenges, end-of-life care, and home care, along with their Persian equivalents. The search covered literature published between 2000 and 2024. The review identified several prominent ethical challenges faced by nurses in home-based end-of-life care, including: lack of attention to patients’ rights and independence, disrespect for the dignity of elderly patients, inadequate empathetic care, poor communication, and unsafe home environments for nurses. These challenges may lead to moral distress, as well as psychological and emotional consequences for both the care providers and the elderly patients. Given the serious ethical challenges nurses face in end-of-life home care for the elderly, it is essential for them to be well-versed in ethical principles relevant to this context. Enhancing awareness and competence in ethical practices can help nurses uphold patient rights, promote autonomy, and provide high-quality, compassionate care through effective communication and support.
Alireza Zare, Mohammad Hossein Taklif, Alireza Javid, Zahra Amadeh, Negin Farid,
Volume 17, Issue 0 (12-2024)
Abstract
As the global elderly population continues to rise, nursing care for this demographic faces increasing ethical challenges. The elderly are particularly vulnerable, requiring specialized care that addresses their physical, psychological, and social needs. However, these needs often present ethical dilemmas, including issues related to autonomy, informed consent, fairness in resource allocation, and managing conflicts between patients and their families. This systematic review aims to identify the ethical challenges nurses face in caring for elderly patients and to propose solutions that enhance the quality of care. A comprehensive search was conducted across several reputable databases, including PubMed, Scopus, CINAHL, and Google Scholar, using keywords such as "nursing ethics", "elderly", "ethical challenges", and "ethical care". Articles published between 2010 and 2023 in English and Persian were considered for inclusion. After an initial screening, 40 eligible articles were selected for final analysis, and thematic analysis was used to interpret the data. The findings reveal several key ethical challenges for nurses in elderly care, including respecting patient autonomy, navigating decision-making processes in cases of cognitive decline, ensuring confidentiality, and managing family pressures. Additional difficulties include resource shortages, high workload, and limited access to ethics training. Proposed solutions to address these challenges include continuous ethics education, the development of comprehensive ethics protocols, and the formation of interdisciplinary teams to facilitate more informed decision-making. Addressing ethical challenges in elderly care requires robust planning and action from health systems. By establishing clear ethical guidelines, promoting ongoing education, and fostering a supportive work environment, the quality of care for elderly patients can be significantly improved. Further research should evaluate the effectiveness of these strategies in mitigating ethical issues within nursing practice.
Fatemeh Roudi, Hedayat Jafari, Mohammadreza Jalilfar, Seyed Mohammad Mirshafiei, Seyed Tohid Hoseini, Soodabeh Eslami,
Volume 17, Issue 0 (12-2024)
Abstract
Nurses are critical healthcare providers during global crises, particularly in situations of armed conflict and war, where they face unique and often overwhelming ethical challenges. These professionals are tasked with making immediate and difficult decisions under extreme conditions. This study aims to thoroughly examine the ethical challenges encountered by nurses during global crises, with a particular focus on armed conflicts and wars. This systematic review analyzed articles sourced from PubMed, Scopus, ScienceDirect, Magiran, and Google Scholar databases, using the following search terms: "nursing ethics," "war," "global crises," "ethical considerations in nursing during war," and "nursing ethics in armed conflicts." Following a thorough review and filtering process based on the study's objectives, seven articles were selected for inclusion. The findings highlight several ethical challenges faced by nurses during wartime. These challenges include: allocating limited resources under dire circumstances, providing care to both combatants and civilians without bias, maintaining patient confidentiality while cooperating with military authorities, and delivering care in hazardous and unpredictable environments. The ethical issues nurses encounter in global crises, particularly in war, include: 1) the tension between professional duty and political or military affiliations, 2) the ethical dilemma of allocating scarce resources in critical conditions, 3) the decision of which patients should be prioritized for treatment, and 4) the significant risks to life involved in providing care in conflict zones. Nursing care during global crises, especially in wartime, presents profound ethical dilemmas that demand rapid and sound decision-making. Adequate training in nursing ethics tailored to wartime conditions, as well as robust support for nurses in these high-pressure environments, are critical to addressing these challenges effectively.
