سیده سولماز موسوی

academic adjustment plays an important role in the academic achievement and general intercultural experiences of students. The purpose of this study was to determine the role of sense of coherence and hope beliefs in predicting students' academic adjustment.

This study was correlational. The statistical population of this study consisted of all second-grade male secondary school students of Farsan, who were studying in the year 2018. Of this sample population, 120 people were selected and responded to questionnaires of academic adjustment, sense of cohesion and hope Beliefs. Data were analyzed by descriptive statistics, Pearson correlation coefficient and multiple regression.

The results of correlation coefficient showed that the academic adjustment was related positively to agency thinking, pathway thinking and total score of sense of coherence and the components of Comprehensibility and Manageability. The results of regression analysis also showed that variables of sense of coherence and hope beliefs predict about 17 Percent of the variance of academic adjustment in their students.

The results show that hope beliefs and sense of coherence are among the variables related academic adjustment in students, which should be presented in educational programs with ways to increase sense of those.

Hypertension is the major risk factor for cardiovascular disease. The purpose of this study was to quantify the prevalence of hypertension in adults of Torbat-e Heydarieh City.

this cross-sectional study was performed on 278 volunteers over the age 18, who referred Torbat-e Heydarieh Health centers. Demographic information was collected by a questionnaire and then blood pressure was measured by standard method, and those with high blood pressure were re-measured two weeks later. The SPSS software and Chi square test were used for data analysis. P<0.05 was considered statistical significance level.

the prevalence of hypertension was 23.03% and no statically differences were observed between men and women (p= 0.069). 32.8% of participants with hypertension were unaware of their disease and 48.4% of them using antihypertensive medication. There is a significant correlation between hypertension prevalence and aging, urbanization (p=0.008), low physical activity (p=0.047), low level of education (p=0.046) and family history of hypertension (p=0.003). But there was no significant association between high blood pressure and smoking (p=0.101), alcohol consumption (p=0.433) and diet (P>0.05).

The prevalence of hypertension is high in the study community, especially in the urban community. On the other hand, the rate of awareness and treatment is low. Therefore, the intervention of health organizations in order to educate, prevent, change lifestyles and monitor people from an early age is essential.

