فصلنامه آموزش و اخلاق در پرستاری
سال دهم شماره 1 (بهار و تابستان 1400)

With the outbreak of new coronavirus disease, various aspects of human life have been affected. Medical students who are to serve as health care professionals in the not-so-far future are in dire need of adequate-quality education. Social distancing has transformed the teaching method of a large part of these studentschr('39') courses to a virtual way. To ensure the appropriate quality of education in the pandemic course, it is important to accurately determine the challenges and needs of medical students, which was studied qualitatively in this study.

This is a qualitative-analytical study that was conducted on students of Jahrom University of Medical Sciences with the aim of examining studentschr('39') perceptions and requests of different dimensions of virtual education. After collecting information of students of different fields by open-ended question and answer in Navid system and social networks (WhatsApp), the results were qualitatively analyzed.

In the present study, 550 students of different fields of medical sciences participated in groups and stages. From the analysis of the obtained data, 5 different sections were identified. In the dimension study of the benefits expressed by the students, 11 cases were identified with the general theme of satisfaction with the easy access to the content. In the study of the disadvantages expressed by students, 19 cases were mentioned, which were often related to problems due to lack of technology infrastructure and volume of content or lack of studentschr('39') time. Studentschr('39') demand for quality improvement of educational content had 20 different requests that identified the needs and challenges of students. Studentschr('39') learning styles during the quarantine period also had 8 cases in which the diversity seen in its items shows the need to customize education based on the studentchr('39')s learning style. Examination of the psychological dimensions experienced in education in the corona course led to the identification of 8 negative dimensions and 6 positive dimensions.

The present study helped students at Jahrom University of  Medical Sciences by identifying the strengths and challenges of e-learning during the corona virus pandemic.

Operating room students in the clinical education environment have high-stress levels that affect their learning. Considering that student stress control is of particular importance in the operating room clinical education environment; therefore, the aim of this study was to investigate the effect of clinical education team students (Peer-Mentoring plan) on the level of clinical stress in operating room students.

In this quasi-experimental study, the effect of the Peer-Mentoring plan on the clinical stress of operating room students before and after the intervention was investigated. 8th-semester students of this field were used as teaching assistants to teach 4th-semester students. In the control group, trainerschr('39') education was being done in the common method. The data collection tool was a researcher-made clinical education stressors questionnaire consisting of 29 questions that its validity and reliability were confirmed. Data were analyzed using SPSS 16 software and descriptive statistical tests (mean and standard deviation) and inferential test (chi-square and independent t-test).

The mean total score of clinical stressors in the control group before and after the intervention was not significantly different (P = 0.783). But the mean score of total clinical stressors in the intervention group before the internship was 66.10±14.80 which decreased to 59.00± 13.51 after the intervention and paired t-test showed a significant difference (P=0.035).  

The results showed that the Peer-Mentoring approach is effective in reducing the clinical stress of operating room students. It is suggested that this method be used in the clinical education of paramedical students.

The cornerstone of all nursing care is professional ethics. Nursing ethics is the essence of nursing professionalism and its observance is the same as the expectations of the patients. Therefore, this study was conducted to investigate the barriers to professional ethics in nursing practice from the perspective of nurses at Imam Khomeini Hospital in Sarab (2018).

This descriptive cross-sectional study was performed on 108 clinical nurses in Sarab city hospital in 2018 who were selected by simple random sampling. The data collection tools of the two questionnaires, which included demographic characteristics and a standard research questionnaire of the Barriers to observe standards of professional ethics from the perspective of nursing staff that had three areas: Management, environment, and personal care. SPSS software version 24 was used to analyze the data and in this regard, descriptive statistics (including: frequency, percentage, mean and standard deviation) were used.

From the nurseschr('39') point of view, the most important obstacles in the managerial dimension are the shortage of staff with an average (4.1±35.05) and insufficient moral and legal support of senior managers of nursing staff with an average (4.1±25.02), in the environmental dimension. Abnormal expectations of patients and their companions from nursing staff with a mean (4.1±10.15) and crowded wards with an average (3.1±87.22), also in the individual-care dimension, there was insufficient income or insufficient rest in the nursing staff with an average (3.1±87.24).

Lack of staff, insufficient income or insufficient rest, and unreasonable expectations of patients and companions were identified as influential aspects in non-compliance with professional ethics. Therefore, it is hoped that the medical authorities will try to remove the existing barriers by providing appropriate solutions, to witness the observance of rights in systems valleys in a better way.

