Showing 76 results for Nursing
Mina Mobasher, Nozar Nkhaee, Sareh Garoosi,
Volume 1, Issue 1 (7-2008)
Abstract
Background: The ethical climate (organizational culture) of an organization as perceived by a group of its workers is believed to affect ethical practices, job satisfaction and quality of care.
Objectives: To assess the ethical climate of teaching hospitals of Kerman city according to nursing staffs’ views.
Methods: A 26-items questionnaire was translated to Persian which its content validity was acceptable according to the literature review. Its reliability was in an acceptable range according to Cronbach’s alpha (0.92). It was distributed between a convenient sample of 350 nursing staff who worked in the four teaching hospitals of Kerman city. Three hundred and two subjects completed the inventory. All questionnaires were anonymous.
Results: The majority of them (76%) were female. The mean (±SD) age of the individuals were 32.4 (± 8.5). Subscription to the expression “always” was mostly seen for the item “my manager is someone I respect” and it was seldom observed for the item “nurses are supported and respected in this hospital”. There was no significant difference in the total score of the inventory according to background variables (i.e. age, sex, educational level, employment status and hospitals).
Conclusion: According to the great impact of organizational culture on nurses’ practices it seems that some aspects of organizational culture of teaching hospital especially the aspects that are related to physicians and top level managers need to be improved
Fatemeh Hashemi, Alireza Nikbakht Nasrabadi, Fariba Asghari ,
Volume 4, Issue 2 (4-2011)
Abstract
Reporting professional errors is an essential step towards improving patient safety not only in hospitals but also outpatient healthcare centers. Unfortunately, nurses, like many other members of the medical team, do not report most of their mistakes and errors in performance. The objective of this study was to assess possible determinants of the tendency to report nursing errors by exploring the experiences of clinical nurses and nursing managers in this regard.
In this qualitative study, 115 nurses employed by hospitals and specialty clinics of Tehran and Shiraz Universities of Medical Sciences were enrolled. Data were collected through 17 sessions of semi-structured discussion groups, and contents were examined and analyzed based on an empirical-analytic approach. The main patterns observed in this study included 1) nurses' overall perception of error, 2) obstacles in reporting nursing errors, 3) motives of reporting error. Reporting errors can provide valuable information for prevention of future errors and improvement of patient safety. Overall, considering the obstacles and motives of reporting nursing errors, there is need for codes and regulations in which the process of reporting error and the components of error are clearly determined and defined.
Iraj Shakeriniya ,
Volume 4, Issue 3 (5-2011)
Abstract
Moral distress is a psychological phenomenon whose effects on people’s functions can be considered as a subject of study. Although moral distress exists in numerous professions, research dedicated to this phenomenon has proved that due to the nature of the nursing profession, it is a familiar source of stress for most nurses. Nurses are more often than not faced with moral dilemmas in the workplace, and suffer moral distress as a result. The present paper aimed to study the history of moral distress, its definitions, consequences and coping strategies through library and online research, and although it attempted to investigate the phenomenon of moral distress in general, its focus has mainly been on moral distress in the nursing profession. A thorough understanding of moral distress and its negative and positive aspects is believed to raise awareness and lead to improvements in nurses, and educate them on appropriate coping strategies to help reduce their emotional suffering.
Mohammad Zirak, Sima Moghaddsiyan, Farahnaz Abdollahzadeh, Azad Rahmani,
Volume 4, Issue 4 (7-2011)
Abstract
Nurses are confronted with numerous situations calling for moral decision-making in their workplace every day. Nursing students should therefore attain a satisfactory level of moral development during their university years. The present study was conducted to determine nursing students’ level of moral development, as there seems to be a shortage of similar studies throughout the country.
This descriptive, correlational research was performed in 2010 study samples were 115 junior and senior students of the Department of Nursing and Midwifery of Tabriz University of Medical University who were selected by census. These students’ level of moral development was evaluated through the Nursing Dilemma Test (NDT), which has been created based on Kohlberg’s theory of ethical development. NDT assesses nurses’ moral development in three levels: pre-conventional, conventional and post-conventional, and evaluates their observance of clinical considerations at the same time. A number of the participants’ sociodemographic characteristics were also collected through a questionnaire. Data analysis was performed using SPSS statistical software, and descriptive and inferential statistics.
