Introduction: Maintaining dignity is one of patients is one of the main ethical responsibilities of caregivers. However, in many cases, the dignity of patients, especially autistic teenagers is not maintained. The extent to which dignity needs are met for this group within the Iranian care system is difficult to determine as dignity is an abstract concept, and there are few related research studies reported. Objectives: The objective of this study is to find out caregivers perspectives on dignity in teenagers with (...) autistic spectrum disorder. Research design: This study uses a qualitative research design. The data were collected through individual, semi-structured interviews and field notes developed during the interviews. In order to analyze the data, qualitative conventional content analysis was used. Participants and research context: In all, 16 professional caregivers for autistic teenagers working in public hospitals were recruited based on a targeted sampling method to reach data saturation from February 2016 to July 2017. Findings: The findings of this study were presented in three main themes, “privacy,” “respecting individual identity,” and “comprehensive support,” and 11 categories. Ethical consideration: This study’s protocol was approved by the Research Ethics Committee of medical universities located in Southeast of Iran and the required ethical principles were followed throughout. Discussion and conclusion: Based on the findings of this study from the perspective of caregivers, autistic teenagers need to be cared for and educated in a respectful environment where their privacy is maintained, their individual identities are respected, and they receive comprehensive familial, social, and financial support. These conditions would maintain the dignity of such teenagers and would result in appropriate behavioral outcomes. Therefore, it is suggested that a cultural, professional and institutional background in which all components of the autistic teenager’s dignity are protected and emphasized be provided. (shrink)

Introduction: Maintaining patient dignity in a caregiving environment is one of the most important moral responsibilities for caregivers. Nonetheless, there are vulnerable groups, specifically teenagers, who in their final stages of life are prone to their dignity being threatened. Moreover, dignity is an abstract concept and there is no studies done on teenagers’ dignity in the final stages of life available in Iran.Purpose: The purpose of this study is to describe the caregivers’ experiences regarding teenagers’ dignity in the final stages (...) of life.Research design: This study is a descriptive phenomenological qualitative research project. The data was collected using deep individual and semi-structured interviews as well as taking notes. The Colaizzi analysis method was used to analyze the data.Participants and research context: 22 caregivers working with teenagers in the final stages of life in a public health centers in Iran who had the criteria to enter the study were selected using a purposeful sampling method and invited to join the study from August 2018 to June 2019. The sampling continued until data saturation.Findings: The findings of the present study were presented in the form of three main themes including “private,” “respecting individual identity,” and “attention to teenagers’ needs” and an additional eight categories.Ethical Considerations: The study’s protocol was approved by the Research Ethics Committee of the Shiraz University of Medical Sciences and all ethical principles were followed throughout the study.Discussion and conclusion: Based on the present study from the caregivers’ point of view, teenagers in their final stages of life required to be cared for and taught in an environment that their privacy was maintained and their individual identity was respected as well as getting attention from the caregivers and companions. In such situations, the teenagers felt calm and their dignity was maintained; therefore, providing a cultural, professional, and organizational setting where all the components of maintaining dignity in teenagers are supported and prioritized is necessary. (shrink)

The purpose of this study is to assess the efficacy of transcranial direct current stimulation in patients with treatment-refractory trigeminal neuralgia and examine the utility of neuroimaging methods in identifying markers of such efficacy. Six patients with classical TN refractory to maximal medical treatment, underwent tDCS. All patients underwent pre- and posttreatment functional magnetic resonance imaging during block-design tasks as well as single-shell diffusion MRI acquisition. The precise locations of tDCS electrodes were identified by neuronavigation. Five therapeutic tDCS sessions were (...) carried out for each patient with either anodic or cathodic applications. The Numeric Rating Scale of pain and the Headache Disability Index were used to score the subjective efficacy of treatment. Altered activity of regional sites was identified by fMRI and associated changes in the spinothalamocortical sensory tract were measured by the dMRI indices of fractional anisotropy and mean diffusivity. Fiber counts of the bilateral trigeminal root entry zone were performed as an added measure of fiber loss or recovery. All patients experienced a significant reduction in pain scores with a substantial decline in HDI in the number of contralateral sensory fibers in the STCT with either anodic or cathodic tDCS treatment in four of the six patients. A significant reduction in FA was observed in the ipsilateral REZ in the posttreatment phase in five of the six patients. Preliminary evidence suggests that navigated tDCS presents a promising method for alleviating the pain of TN. Different patterns of activation manifested by anodic and cathodic stimulation require further elaboration to understand their implication. Activation and attenuation of responses at various sites may provide further avenues for condition treatment. (shrink)