Bad news can cause a strong emotional and stressful response, unpleasant feeling or behavior, it can change their attitude towards themselves or their futures. Given the importance of how to tell bad news to a patient or his/her family and its consequent effects, this study includes summarizing previous literature by conducting multidimensional research along with providing a solution for expressing bad news to patients based on Islamic religion and Iranian culture to achieve a model for this issue.

This study is a hybrid study with three stages: theoretical, field work and final analysis.

According to this study, a model for delivering bad news based on Islamic-Iranian culture had been developed, entitled “TAT”. This model consists of three stages: 1- Team formation, preparation, and coordination for delivering bad news; 2- Notification; 3- Transcending and planning for the future, and follow-up.

According to this model, when notifying patients, their religious attitudes and faith should be considered. Although, hardships and illnesses can make people think of transcendence, regardless of their faith level. Hence, care settings should facilitate this process of transcendence and application of spiritual support and care for patients and their families based on their wants and needs.

 Patients are the key to outpatient education of medical students around the world and patientschr('39') satisfaction with the services received increases patient participation and improves the process of clinical education of students. The presence of students in clinics is also necessary to strengthen their educational and social role. Therefore, the purpose of this study was to explain the experiences of patients referred to the teaching clinics of hospitals affiliated to Jahrom University of Medical Sciences in relation to the presence of medical students

 The present study is a content analysis study. Participants included 11 patients referred to the Art Clinic and the Imam Reza (AS) Clinic in Jahrom. Purposeful sampling was performed. The study was conducted from May 2018 to June 2018. Data analysis was performed using MAXQDA 10.0 software

 From this study, 2 main themes (patient rights and students chr('39')rights in the field of learning), 8 main categories (privacy, heterosexual adaptation plan, ethnicity and culture, satisfaction, studentschr('39') learning needs, attention to the patientchr('39')s physical and mental characteristics, The advantage of studentschr('39') presence in the doctorchr('39')s office is the patientchr('39')s prior knowledge of the treatment process) and 30 sub-categories, which was obtained from a total of 104 semantic units

 Observance of patient and student rights are two important principles in clinical education that should be given special attention from a moral and legal perspective; this will help to establish and establish the discourse of the studentchr('39')s presence with the treating physician. Therefore, the presence of the student can be achieved by satisfying the patient and the student if the mentioned items are observed.

Considering the severe ethical challenges caused by the outbreak of Quid 19 and related care, is important to study and analyze these tensions and ethical problems. A review approach may provide important insights into these challenges. Therefore, this study was conducted to summarize the common and emerging moral problems and challenges that emerged in the Covid 19 pandemic crisis.

An integrative review study was conducted in PubMed, Google Scholar, Web Of Science, and Scopus databases, based on Mesh and keywords mentioned in related studies and the use of logical operators (OR, NOT, AND), among the studies published since January 30, 2020. Then the results were extracted.

Lack of patient-centered and empathetic care, discrimination, lack of attention to patient independence and family-centered care, sense of lack of responsibility, a conflict between professional commitment and personal responsibilities are some of the most common ethical challenges that lead to moral damage, psychological-emotional consequences, moral stress, disability to psychological adjustment and loss of interpersonal respect. However, facing these challenges can enhance the skills, innovation, and creativity of nurses. Self-care strategies, structural support, and specialized interventions can mitigate negative outcomes and reinforce positive consequences.

Nurses may have difficulty translating ethical decisions into ethical practice while caring for Covid 19 patients. Therefore, it is time in this difficult time, to meet these challenges and support nurses, effective coping strategies at different levels be considered.

Ethical performance is one of the main components in providing holistic and quality care to clients. Therefore, considering the importance of the issue of nursing ethics, the present study was conducted with the aim of comparing the job performance of nurses based on nursing ethics in intensive care and general care wards.

The present study was a cross-sectional method. A total of 160 nurses working in special and general wards in selected hospitals of Isfahan were selected by available methods. The instrument of the questionnaire for measuring the performance of nurses in the ritual of nursing ethics with its validity and reliability is pre-determined. Data were analyzed using valid independent t-test, multivariate variance.

The best job performance of nurses in the public sector was in the components of nurse and society, nurse and clinical services and the weakest performance was the component of nurse and education and research. Among nurses in special wards, the best job performance of nurses was in the components of nurse and providing clinical services and the weakest performance was the component of nurse and colleague. The mean score of nurseschrjob performance on nursing ethics in intensive care units was higher (p <0.001). 