According to the findings of this study, 13 students (11.3%) were in the pre-conventional, 33 (28.7%) in the conventional, and 55 (47.8%) in the post-conventional level, and 14 (12.1%) took clinical considerations into account more than others. There seemed to be no meaningful statistical relationship between the students’ moral development and their age (P = 0.49), sex (P = 0.21), marital status (P = 0.79), place of education (P = 0.32), and year of education (P = 0.92).
These results showed that although approximately half of the students under study were in the post-conventional level, which is an acceptable level of moral development, a great percentage were still in the lower levels. This means that those in administrative positions in nursing departments need to pay more attention to the moral education of nursing students.
Majid Hassanpoor, Mohammadali Hosseini, Massod Fallahi Khoshknab, Abbas Abbaszadeh,
Volume 4, Issue 5 (10-2011)
Abstract
Making decisions for recipients of health care while offering clinical care is an important part of nurses’ responsibilities. In order to ensure patient satisfaction, nurses are obligated to observe ethical standards in the decision-making process. This paper aimed to determine the effect of teaching professional ethical principles on ethical sensitivity in nurses’ decision-making.
In this semi-empirical study, 80 Social Security nurses were selected through purposive sampling and were then randomly placed in two groups of 40 each, the intervention group and the control group. Research tool was the Ethical Sensitivity Scale Questionnaire for decision-making, the validity of which was assessed using content validity, and whose reliability was confirmed with a Cronbach’s alpha coefficient of 0.83 for internal consistency. At first the ethical sensitivity in decision-making was evaluated in both groups, and then an educational workshop on nursing ethics was held for the intervention group every other week the workshop consisted of 4 three-hour sessions, and upon completion of this workshop, both groups filled in the questionnaire once more, and data were analyzed using SPSS software.
There was no significant difference between the average ethical sensitivity in decision-making of the two groups before the intervention after the intervention, however, the difference was meaningful (P = 0.001). Moreover, the average ethical sensitivity in decision-making of the intervention group was significantly different after the intervention (P = 0.001).
Based on the findings of this study, teaching nursing ethical principles has a positive effect on nurses’ ethical sensitivity in decision-making. It is therefore recommended that this educational program be offered to nursing students and health care staff.
Mohammad Reza Heidari, Monireh Anoosheh, Taghi Azad Armaki, Eisa Mohammadi,
Volume 4, Issue 6 (12-2011)
Abstract
Caring for dying patient is one of the painful events and a tough experience for nurses. Care of dying patient according to his/her cultural norms is one of the principles of nurse's professionalism. Therefore identifying and explaining the daily experiences of nurses in cultural care of dying patients would help in determining caring standards. Due to the lack of such studies, the aim of this study was to explain the nurses' experiences in the care of dying patients.
This study is a qualitative investigation with content analysis method. Eighteen nurses working in teaching hospitals of Tehran were selected by purposeful sampling method from 2010 to 2011. Data were collected through semi-structured face to face interviews. Content of the interviews were transcribed and analyzed by content analysis.
The findings were classified into two themes of cultural exposure and cultural skills. Understanding of family presence and family bereavement were two sub-themes of cultural exposure. Cultural skills consist of 3 sub-themes i.e., preparation for telling bad news, facilitating facing death and solacing family members.
Regarding our results, in order to meet patients and their families expectations in a respectful manner, nurses awareness of cultural norms of the dying patient and his/her family seems to be necessary. It would be an important step in reforming and improving nursing performance and professional development.
Akram Sadat Sadat Hosseini, Zohreh Vanaki,
Volume 5, Issue 1 (12-2011)
Abstract
Nurses face to a lot of different gender perspectives in their routine work. Cultural and social backgrounds influence gender stereotyping and it causes significant changes in nursing roles. This article reviews and analyzes the effect of gender on nursing. Gender perspective in nursing has affected services and quality of nursing practices. Although gender perspective affects health care system, its elimination is not beneficial. Because its elimination abducts nursing from its real spirit and disappoint women from exposing their emotional and mental abilities. Therefore gender stereotyping affects nursing from different dimensions and it will improve nursing profession by leading right way.