Introduction: Dignified care is one of the moral responsibilities of professional caregivers. However, in many cases the dignity of hospitalized patients, especially women in the delivery room, is not maintained. Dignity is an abstract concept and there has been no previous research exploring the dignity of pregnant women in the delivery room in Iran. Objectives: The objective of this study is to define and explain the concept of dignity for pregnant women in the delivery room from the perspectives of professional (...) caregivers. Research design: This is qualitative research. The data were collected through in-depth semi-structured individual interviews. The conventional content analysis method was used to analyze the data. In qualitative content analysis, participant narrative is examined in-depth and sorted into categories and themes. Participants and research context: Potential participants who met the entrance criteria for this study were approached between July 2016 and February 2017. In all, 20 professional caregivers working in the delivery room setting within Iranian general hospitals were invited to participate in the study. The sampling was done through targeted sampling until saturation was achieved. Ethical considerations: The research ethics committee of the Shiraz University of Medical Sciences has approved the study’s protocol and all commonly recognized ethical principles were followed throughout the study. Findings: The findings of this study were presented in three main themes, including “privacy,” “respecting patients’ preferences,” and “comprehensive attention” and eight categories. Discussions and conclusion: Women in the delivery room need to be taken care of in an environment where healthcare staff promote the preservation of dignity through maintaining privacy, by providing attentive care and through ensuring that patient preferences regarding care and treatment are respected. In such an environment, the dignity of these women would be maintained and desirable outcomes achieved. (shrink)

Background: Nurses require empowerment if they are to make ethical decisions. Ethical empowerment has always been one of the main concerns in nurse training programs. Research aim: The present study was conducted to determine the effect of an ethical empowerment program on critical care nurses’ ethical decision-making. Research design: This is a clinical trial study with two groups and pre and post design. Participants and research context: In this study, 60 nurses working in Intensive Care Unit were selected through random (...) sampling and then divided into a control and an experimental group after filling out the Moral Sensitivity Questionnaire. Both groups completed the questionnaire again immediately and 2 months after the ethical empowerment workshop had been held for the experimental group. The collected data were analyzed in SPSS-16 using descriptive and inferential statistics. Ethical considerations: The goals of the study were explained to the participants and then a written informed consent was received from them. Findings: The results showed no significant differences between the two groups in terms of their ethical sensitivity scores at the beginning of the study; however, immediately and 2 months after the intervention, the mean score increased significantly in the experimental group. Moreover, the scores obtained 2 months after the workshop increased compared to the pre-intervention scores but showed a drop compared to the scores reported immediately after the workshop. Discussion: The ethical empowerment program, given to the critical care nurses in this study, improved their ethical sensitivity in making decisions significantly over time. Despite the extensive methods, available for teaching nursing ethics, the ethical empowerment program, adopted in this study, had long-lasting effects in terms of ameliorating the process of ethical decision-making in clinical situations. Conclusion: The ethical empowerment of nurses requires the adoption and application of proper methods and patterns of complying with nursing ethics. (shrink)

Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding care provided to critically ill patients in critical care units. The ongoing COVID-19 pandemic has introduced new ethical challenges and changes in clinical practice, further exacerbating the experience of moral distress among these nurses. This systematic review compares the factors influencing moral distress among critical care nurses before and during the COVID-19 pandemic to gain a comprehensive understanding of the impact of (...) the pandemic on moral distress. For this systematic review, PubMed, Scopus, ProQuest, Web of Science, medRxiv, bioRxiv, Embase, and Google Scholar were all utilized in the search. The search covered articles published from 2012 to December 2022, encompassing a 10-year timeframe to capture relevant research on moral distress among critical care nurses. In total, 52 articles were included in this systematic review. The findings indicate that personal, caring-related, and organizational factors can influence nurses' moral distress. Before the pandemic, factors including futile and end-of-life care, conflicts with physicians, nurse performance and authority, poor teamwork, decision-making regarding treatment processes and patient care, limited human resources and equipment, medical errors, patient restraints, and nurses' age and work experience affect critical care nurses' moral distress. Similarly, during the COVID-19 pandemic, factors contributing to moral distress include futile and end-of-life care, fear of contracting and spreading COVID-19, decision-making about treatment processes, poor teamwork, and being female. This study revealed that the factors contributing to moral distress were approximately similar in both periods. Futile care and end-of-life issues were critical care nurses' primary causes of moral distress. Implementing prevention strategies and reducing these underlying factors could decrease this major issue and improve the quality of care. (shrink)

