Showing 21 results for Clinical
Alireza Parsapoor, Fariba Asghari,
Volume 5, Issue 1 (3-2012)
Abstract
Healthy volunteers are the first group who take part in experimental studies on the efficacy of new drugs. Parallel with expanding the boundaries of medical science, medical research has shown rapid growth which has caused new and critical ethical challenges in medical research.A clinical trial is one of the essential methods in clinical research and a very challenging method from the ethical viewpoint.Recruiting healthy volunteer participants is necessary in clinical trials of drugs, and it requires special and careful ethical considerations. Although recruiting healthy volunteers is not limited to clinical trials, we have focused our discussion on ethical issues of research on healthy volunteers in this kind of study. In this paper, ethical challenges of involving healthy volunteers in clinical trials have been discussed in four domains of risk-benefit assessment, fair subject recruitment, incentives, and informed consent.
The authors believe and argue that using the daily life risks standard as the acceptable risk for healthy volunteers is impractical. We suggest defining a reasonable risk that is acceptable to the research ethics committee. The ethical committee, as a jury, can then evaluate the public acceptance of the risks.
Akram Izadikhah, Changiz , Niko Yamani, Ibrahim Mirshahjafarey,
Volume 6, Issue 1 (4-2013)
Abstract
Documentation of accepted ethical behavior in special settings is one of the strategies employed to foster ethics in organizations. Such documents, known as codes of ethics, vary in different societies according to their cultural and ideological differences. Medical educators have dual professional roles (as physicians and teachers) that sometimes seem ethically incompatible. Therefore, having codes of ethics is essential in this profession. The aim of this study was to develop codes of ethics for clinical medicine educators with an Islamic-Iranian approach.
This was a three stage developmental research. First, a comprehensive literature review was conducted. Using content analysis method, the first draft of a code of ethics for clinical medicine educators was prepared. Second, the draft was thoroughly and critically reviewed and revised in experts’ focus group discussion and the 2nd draft was devised. This was further reviewed by a group of 24 experts at the national level (validated) and revised according to their comments, and thus the 3rd draft was prepared to be presented for formal approval process.
The final document includes 55 codes of ethics in 18 topics (conscientiousness, accountability, respectfulness, scientific excellence, respect for others’ freedom, equity, patience, religious commitment, modesty, trustworthiness, humility, contentment, relationship with coworkers, attentiveness toward patients, attentiveness toward learners, kindness, confidentiality, and discipline).
It seems that extracting ethical concepts from the rich Islamic-Iranian cultural resources is feasible, and provides an appropriate basis for the development of ethical codes for medical educators. Compared to Western codes, such codes may be better accepted in Iranian contexts and will be implemented more readily if the organizational settings are prepared simultaneously.
Nazafarin Ghasemzadeh , Nazila Nikravan Fard , Mohammad Hossein Rahimi Rad , Sara Mousavipour , Fatemeh Faramarzi Razini ,
Volume 6, Issue 2 (5-2013)
Abstract
Considering the importance of medicine and the ever-increasing developments in medical research, the implementation of such research according to the ethical principles and criteria of creditable national and international declarations is of great significance. According to these declarations, the researcher has the highest responsibility to observe the rights and safety of participants. The present study intends to survey the rate of observance of research ethics in proposals approved at Urmia University of Medical Sciences between the years 2003 and 2008. Three hundred and twenty four research proposals that had been approved between 2003 and 2008 were evaluated retrospectively. Related checklists (self- constructed ones and World Health Organization checklists) were completed for each project, a statistical analysis of the results was done by SPSS software, and descriptive statistics were subsequently extracted. A summary of the most important results is as follows: In 85.5% of the proposals, the ethical considerations part was completed. In 68.4% of the cases the participants were aware of participating in the study and in 67.9% of the cases the informed consent of participants was obtained, 50.9% of which was in written form. Among clinical trials, in 80% of the proposals informed consent was obtained, 85% of which was written. Out of 60 clinical trials, 37 projects (62%) were confirmed by the ethics committee. Considering the results obtained in this study, principles of research ethics were applied more closely in this study compared to similar studies in Iran. It seems this is due to the establishment and launch of regional ethics committees in 2003 and afterwards. However, in order to bring these measures closer to current standards, holding educational workshops for honorable members of scientific boards and students is recommended. Moreover, more accurate supervision of ethics committees, especially in clinical trials and animal experimentations, seems to be beneficial.
