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As the nursing profession evolves, the professional responsibilities of nurses have increased and they need autonomy in their activities. Despite the pursuit of autonomy in nursing, the profession faces challenges.

This study aimed to investigate the challenges of achieving autonomy in nursing.

This study was a systematic review with a key words such as autonomy in nursing, challenge in nursing which was used library studies search the databases such as: PubMed, Science Direct, Scopus, Google Scholar and two Iranian databases: SID and MagIran were investigated. Prisma checklists were used to check and control the quality of articles. All searches were done in 2005-2019.

After searching all international and domestic databases, 25 articles entered the final analysis. The most important challenges consist of: ambiguous definition of autonomy, the use of inappropriate measurement tools, the lack of a theory of nursing autonomy, inadequate student education, lack of teamwork, lack of manager support and inadequate managementstructure, hospital size and It impacts was about the structure of the organization and the extent and power of the nurses.

The solutions needed to address these challenges should be in place. Extensive research with valid tools, qualitative research to precisely define the concept of independence, modify students' curricula, encourage teamwork, and ultimately support managers, increases nursing independence.

Psychological well-being and happiness describe the components that refer to mental health or positive functioning. Thus, the definition of happiness is not limited to emotional well-being; because other elements such as cognitive elements are involved in happiness. The aim of this study was to investigate the role of psychological well-being components in predicting happiness.  

This is a descriptive-analytical study. The statistical population included all undergraduate students of Tabriz University in the academic year 1397-98 that 174 people were selected by judgmental sampling. The Reef Psychology Welfare Scale and the Oxford Happiness Scale (OHI) were used to collect research data.

In this study, 119 (68.4%) females and 55 (31.6%) males were present as a sample. The mean and standard deviation of the subjects were 22.00 71 3.71 years, respectively. The results of correlation coefficients showed that there is a significant relationship between the components of psychological well-being and happiness (P <0.05). Based on the results of hierarchical regression analysis, 19.7% of the variance of happiness was explained by the components of psychological well-being. Also, according to beta coefficients and t value, self-acceptance component, mastery of the environment and positive communication with others were significant at the level of P <0.05.

According to the results, students who have experienced more psychological well-being, in other words, have reached a degree of self-acceptance, are able to control stress and stressors to some extent, and have acquired the necessary skills to communicate effectively with others. They have more inner self and as a result they will experience more happiness.

 Today, commercial companies have a great desire to resolve their disputes through arbitration. One of the issues that the arbitrator or arbitrators must always pay attention, is the observance of ethical principles and obligations; Because not paying attention to this issue, on the one hand, can cause the judges to lose trust and, on the other hand, cause the referee's verdict to be annulled.

 The present article examines the position of ethics in arbitrating companies' commercial disputes using descriptive-analytical methods and library and other available resources.

Ethical Considerations: 

In all stages of writing the article, honesty and trustworthiness have been observed and all materials taken from other scientific works are accompanied by accurate references to sources.

 The findings of this article indicate that the observance of ethical obligations by arbitrators is recognized as the most important basis for the acceptance and legitimacy of this institution in the justice system of any country and ethical codes are the most important source of ethical obligations of arbitrators. Also, the most prominent ethical principles that have been emphasized in the US, British and Australian jurisdictions in corporate litigation or arbitral tribunals are: the principle of independence and impartiality. The principle of disclosure, the principle of confidentiality and the principle of expertise, all of which are discussed in this article.

 Considering that no ethical code has been developed in Iran for arbitration in commercial disputes, it is necessary to specify the ethical standards that arbitrators must follow regardless of existing laws and regulations; Therefore, it seems necessary to prepare a draft code of ethics by institutions such as the Arbitration Center of the Iranian Chamber of Commerce, to judge commercial disputes using the experiences of leading countries in this field such as the United States.

With the increasing pace of change in today's world and the changing needs of individuals, the nursing profession needs to adapt to these changes and constantly rebuild in this area. Under these circumstances, nurses are expected to make decisions, reflect, and take responsibility for their decisions rather than just doing what is called ordering. Autonomy in the workplace is one of the strong predictors of nurses' retention in the profession and their job satisfaction, and reducing its levels will increase the decline in the nursing workforce. Autonomy is one of the most important components of self-motivation and its presence in the workplace promotes employee health. Gaining autonomy has been one of the main challenges of professionalism in nursing throughout history. The present study is a descriptive comparative study that was conducted with the aim of comparing the professional autonomy of nurses working in the intensive care unit and other departments in the selected hospital of Iran University of Medical Sciences in 2020.