BackgroundEthical decision-making of nurses could affect patients’ recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making.MethodThe present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed (...) using Granheim and Landman approach.ResultsBeing torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations.ConclusionsResults of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients’ benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges. (shrink)

Background The ethical climate is an essential component of organizational climate or culture. The ethical climate is necessary for clinical practice in operating rooms. Objective This study aimed to compare the ethical climate from the perspective of operating room nursing students and operating room staff of hospitals affiliated with Mashhad University of Medical Sciences, Iran. Method This analytical study was performed on 95 operating room nursing students and 169 operating room staff of hospitals in Mashhad, Iran. The students were selected (...) through the census method and the staff were selected by using stratified random sampling. The data were collected via Olson’s Hospital Ethical Climate Survey and analyzed by using BMI SPSS version 21. Results The total mean scores of the ethical climate were 3.44 ± 0.45 and 3.32 ± 0.48 from students and staff’s perspectives, and the independent t-test showed no significant difference between them ( p 0.05). Furthermore, the results of the study indicated a significant difference in communication with physicians’ score between operating room staff (2.82 ± 0.49) and students’ views (3.25 ± 0.6) ( p < 0.05). Conclusion Although it is difficult to create a right ethical climate in operating rooms, but hospital managers should implement practical programs to improve the ethical climate of operating rooms and inter-professional teamwork. Besides, deans of faculties can provide ethical-based education for students, who can effectively create an ethical climate. (shrink)

The outbreak of a new, potentially fatal virus, SARS‐COV‐2, which started in December 2019 in Wuhan, China, and since developed into a pandemic has stimulated research for an effective treatment and vaccine. For this research to be successful, it is necessary to understand the pathology of the virus. So far, we know that this virus can harm different organs of the body. Although the exact mechanisms are still unknown, this phenomenon may result from the body's secretion of prostaglandin E2 (PGE2), (...) which is involved in several inflammation and immunity pathways. Noticeably, the expression of this molecule can lead to a cytokine storm causing a variety of side effects. In this paper, we discuss those side effects in SARS‐COV‐2 infection separately to determine whether PGE2 is, indeed, an important causative factor. Lastly, we propose a mechanism by which PGE2 production increases in response to COVID‐19 disease and suggest the possible direct relation between PGE2 levels and the severity of this disease. Also see the video abstract here: https://youtu.be/SnPFAcjxxKw. (shrink)

Background: Certain factors may facilitate or inhibit the formation of moral sensitivity in nurses performing cardiopulmonary resuscitation (CPR). The identification of these factors in the context can help develop strategies to promote nurses’ moral sensitivity and offer new insights into the consequences of their moral decisions. Objective: Taking into account the possibly multi-factorial nature of moral sensitivity, this study aimed to identify the factors affecting the formation of nurses’ moral sensitivity in CPR settings. Research design and methods: This study performed (...) a conventional qualitative content analysis. Twenty-one participants were selected via purposive and theoretical sampling. The data were collected through in-depth semi-structured interviews and simultaneously analyzed via content analysis. Participants and research context: In total, twenty-one participants (fourteen clinical care nurses, three head nurses, two educational supervisors, and two faculty members) from different cities of Iran were interviewed. Ethical considerations: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran (IR.UMSU.REC.1399.337). Findings: Four categories (underlying factors, professional factors, organizational inhibitors of ethics, and professional limitations) and 13 sub-categories were extracted. Discussion: The formation of moral sensitivity requires a range of ethical standards and their maintenance, not only at the individual level but also at the profession, organization, and community levels. So eliminating inhibitors of ethics in these contexts can improve nurse’s ethical performance in CPR settings. Conclusion: Any measures taken or decisions made by nurses in CPR are driven by numerous ethical issues to which nurses must be morally sensitive. Some factors facilitate and some inhibit the formation of moral sensitivity in nurses. (shrink)

Publication date: 11 June 2018 Source: Author: Fatemeh Nemati Sogolitappeh, Amjad Hedayat, Mehrdad Rezaee Arjmand, Mohamad Khaledian The purpose of the present study is to investigate the relationship between spiritual intelligence and emotional intelligence with resilience in undergraduate students. The population of the study included all students of Payam Noor University in Ghorveh during 2016-2017 academic years. According to the principles of statistical methodology for correlational studies, 100 students from different disciplines were selected as sample of the study using (...) simple random sampling method. In this research, King's Spiritual Intelligence Questionnaire, Bar-Ann 90-questions Emotional Intelligence Questionnaire, and Conner and Davison resilience questionnaire were used. Descriptive statistics and inferential statistics were used to analyze the data. The results of this study showed that there is a significant positive correlation between spiritual intelligence and emotional intelligence and resilience. Regression coefficients showed that spiritual intelligence and emotional intelligence predict 53.9% of the variation in resiliency. (shrink)

Graphical AbstractBy now it is well known that the SARS-COV-2 virus can affect and harm various organs of the body. However, the exact mechanisms for this phenomenon are still unknown. In article 2000198 Fatemeh Aliabadi et al. hypothesize that the body's secretion of prostaglandin E2 (PGE2), a molecule that is involved in several inflammation and immunity pathways, may lead to a cytokine storm causing a variety of side effects.

