فصلنامه اخلاق پزشکی
پیاپی 38 (زمستان 1395)

The present study aimed to investigate the relationship between the psychological capital and spirituality and Internet addiction in students studying at Jondishapuor University of Medical Sciences.
In this descriptive-correlational study, applying a multi-stage cluster sampling method, 360 students in the second semester of the 2014-15 academic year were selected. The participants completed Young’s Internet addiction questionnaire, Luthans’ psychological capital questionnaire, and Parsian & Dunning’s spiritual questionnaire. Running SPSS 20 statistical software, the data were analyzed by Pearson correlation coefficient and multivariate regression analysis.
Ethical Considerations: Verbal informed consent was obtained from the participants and the confidentiality of their information was assured.
Findings: Students fell in the age range of 18 to 26, with the mean and standard deviation of 21.64±2.21, 62.2% of whom were females and 37.8% were males. 30.3% of them were regular Internet users, 53.9% were at risk, and 15.8% were addicted to the Internet. The mean and standard deviation of psychological capital was 72.68±16.34, the highest mean of the components of which were related to "resilience" with the mean of 18.40. The mean and standard deviation was 75.37±18.78 for spirituality and 49.28±15.75 for Internet addiction. There was a significant negative correlation observed between spirituality and psychological capital and its components with Internet addiction. 42% of the whole variance of Internet addiction was explained by the spiritual and psychological capital components.
The findings indicates on a need for planning to strengthen the foundations of faith and spirituality in the students by providing encouragment and supportive learning environments which can enhance spirituality and assertiveness and develop psychological capital.

The present study was carried out aiming to determine the relationship between moral distress and moral sensitivity among nurses.
This descriptive analytical study was conducted on 257 nurses employed in teaching hospitals affiliated to Birjand University of Medical Sciences (South Khorasan) in 2015. Available sampling was done among the nurses working in intensive care units (ICU, CCU, NICU and dialysis) in the whole province meeting the inclusion criteria. The data collection tool was a three-part questionnaire consisting of the demographic information questionnaire, Corly moral distress questionnaire, and the Korean version of the Hun moral sensitivity questionnaire. The collected data were analyzed running SPSS statistical software version 16.
Ethical Considerations: Written consent was obtained from all participants. Additionally, all of them were assured of anonymity of the questionnaires and confidentiality of the information.
Findings: There was no significant relationship between moral distress and the nurses’ moral sensitivity (P=0.2). The mean scores (out of 5) were 3.5±0.66 for the total moral distress, 3.5±0.75 for the intensity of moral distress, and 3.54±0.66 for the frequency of moral distress, respectively. The mean for moral sensitivity (out of 4) was 3.1±0.45. There was a statistically significant relationship between moral sensitivity and moral distress with age and years of work experience, and also between moral distress and the type of the ward (P The findings indicates that nurses who do not have sufficient executive power for moral performance will experience moral distress, despite their high and low levels of moral sensitivity. Thus, it is necessary hospital administrators to take some specific measures to carry out periodic evaluation of this phenomenon, and hold some codified trainings in this regard.

The present study aimed to evaluate the effectiveness of forgiveness-oriented group counseling based on Islamic perspective to restore the marriage relationship after marital infidelity in married women who referred to counseling centers in Tehran.
This study is a randomized clinical trial. The statistical population of the study consisted of the women who referred to counseling centers of Tehran in 2015 due to their husbands’ infidelity. Thirty women were randomly assigned into intervention and control groups. Having conducted the pre-test using the forgiveness questionnaires, the intervention group took part in nine weekly sessions of forgiveness therapy based on the Islamic perspective. Then, the post-test was carried out using the same questionnaire for both groups. The data were analyzed in SPSS 18 software using analysis of covariance.
Ethical Considerations: After presenting the research objectives, emphasizing the confidentiality of the information and obtaining patient's verbal consent to participate in the study, the questionnaires were distributed among the participants to be completed.
Findings: The mean ages of the participants in the intervention and control groups were 33.41 and 35.32, respectively and the mean durations of their marriages were 9.11 and 10.33 years, respectively. There is no significant difference in demographic characteristics between two groups (P>0.05). The pre-test and post-test mean scores for forgiveness in the intervention group were 18.33 and 34.33, respectively. Forgiveness-oriented group consulting based on Islamic perspective had a significant effect on increasing women's willingness to forgive (P The findings signified using forgiveness-oriented group counseling based on the Islamic perspective in planning therapeutic interventions.

Information transfer based on real needs of the patients is an important part of the medical services. This study aimed to determine the effect of patient-doctor communication on information seeking behaviors of diabetic patients.
This descriptive-analytic study was done on 362 diabetic patients receiving care in governmental medical centers supervised by Deputy of Health in Isfahan province- Iran who were selected using disproportionate stratified random sampling. The data gathering tool was the Lango questionnaire which was localized for Iranian society by researchers in 2012. Data were analyzed using SPSS 20 software.
Ethical Considerations: Patients’ verbal consent was obtained and they were also assured about confidentiality of the information.
Findings: There was a significant difference between information seeking behavior of people who depend on their physicians for gaining information and those who do not in the terms of information retrieval (P=0.003). There was also a significant relationship between consulting the physician and three of the four dimensions of information seeking behavior of diabetic patients and also between transfer of medical information to the patient and dimension of information sources in patient information seeking behavior (P The findings indicates on the effect of patient-doctor communication on information seeking behavior of patients. It is recommended physician provides information to the patient that requires identifying the information needs of patients and considering their health information seeking behavior.