Shahram Samadi, Mohamad Sadegh Khabbaz, Fariba Asghari, Omid Nabavian, Ghasemali Khorasani, Jalil Makarem,
Volume 8, Issue 2 (7-2015)
Abstract
The present study is an overview of the causes of patient complaints against physicians and the medical staff in Imam Khomeini Hospital Complex, and strategies to reduce the complaints. For this purpose, complaints that had been filed with the clinical governance office of Imam Khomeini Hospital Complex in 2012 and 2013 were investigated. The information in the forms included age and sex of the plaintiffs, their level of education, type of complaint and similar details. Of the 309 complaints, 174 had been recorded in 2012 and 135 in 2013. The plaintiffs were males with a mean age of 50.5, and 69.6% of them had high school diplomas or lower. Most (16.2%) of the complaints pertained to the emergency department, while 48.5% and 22.7% of the complaints were related to doctors and nurses respectively. In 62.5% of the cases, the accused had been acquitted and 34% had been convicted. The main cause of complaint involved treatment and care at 40.1% and 36.6% respectively. In general, the most common causes of complaints were treatment and care for doctors, and lack of respect for nurses and others. Thus, more attention should be paid to the continuous education of medical students and residents during training years in order to increase the knowledge and skills of physicians. Other measures that can reduce complaints are: providing sufficient information to patients before diagnostic or therapeutic procedures improving the equipment in health centers educating the society and raising public awareness of the treatment process offering the necessary information during medical procedures obtaining informed consent careful choice of the medical team and assigning them to the right position and holding communication skills workshops.
Kobra Omidfar,
Volume 8, Issue 4 (11-2015)
Abstract
Medical laboratory is one of the health service providers that intensely responsible for the life of patient / client. With an increase in the number and variety of laboratory tests in recent years, the role of laboratory science in identifying and assessing the cause of disease has been more recognized. Performing the laboratory tests with the utmost accuracy, precision and speed using up to date methods as well as protecting the rights, integrity and respecting human dignity and also the establishment of priorities and the requisites for quality management systems can have a significant impact on patient satisfaction and quality which are the characteristics of a good medical laboratory. The principle concept of doing good and not doing bad is the essence of every code of medical ethics. Therefore, in laboratory medicine like other areas of medical sciences, there are ethical questions that have become more complex with the development of diagnostic tests. Medical laboratory practitioners usually deal with issues of confidentiality of patient information, as well as issues related to research ethics, professional ethics and business ethics.This study has collected important and common topics of medical ethics in laboratory medicine which leads to increase readers’ and practitioners’ information in this field. It is hoped that such information could be effective and practical to improve the laboratorial services for patients.
Soodabeh Joolaee, Mohamad Ali Cheraghi, Fatemeh Hajibabaee,
Volume 8, Issue 4 (11-2015)
Abstract
In order to improve service quality, there are various committees in hospitals including ethics committees, which may be among the most important and necessary establishments within the health care system. Hospital ethics committees are designed to ensure proper clinical decision-making and are responsible for monitoring the ethical provision of services in hospitals. They also aim to assist patients and health care professionals without interfering in the physician-patient relationship. This article was part of a comprehensive review study performed in 2014 and 2015 by searching database not restricted to any particular period of time. The keywords used to search the sources available in English included “hospital ethics committee”, “healthcare ethics committee”, “clinical ethics committee”, and “institutional ethics committee”. Since ethical counseling is one of the main tasks of hospital ethics committees, their existence in hospitals appears to be essential. There have been few studies on the functions of hospital ethics committees in Iran, and it seems necessary to investigate the activities of these committees in the country. Moreover, it is recommended that the Ministry of Health and Medical Education take more serious actions to establish and monitor ethics committees in hospitals throughout the country.