BackgroundBurn patients are among the most vulnerable groups of patients requiring principled ethical care. Caring for these patients often brings various ethical challenges for the members of the health care teams, especially nurses, which affect the clinical decisions made for these patients. A limited number of studies have addressed the ethical challenges of caring for burn patients for the responsible caregivers, so the present study attempted to identify these challenges. The present study aimed to explore the health professionals' experiences of (...) the ethical challenges during caring for burn patients.MethodsThis was a qualitative study with a descriptive, phenomenological design. 22 health professional practiced in public burn centers in Iran who met the inclusion criteria of the study were selected via purposeful sampling to participate in the study from June to August 2019. Data were collected using semi-structured, in-depth interviews with the individuals as well as field notes. Sampling was continued up to the data saturation. Thereafter, the collected data were analyzed using Colaizzi's method.ResultsThe findings of the study yielded 3 themes, including respect for the patient's privacy, respect for the patient's personal identity, and care challenges, as well as 9 categories.ConclusionThe findings of this study showed that the burn patients’ caregivers face some challenges in the domains of maintaining the patient's privacy, respecting the patient’s personal identity, and making the best clinical decision. Thus, providing the cultural, professional, and organizational requirements of meeting the challenges of caring for burn patients can consequently result in the caregivers’ inner peace and the improved performance. (shrink)

Background The organizational climate in the operating room is special due to the specific conditions of the patient, and the ethical climate may affect moral distress of the operating room staff. Objective This study determined the relationship between ethical climate and moral distress from staff working in operating rooms of hospitals affiliated to Mashhad University of Medical Sciences. Method This analytical study was performed on 169 operating room staff in Mashhad, Iran. The operating room staff was selected using stratified random (...) sampling. The data were collected via Olson's Hospital Ethical Climate Survey and the Corley Moral Distress Scale and analyzed with IBM Statistical Package for the Social Sciences (SPSS) software version 21. Results The results showed no relationship between the ethical climate, the frequency, and intensity of moral distress of the operating room staff ( p > 0.05). In addition, the mean score of the ethical climate was 3.32 ± 0.48, indicating the average ethical climate in the operating room. The mean frequency and intensity of moral distress were 36.36 ± 11.68 and 48.8 ± 15.92, showing a moderate rate. There was a significant inverse relationship between the dimensions of ethical climate, the relationship with physicians, and the intensity of moral distress ( p <0.05). A significant relationship was found between the intensity of moral distress, the level of education, and field of study ( p <0.05). Conclusion The results of the current study showed that interventional programs should be implemented to reduce moral distress and improve the ethical climate in the operating room. (shrink)

This study was administrated to undergraduate students living in the various hostels of Universiti Sains Malaysia. The primary purpose of this study was to identify the most important factors that predict undergraduate students’ level of satisfaction with the student hostels they are living in. This paper also explored the difference in the satisfaction levels of students living in hostels within the campus and those living in hostels outside the campus. Based on literature review, it was hypothesized that there would be (...) a difference in the satisfaction level between these two groups of hostel residents due to the different characteristics that these hostels have. Additionally, this study investigated the most preferred hostels among students and identified the reasons for the preference. A sample population of 288 students (220 females; and 68 males) was involved in this study with 48.3% living in hostels inside the campus and 51.7% living in hostels located outside the main campus area. The result of the study suggests that satisfaction with fees, distance from university facilities, room safety, room size, hostel security, and hostel facilities are the most important factors which predict undergraduate students’ satisfaction with their hostel. There was also a significant difference in the satisfaction level between inside-campus and outside-campus hostels students. The most important factors that influenced that students satisfaction levels were distance from the university facilities, the exterior condition of the hostel, hostel population, satisfaction with transport, hostel security, room size, and room safety. The study also found that the most preferred hostel among the students was Cahaya Gemilang due to its strategic location, close distance to lecture halls and other main facilities in the campus and, good internet network connection. Keywords: satisfaction, hostels, predicting factors, undergraduate students. (shrink)