Mohammadreza Jalilfar, Hedayat Jafari, Fatemeh Roudi, Seyed Tohid Hoseini, Soodabeh Eslami, Seyed Mohammad Mirshafiei,
Volume 17, Issue 0 (12-2024)
Abstract
With the increasing need for home nursing care, patient autonomy emerges as a crucial ethical principle in delivering care services. Therefore, this study aimed to investigate the importance of autonomy and individual independence in home-based patient care. In this systematic review, articles from PubMed, Scopus, ScienceDirect, Magiran databases, and Google Scholar search engine, published within the last 10 years, were used to search for articles related to autonomy and independence in home nursing care. The keywords used in the search were: "patient autonomy", "home nursing care", "nursing ethics" and "autonomy in nursing home care". After reviewing and filtering the articles based on the study's objectives, 20 articles related to autonomy in home nursing care were included in this systematic review. The findings of these studies indicated that various factors can influence patient autonomy at home-care, including: · Individual factors: age, gender, physical and mental health status of the patient; · Family factors: family support, family relationships, family culture; · Social factors: social support, access to social resources; · Organizational factors: care policies, organizational structure, organizational culture. Considering these findings and their comparisons, it can be concluded that to promote patient autonomy at home, all the mentioned factors should be considered. Some of the suggested solutions to promote patient autonomy are: · Educating the patient and family about patient autonomy; · Strengthening family support for the patient; · Providing social support services to the patient; · Developing care policies that support patient autonomy; · Improving organizational structure and culture. Patient autonomy is one of the essential ethical principles in home nursing care. Considering the factors affecting patient's autonomy, comprehensive solutions should be considered to promote it. Patient and family education, strengthening family support, providing social support services and improving organizational structure and culture are among the effective solutions in this field.
Reza Abdollahi, Aynaz Bagherzadi, Mrs Mir Hossein Ahnmadi, Mr Yousef Mohammadpour,
Volume 17, Issue 1 (3-2024)
Abstract
Organizational support is a key factor that may influence and moderate compassion fatigue among nurses. Therefore, this descriptive-analytical study aimed to explore the relationship between organizational support and compassion fatigue in emergency department nurses. The research population consisted of all nurses in the emergency departments of educational hospitals in Urmia, Iran in 2024. A total of 150 nurses were randomly selected based on the inclusion criteria for the study. Data were collected through three questionnaires including a demographic information form, Eisenberger’s Organizational Support Scale, and Figley’s Compassion Fatigue Scale. Data analysis was performed using SPSS software version 15. The results indicated a significant negative relationship between organizational support and compassion fatigue (r=0.45 and p< 0.05). The mean score for organizational support among emergency department nurses was 21.13± 0.54. Moreover, the mean scores for compassion fatigue, compassion satisfaction, and secondary traumatic stress were 27.73 ± 8.54, 38.73 ± 1.81, and 28.45 ± 4.82, respectively. The overall mean score for the nurses' job quality was 31.93 ± 4.32. Given the results of the present study and the role of organizational support in reducing compassion fatigue among nurses, it is crucial for nursing managers and policymakers to take certain measures such as improving working conditions and addressing the needs of nurses to enhance organizational support, consequently helping to reduce and mitigate compassion fatigue among nurses.
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.
Mohammadmahdi Pazhavand, Maasoumeh Barkhordari-Sharifabad, Khadijeh Nasiriani,
Volume 18, Issue 1 (3-2025)
Abstract
Identifying an effective coping strategy for moral distress, as an important and common phenomenon among intensive care unit nurses, seems essential. The knowledge-to-action model aims to identify effective methods for implementing evidence into clinical practice. The present study sought to determine the effect of an intervention based on the knowledge-to-action model on moral distress among nurses working in intensive care units. This was an experimental study, and the statistical population included nurses working in the intensive care units of Namazi Hospital in Shiraz, Iran. A total of 100 eligible nurses were selected through convenience sampling and then randomly assigned to intervention and control groups. For the intervention group, the knowledge-to-action model was implemented. Data were collected using the Hamric Moral Distress Scale before and one month after the intervention. Both groups completed the questionnaire at these time points. Data were analyzed using descriptive and inferential statistics with SPSS version 19. The findings showed that the two groups were similar in terms of demographic characteristics and mean moral distress scores before the intervention. After the intervention, the mean scores of moral distress in the intervention group were significantly reduced in the frequency dimension (2.12±0.34) and severity dimension (2.32±0.46) compared to the control group (frequency: 2.51±0.43; severity: 2.57±0.55) (p<0.001). The results indicated that implementing the knowledge-to-action model reduces moral distress in intensive care unit nurses. Therefore, it is recommended that nursing managers adopt this model to improve the quality of care.
Samaneh Fallah-Karimi, Zahra Khalilzadeh-Farsangi, Azizollah Arbabisarjou, Fatemeh Etemadinia,
Volume 18, Issue 1 (3-2025)
Abstract
Nurses working in intensive care units are frequently exposed to complex ethical issues and difficult decision-making, placing them at high risk for moral injury. Such injury can negatively affect their professional performance and mental health. Accordingly, this study aimed to explore the relationship between moral injury and moral courage among nurses working in intensive care units. This descriptive cross-sectional study was conducted in 2024. The study population consisted of 150 nurses working in intensive care units. Data were collected through Sekerka’s Moral Courage Questionnaire and the Moral Injury Symptom Scale for Health Professionals. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and the independent samples t-test via SPSS software version 22. The findings revealed a significant inverse relationship between moral injury and moral courage (r = -0.64, p < 0.001). Moreover, moral courage levels were higher among registered nurses compared to nurses in the compulsory service program. Besides, a direct relationship was observed between age and moral courage, suggesting that moral courage increases with age. The results of this study highlight the importance of designing and implementing effective educational programs to reduce moral injury and promote moral courage among this group of nurses.