Mahnaz Sanjari, Farzaneh Zahedi, Maryam Aalaa, Maryam Peimani, Alireza Parsapoor, Kiarash Aramesh, Sadat Bagher-Maddah, Mohammad Ali Cheraghi, Ghazanfar Mirzabeigi, Bagher Larijani,
Volume 5, Issue 1 (12-2011)
Abstract
Quality of nursing care services directly influences individuals' health status. Compiling codes of ethics according to the religion and culture of each population could be an appropriate approach in improving quality of health care services especially nursing care. Hence, the most important priority in our national health system is developing ethical guidelines.
For this purpose a task force has been established in collaboration with nurses, physicians, lawyers and clergymen who were expert in the field of medical ethics. The code of ethics for Iranian nurses was drafted in 2010. The draft that included 12 values and 71 regulations of professional ethics were finally approved in the second session of the Ethics Supreme Council of the Ministry of Health and Medical Education on 6 March, 2010.
The values consist of concepts such as maintaining human dignity, adherence to professional obligations, accountability and responsibility, patient privacy, promotion of scientific and practical competence and respect to individual's autonomy.
Also, 71 regulations of professional ethics divided to five sections including "Nurse and Community" consisting of 9 items, "Nurse and Professional Commitments" with 14 items, "Nurse and Clinical Services" with 23 items, "The Nurse and Other Healthcare Providers in Medical Team" with 15 items, and also "Nurse, Education and Research" including 10 items.
Mojgan Khademi, Easa Mohammadi, Zohreh Vanaki,
Volume 5, Issue 3 (6-2012)
Abstract
Valuing human being is the foundation of nursing and the essence of care. Specified aspects of the health care are not compatible with the humanistic agenda. Thus, the challenge is to integrate a humanistic approach into nursing. Nursing scientists have tried to solve this problem by developing human centered theories. Internal evaluation of these theories helps decide about their applicability in solving this problem and enhancing a humanistic approach.The aim of this article is to investigate the applicability of some humanistic theories to nurses' practice. The method is critical review of related literature. Data have been gathered by consulting books, searching some data bases, and using some guiding questions. Findings revealed that humanistic nursing theories, transpersonal care, and human development are becoming specifically expanded under the influence of humanism philosophy. In these theories, human being is free and prepared to grow in a mutual interaction with the environment. Nursing flows from its presence along side others and respect for people's potentials, and has a share in human growth. Emphasis on human interactions has increased the scope of applicability for these theories, but some characteristics of these theories, users, and different context necessitate modifying these theories and developing new ones.
Abbas Abbaszadeh, Fariba Borhani, Mohadeseh Motamedjahromi, Homa Zaher,
Volume 5, Issue 7 (2-2013)
Abstract
Nursing advocacy is an essential aspect of nursing professionals' ethics that promotes patients' autonomy, safety, and rights. It seems that nurses' attitudes toward nursing advocacy can affect their role as patients' advocates and improve the nurse-patient relationship. This study aimed to investigate nurses' attitudes toward patient advocacy in educational hospitals in Kerman.The data for this descriptive-analytical study was collected using a self-administered questionnaire by quota sampling among 385 nurses from four teaching hospitals of Kerman and analyzed using the SPSS software including descriptive and inferential statistics. Overall the nurses' attitude toward nursing advocacy was relatively positive. There was a significant relationship among nurses' attitude and age, sex, nursing experience and participation in workshops, while we could find no significant relationship between nurses' level of education and their attitude. The nurses' attitude in mental hospitals was more appropriate than others, and the majority of participants were confident that they were suited for the advocacy role.The cognitive aspect of nurses' attitude was stronger than the behavioral aspect. Despite the lack of significant effect of education, more nursing experience led to more willingness to play the advocacy role. In psychiatric hospitals, nurses with more independence and stronger relationships with the patients became more familiar with the needs of patients so these nurses made more effort to defend them. It seems Iranian nurses have felt morally obligated to defend their patients for many years. In order to support nurses' advocacy role in our country, we believe it is necessary to reinforce this attitude in nurses through holding ethical workshops.