Courage is one of the moral virtues and the source of many personal and social achievements that are essential for providing quality care. Moral courage is to take action act fearlessly and act on the basis of will; that is, the individual acts without regard to other factors, only on the basis of values and what is good to others. Nurses are the ethical focus of the professional career group and inspiration source for moral care and compassionate. Moral courage is a professional management competence and the most important elements among the four virtues necessary for management; including foresight, justice and moderation, as well as a factor stabilizing the action. By seeing managers as ethical and behavioral models, nurses learn the correct and expected performance, and the courage to respond correctly to one situation is strengthened in them. The purpose of this study was to compare the mean moral courage of nurses and nursing managers working in hospitals affiliated to Shahid Beheshti University of Medical Sciences.
This descriptive cross-sectional study was conducted for 3 months starting from September to November 2015. A total of 70 nurses and 61 nurse managers were selected using convenient sampling method. Data collection was carried out using the Moral Courage Scale developed by Sekerka et al. in 2009. This scale consists of 15 questions categorized into five areas of moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals. The response scale is 5-point Likert scale that is always arranged from Never (1) to Always (5). This scale was translated and back translated by Mohammadi et al. in Iran, and its validity was assessed through a survey of 10 experts in the field of medical ethics and content validity index (CVI) of 81% was obtained. Cronbach's alpha coefficient of 0.85 was obtained for the instrument reliability. To determine the reliability, the scale was completed by 20 nurses and nurse managers and the Cronbach's alpha of 0.86 was obtained. Data analysis was carried out by SPSS ver.22. Descriptive analysis of data was performed using central indices and comparison of mean moral courage in two groups using independent t-test. Pearson correlation coefficient was used to determine the relationship between age, work experience and moral courage. The response rate was 100% and 87% in the nurses and nursing managers groups, respectively.
Ethical considerations: To carry out the research, the relevant permission was obtained from Ethics Committee of the Shahid Beheshti University of Medical Sciences. The informed consent was obtained from participants after explaining the research aims and its implementation procedure. Also, the researcher assured participants about the confidentiality of their information and documents and explained to them about the freedom to withdraw from the research at any stage without being suffered from any adverse consequences.
Findings: A total of 40 (30.5%), 21 (16%), 38 (29%) and 32 (24.4% ) of cases of the 131 nurses and nursing managers participating in the study, were employed in internal medicine, surgical wards, ICU and emergency departments and the nursing office, respectively. Nursing managers included 31 (23.7%) head nurses, 27 (20.6%), educational and clinical supervisors, and 3 matrons (3.2%). The mean moral courage was 4.31 ± 0.40 and 4.33 ± 0.32 among nurses and nursing managers, respectively. The mean moral courage of the two groups was not significantly different (P= 0.06). There was a significant relationship between age, nursing management experience and moral agency (P= 0.04), as well as nurse's work experience, and then multiple values and going beyond compliance (P= 0.035). The mean moral courage was desirable among nurses and nursing managers. There was no significant difference between nurses and nursing managers in terms of mean of moral courage and its 5 items (moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals).
The desirability of the mean moral courage of nurses and nursing directors in this study is a clear and positive point for health service providers that can be used to promote professional performance. Regarding the fact that there was a significant relationship between increase in age and work experience and the dimensions of moral courage in both groups, and considering that moral behavior and courage may decrease over time due to the influence of anxiety, fear and its negative consequences; therefore, to increase the moral courage of members of the organization, appropriate planning for training staffs, holding workshops and discourse sessions and encouraging and protecting moral behaviors are recommended. Also, strengthening the moral capabilities of managers and nurses having a higher work experience can provide the appropriate models for promoting moral performance in the organization.
Please cite this article as: Moosavi S, IzadiA. Comparison of moral courage of the nurses and nursing managers working in hospitals affiliated to Shahid Beheshti University of Medical Sciences. Med Ethics J 2017; 11(41): 17-24.

Researchers tend to understand children’ response to disease, hospitalization and their health and disease experiences for various reasons. The importance of information has increased the demand for qualitative research on children in order to gain sufficient and deep knowledge and understanding of their insights in this age group about health and disease so that we can plan for better physical, mental care and finally improve their quality of life by acquiring of necessary knowledge and information. Although ethical considerations in qualitative research are similar in different groups, ethical considerations are critical in this group considering the complex process of qualitative research and children’s vulnerable nature. This study was designed to determine the ethical considerations in qualitative research with children’s participation.
In this review, Persian and English articles published in Scopus, PubMed, SID, Irandoc, Magiran and Google Scholar databases were searched with no time limit using main keywords of "Ethical Considerations and Qualitative Research "or" Qualitative Research and Children ". The title and abstract of all articles were studied, duplicate and non-related articles were deleted, and contents of related articles were later analyzed.
Ethical Considerations: This study has been approved by the Vice Chancellor for Research and Technology, and Ethics Committee of Shahid Beheshti University of Medical Sciences with the identification code: IR.SBMU.RESEARCH.REC1395.514. Publication of the results is carried out without bias, honestly and by citing the original reliable resources and references.
Findings: Review of extract studies revealed general principles and ethical considerations in qualitative research with children’ participation are similar to other qualitative research and include attention to children’s participation, obtaining informed consent, ability to establish friendly and honest relationships, confidentiality and researcher’s sensitivity regarding publication of information and the imbalance of power.
The findings suggest that the ability to establish a friendly relationship and win the child's trust play a very important role in the child's active participation in the research process as well as reducing the imbalance of power between the researcher and the child. So, it is essential to directly obtain information from the child. Obviously, the participation of children in research play a very important role in empowering and valuation to view of this vulnerable group. Thus, children' research must be carried out in a valuable, supportive and safe environment using appropriate methods to support their social and mental abilities, so that children easily express their opinions. Obtaining informed consent is an ongoing process that requires researcher’s patience and the guarantee that the child has understood the necessary information. In fact, obtaining children’ consent and encouraging them to make a decision strengthen the right to participate in or withdraw from the study, even if the parents are not willing to participate in the study. Therefore, the researcher must ask children in the process of research regarding their consent and participation in the study and must pay attention to their body language and gestures. The ethical principle of confidentiality of information is the challenging part because most children are not independent of their parents; therefore, interviewing with children alone is associated with some problems. Sometimes a child may also disclose information and researchers in support for vulnerable children, are forced to disclose certain informationin some cases. Two other very important concepts in the process of qualitative research with children’s participation include freedom, power, and thus an imbalance of power between researcher and participant. Establishing a friendly false relationship is immoral, so the way in which the researcher introduces him/herself, the language and clothes used and body language and manner of interacting with children have an impact on their relationship. The difference in children’s perception and experience of the world’s, compared with adults, and their different ways of communication, make it different and challenging to implement and observe ethical principles. Long tradition of the research on children mainly focused on getting information from families and caregivers instead direct research on children. Today, researchers should know that the concept of children research is defined as study ‘’with’’ child instead of "on" child. This fact highlights the importance of Children's participation and consent in the process of research. Even if researchers attend to active participation of children in the process, the concept of vulnerability is still dominant in them that require more caution for children's participation in the research. Children’s research must be conducted in a supportive and safe environment using appropriate methods, but different from adults, in order to support their social and mental abilities, so that, children easily express their opinions. The researcher must frequently review the thoughts and process through self-reflection and ask questions regarding whatever is doing in this process. Also, the researcher must clearly explain his/her motivation regarding the involvement of children. He must win trust and honesty of adults responsible for children and to do so, all forms of applied ethics should be completed in research and child-centered approach must be used in their study. Also, in qualitative research with children’s participation, in addition to the fact that methodology and ethical considerations should be assessed by knowledgeable individuals, the Research Ethics Review Committee should carefully examine the capacity and strength of children in a proposed research project.