Nurseschr job performance based on nursing ethics was observed at a high level in intensive care unit nurses compared to general ward nurses. Therefore, it is suggested that public sector nurses become more familiar with the codes of nursing ethics.

introduction: 

Confidentiality is a moral principle with a deep history in the history of medicine that can be considered as the duty of the medical community to maintain secrets that are provided to the medical community in accordance with the profession. The purpose of this study is to report a case of ethical decision challenge in the principle of confidentiality of a woman pregnant with drug addiction.

Case Report: 

The case is a 26-year-old woman who, after being transferred to a camp to quit drugs, is found to be pregnant, so she is returned home by her family, and her first husband, assuming that the child belongs to her, takes care of the child. Takes. At the motherchr(chr('39')39chr('39'))s visit to the health center, the pregnancy was confirmed at 15 weeks and the client was addicted to glass and asked the health center colleagues not to inform her husband that the pregnancy was the result of her relationship with another young man.

The ethical challenge we face in this study is to keep the patientchr(chr('39')39chr('39'))s secrets confidential while respecting human dignity and the patientchr(chr('39')39chr('39'))s right to health care, without stigma and discrimination of routine and special care during pregnancy according to the patientchr(chr('39')39chr('39'))s condition. Was given and in the face of the dilemma of secrecy and deception of the patientchr(chr('39')39chr('39'))s ex-wife, they considered the observance of secrecy as the first and observed it.

Professional nursing values, the major form of professional practice. Although much research has been done in this regard, However, in the available sources, no study was found that examined the professional values in operating rooms. Therefore, the present study was conducted to investigate the operating room nurses perception of professional values.

In this cross-sectional descriptive study was done in 2017. 110 participants in the study included operating room nurses from 7 educational centers affiliated to Golestan University of Medical Science. Data were collected using the Shank and Weiss Nursing Value Scale. Data were analyzed using SPSS / 18 software using descriptive and inferential statistics.

The mean score of professional values was 61/14±05/103. The highest professional value was in the care dimension with an average of 39/5±33/38 and the lowest professional value was in the justice dimension with an average of 06/2±59/12. Also, in the study of demographic variables, the mean of professional values in people with different educations was significantly different. (P<0.05).

This study shows that operating room nurses done great importance on professional values in patient care. In some dimensions, such as care, this rate was high. But in some dimensions, such as justice, it was so low that it needs more support, so it is necessary to pay attention and emphasize on teaching all aspects of professional values.

Fear and anxiety due to possible infection with Covid-19 have created a high and destructive psychological burden that can lead to mental disorders, poor performance, poor communication with patients, anger, and rage, weakened immune system. And reduce the bodyability to fight disease in people in the community, including the treatment team (nurses, doctors, etc.). For this purpose, the present study was conducted to investigate the effect of Islamic ethics on the administrative health system with the mediating role of nursesspiritual capital in hospitals in Hamadan.

This research is applied in terms of purpose and descriptive-cross-sectional in terms of the data collection method. The statistical population includes nurses of hospitals in Hamadan. Data collection tool using Yousef (2001) standard questionnaire for four-dimensional Islamic ethics (precision work, humanitarian work, independence, and social utility), Howie and Fieldman (1996) questionnaire for office health with three dimensions (structural, cognitive, and relational). Zohar and Marshall (2004) had four dimensions for spiritual capital (spiritual value, morality, importance, and influence). Content validity, convergence, and divergence tests were used to assess validity and Cronbachalpha, factor loads, and combined reliability tests were used to assess the reliability of the questions.

It was found that Islamic ethics among nurses of hospitals in Hamadan has a positive and significant effect (b= 59%, p <0.01) on administrative health. Also, the spiritual capital of nurses has a significant positive effect on administrative health (p > 0.01, b= 83%), while spiritual capital plays a positive mediating role between Islamic ethics and administrative health (p > 0.01, b= 63%).

It can be concluded that the basic components of Islamic ethics including trust in God, humility towards the people, honesty, and fulfillment of the covenant can create a spiritual correlation between organizational human resources including hospital nurses who are the basic element of medical staff and healthy nurses. Morality in the body of a hospital pursues transcendent and positive thoughts, and this positive and responsible sense prevents them from engaging in unhealthy administrative behaviors.