Ahmad Izadi, Hlham Imani, Zahra Khademi, Fariba Fariasadi Noughabi, Nina Hajizadeh, Fatemeh Naghizadeh ,
Volume 6, Issue 2 (5-2013)
Abstract
Nurses encounter challenging ethical issues in practice that can make decision making tough for them. The purpose of this study was to determine the moral sensitivity of critical care nurses in clinical decision making and its correlation with their caring behavior in teaching hospitals of Bandar Abbas in 2012.This research is a descriptive analytic study with intensive care unit nurses as its participants. A demographic and background questionnaire, a standard questionnaire of the nurses’ moral sensitivity, and a caring behavior questionnaire were used to collect information. Data were analyzed using SPSS16 software, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis, and Spearman’s correlation.The mean score of the nurses’ moral sensitivity was 70.15 ± 6.90 (maximum score was 96 and minimum score was 49) that was moderate in 85.6% of the nurses. The mean score of the nurses’ caring behavior was 108.90 ± 10.62 (maximum score was 120 and minimum score was 69). There was no significant correlation between moral sensitivity and caring behavior scores, but both scores were significantly associated with the place where the nurses were working. The dimension of respect for patient autonomy had a significant relationship with participation in medical ethics seminars or workshops.The moral sensitivity of the nurses in this study was moderate and did not have a significant correlation with caring behavior scores. In view of the fact that nurses deal with serious situations in patient care that call for adequate ethical abilities for decision-making as well as good performance, it is necessary for them to be familiar with and sensitive to ethical issues related to their profession.
Leila Afshar, Soodabeh Joolaee, Khorshid Vaskouei, Alireza Bagheri,
Volume 6, Issue 3 (8-2013)
Abstract
Organizational justice is of great importance particularly for hospital personnel, and job stress has the potential to put their health at risk. The purpose of this study was to determine the relationship between organizational justice and job stress among the personnel of a hospital in Isfahan.
In this correlation study, the samples consisted of 150 personnel that were working in a governmental hospital in Isfahan. Samples were selected through convenience sampling in 2012. Data were gathered by personal data questionnaire, Niehoff organizational justice questionnaire and job stress questionnaire. Data were analyzed by descriptive and analytical statistics.
Results showed that job stress among hospital personnel varied from 48.6% (moderate) to 39.4% (mild) and 12% (severe). Moreover, findings showed there was a relationship between organizational justice in the domain of interactional justice and job stress among hospital personnel (r = - 0.18, P = 0.03).
According to the findings, it is essential to pay attention to the concept of organizational justice in hospitals in order to decrease job stress among the personnel.
Hossein Ebrahimi, Abdolhassan Kazemi, Mohammad Asghari Jafarabadi, Arezo Azarm,
Volume 6, Issue 4 (10-2013)
Abstract
One of the most important issues in nursing ethics is moral distress, which is a severe psychological problem among nurses. The purpose of this study was to determine the nurses’ moral distress in the hospitals of the northwest of Iran.This was a cross-sectional study in which 418 nurses were selected by randomized multistep sampling method in the northwest of Iran in 2012. Data collection was done using the moral distress standard scale with high reliability and validity. In order to analyze data, descriptive (mean, standard deviation, frequency and percent) and inferential statistics (independent t-test and one way ANOVA) were used.The mean score of nurses’ moral distress was 148.49 ± 32.93, and 222 nurses (53%) suffered from severe moral distress. Of the three provinces under study, Zanjan (152.46 ± 35.88) and intensive care units (152.72 ± 33.36) had the highest moral distress scores. Among the respondents’ demographic characteristics, province (P < 0.01), education (P < 0.05), type of shift (P < 0.05) and job status (P < 0.05) were significantly related to the level of moral distress experienced by the nurses.Due to the high level of moral distress in the nursing profession, dealing with it requires a lot of attention. Studies on casual and predictive factors in different wards and teaching coping strategies to nurses appear to be necessary in order to address this issue.