Considering the high prevalence of diabetes is world wides, self-care programs in diabetic patients are important. There are many studies about self-care programs and assess the outcome of these programs. But the quality of methodology and reporting of these investigations in Iran for use in evidence-based practice has not been extensively studied. This study aimed to determine the quality of the methodological reports of randomized controlled trials on self-care programs in diabetic patients, published in Iranian journals.
In this Secondary study randomized controlled trial articles in Persian and English-language related to diabetes and self-care education, published at local journals magazines in Magiran, SID, Iranmedex, Irandoc databases and Google Scholar and Scopus from 2010 up to June 2016 were searched and assessed using the Jadad scale.
Results showed 29 articles based on Jadad 5 and 13 points had average scores of 2±0.92 and 8.65±1.11 respectively. Randomized allocation in 89.65 % of the studies was noted. Only 3 cases (6.89 %) of the studies were blinded and 13 studies (44.82 %) were reported withdrawal and its causes.
Results of this study showed poor quality of methodological reporting, i.e. (average score below 9). Weaknesses observed in the reporting of trials, required more accurate guidelines and clinical trial assessment tools for authors and scientific journals reviewers.

Moral courage is a virtue that helps people overcome their fears and limitations and make the right decision and take the right action when encountering any situations. Due to the nature of their profession, nurses daily face many moral issues, and their correct decisions and performances require moral courage. The aim of this study was to determine the moral courage of nurses employed in hospitals affiliated to Shahid Beheshti University of Medical Sciences.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2015. The research population was composed of nurses employed in hospitals affiliated to Shahid Beheshti University of Medical Sciences. The study samples were 155 people. The moral courage questionnaire of Sekerka and colleagues (2009) was used to collect the data. Data were analyzed using descriptive statistics, Pearson correlation coefficient, independent t-test and one-way ANOVA on the SPSS software v.22.
The mean score of moral courage of nurses was 63.72±5.91 (15-75). The highest and lowest mean scores were for the dimensions of moral agency (13.73±1.22) and endures threats (11.40±1.80) respectively. The work experiences of nurses had a significant positive relationship with moral courage and beyond compliance (P In this study, moral courage of nurses was at a desirable level. According to the findings, while taking steps to strengthen this virtue, we could strengthen nurses’ moral reasoning to make right decisions and perform ethical practices. In addition, strengthening nurses’ moral courage and reasoning can help them play their role as the patient advocate.