Sajjad Nemati, Dariush Rokh Afrooz, Nasrin Elahi, Mohammad Hossein Haghighizadeh,
Volume 13, Issue 0 (3-2020)
Abstract
Evaluating clinical performance of nursing students as a resource to determine educational needs and decision-making is essential to change the educational environment and improve the quality of education. The aim of this study was to evaluate the professional behavior of nursing students in the clinical environment with the Small Scale Professional Assessment Tool (P-MEX). This descriptive cross-sectional study was conducted with the participation of 86 nursing interns of Ahvaz University of Medical Sciences in 2019. Data collection tools were demographic information questionnaire and P-MEX Cruess evaluation form. The validity and reliability of this instrument was evaluated by observers and was determined with Cronbach's alpha coefficient of 76%. Data were analyzed using SPSS software version 20 and descriptive statistics, independent t-test, analysis of variance, and post hoc test. In professional skills, most participants in the first stage were 51.2% at the average and expected level and 48.8% above the expected level, and in the second stage, most were 84.9% at the average and expected level and 15.1% higher than they were as expected. In this study, based on the evaluation scores in two stages, although the average total clinical skills scores of most students were within the expected range of the 4-point Likert scale, the skill scores were lower in the special wards. Therefore, for the full development of professional skills, it is necessary to develop appropriate methods of planning and training in the field of professional behaviors.
Seyedeh Mahboobeh Rezaeean, Zahra Kazemi Gelian, Ghasem Kazemi Gelian, Zohreh Abbasi, Elahe Salari, Mahbubeh Tabatabaeichehr,
Volume 14, Issue 0 (3-2021)
Abstract
Failure to follow professional ethics in midwifery will lead to harmful risks, including an increase in maternal and infant mortality. The aim of this study was to investigate the barriers to professional ethics in midwifery clinical care from midwives ’viewpoints in hospitals specializing in obstetrics and gynecology in North Khorasan province in 2018. This cross-sectional descriptive study was performed with the participation of 141 midwives working in specialized obstetrics and gynecology hospitals in North Khorasan province, using classified sampling. The data collection tool was a questionnaire consisting of two parts: demographic information and barriers to professional ethics, in three areas: environmental and managerial and personal care. Data were analyzed using SPSS software version 22 and descriptive and inferential statistics. From the perspective of midwives, all three categories of environmental factors (73.94%), personal care (64.66%) and management (64.97%) were among the barriers to professional ethics. The most important barriers to professional ethics in the managerial dimension are staff shortages (80%), in the environmental dimension, biological changes in the body during work shifts (85.2%) and in the personal dimension, dissatisfaction with basic needs, such as insufficient income or adequate rest in midwifery (80.9%), was. Given the importance of observing professional ethics and the issues and problems arising from non-compliance, it is suggested that managers and officials make the necessary planning by hospitals to remove the barriers mentioned by midwives.
Maryam Aala, Rita Mojtahedzadeh, Aeen Mohammadi, Neda Mehrdad, Moloud Payab, Snor Bayazidi, Mahin Nomali, Mohammad Eghbal Heidari, Alireza Olyaemanesh, Bagher Larijani,
Volume 16, Issue 0 (11-2023)
Abstract
The COVID-19 pandemic has created opportunities and challenges for education and research as the two main academic activities in medical sciences disciplines, which due to their mutual influence can be used to propose solutions for improving these two areas. The present study was conducted to compare two review articles, each of which dealt with one of these two areas.