The research environment includes intensive care units (6 wards) and normal wards (16 wards) of Hazrat Rasoul Akram Hospital (PBUH) affiliated to Iran University of Medical Sciences. The research community is working in special wards and inpatients. the study was done by census method,and 310 nurses participated in the study. In this study, the standard questionnaire of professional autonomy of Dempster 1990 nurses was used and its reliability was confirmed with Cronbach's alpha of 0.95. The criterion for entering the research is to have at least 6 months of work experience in the current department.

Findings showed that the professional independence score of the studied units in ICU was 107.78±13.18 and in CCU was 99.10 ± 11.26 which according to Pvalue = 0.079, there was a significant difference between There are no scores for the two groups. However, the mean score of professional independence score of the studied units in normal wards was significantly different due to P value <0.001 compared to ICU and CCU intensive care units. Nurses in ICU and CCU intensive care units had higher independence scores than nurses in other wards. Also, in the normal sections, the highest scores of professional independence are related to the mental section (mean= 81.45) and the lowest scores of professional independence are related to the internal section of men (mean=70).

Professional independence in the intensive care unit is at a medium level and in the normal sector is at a low level. Due to the direct impact of nurses 'professional independence on the level of quality of patient care and nurses' performance, therefore, measures should be taken to support managers and change the management structure and improve the ability of nurses.

.Adolescence has been considered as an era with rapid changes in so many aspects of life, like corporal, cognitive, and social aspects. The hearing impaired teenagers face a lot of complications in the struggle to gain identity, independence, and developmental self-actualization. Deaf people mostly face a biased interaction with their society and, as a result, instead of being considered teenagers with special needs, they are considered as deaf disabled people. The present paper is an attempt to address different parameters which affect the life of deaf adolescents including identity, independence, and loneliness.
We investigated most of the studies which were conducted on challenges of deaf teenagers during their adolescence. Both English and Farsi papers were collected and investigated since 1981 using search engines SID, SAGE, WILEY, SCOPUS, SCIENCE DIRECT, EMERALD, and ERIC PUBMED. In so doing, the following keywords were used: hearing, deafness, hearing disorders, hearing loss, adolescence, adulthood, puberty, identity, independence, and loneliness.
Different parameters can affect the identity, independence, and the loneliness of the deaf teenagers which should be investigated to first prevent and then minimize their problems and psycho-social issues to facilitate their growth.
By conducting more goal oriented studies and collecting more data, we can gain more information, so better programs can be set for the future of the deaf teenagers. Parents’ decision on using cochlear implant or hearing aids, choosing an appropriate school, access to effective communication inside and outside the home, having a supporting group with which the deaf teenager can coordinate themselves, and etc. can all be powerful means by which a deaf teenager can develop a meaningful identity and reduce possible negative effects of deafness.

Aging, which is an inevitable process in life, brings about some limitations and disabilities. Providing conditions which are suitable for the elderly can result in a relatively healthy, comfortable, and independent life. Given the important role of mosques in maintaining people’s physical, psychological, social, and spiritual health, the current study aimed to assess the suitability of mosques’ structure in the light of the elderly’s needs.
This study, which adopted a cross-sectional design, was conducted among 30 mosques of Sabzevar in the summer of 2016. Data were collected using a 70-item checklist made by the researchers. Elements of spatial structures (e.g. elderly-friendly houses, churches, and parks) were utilized in designing this instrument. The opinions of some experts in ergonomics, elderly science, and civil engineering were also sought. The current conditions of various parts of mosques, including shabestans, rest rooms, wash sinks, corridors, stairs, and entrances, were assessed in this study. All ethical issues were observed in this research and the researchers declared no conflict of interests.
About 50% of people who referred to mosques were seniors. The average number of stairs was bigger for the female parts than that of the male parts. Easy access to public transportation was available for around 70% of the mosques. None of the mosques had entrances with equal ground levels in the outside and inside. Finally, about 80% of the studied mosques did not have any ramps for the rest rooms or wash sinks.
The assessed mosques were in appropriate conditions in some parts like the ground surface of the yard and the building, lighting, and temperature. However, interventions are required in some parts like rest rooms, stairs, and corridors. Since the population of the elderly is growing in Iran, the physical structure of mosques should undergo some ergonomic interventions to protect seniors’ comfort and independence and enhance their safety.