Approaches to induce tumor differentiation often result in manageable and therapy‐naïve cellular states in cancer cells. This transformation is achieved by activating pathways that drive tumor cells away from plasticity, a state that commonly correlates with enhanced aggression, metastasis and resistance to therapy. Here, we discuss signaling pathways, epigenetics and non‐coding RNAs as three main regulatory levels with the potential to drive tumor differentiation and hence as potential targets in differentiation therapy approaches. The success of an effective therapeutic regimen in (...) one cancer, however, does not necessarily sustain across cancer types; a phenomenon largely resulting from heterogeneity in the genetic and physiological landscapes of tumor types necessitating an approach designed for each cancer's unique genetic and phenotypic build‐up. (shrink)

Background: In disaster situations, nurses may face new and unfamiliar ethical and legal challenges not common in their everyday practice. Research question/objectives/hypothesis: The aim of this study was to explore Iranian nurses’ experience of disaster response and their perception of the competencies required by nurses in this environment. Research design: This article discusses the findings of a descriptive study conducted in Iran in 2012. Participants and research context: This research was conducted in Iran in 2012. Participants included 35 nurses who (...) had experience in healthcare delivery following a disaster event in the past 10 years, either in a hospital or out-of-hospital context. Ethical considerations: This research study was approved by the Ethics Committee of the Isfahan University of Medical Sciences. Findings: From this study, five themes emerged as areas that nurses require competence in to work effectively in the disaster setting. This article focusses on one theme, the ethical and legal issues that arise during disaster response. Within the theme of ethical and legal issues, two sub-themes emerged. (1) Professional ethics explores professional responsibility of nurses as well as sense of ethical obligation. (2) Adherence to law refers to nurses’ familiarity with and observation of legal requirements. Discussion: This article adds to a growing pool of literature which explores the role of nurses in disasters. The findings of this study emphasize the need for nurses working in the disaster setting to be aware of professional responsibilities and familiar with legal requirements and the challenges related to observing ethical responsibilities. Conclusion: In highlighting these issues, this article may provide a useful starting point for the development of an educational framework for preparing nurses and other health professionals to work in the disaster setting. (shrink)

Background: Discrimination and injustice are big obstacles in nurses’ way to socialization and are among the major clinical challenges faced by nurses. Workplace discrimination is associated with such negative consequences as stress, fatigue, demoralization, loss of professional commitment, tension and conflicts at work, and resignation. A review of literature shows that not much research has been dedicated to workplace discrimination in nursing. Objective: This study aims to investigate nurses’ perception of workplace discrimination. Method: This cross-sectional study was conducted in the (...) hospitals affiliated with a university of medical sciences in the largest city in the south of Iran in 2019. The participants consisted of 597 nurses who were selected through stratified random sampling. Data were collected using a researcher-made workplace discrimination questionnaire and analyzed in SPSS v. 21. Findings: The mean of the nurses’ workplace discrimination scores was found to be 102.57 ± 14.5, which is considered as moderate. The nurses’ mean scores for the dimensions of vertical and horizontal discrimination (44.53 ± 6.8), consequences of discrimination (20.52 ± 5.55), and unfair promotion (12.38 ± 2.44) were moderate. As for the two other dimensions of workplace discrimination, namely, gender discrimination (14.41 ± 3.28) and cultural-organizational discrimination (11.88 ± 2.99), the participants’ mean scores were low. There was a significant relationship between the nurses’ workplace discrimination mean score on the one hand and their employment status (p = 0.016) and work experience (p = 0.002) on the other. However, the nurses’ workplace discrimination mean score was not found to correlate with their level of education (p = 0.65), marital status (p = 0.274), and gender (p = 0.479). Ethical consideration: This study has been approved by the ethics committee of the university. All the participants had signed the written informed consent form before participation. Conclusion: Hospital managers should take measures to reduce discrimination and establish organizational justice to raise nurses’ morale and improve the quality of their performance as caregivers. (shrink)

Nursing, a scientific and practical discipline, faces continuing challenges of finding new direction in order to decipher its core values and develop current ethical codes for nursing practice. In 2009–10, 28 nurses were purposely selected and interviewed using a semi-structured format in focus groups and individually. Thematic Content Analysis helped explore the perception of Iranian nurses on ethical values in patient care. Seven major themes emerged: respect for dignity, professional integrity, professional commitment, developing human relationships, justice, honesty, and promoting individuals (...) and the nursing profession. Iranian nurses revealed a unique and culture-based set of ethical values. This study found that Iranian nurses place a greater emphasis on preserving the dignity of those accompanying the patient and in showing regard for patients' religious beliefs in a gender appropriate environment. (shrink)