This comparative study with a qualitative explanatory design was conducted in three steps. First, two review articles were selected that investigated the opportunities and challenges caused by the coronavirus pandemic to propose strategies for the post-corona era. Then, both studies were carefully studied and described. Finally, two researchers separately extracted the similarities and differences mentioned in the two articles and compared them to remove the inconsistencies. A panel of experts confirmed the findings. The opportunities and challenges mentioned in the two articles were extracted and categorized into two areas based on similarities and differences. The similar proposed strategies for the post-corona era were continuing to use virtual space facilities, diversifying the communication methods with students and research participants, and providing and developing suitable electronic infrastructure. Comparing two review articles and determining the similarities and differences between the opportunities and challenges caused by the COVID-19 pandemic and the strategies for the post-COVID-19 era related to medical education and clinical research, led to proposing strategies that could promote these two related areas coherently.
Reza Shahrabadi, Roghayeh Javan, Roghayeh Zardosht, Mojgan Ansari, Mehdi Rabiei, Hamideh Yazdimoghaddam,
Volume 16, Issue 1 (3-2023)
Abstract
The health team, in their daily operations, are faced with many ethical issues they have to solve. Moral knowledge includes confronting with and resolving conflicts, values, norms, interests, or laws. Identifying the ethical challenges of the health system can contribute to the efficiency of educational and health programs of universities of medical sciences. The objective of this study was to explain the components of professional ethics in therapeutic and health interactions with patients. In this qualitative research, the Delphi method was used to determine the components of professional ethics. The participants were composed of three groups including faculty members, students, and clinical staff who were selected using purposive sampling. First, by reviewing the literature, a semi-structured questionnaire was developed to investigate different components of professional ethics. Then, using the Delphi method in four rounds, the ethical components were selected and by checking content validity indices (CVR and CVI), the final version of professional ethics components was explained based on therapeutic and health interactions with patients. The results of the qualitative research and the Delphi model led to the extraction of the 12 most common ethical components including disclosure of patients’ secrets, lack of justice in providing services, lack of respect for the patient’s discretion, medical and treatment staff errors, lack of compliance with regulations and standards of treatment and care, non-observance of legal regulations in telling bad news by the doctor, non-observance of dying patient’s rights, non-observance of patient’s privacy, lack of proper training of care principles and new and up-to-date treatment tips to students and staff, and finally, non-observance of professional communication. Accordingly, the final components were compiled as a questionnaire. Achieving ethical competence requires the identification of ethical components in educational, therapeutic, and care environments, especially in interaction with the patient. Therefore, it is necessary to identify, structure and formulate ethical components in regular and continuous training programs in the field of importance and observance of ethical principles in medical and health centers.
Homa Sadeghi Avval Shahr,
Volume 17, Issue 0 (12-2024)
Abstract
Effective medical education requires the cultivation of essential professional attributes, including ethical reasoning, communication skills, empathy, and professionalism. Traditional teaching methods often fall short in adequately developing these crucial aspects. Reflection-based learning, with its emphasis on self-analysis and critical thinking, presents a promising pedagogical approach to address these limitations. This review study examined the literature on reflection in medical education. A comprehensive search of the Web of Science, PubMed, Scopus, and Google Scholar databases was conducted using keywords such as "education," "reflection," "professionalism," "professional behavior," and "medical students" from 2010 to 2024. Eighteen relevant articles were selected and analyzed for their type, focus, and conceptual implications. Different approaches to integrating reflection into professionalism education were then categorized and analyzed. The reviewed literature highlights a multifaceted approach to incorporating reflection into medical education. Key strategies include contextual reflection, linking reflections to specific clinical experiences; utilizing structured frameworks such as the Gibbs Cycle to guide the reflective process; fostering peer-to-peer learning through discussions, peer feedback, and mentorship; and seamlessly integrating reflection as an ongoing and assessed component of the medical curriculum. Findings suggest that an educational approach emphasizing practical application, experiential learning, and structured reflection opportunities can significantly enhance students' understanding of professional behavior. This approach is anticipated to lead to improvements in communication skills, ethical reasoning, empathy, and self-awareness, ultimately contributing to better patient care and a stronger medical workforce. Reflection-based learning offers a valuable strategy for developing professional competence in medical education. This approach necessitates the active integration of reflection into clinical learning activities, utilizing structured frameworks, and providing ample opportunities for peer and faculty support. Future research should rigorously investigate the impact of specific reflective activities on tangible improvements in clinical skills and behaviors.