Respect for the human dignity as a moral principle is the professional responsibility of each nurse. Studies indicate the fact that the dignity of patients in care is neglected by healthcare professionals. This study aimed to determine the status of dignity in the hospitalized patients from the perspective of nurses in Iran.
Material & In this cross-sectional study which conducted from 2012- 2013 in Isfahan’s hospitals, 368 nurses were selected by cluster sampling method. Data were gathered through a questionnaire with Likert scale in the dimensions of “respecting privacy”, “promotiong autonomy” and “nurse- patients respectful interaction” and were analyzed using descriptive and analytical statistics with SPSS software version 16.
Based on the findings from this study nurses were more satisfied with the patient's autonomy and the respectful communication and these componnets had the most mean (0.53 ± 2.43, 0.35 ± 2.40) and score (82%, 79%) respectively. Privacy of the patients had the lowest mean and scores (0.52 ± 2.43, 76%).
This study showed the importance of being polite and respectful. A respectful tone of voice, using simple and understandable language, respond to every patient’s question and pay attention to gender of the nurse when the patient prefers a nurse of the same gender is so important in good communication between nurses and patients and require special attention.

The aging population is Probably the most important demographic phenomenon at the end of the twentieth century and the beginning of the twenty-first century. Having independence in that period that leads to more satisfaction and a sense of personal control better and finally promote sense of worth and dignity of the elderly. This study aimed to explore the concept of independence in maintain the dignity and older adults, was conducted a content analysis approach.
This study used purposeful sampling and semi-structured interviews. The statistical sample included 15 old people living in Tehran city in 2013. In order to analyze the data, typed interviews texts were transferred into MAXQDA software and coded by the software.
Based on the analysis of the study data, the extracted themes in relation to the concept of independence in maintain the dignity Elderly consisted of three sub-themes including physical ability, financial independence, and not being a burden to others.
The themes indicate that: provide comprehensive requirements for maintaining the independence of older adults, to raise the morale and maintain human dignity, he seems essential. . Since the present study represents the understanding of human dignity by maintaining the independence of the elderly experience Could be result in to the development of strategies of support from family members, health care providers and policy makers

Consideration of patient autonomy is an essential element in individualized and patient-centered care. Since outcomes of respect for patient autonomy، as one of the four key principles of ethical practice and health-related، is required for autonomy support and it is not clear this study was performed to explore outcomes of respect for patient autonomy in hospital.

This study was conducted with qualitative research approach and conventional content analysis method in 2013. With the use of purposeful sampling 13 patients، 7 nurses and 1 doctor were interviewed over a 10-month period in Tabriz and Hamadan teaching hospitals of Iran. The data were obtained by interviews with participants. The data were analyzed using qualitative content analysis method and using MAXQDA10 software.

out of 21 contributors included in study، we concluded 494 primary code، 13sub categories and four themes that indicated nature and dimensions of patients’ perception from consequences of respect for patient’s autonomy. These themes included: 1. Mental and physical comfort 2. Reduce dependence 3. Adherence 4. Trust.

Resultsof this study showed outcomes of respect for patient autonomy. These results can help the treatment team until motivate to respect for patient autonomy.

Success of health systems significantly depends on the human resources. Any job having specific features can cause employees motivation. The objective of the present study was to survey the potential power of the jobs at hospitals affiliated with Neyshaboor School of Medicine،Iran. This descriptive cross-sectional study was conducted in the winter of 2012. Employees of hospitals affiliated to Neyshaboor School of Medicine in two job categories of clinical and administrative comprised the study population. A sample of 264 was selected according to a stratified random sampling. Data collection was conducted by questionnaires. 202 completed questionnaires were analyzed using descriptive statistics and one-sample t test. There was no relationship between the demographic variables such as age، gender، work experience، marital status، education، and kind of membership and employment potential. In the occupational groups، the means of the variation، identity، importance، independence، and feedback were 4. 99، 5. 20، 5. 59، 4. 46 and 4. 85، respectively. The mean of motivation scores was 117. 1 that did not indicated a significant difference with the standard value of 125. The occupations had variation، identity and importance. There were significant differences between the means of task variety، task identity، and autonomy and their standard values. However، there was no significant difference between motivating potential and its standard value. Discussion and The studied jobs had variety، identity and significance، but they lacked independence and feedback. Hence، it is recommended that the authorities set redesigning the jobs in their agenda in order to increase independenc، and feedback of the jobs.