In the contemporary era, thinkers abandoned the issue of the mind in a way that gives rise to the idea that it is essence or material, and addressed the issue of what are mental states, what are their characteristics? On the other hand, Islamic thinkers has always been concerned to the human soul. Fakhr Razi, a famous Muslim theologian, has significant opinions in the discussion of philosophical psychology. He considers the soul to be different from the body, and he has (...) studied a number of soul states and some of their characteristics. The current research deals with the question: what is the relationship between the states and qualities of the soul from Fakhr Razi's point of view and mentality in the contemporary philosophy of mind? In this search, some similarities between Fakhr Razi's opinions and contemporary mentality will be clarified; Emotional states such as pain and pleasure, and perceptual states from the point of view of Fakhr have certain characteristics such as the phenomenality and direct experience of these states for the soul. He has criticized Ibn Sina for not paying attention to these states in the definition of pleasure and pain. He also paid attention to science, which is one of the cognitive states, and it seems that by proposing the addition theory, he intended the consciousness for soul. (shrink)

BackgroundWhile neighborhood safety and stranger danger have been mostly canonized to play a part in parents’ physical activity avoidance, less is known about the impact of parental stress and perceived risk on children’s PA avoidance and consequently on children’s level of PA and wellbeing. Understanding the contributors to children’s wellbeing during pandemic disease is the first critical step in contributing to children’s health during epidemic diseases.MethodsThis study employed 276 healthy children, aged 10–12 years, and their parents. Data were collected in (...) October and November 2020, about 9 months after the local closing of schools due to the coronavirus disease 2019 pandemic. Parents and children answered a separate set of questions. Besides the demographic information, the parents responded to questions on their stress level, perceived risk of COVID-19, and PA avoidance for children. Children responded to questions on their PA and wellbeing in the last week. Data were analyzed using SmartPLS and IBM SPSS 22.ResultsThe result of the study supported the four directional research hypotheses of the sequential study model. As hypothesized, parents’ stress and perceived risk levels of COVID-19 negatively affected children’s PA. The PA level was shown to predict children’s wellbeing and mental health. Housing type, parents’ job security, number of siblings, number of members living together in-home, and history of death or hospitalization of relatives or family members due to COVID-19 were found to be associated with parents’ stress and children’s mental health.ConclusionThis study sheds light on parents’ role in children’s wellbeing and mental health during the COVID-19 pandemic. Parents with higher stress and high restrictive behaviors might put their children at risk of mental disorders in the end. (shrink)

BackgroundMoral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to (...) determine the frequency and severity of moral distress in nurses through a systematic review and meta-analysis.MethodsIn this review study, searching national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Embase, ScienceDirect, Scopus, CINHAL, PubMed, and Web of Science between 2005 and February 2020 were extracted. The random-effects model was used for analysis, and the heterogeneity of studies with the I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis.ResultsThe frequency of moral distress in 9 articles with a sample size of 1576 persons was 1.7 ± 0.5 from, in 13 articles with a sample size of 1870 persons, 3.07 ± 0.1 from, in 6 articles with a sample size of 1316 persons, 3.2 ± 0.29 from, in 18 articles with a sample size of 1959 persons, 4.6 ± 0.518 from and in 35 articles with a sample size of 3718 persons, 81.1 ± 4.6 from, and the severity of moral distress in 4 articles with a sample size of 1116 persons, 1.7 ± 0.37 from, in 5 articles with a sample size of 1282 persons, 2.6 ± 0.28 from, in 5 articles with a sample size of 944 persons, 3.9 ± 0.63 from and in 8 articles with a sample size of 901 persons was 82.3 ± 5.4.ConclusionThe results of this study showed that the frequency and severity of moral distress in nurses are high and are a serious problem in nurses. Therefore, policymakers in this field should consider its role in the health of nurses and patients. (shrink)

Dignity is a human right and a base for human health. This right must be observed in work environments as a moral obligation. This qualitative study aimed to understand nurses’ experiences of violation of their dignity at work and to explore its dimensions. The participants were 15 nurses working in two hospitals in Tehran. The data were collected through 26 unstructured interviews and analyzed using content analysis. The dimensions of violation were ‘irreverence’, including experiences of abuse and violence, humiliation, and (...) being ignored; ‘coercion and violation of autonomy’, consisting of the control of relationships, lack of privacy, rigidness, and imposition; ‘ignoring professional and scientific ability’, indicating impossibilities in applying nurses’ knowledge; and ‘denying the value of nurse/care’, being the theme that verified the dominance of treatment/cure and lack of recognition of care value. Health systems should take the promotion of the nurses’ dignity into account through providing a dignified work environment. (shrink)