Mina Gaeeni, Hamid Asayesh, Ahmad Parizad, Zahra Abedini,
Volume 17, Issue 0 (12-2024)
Abstract
Clinical education constitutes the cornerstone of nursing education. Enhancing students' theoretical and practical knowledge within the psychiatric department is crucial for improving their attitudes, acceptance, and delivery of care. The outcomes of effective clinical learning encompass the development and refinement of professional competencies, including communication and professional ethics, the cultivation of critical thinking for clinical judgment and decision-making, the enhancement of ethical sensitivity, and the fostering of effective team and group performance. Recognizing the significance of these factors, this study aimed to "explain the experiences of nursing students based on narrative writing-reflection during their first encounter with psychiatric clients." This qualitative study was conducted during the psychiatric nursing internship at the Faculty of Nursing, Qom University of Medical Sciences, over two consecutive semesters. Purposive sampling was employed, and data were collected through 10 semi-structured individual interviews and 2 face-to-face and virtual focus groups (n=5 per group). Data collection continued until data saturation was reached. Data analysis was conducted using a qualitative content analysis approach with the assistance of MAXQDA20 software. The clinical experiences of students during their initial psychiatric nursing training course, as reflected in their narrative writing-reflections, revealed a primary theme: "encouraging ethical and spiritual communication in nursing." This overarching theme encompassed four sub-themes: "enhancing empathetic communication," "enhancing ethical sensitivity," "respecting the dignity of clients," and "listening to the voice of clients' feelings." The experiences gained through the reflective method within the clinical education setting, particularly in specialized clinical environments such as psychiatric wards and during initial encounters with clients in these departments, can provide valuable insights into students' attitudes and perspectives towards these clients and their families. These rich experiences can be effectively utilized to cultivate and strengthen communication and professional ethics among medical science students.
Zahra Abdollahi, Marzieh Barahooei Noori, Mohammad Hossein Khani, Mohammad Hossein Taklif, Negin Farid,
Volume 17, Issue 0 (12-2024)
Abstract
Moral intelligence encompasses an individual's ability to discern right from wrong, possess ethical values, and demonstrate ethical behavior in practice. Clinical competence, a crucial aspect of nursing practice, encompasses a combination of knowledge, skills, and attitudes, including adherence to ethical principles. This systematic review aimed to investigate the relationship between moral intelligence and clinical competence among nurses and nursing students. A comprehensive literature search was conducted using keywords related to "moral intelligence," "clinical competence," "nurses," and "nursing students" in major international databases, including Web of Science Core Collection, PubMed/Medline, Scopus, and Google Scholar, as well as national databases such as Irandoc, SID, and Magiran. The search included publications in Persian and English with no time limitations. After removing duplicates and screening the initial 150 identified studies, five studies met the inclusion criteria. Ethical considerations, including minimizing bias in the selection, extraction, and analysis of evidence, were adhered to throughout the review process. The abstract adheres to PRISMA guidelines for reporting systematic reviews. The review revealed a significant positive correlation between moral intelligence and clinical competence across various dimensions. Studies demonstrated that higher levels of moral intelligence were associated with improved clinical competence, including ethical reasoning and clinical self-efficacy. Factors such as age, work experience, educational status, and individual rank were found to influence this relationship. Additionally, some studies indicated that moral intelligence could predict clinical competence scores, while others demonstrated that it could be a significant predictor of clinical competence alongside other factors such as Grade Point Average (GPA). This systematic review provides evidence for a significant positive relationship between moral intelligence and clinical competence among nurses and nursing students. Enhancing moral intelligence through targeted educational interventions can contribute to improved clinical competence and ultimately enhance the quality of patient care. Future research should focus on developing and evaluating educational programs designed to enhance moral intelligence in nursing education and practice.