People who exhibit field dependence tend to rely on information provided by the outerworld, the field or frame of a situation and their cognitions based on this overall field. Hence, the research purpose is to investigate the relationship between field independence and dependence, obsessive-compulsive symptoms and meta-cognitive beliefs in a nonclinical sample of students. Therefore, a sample of 300 university students was randomly selected from among the Islamic Azad University located in the west ofMazandaran and tested in terms of field independence and dependence, obsessivecompulsive symptoms and meta-cognitive beliefs. Data that were analyzed usingcorrelation coefficient and multivariate regression indicated that there is significant negative relationship between filed dependence-independence and obsessive-compulsivesymptoms. However, significant and positive relationship was observed between the metacognitive beliefs and obsessive-compulsive symptoms. The subscales of positive beliefs about worry, uncontrollability of danger and cognitive self-awareness were the strongest predictors of obsessive-compulsive symptoms in the nonclinical sample. Moreover, it seems that recognition and change of meta-cognitive beliefs in relation to the uncontrollability of danger, cognitive self-awareness and positive beliefs about worryshould be taken into consideration in the treatment of obsessive-compulsive disorder.

Currently، nursing authorities، researchers and scholars closely criticize nursing researches and documents based on its philosophy and methodology، hence the concept development is considered as one of the most important approaches for nursing knowledge development. The present study was a review that used Walker and Avant approach for the autonomy concept development. This approach is one of the methods of conceptualization and concept development that eventually resulted in the theory development. In this study، the autonomy concept was searched by using of the autonomy keyword، in valid data bases، PMDR and INLM. Then all of the related articles reviews and themes related to the autonomy keyword were determined. There are various definitions of autonomy in nursing literature and the concept has been in evolution until now and based on professional literature review، many concepts including themes of self governance، ability، capacity، competent، self-controlling، freedom، critical reflection and decision making have been extracted. Discussion & The concept of autonomy is an abstract and complex concept and its meaning has intervened with other concepts. Formal analyzing of the concept could result in appropriate usage، semantically.

Patients'' protection is a key concept of the nursing ethics that assist in the maintenance of the patients'' autonomy and their decision-making. The nurses'' perception of this matter is effective in the occurrence of the protective behavior toward the patients and this study aims at measuring the nurses'' perception in this respect. The data of this descriptive-analytical study were collected per quotas from among 385 nurses in 4 educational hospitals of Kerman University of Medical Science by using a researcher-made questionnaire and were analyzed in two descriptive and analytical levels by using SPSS software. The results show that the average nurses'' perception of their protective role toward patients is relatively positive. Nevertheless, the necessity to find ways for the increase of the nurses'' perception in this regard seems necessary noting the importance of the patients'' rights.

Originality and dynamism of university activities calls for a democratic atmosphere and considered as a supporting principles for faculties. Giving autonomy to universities is a fundamental policy to enhance their responsibility, accountability, and dynamism. Hence, this study is an endeavor to investigate the autonomy and academic freedom situation in university from the viewpoints of faculty members. Study population included 550 faculty members in Shiraz University of Medical Sciences. According to Morgan tables, a sample size of 230 faculties was selected from different schools. Academic freedom, the effect of international policies, and university independence were measured through a researcher-designed questionnaire including 15 close questions in 4 points Likert scale. The score for each item was calculated out of 100. The questionnaire’s validity was verified by experts and the reliability was approved by Cronbach's Alpha (91%). The mean scores for main domains were: university’s autonomy (81.3±21.3), the effect of international policies (76.9±20.5), and academic freedom (73.3±21.6). Among the items, lack of university’s financial independence and its reliance to governmental budget (85.6), the effect of international politics on international academic associations (79.1), the effect of political attitude of university managers on academic atmosphere (76.9), continuous changes of programs after management changes (76.5) were factors which showed the highest mean scores respectively. Regarding the importance of academic freedom and autonomy in accountability and the growth of creativity and innovation in university, this subject should be considered more than ever. Besides, according to strategic management and planning and establishment of monitoring system and systematic accountability could prevent the redundancy resulted from political changes.