The problem of epistemic luck arises when a person has a true belief that is only true by luck. Before Gettier, it was believed that the element of justification would be sufficient for knowledge; but he showed that it is possible to have a justified true belief that is not an example of knowledge because of the intrusion of luck. Duncan Pritchard has examined epistemic luck in an extensive and detailed manner. He offers a modal account of luck based on (...) two elements: a possible-worlds analysis of counterfactual conditions and a significance condition for the factors that make the truth of the belief lucky. Pritchard argues for the superiority of this account to those that focus on whether the truth of the belief is “accidental” and on whether the believer has sufficient control over the belief. Epistemic luck may be “reflective” or “veritic”. Both undermine knowledge claims, although Pritchard gives the central role to veritic luck in his anti-luck epistemology, which is based on two elements: a safety principle and a condition to ensure that the cognitive faculties of the agent are not impaired. In this article, we will describe, analyze, and subsequently, evaluate the viewpoint of Pritchard. In addition to the critiques offered by others, ambiguities in his counterfactual account of luck and other components of his theory detract from his theory. (shrink)

Background Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses’ perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. Objective The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. Research design The present study (...) is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method. Participants and research context The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022. Findings Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data. Ethical considerations The study’s protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study. Discussion and conclusion From the nurses’ perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients’ psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients’ families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care. (shrink)

Iranian copper coins of the Qajar era—all described by the word falus—have a great variety of designs, weights, and sizes. These coins sometimes also include letters and phrases that are undeciphered to date. This article uses siyāq script to read some of these mystery notations for the first time. The multiple fascinating examples of siyāq numbers found thereby on Qajar coins and countermarks show that, contrary to former belief, some copper coins of this era had specific face values written on (...) them in the siyāq script. This research uses these copper coins to take a small step toward a better understanding of the monetary system of the Qajar era by introducing several denominations never reported before. Finally, as siyāq script had never been discovered on coins, this new possibility now allows numismatists and scholars to revisit and correct former interpretations or to intro- duce and decipher new coins in the future. (shrink)

Research objectives Moral distress is a common phenomenon among nurses and can negatively affect their mental health and quality of the care. This study aimed to determine the effect of professional ethics workshop with virtual follow-up on the moral distress of nurses. Methods This experimental study was performed on 50 nurses in Ghaem Hospital, Mashhad, Iran. The intervention group received 8-hour professional ethics workshop and 4 weeks follow-up through social network. The moral distress was evaluated through the Moral Distress Scale-Revised (...) at the beginning of the study, two weeks after the workshop and at the end of follow-up. Data were analyzed using SPSS21 by descriptive and statistical analysis.This study approved by Mashhad university Medical Ethics Committee and publishing ethics were also observed. Results The changes in the mean value of the frequency of moral distress in the intervention group was not significant, while these changes were significant in the control group ( p < 0.001, df = 2, f = 26.41) and had an upward trend. About intensity changes in the intervention group were significant ( p < 0.01, df = 2, f = 8.52) and had a downward trend, while it was not significant in the control group. Changes in the mean value of level of moral distress in the intervention group were not significant, while these changes were significant in the control group ( p < 0.01, df = 1, f = 16.8). The mean value of moral distress level decreased in the intervention and increased in control group. Conclusion The level of moral distress was increased in the control group due to increase in its frequency. This could be due to awareness of nurses regarding the concept of moral distress which caused them to pay more attention to this issue. Professional ethics workshop did not have effect on the frequency of moral distress, while it reduced the intensity and level of moral distress. Moreover, follow-up through social network reduced the frequency, intensity and the level of moral distress among nurses. (shrink)

Dignity is the most fundamental right of every human being, patients in particular. Despite being a fairly disputed concept, dignity is a multidimensional issue, the interpretation of which is affected by a multitude of factors. Semistructured interviews and observation data from 35 patients, their companions, and nurses were performed to highlight their views with regard to patients? dignity in health care centers. Although findings reveal that nearly all patients felt that their dignity had been violated, there is a considerable difference (...) between participants? viewpoints of dignity. Interactions among participants can increase their awareness of dignity and may lead to its maintenance. (shrink)