Hoda Ahmari Tehran, Ahmad Mashkoori, Tayebeh Ilaghinezad, Maryam Tajadini,
Volume 17, Issue 0 (12-2024)
Abstract
Research shows that stress in medical students leads to burnout and a loss of respect for patients’ rights. These declines in mood and an increase in malpractice are particularly evident during the internship period. On the other hand, literature highlights the importance of reflective practice in education. This study investigates the effect of using student reflective narratives on observing dignity and respect for patients’ rights in clinical education. A mixed-methods study based on reflective learning theories (Gibbs' Reflective Model) was conducted over 12 months with 48 intern students. In a quasi-experimental design, 38 medical students were randomly assigned to either an intervention or a control group. Only students in the intervention group were allowed to engage in conversations with patients and inquire whether they had properly respected the patients’ rights and dignity. The students then reflected on their performances. In the first week, a pretest was conducted in both groups. The intervention group received reflective education and participated in reflection writing during the second and third weeks. In the final week, a post-test was conducted for both groups. To explore students’ perceptions of the effectiveness of reflecting on their performance, a qualitative content analysis was carried out, including 12 semi-structured interviews and 144 reflection notes. The mean scores of students’ performance regarding respect for patients in the intervention group improved significantly in the post-test (12.32 ± 1.21) compared to the pretest (9.85 ± 1.39) (p < 0.05). An independent t-test indicated that the difference in post-test scores between the two groups was significant (p = 0.01). From the interviews, four main themes emerged: improving empathy and understanding patients’ feelings, paying attention to patients’ humanistic dimensions, respecting patients’ autonomy and rights, and promoting interpersonal communication skills. This study demonstrated the positive emotional effects of reflective narrative writing interventions on medical students in observing dignity and respecting patients' rights. It is recommended to incorporate reflective narratives into medical education programs to enhance these qualities.
Fatemeh Hekmatian, Akram Hashemi, Soodabeh Hoveida Manesh, Saeedeh Saeedi Tehrani,
Volume 17, Issue 0 (12-2024)
Abstract
Obtaining informed consent is a fundamental ethical and legal right of participants in clinical trials. It ensures that individuals are adequately informed about the research, including its nature, potential risks and benefits, and their role in the study. This knowledge empowers participants to make informed decisions about their involvement. This study aimed to evaluate the awareness of participants regarding the information provided in informed consent forms (ICFs) for clinical trials conducted at Iran University of Medical Sciences (IUMS) in 2020. This study evaluated the accuracy of the content of ICFs of registered clinical trials and assessed participants' understanding of the information presented. ICFs were reviewed using a ministerial checklist. Participants were subsequently contacted to assess their comprehension of key aspects of the trial as outlined in the ICF. Analysis revealed a discrepancy between the information presented in the ICFs and participants' actual understanding. Despite adequate coverage of certain aspects, such as the research nature of the interventions (98.2%) and the mention of specific benefits (92.7%), significant gaps were observed in participants' comprehension of crucial information. Notably, lower levels of understanding were observed regarding the possibility of invasive interventions (25.7%), the random assignment of participants to study groups and the potential use of placebos (44%), and the possibility of not personally benefiting from the research outcomes (44%). Additionally, only 47.7% of participants reported understanding the confidentiality of their information. These findings highlight the need for improvements in the process of obtaining informed consent. While researchers may adequately address the overall research objectives and potential benefits, crucial aspects such as the potential for invasiveness, randomization procedures, and the possibility of no direct personal benefit may not be adequately communicated to participants. Enhancing participant understanding of these critical aspects is crucial for ensuring truly informed consent and upholding ethical research practices.