Objectives Quality of work life has important role in job satisfaction and quality of services. Personality compatibility with profession is one of the issues that affect job satisfaction. This study was conducted for the purpose of evaluation of nurses’ quality of work life in Sabzevar University of Medical Sciences, and comparing it with their demographic data and its correlation with personality-profession compatibility.
Materials & Methods This cross-sectional study was conducted among nurses in Sabzevar University of Medical Sciences by two-stage sampling (quota - random) method. Holland personality-profession compatibility questionnaire and quality of life questionnaire were used for this study, after confirming their reliability and validity by coefficient and expert agreement. The obtained data were entered into SPSS and were analyzed with statistical analysis.
Results The average quality of work life in the studied nurses was 20.51 and standard deviation was 4.16. About 39.5% of nurses were dissatisfied with the quality of their work life, 4.8% satisfied, and 1.6% was very satisfied. Personality of the 20.6% of participants was quite compatible, 33.4% was relatively compatible, and 46% was incompatible with nursing profession. Average quality of work life in terms of personality compatibility differences was not statistically significant.
Conclusion In this study, the quality of work life has been reported poor, and most nurses showed inappropriate personality for this profession. According to the main results, attention of managers to these two important issues in this group, as the largest health care provider group, was suggested.

Randomized controlled trial studies provide substantial evidence for evaluation of the effectiveness of nursing interventions. Evidence-based practice is the ultimate goal of nursing and requires integration of the best research documents to present high quality health care.
This descriptive cross-sectional study is aimed to determine methodological quality of randomized controlled trials reports in the Iranian Nursing Journals with the Persian and English language with the Oxford quality scoring system or the Jadad Scale.
Searching for nursing randomized controlled trial articles which were indexed in various databases, including SID, Magiran, Irandoc, Iranmedex and Google Scholar were done by these Persian and English keywords, randomized controlled trial and clinical trial in combination with Nursing. After applying the inclusion criteria and removing irrelevant articles, only 42 articles were left to review. They were assessed by the Oxford quality scoring system or the Jadad Scale.
The mean of the methodological quality of the selected articles was 1.38±1.07 based on the three direct questions for bias control in the Jadad Scale (minimum favorable mean is 3 points). From 42 selected articles only 31% applied a random allocation with low bias, 9.6% of the articles applied double-blind or single-blind methods during the sampling. Attrition was only mentioned in 7.1% of the articles.
Considering the vital role of randomized controlled trial studies during the evidence-based performance in nursing is important. Any weaknesses in the methodology and inadequate reporting of the results could lead to bias and the wrong conclusions in the study. Based on the findings, it is obvious that there is a need to improve the quality of reporting of the nursing randomized controlled trials in the Iranian Nursing Journals with the Persian and English language, especially in the methodology part.

The nature of nursing is such that we have to pay attention to care ethics more than therapeutic considerations. A nurse should be able to justify why he / she has chosen an action and has disregarded other solutions. Indeed he / she should be sensitive to concepts and positions. This study aimed to comparison of sensitivity of nurses and nursing students working in Aja University of medical sciences. This study is a descriptive cross-sectional study during 4 months in 1393. 105 students who studied in fifth semester and higher were selected by census and 77 nurses who worked in hospitals related to Artesh University of medical sciences were selected by sampling available to study environment. Data was collected by using MMSQ (kim) ethical sensitivity questionnaire that its reliability and validity was studied and analyzed by descriptive statistics and statistical tests appropriate to the aims. The mean and standard deviation of the ethical sensitivity was 3/54±0/41 in nurses and 3/45±0/34 in nursing students. The comparison of the two groups using an independent T test showed no significant difference (p=0/1) Ethical sensitivity level in students and nurses was higher than average. According to effect of ethical sensitivity to selecting appropriate solution and its outcomes on patients, this study requires effort of authorities to promotion of ethical sensitivity in caring.