Appropriate ethical climate can lead to increased job satisfaction is an organization. The present study aimed to investigate the correlation between ethical climate and job satisfaction of the nurses in Shahid Beheshti University of Medical Sciences.
This cross-sectional study was conducted on 79 nurses working in teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2013. The data was obtained using three demographic, Victor and Cullen’s ethical climate, and Job Descriptive Index questionnaires. Data analysis was carried out by running STATA version 13 software at the significance level of 0.05.
Ethical considerations: Verbal consent for participation was obtained from the participants and they were ensured of the confidentiality and anonymity of the questionnaires.
Findings: Professionalism atmosphere, with an average of 34.3, was the prevailing atmosphere in the studied hospitals; and independence atmosphere, with an average of 2.90, was reported as the least ethical climate in the hospitals studied. The highest job satisfaction of the participants was related to the supervision, with an average of 3.54, and the lowest job satisfaction was associated with the payment with an average of 2.02. All the aspects of job satisfaction had a significant direct relationship with the interest atmosphere. There was also a significant relationship between all dimensions of job satisfaction with the professionalism atmosphere.
Professionalism atmosphere with the highest average displayed that, as Maslow pointed out, the nurses pay attention to a higher level of needs for their job satisfaction. Therefore, improving the prevailing ethical climate can lead to increased levels of job satisfaction and productivity in most organizations.

There are many hidden threats in government-run hospitals that affect the incidence of medical errors. The aim of the present study was to determine the frequency and types of medical errors in Taleghani Hospital affiliated to Shahid Beheshti University of Medical Sciences in 2014.
In this descriptive-analytical study, the voluntary error-reporting form was used for data collection in accordance with the standards of the patient-safety-friendly hospitals. Of the 300 forms distributed, 162 error reporting forms were collected during one year, and the data for each form was entered into the software by determining their Identification code. SPSS version 19 software was used for the quantitative tests, and the comments by 10 experts were drawn upon for causal analysis of the data.
Ethical Considerations: Completion of medical errors form report was carried out voluntarily, anonymously, without naming the error reporter, and the unit where the error had occurred.
Findings: The total number of errors reported was 158 errors in 2014. Frequency of the errors consisted of medication errors 38.6%, errors in treatment 36.1%, and errors in recording 25.3%, respectively. Events statistics was 33.5% for incident events, 15.2% for accident events, and 1.3% for sentinel events. Medication errors analysis based on the six principles of drug administration included wrong patient (32.14%), wrong drug (18.7%), wrong order (15.3%), wrong prescription (14.96%), wrong dosage (11.9%), and wrong time (7%).
Despite informing the people and holding educational sessions, there still remain some barriers to reporting errors in the health system. Hence, professional ethics education and error systematic management approaches are recommended.

Recent advances in genetics and molecular technologies have raised some complex ethical questions and challenges. This study aimed to review the ethical considerations related to genetic testing in infants and children.
In this review article, the keywords "genetic testing" AND "infants" OR "children" AND "ethical considerations" OR "neonatal screening" AND "ethics" were searched in PubMed, SID and Google Scholar databases and the relevant literature was determined and analyzed.
Ethical Considerations: Measures were taken to ensure honesty in reporting and citing the texts.
Findings: While introducing ethics does not always give definitive answers to the difficult questions of biomedicine, such rules can be helpful in providing some tips for correct decision-making. The most important ethical issues identified in this study included individual autonomy, consent, disclosure of information, confidentiality and privacy as well as justice.
Since genetic testing has increasingly become possible for children and adolescents, it is recommended that ethical codes for genetic testing in children and adolescents be developed and their proper implementation be monitored so as to prevent any unethical abuse of such tests.

A major reason for professional ethics education for the nurses is increasing their awareness about ethical dimensions and moral sensitivity. This study was conducted to recognize developmental strategies of nursing ethics education.
In this review, the systematic search method was used. Using the keywords of "education, teaching, professionalism, ethics, nursing and medicine" separately and then in combination, in "Science Direct, Scopus, Ovid, Proquest, Eric, Pubmed, SID, Irandoc, Iranmedex" databases, English and Persian articles dating from 2005 to 2016 were searched. 1648 articles were identified. After removing the duplicate and irrelevant papers according to the study inclusion and exclusion criteria, eventually 16 papers were selected and entered the analysis.
Ethical Considerations: Honesty and integrity were considered in reporting the results and citation of the texts.
Findings: The findings indicats that multiple strategies are involved in nursing ethics education, which are introduced under four main nursing ethics education development strategies: nursing ethics curriculum with an integrative perspective, nursing ethics education at all educational levels (Associate, Bachelor, Master and PhD), nursing ethics inter-professional education, and professional ethics education at the bedside.
Paying attention to the impact of students’ learning on the current method of nursing ethics education, using the modern methods of professional ethics education, and enhancing the teachers’ and students’ attitudes are among the most significant factors to be taken into account in the development of nursing professional ethics.