Simin Kokabi Asl, Sareh Zekavat, Somayeh Rostamkhan, Abolfazl Dehbanizadeh, Mahsa Ghaemizadeh, Milad Amiri,
Volume 17, Issue 1 (3-2024)
Abstract
The intensive care unit (ICU) is a challenging and stressful environment where nurses encounter difficult ethical decisions daily. Therefore, this study aimed to determine the correlation between moral reasoning and clinical belongingness among Iranian ICU nurses. This cross-sectional, descriptive-analytical study was conducted on 126 nurses working in the adult ICUs of hospitals in Yasuj, Iran in 2023 using census sampling. Questionnaires measuring clinical belongingness and moral reasoning were used to collect data. Data were analyzed using independent samples t-test, ANOVA, regression, and Pearson’s correlation coefficient via SPSS-26 software. The findings revealed that the mean scores for clinical belongingness and moral reasoning among the nurses were 109.68 ± 13.75 and 36.07± 5.50, respectively, indicating good clinical belongingness and moderate moral reasoning. Moreover, a statistically significant relationship was identified between the place of service and clinical belongingness (p = 0.02), while no significant relationship was found between clinical belongingness and moral reasoning (p>0.05). Although no significant relationship was established between clinical belongingness and moral reasoning, certain demographic characteristics showed a significant predictive relationship with nurses' clinical belongingness. Accordingly, it is recommended that nursing officials and managers utilize these findings to improve moral reasoning and the sense of belonging to the clinical environment among nurses.
Farshid Mohammadmousaei, Zeinab Raiesifar, Seyed Ali Mousavi, Nastaran Khorsandi Bahar, Fatemeh Esmaelzadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Maintaining patient privacy is a fundamental right of patients and an ethical duty of healthcare professionals. The present descriptive, cross-sectional study was conducted in 2022 to compare the perspectives of patients and staff in obstetrics and gynecology operating rooms in Mashhad, Iran, on the extent to which patient privacy was preserved. Patients were selected using random sampling in the operating rooms of hospitals affiliated with Mashhad University of Medical Sciences. Data were collected through a demographic information form and a standardized questionnaire to assess hospitalized patients’ privacy. Data were analyzed via SPSS-22, utilizing descriptive and inferential statistics, with a significance level of P<0.05. The mean ages of patients and staff participating in this study were 39.07±12.56 and 31.65±8.42 years, respectively. The mean score of preserving privacy from the patients' perspective was 38.92±22.41, whereas from the staff's perspective, it was 64.26±8.02, and the difference was statistically significant (p=0.0001). The lowest scores in both groups for personal privacy were 4.97±8.77 for patients and 13.37±2.66 for staff. Results indicated that the staff perceived the level of preserving patient privacy to be above average, while patients considered it below average. Therefore, given the patients’ specific conditions, high stress levels, and physical and mental limitations to support themselves, it is essential to implement targeted training and take necessary measures to encourage the staff to pay more attention to patient privacy and raise patient awareness in this regard.