Personality compatibility of individuals with profession that provides services to others is one of important issues that have received less attention while there is a great impact on the quality of services provided and to professional success. This study aimed to assessment of personality compatibility of nurses with nursing profession in Sabzevar University of Medical Sciences in 2013. 62 nurses were worked in Sabzevar University of Medical Sciences in 2013 were selected by simple random sampling participated in this cross-sectional study. This survey Instrument was standardized questionnaire of Holland personality-job compatibility that by means of it compatibility of nurses’ personality with the nursing profession is determined at three levels: non-compatible, relatively compatible and absolutely compatible. Data was analyzed by SPSS. 46% of nurses participating in this study had non-compatible personality and 33/4% of them had relatively compatible personality and only 20/6% had absolutely compatible personality whit nursing profession. Compatibility of personality whit nursing profession according to demographic characteristics had no meaningful differences. this study showed large percentage of nurses working in Sabzevar University of Medical Sciences had non-compatible personality whit nursing profession, and this results shows attention to this important issue by health managers and correction of selection of more compatible nursing student are necessary.

In order to face the challenges of today’s health system، it is extremely important to promote collaborations among disciplines. Nevertheless، it seems that nurses and physicians cooperate more effectively in academic areas، and their partnership in the actual work place and clinical settings is associated with challenges. This cross-sectional study aimed to determine the attitudes of doctors and nurses in hospitals affiliated with Shahid Beheshti University of Medical Sciences toward collaboration with each other. For this purpose، the Jefferson Scale of attitudes toward physician-nurse collaboration was used after it was translated and its validity and reliability were examined on 59 physicians and 164 nurses. Data were analyzed using the SPSS software version 18. The results showed a more positive attitude toward the concept of collaboration among nurses (3. 49) than physicians (3. 12) (P = 0. 02). Moreover، a significant difference was observed between the attitudes of physicians and nurses toward working together across various items of the questionnaire (F = 5. 06، P = 0. 02)، with the exception of the area of nursing autonomy (F = 0. 95، P = 0. 32). An appropriate nurse-physician relationship and agreement over treatment plans can increase the quality of care، and lack of cooperation can lead to stress in the workplace. Therefore، in-service training for doctors and nurses and attention to the importance of cooperation among members of the medical team must be incorporated into the nursing and medical curriculum. Thus، the traditional views on the role of nurses will change، and nurses will be able to perform their professional duties more effectively. Consequently، the cooperation between physicians and nurses and the fortified synergy between the roles will improve the quality of care.

Depression and anxiety are psychological problems after cardiac surgery and hospitalization. Patient education and giving information has important role in nursing care in reducing anxiety and depression. In different methods individual and face to face teaching is an effective method. The main purpose of this study was the preparatory face to face education to reduce depression and anxiety in open heart surgery patients. This was a quasi-experimental study on one-hundred and twenty patients dividing into two groups of sixty members, chosen at random and matched by age, sex, marital status employment status and type of surgery. The patients receiving information booklet and educational program were put in the experimental group and other patients were put in the control group only receiving normal education. The information was gathered by the standard questionnaire of Hospital Anxiety Depression Scale (HADS). For data analysis in spite of mean and standard deviation, correlation, T, ANOVA with SPSS 14 were used. According to the findings of the study the anxiety and depression in both groups were reduced after the surgery (P-value<0.0001). But in experimental group was significantly less than control group. The anxiety scores before and after the surgery in experimental group was 11.63 and 6.68 and in control group was 13.3 and 9.6.For the depression the scores was 10.3and 5.85, and for the control group was 11.28, 9.16.According to the result of the study about the relationship between anxiety, depression and demographic variables, the amount of depression in women and addicted subjects were more than the rest of the group, furthermore jobless subjects had more anxiety (P<0.05). The result of the study showed that undergoing heart surgery patients, experienced anxiety and depression that can negative effect on them. Despite of difference between pre and postoperative scores, in experimental group was significant. Furthermore education specially face to face educational program and giving information was very effective method in reducing their depression and anxiety. This teaching method for better interaction with client and its simply is useful for nurses. Also attention to female, addicted and jobless is recommended.