Somayeh Mohammadi, Nozar Nakhaei, Fariba Borhani, Mostafa Roshanzadeh,
Volume 6, Issue 5 (12-2013)
Abstract
Moral intelligence is one of the dimensions of intelligence that can provide a framework for the proper function of man, and be used as a predictor for people’s conduct. Nurses’ performance is of great importance because of the moral and human nature of their profession, and their adherence to ethical principles improves the nursing care quality as well as organizational performance. Therefore, the present study aimed to assess moral intelligence in nurses.This cross-sectional study was conducted on 400 nurses from teaching hospitals in South Khorasan. Participants were selected through census method. Data were collected by Lennik & Kiel’s moral intelligence questionnaire, and data analysis was performed using SPSS 16 software and descriptive and analytical statistics tests. The results suggest that the nurses’ moral intelligence score was 4.35 ± 0.56 (range: 1-5). There was a direct and meaningful relationship between moral intelligence and age and years of practice (P < 0.05).Optimal levels of moral intelligence suggest the importance that nurses attribute to moral values, and can also be an indirect manifestation of their moral conduct in healthcare environments.
Sima Moghadasian, Farahnaz Abdollahzadeh, Azad Rahmani, Farmisk Paknejad, Hamid Heidarzadeh,
Volume 6, Issue 5 (12-2013)
Abstract
Do not resuscitate order (DNR) is one of the most challenging issues in end of life care. The attitude of health care providers has an important role in legalization of this procedure. The aim of the present study was to investigate the viewpoints of nursing students on DNR orders. One hundred and eighty six nursing students from Tabriz University of Medical Sciences (TUOMS) and Kurdistan University of Medical Sciences (KUMS) participated in the present study. Data collection was performed by Attitude on DNR Order Questionnaire that consisted of 25 items. The results showed that nursing students have a negative attitude toward many aspects of DNR orders, had many misconceptions about this procedure and tended to acquire more information about it. Also, students reported a negative attitude about passive euthanasia and reported that cultural and religious factors are important in their attitude toward DNR orders. Moreover, there was no statistical difference between the attitudes of nursing students from these two universities with two different cultural and religious backgrounds (P > 0.05).Considering the lack of knowledge of nursing students about DNR orders it is suggested that nursing students should be educated on the subject. Due to little research evidence conducting further studies is recommended.
Hadi Jafari Manesh, Mehdi Ranjbaran, Katayon Vakilian, Reza Tajik, Amir Almasi-Hashiani,
Volume 6, Issue 6 (2-2014)
Abstract
Assessing nursing students’ level of respect for ethical codes of nursing is essential as these students are the future health care providers. There is a need to check observance of ethics codes among students, because that will determine ethics education and training needs. This study aimed to assess nursing students’ compliance with professional ethical codes and some of the relevant factors.This is a descriptive-analytic and cross-sectional study performed by census on 118 nursing students who were training in hospitals of Shahid Beheshti University of Medical Sciences. The data gathering tool consisted of a questionnaire including demographic information, and another questionnaire which was developed by the researcher based on studies in Iran and throughout the world.The ethical codes that were respected most included "principles of conflict management" and then "respect for the medical staff". "Respect for patients' rights" and "patient education" received less consideration. Grade point average, gender, marital status, interest in nursing and likelihood to work in nursing had significant association with respect for ethics codes.The results of this study can be used in developing courses on nursing ethics and educating nurses on the subject, and could be of special interest to health planners and policy makers.
Madineh Jasemi, Leila Valizadeh, Vahid Zamanzadeh, Fariba Taleghani,
Volume 6, Issue 6 (2-2014)
Abstract
Holistic care is a comprehensive approach for achieving optimal level of care for patients. Identifying the motivational factors can increase quality of nursing care and improve the healing process. Investigation of nurses’ experiences will provide real and meaningful results in this field. In this study we aimed to explore nurses' experiences regarding holistic care.This qualitative study was conducted on 18 nurses from Uremia, Tabriz, Ardebil and Tehran teaching hospitals of Iran. The data were obtained by interviews with nurses. These interviews were transcribed and analyzed by the conventional content analysis method and using MAXQDA software.Personal characters and experience of hospitalization were identified as motivational and promotional factors in providing holistic care.Considering the role of personal characters and experience of hospitalization in holistic care, paying more attention to nurses’ characteristics and upgrading their communication skills and knowledge are necessary for development of holistic care and are highly recommended.