Reza Abdollahi, Haleh Ghavami,
Volume 18, Issue 1 (3-2025)
Abstract
Due to the inherently demanding nature of their profession, nurses face significant job-related stress that can adversely affect their lives and the quality of nursing care. Moral courage may serve as a key factor influencing occupational stress among nurses. Accordingly, this study aimed to examine the relationship between moral courage and occupational stress among nurses. This descriptive-analytical cross-sectional study was conducted in 2024 with 120 nurses from emergency departments of educational and therapeutic hospitals in Urmia, Iran, who were selected via two-stage sampling. Data were collected through a demographic information form, Sekerka’s Moral Courage Scale, and Gray-Toft and Anderson’s Nursing Stress Scale. Data were analyzed using Pearson correlation coefficient, multiple linear regression, independent t-test, and one-way ANOVA in SPSS software version 23. The results showed the mean scores for professional moral courage and occupational stress were 85.93 ± 15.68 and 10.77 ± 0.23, respectively. Moreover, there was a significant negative relationship between moral courage and occupational stress in nurses (r = -0.33 and P< 0.05). Specific dimensions of moral courage, such as moral factor, threat tolerance, and moral purpose, had a significant negative effect on occupational stress (P< 0.05). These findings suggested that moral courage plays a significant role in mitigating occupational stress among nurses, which can influence their performance and, consequently, the quality of nursing care. Therefore, by fostering an environment that promotes moral courage, nursing managers can play a vital role in decreasing and mitigating the occupational stress experienced by nurses as well as enhancing the quality of care.
Hossein Motaarefi, Shahriar Sakhaei, Amin Soheili, Hassan Ebrahimpour Sadagheyani,
Volume 18, Issue 1 (3-2025)
Abstract
Patients’ perceptions of healthcare service quality and satisfaction with their legal rights constitute the primary objective of the care team and should be considered a criterion for accreditation evaluation. In this regard, a thorough examination of healthcare providers’ and patients’ perceptions, emotions, and experiences regarding the reasons for ‘Discharge Against Medical Advice’—as a patient’s legal right—can help identify hidden factors influenced by temporal and spatial conditions. This qualitative study employed a conventional content analysis approach, involving semi-structured interviews with 24 healthcare providers and patients selected purposively. Researchers repeatedly reviewed recorded content and notes to code the data. Subsequently, key codes and themes were clustered, categorized into specific topics, and labeled. Finally, an interpretation of the obtained data reflecting the study’s approach was presented. Through conventional content analysis, 203 codes were extracted. After categorization, four subthemes, including human factors, processes, facilities, and environment, were identified under the core theme of “uncertainty and distrust” as reasons for discharge against medical advice. Discharge against medical advice is recognized as both a challenge for hospital accreditation and an adverse outcome for patients. Addressing uncertainty-related issues and fostering public trust through team collaboration and implementing novel policies can mitigate discharge against medical advice.
Rahele Samouei, Shokoofeh Samouei, Narges Meshkineh ,
Volume 18, Issue 1 (3-2025)
Abstract
Faculty members and researchers bear the greatest responsibility for producing scientific research outputs due to the nature of their profession and mission. Given the role of ethical principles in ensuring evidence-based research, their impact on research utilization in society, and the importance of scientific evaluations, this study was conducted to design and psychometrically evaluate a questionnaire on factors related to unethical research practices among researchers. This cross-sectional study was conducted in 2024 among faculty members and researchers at medical sciences universities in Iran. Based on a preliminary qualitative study, 40 items were initially generated for the questionnaire. The validity of the questionnaire was assessed through face validity, content validity (CVR, CVI), and criterion validity (divergent and convergent). Besides, exploratory factor analysis (EFA) and reliability testing (Cronbach's alpha) were performed. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and Student's t-test. During the content validity assessment, 11 researchers evaluated the items. Applying cutoff scores of 0.59 for CVR and 0.79 and above for CVI, 16 out of 40 items were removed, retaining 24 items. Exploratory factor analysis revealed five key factors, including “researchers’ irresponsible and unprofessional behaviors and beliefs”, “inefficient basis for competition and career advancement among researchers”, “lack of awareness and up-to-date knowledge among researchers”, “inefficient organizational culture and policies”, and “lack of supervision over researchers and research”. Descriptive findings indicated significant differences in the mean scores of factors associated with unethical research practices of researchers by gender (P=0.002) and organizational position (P=0.004), but not by education level. The findings from this study confirmed the strong psychometric properties of the questionnaire on factors related to unethical research practices.