one of basic principles in observance of patient right, is respect for independence, that careless of by nurses inparalell with limitation of physical ability arised from disease and hospitalization can causes situational, crisis in patient. This study aimed to assess the observance of independence in hospitalized teenagers during nursing care. In this descriptive study, the data were collected using convenience method sampling of 180, 12-18 years old hospitalized teenagers in hospitals of Tehran University of Medical Sciences which had criteria for enaeving is the study. Demographic data and observance of indenendeuce were collected by a questioner which was filled out by attended. Data we analysis with SPSS software and using man-whitney u and kruskal-wallis tests. More than one third of the studied teenagers (36.1%) were between 14-15 years old; more than half of them were males (53.3%). Findings shown from view paints Most of teeagers (66/7%) observance of their independence through nursing care is moderate. From view points of teenagers, t he most observanced expression about independence was phrases “presence of the favorite person as companion” and the least observance phrases were “choosing the bed and the room location with the teenager’s opinion”and “change the nurse if there is a tendency for”. Furthermore, results showed that there was a statistically significant difference between adolescents` perceptions and observance of their independence in demographic variables such as age, experience of hospitalization, number of hospitalizations, cause of hospitalization, duration of illness and duration of hospitalization. The findings of this study indicated from view of teenagers observance of their independence through nursing care is low. Furthermore planning of educational courses for nurses about importance of independence and observance of it suggested.

In near future, most of the elderly people will be living in developing countries such as Iran. Maintaining autonomy and independence is the main goal in elderly care. This study was conducted to understand the concept of autonomy from the viewpoint of elderly people. A qualitative research based on van Manens phenomenological methodology was developed. Semi-structured interviews were used for 10 old people who were selected by purposeful sampling. Research activities of van Manens methodology were used for analysis of verbatim transcripts. Four themes emerged by which the phenomenon of autonomy could be illustrated. These themes were: being a self director, not being a burden, financial independence and living in one’s own house. Being a self director included sub-themes of independence, decision making, freewill and authority. Not being a burden included sub-themes of self-care, independent performance and being useful for the family and community. Financial independence included sub-themes of experience of inflation, financial security, fear of financial dependency, and relation between financial ability and health status. Living in one’s own house included sub-themes of having separate life from offspring, hate of living in nursing homes, feeling of dignity by having separate life from offspring, and family’s effort for the older people to live in their own house. The attention paid to these themes by older people showed that autonomy is both multidimensional and context-dependent in older people of Iran. The findings will help health professionals to develop an effective caring system for older people.

Nursing Roy adaptation model is concentrated on adaptation rate and has a positive role in health, quality of life. The aim of this study is the assessment of adaptation rate female patients with coronary artery disease in the aspects of physiology, self perception, role playing and independence/dependence. In this correlation analysis study the method of sampling was randomized stratification. The study samples were 250 individuals and the data gathering tool was a questionnaire. Data analysis was performed by SPSS software version 13. There was a significant difference between education level and the number of family members, the mean family income and adaptation rate (p<0.001). At the physiologic aspects, individuals according to self protective activities with 152 cases (61.2%), health behavior and protection against risk factors with 212 cases (84.8%) had a moderate adaptation. At the self-perception aspect 206 cases (82.4%) had a moderate adaptation. Meanwhile at the independence/dependence aspect 109 cases (43.6%) had a low adaptation. At the role playing aspect 224 cases (89.6%) had a moderate adaptation. Adaptation rate according to quadruple aspects of physiologic, self-perception, role playing and independence/dependence was significant (p<0.001). This study showed the value of using a nursing theory as an organized framework for assessment of life experiences in female patients with coronary artery disease. It can be useful for better adaptation of human with occurred changes.

Respecting to individuals’ autonomy is a basic need of patients which nurses have an important role in fulfilling it. The study aimed at assessing the patients’ perception of getting their autonomy respected during nursing care. Census sampling was used to select 187 patients who were admitted to one of the three hospitals affiliated to Tabriz University of Medical Science. Data was gathered using a questionnaire measuring patients’ perceptions of getting their autonomy respected, in two subscales: getting information and participation in decision making. Data was analysis with Mann-Whitney U test, Kruskal-Wallis H test and Spearman correlation coefficient. Most of patients believed that nurses’ respect to their autonomy through giving information and participation in decision making aspects was low. Furthermore, results showed there was correlation between patients’ perception of their health, their needs for nursing care and their age with their perception of getting respect to their autonomy during nursing care. Patients revealed that their autonomy during nursing care is not respected. Their perception was positively improved by their increased need to nursing care. Educating the nursing staff on importance of autonomy in nursing care is recommended.