فصلنامه آموزش و اخلاق در پرستاری
سال دوم شماره 4 (زمستان 1392)

Establishing an effective communication with patients is an essential aspect of nursing care. However, most of studies described the nurse-patient relationship as weak. Recognition of barriers in nurse-patient’s effective communication from their viewpoint could facilitate the actions need to be taken for removing such barriers. The study aimed to assess barriers of nurse-patient’s effective communication from nurse's viewpoints. Methods and Materials: This descriptive study was undertaken in 2013, with a sample of 100 nurses drawn from two educational hospitals in jahrom. They were selected by random sampling. Data were gathered through a questionnaire with 30 questions for nurses on a 5-point Likert rating scale.It asses's four aspects of communication barriers including (job characteristics, socio-demographic factors, clinical condition of patient and environmental factor). Data were analyzed using SPSS19 software, descriptive statistics (percentage, frequency, mean and standard deviation) and inferential statistics (kolmograph nonparametric test, Mann-Whitney and Spearman correlation test). The results of this study showed that the greatest barriers of Nurse - Patient communication related to Occupational characteristics of nurses with an average score of 78/24± 9/80. Environmental factors, socio-demographic factors and clinical conditions of the patients, respectively, were communication barriers that nurses have more emphasis on it. In this study, found a statistically significant correlation between mean scores of communication barriers with age and working hours of nurses. Nurses also perceived as major barriers to communication have been identified in relation to the characteristics of their job. Thus health manager should put their attempts on eliminating or modifying the most important barriers announced by nurses.

Hypertension is a major risk factor for cardiovascular diseases; thus, effective education is required in order to enhance hypertensive patients’ lifestyles. This study aimed to evaluate the effectiveness of lifestyle education on hypertensive patients’ knowledge and performance. This quasi-experimental study was performed on 40 patients with essential hypertension who were selected by convenient sampling in Peymanieh Hospital in Jahrom City during 2011-2012. The data collection tool consisted of a researcher-made questionnaire and cheek list which were completed by the patients one month before and after the intervention. Intervention was conducted by written and oral educational programs. Findings were analyzed by SPSS 17.0 and paired T-test. Participants consisted of 24 women (60%) and 16 men (40%) with the mean age of 64.50±11.70. The means of patients’ knowledge and performance were respectively 5.59±0.91 and 11.89±2.65 before educational intervention. The same means changed to 6.58±1.15 and 13.28±1.78 after the educational intervention which revealed a significant relationship (P>0.05). The difference between the means of blood pressure before and after the intervention were statistically significant (P>0.05). Lifestyle education enhances hypertensive patients’ knowledge and Performance. Hence, it is suggested to employ educational programs targeting nutrition, exercise, stress, smoking, disease and the regular use of medicines among these patients in order to improve their knowledge and behavior.

Adherence to professional codes of ethics is essential to all nursing practices which are usually neglected in clinical settings due to a number of reasons. The present study aims to study barriers to the practices of professional ethics and present practical strategies for its improvement. Methods and This is a descriptive and cross-sectional study conducted by random sampling method on 138 nursing staff in selected hospitals affiliated to Tehran University of Medical Sciences during 2012. The data collection tool was a researcher-made questionnaire. The best practical strategies were presented according to the results yielded by the first part of questionnaire and also nurses’ prioritization of barriers in the second part. In nurses’ view, the most important barriers to professional ethics adherence were respectively human resource shortage, failure to fulfill nurses’ basic needs, and biological and physical changes during night shifts. Development of nursing ethics committees in Iranian Nursing Organization and country’s hospitals was proposed as the best practical strategy to improve professional ethics adherence. Professional ethics regulations were explained as well. According to the present findings, limitations and possibilities, developing nursing ethics committees is the best strategy for improving professional ethics adherence. Development of such committees will hopefully contribute to higher adherence to ethical codes, enhance nursing profession and the quality of care, and also elevate patients’ satisfaction.

