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The Effect of An Intervention Based on the Knowledge-to-Action Model on Moral Distress in Critical Care Nurses
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.

The Necessity of Spiritual Health Education in Iranian Universities of Medical Sciences: A Qualitative Study
Akram Heidari, Morteza Heidari, Baqer Larijani, Professor Ali Mohammad Mosadeqrad,
Volume 18, Issue 1 (3-2025)
Abstract
Spiritual health refers to having purpose and meaning in life and a sense of belonging to something beyond the self, which strengthens inner peace, satisfaction, and happiness. This qualitative study was conducted in 2024 using an interpretive phenomenological approach. Through semi-structured interviews with 47 policymakers, managers, faculty members, staff, and students, a total of 183 benefits of spiritual health education in universities of medical sciences were identified. These benefits were categorized into six groups: benefits for faculty members, students, staff, patients, society, and the university. For faculty members, spirituality education leads to enhanced ethical awareness, increased motivation, job satisfaction, professional commitment, and improved quality of education. Students, by strengthening spirituality, gain greater communication and empathy skills, experience reduced stress and anxiety, and demonstrate improved professional competencies. Healthcare staff benefit from reduced medical errors, increased resilience, improved social relationships, and enhanced quality of care. Patients receiving spiritual care experience lower levels of stress and depression, improved mental health and quality of life, and a more rapid course of treatment and recovery. At the societal level, spiritual health education contributes to more positive social behaviors and the development of a healthier community. Furthermore, universities implementing such education can design more comprehensive curricula, promote interdisciplinary research, strengthen professional ethics, and train holistically oriented healthcare professionals, thereby increasing their credibility and productivity. Spiritual health education in Iranian universities of medical sciences, by exerting positive effects on faculty members, students, staff, patients, society, and the university itself, results in the improvement of psychological and professional well-being, the enhancement of educational quality, and the increased productivity and credibility of the higher education health system of the country.

A Critique of the Jurisprudential-Ethical Foundations of Applying the Term “Death” to the Vegetative State
Sayyed Mohammad Taghi Hosseini Vardaniani, Dr Ahmad Salami, Sayyed Morteza Hosseini, Jannat Mashayekhi,
Volume 18, Issue 1 (3-2025)
Abstract
The vegetative state is a condition in contemporary medicine that raises numerous ethical, jurisprudential, and legal challenges. The most fundamental question when confronting this condition concerns whether individuals in such a state are considered alive or deceased, as subsequent rulings and implications are typically contingent upon the answer to this question. Some contemporary Islamic jurists, drawing upon the jurisprudential division of life into “stable life” and “unstable life”, have deemed individuals in a vegetative state to be deceased, given their lack of volition and consciousness. This study argues that the concept of “unstable life” does not apply to these individuals, particularly in cases of persistent and chronic vegetative states where the possibility of regaining consciousness, however remote, exists. Furthermore, the continued function of the brainstem and the non-fulfillment of the medical and legal criteria for brain death in many systems affirm that the designation of “deceased” is incorrect. From an Islamic perspective, the definitive separation of the soul from the body, which is the condition for the occurrence of death, cannot be ascertained in the vegetative state. Ultimately, in circumstances of doubt regarding the life or death of a person in a vegetative state, this uncertainty constitutes a “case-specific doubt”, and by applying the legal principle of “presumption of continued life”, the individual must be deemed alive and all the corresponding legal and religious consequences of life must be accorded to them.

A Comment on: "Is It Possible to Apply an Advance Directive in Iran’s Health System?"
Fatemeh Fallah Tafti, Hamidreza Mohammadi,
Volume 18, Issue 1 (3-2025)
Abstract
This Article has no Abstract.
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