Mehdi Golafrooz, Hajar Sadeghi, Fatemeh Ghaedi, Yaser Tabarraei, Fariba Keighobadi, Farzaneh Keighobadi,
Volume 7, Issue 1 (5-2014)
Abstract
Although errors in health services are harmful and the consequences might be irreversible in some situations, none of the health care providers are free of errors. Since health provision is the main goal of the nursing care, it is important to report professional errors in order to reach this goal. However, there are many obstacles in reporting nursing errors that should be identified and solved. The present study tried to evaluate the nurses’ point of view about managerial and moral obstacles in expressing nursing errors.Two hundred and one nurses of the educational hospitals of Sabzevar University of Medical Sciences were enrolled in this descriptive analytic study. The students were selected by convenience sampling method and the study data was collected using a questionnaire that consisted of a demographic part and a researcher made part with 13 and 27 questions related to managerial and moral obstacles respectively. Content validity index and reliability were measured by internal consistency (α = 80) and test-retest (r = 0.84). Data analysis was done by SPSS 18 software.The results of this study showed that the main reported managerial obstacle in reporting nursing errors was endangerment of academic position (43.3%), and the main moral obstacle was losing physicians' support (55.2%). Thus this problem might be solved by designing appropriate plans from both managerial and moral points of view.
Somayeh Mohammadi, Fariba Borhani, Leili Roshanzadeh, Mostafa Roshanzadeh,
Volume 7, Issue 2 (7-2014)
Abstract
Moral distress is one of the ethical challenges that nurses face due to the nature of their career. Nurses' frequent confrontation with this phenomenon can have different outcomes such as frustration and boredom in providing patient care. This will lead directly to a decline in care quality and can hamper the accomplishment of health goals. Therefore, the present study examined the relationship between moral distress and compassion fatigue in nurses.This cross-sectional study was conducted on 260 nurses of intensive care units in Kerman who were selected through convenience sampling method. In this study, Corley’s moral distress scale and Figley’s Compassion Fatigue Scale were used for data collection. The collected data were analyzed using the SPSS software and descriptive and analytical statistics.The results of this study indicate that there is a significantly positive relationship between moral distress and compassion fatigue (P<0.05). From a total range of 0 to 5, the average score of moral distress was 3.5±0.8 in terms of intensity, and 3.9±0.55 in terms of frequency. The mean of compassion fatigue score was 3.5±0.68 from a range of 0 to 5.Moral distress and its association with compassion fatigue suggest that conditions contributing to moral distress can have an important role in the quality of care. It is clear that strategies should be adopted to prevent the occurrence of these conditions. Informing nurses about moral distress and its consequences as well as periodic consultations will play an important part in the identification and management of moral distress and its consequences.
Fariba Keighobadi, Hajar Sadeghi, Farzaneh Keighobadi, Yaser Tabaraei,
Volume 7, Issue 3 (9-2014)
Abstract
The nursing profession is based on ethics. Clinical decisions that most nurses have to deal with include cases that involve moral conflicts. Moral distress is a phenomenon that causes pain, suffering, anxiety, depression and psychological damage. Emotional exhaustion can cause moral distress and is a consequence of job stress that has even been investigated as a reason for the high turnover in nursing. Therefore, the present study investigated the relationship between moral distress and emotional exhaustion among nurses.In this cross-sectional study, 265 nurses who employed in teaching hospitals of Sabzevar University of Medical Sciences were selected through convenience sampling. Data collection tools included a questionnaire on personal information a moral distress scale whose validity and reliability had been measured in previous studies (Cronbach's alpha 0.86) and a scale for emotional exhaustion that had also been tested for validity and reliability through content validity and test-retest (r = 0.84). Data analysis was performed using SPSS version 18.In this study, mean and standard deviation of moral distress and emotional exhaustion of nurses were 4.99 (0.91) and 4.17 (1.58) respectively. A statistically significant correlation was found between moral distress and the nurses’ field of work (rho = 0.338, P = 0.000). There was also a significant correlation between emotional exhaustion and rotating working shifts (rho = 0.385, P = 0.000) and ward (rho = 0.173, P = 0.03).The moral distress and emotional exhaustion of the nurses in this study were found to be higher than average. Education, counseling and raising nurses’ awareness of these concepts seem to be necessary in order to empower them to better deal with ethical issues.