Human dignity has been considered by religious authorities for a long time and is recognized today in health systems and patient rights. This review article surveyed the articles published from 1990 to 2013. Keywords including human dignity, human status, patient’s privacy and patient’s personal space were used to search scientific Persian databases. Dignity and privacy were used as keywords to obtain articles from scientific English databases. As one of the most significant aspects of human dignity, privacy consists of four dimensions: physical, psychological, social and informational. Care and treatment environments are places where patients’ privacy is commonly invaded. Respecting Patient's privacy is essential for establishing effective communication between patient and treatment team and creating a peaceful milieu for patients. Violation of patients’ privacy may lead to patients’ anxiety, aggression, refusal of physical examination, and concealing medical history which subsequently reduces the quality of services. Since quality improvement is a blueprint for all health care practices, protecting patient's privacy have gained greater significance. It is tightly related to the sphere of nursing, and thus, relevant trainings must be included in nursing students’ educational curriculum and their service training. Further studies are also required to investigate different aspects of this problem.

Patients with MS require reverence and respect due to the grueling problems associated with their condition. As recounted in care experiences of MS patients, some factors facilitate and some debilitate the ethical presentation of care. The present study was designed to define and explore the elements of reverence and ethical care in MS patients’ care. This research uses thematic and qualitative analysis. Researchers acquired data simultaneously from interviews, observations and field notes to collect data from 31 participants with experiences of care. Five themes emerged from the analysis of the transcribed data: confidentiality of care, feeling of worth, orientation and sensitivity, respecting patients’ rights and curiosity as a deterrent factor. The findings revealed that the care of these patients requires special delicacies due to the nature of their illness; thus, nurses and their families particularly attend to the patients with reverence according to the ethics of care. Therefore, healthcare policy makers should design and implement their care plans with a focus on Iranian cultural context, and pay due attention to the ethical tenets demanded by the specific circumstances of caring for these patients

Evidence-based nursing has been raised as a method of health care practice based on the latest findings and observations. As part of professional nursing practice, clinical decision making will also affect the quality of care and nurses can utilize evidence-based nursing for providing an effective care. The present article’s goal was to determine the impact of evidence-based nursing education on nurses’ clinical decision making. This quasi-experimental and interventional study was performed on 60 nurses who were assigned into 2 groups of control and intervention clinical nursing in 2012. Evidence-based nursing was taught in the intervention group. Data were collected by clinical decision questionnaire, and analyzed by SPSS 17.0. Intervention group’s ability for evidence-based clinical decision making was measured before and after intervention by paired t test. The results showed that evidence-based nursing education upgrades nurses’ scores in clinical decision making (p=0.009). Findings revealed that the mean score increased to 86.94 ± 9.92 after the educational intervention. In addition, t test revealed the intervention group’s ability for evidence-based clinical decision making before the intervention did not significantly vary from that of control group Evidence-based nursing education enhances nurses’ clinical decision making. It is thus, recommended that recurrent educational courses be included in service training programs to improve nurses’ decision making and performance.

The essential goal of the nursing education is acquiring the clinical competency for safe care delivery to patients, especially in the internship period, the final phase of nursing education, that students are prepared for entry to clinic as newly graduated nurses. This study aimed to determine the nursing student`s competencies during the internship period. In this qualitative study, conventional content analysis was used.16 persons from different universities that participated to clinical education in internship period, interviewed semi-structured. Obtained data from participants was recorded and analyzed by Maxqda2007 software and themes were extracted inductively by 7-steps content analysis method. During data analysis, one essential theme (humanistic patient-centered care) and 4 categories were developed: "humanistic view to patient, communication with patient and family, scientific care based on the patient needs and patient safety". We suggest that Special programs be taken in order to acquire humanistic patient-centered care competency in the internship period as the final time for the nursing students education.

Positive ethical climate is an unavoidable necessity in the nursing profession. Studies have pointed out on the effects of ethical climate on a variety of variables such as job satisfaction and organizational commitment. The aim of the study was Perception of ethical climate and its relationship to nurses’ demographic characteristics. This study was a descriptive - cross sectional study. The study population was all nurses working in 4 teaching hospitals of Qom in 1392. 226 nurses participated in the study with available sampling method. Information collected using one valid and reliable questionnaire. Questionnaire based on persian version of Olson in 5 dimensions (Managers, colleagues, physicians, patients, hospitals) investigate hospital ethical climate occupational morale. Data analysis using descriptive and inferential statistics and application software spss (v18) was carried out. Results showed that ethical climate of the hospitals of Qom has been positive. The lowest mean was allotted to value of the ethical climate questionnaire as “Physicians consult about treatment decisions with nurses” that was in physician area. To further improve the ethical climate in hospitals involves the detection of imperfections in conjunction with physician. Efforts to improve the ethical climate in the broader organizational climate in hospitals can as a valuable strategy for improving organizational objectives and provide effective medical services to the community should be considered.