A significant development for conducting research on patient rights has been made in Iran over the past decade. This study is conducted in order to review and analyze the previous studies that have been made, so far, concerning patient rights in Iran. This is a comprehensive review study conducted by searching the Iranian databases, Scientific Information Database, Iranian Research Institute for Information Science and Technology, Iran Medex and Google using the Persian equivalent of keywords for ‘awareness', ‘attitude’, and ‘patient rights'. (...) For pertinent Iranian papers published in English, scientific databases PubMed, and Google Scholar were searched using the keyword ‘patient rights' and ‘Iran’. A total of 41 Persian and five English articles were found for these keywords, only 26 of which fulfilled the objective of our study. The increasing number of papers published indicates that from 1999 onwards, this subject has begun to draw the attention of Iranian researchers in a progressive fashion and Iranian papers in English have also been compiled and published in international sources. (shrink)

The purpose of the present study was to compare differential functioning of Iranian English versus Persian teachers in responding to compliments and to investigate the possibility of sociolinguistic transmission of speech act of responding to compliments from English culture to native Iranian Persian speakers. Following Chen and Yang (2010), we hypothesized that exposure to English would affect the complimenting behavior of Persian speakers, leading to more acceptance of compliments compared to those with little or no exposure to English. Participants of (...) the study were 50 English teachers, regarded as “exposed-to-English” or E group, and 50 Persian teachers, considered as “unexposed-to-English” or U group. The participants’ age ranged from 20 to 35 and they were selected through non-randomized convenience sampling. A Discourse Completion Test (DCT) comprising eight complimenting situations was developed in two versions, i.e. English and Persian, in light of Mane’s (1983) taxonomy. The results revealed a significant difference in performance between groups and that Iranian English teachers’ Compliment Response (CR) behavior changed due to exposure to English and approached English culture. Further findings and implications are discussed in the paper. (shrink)

Flooding is one of the most damaging natural hazards globally. During the past three years, floods have claimed hundreds of lives and millions of dollars of damage in Iran. In this study, we detected flood locations and mapped areas susceptible to floods using time series satellite data analysis as well as a new model of bagging ensemble-based alternating decision trees, namely, bag-ADTree. We used Sentinel-1 data for flood detection and time series analysis. We employed twelve conditioning parameters of elevation, normalized (...) difference’s vegetation index, slope, topographic wetness index, aspect, curvature, stream power index, lithology, drainage density, proximities to river, soil type, and rainfall for mapping areas susceptible to floods. ADTree and bag-ADTree models were used for flood susceptibility mapping. We used software of Sentinel application platform, Waikato Environment for Knowledge Analysis, ArcGIS, and Statistical Package for the Social Sciences for preprocessing, processing, and postprocessing of the data. We extracted 199 locations as flooded areas, which were tested using a global positioning system to ensure that flooded areas were detected correctly. Root mean square error, accuracy, and the area under the ROC curve were used to validate the models. Findings showed that root mean square error was 0.31 and 0.3 for ADTree and bag-ADTree techniques, respectively. More findings illustrated that accuracy was obtained as 86.61 for bag-ADTree model, while it was 85.44 for ADTree method. Based on AUC, success and prediction rates were 0.736 and 0.786 for bag-ADTree algorithm, in order, while these proportions were 0.714 and 0.784 for ADTree. This study can be a good source of information for crisis management in the study area. (shrink)

Background: Although many studies have addressed COVID-19, the challenges faced by nurses in their workplace after recovering from this disease have not been investigated. As the backbone of the health system and at the forefront of the fight against COVID-19, nurses are exposed to serious risks of infection and even death. They may also face numerous challenges in their workplace after recovering from COVID-19. It is therefore ethically recommended that the problems of these nurses be solved to increase their job (...) satisfaction and encourage them to remain in their profession. Objectives: The present research was conducted to determine the workplace challenges faced by nurses who had recovered from COVID-19. Methods: This qualitative study was conducted using the interpretive phenomenological approach proposed by van Manen. The data collected through 17 in-depth semi-structured interviews with 14 eligible nurses at different occupational levels were analyzed using the six steps proposed by van Manen. These nurses had also recovered from COVID-19. Ethical considerations: This study was approved by the Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1399.318). Findings: Four themes and 20 subthemes extracted from analyzing the data explained the challenges faced by the nurses after their return to work. The themes included declined ethical values (four subthemes), infected nurses, forgotten patients (three subthemes), gradually leaving the job (six subthemes), and corona phobia (seven subthemes). Conclusion: The present findings can be used to lay the foundations for adopting humanitarian policies in health organizations in terms of ethical care provision during future pandemics. (shrink)

This qualitative research study with a content analysis approach aimed to explore families’ experiences of an organ donation request after brain death. Data were collected through 38 unstructured and in-depth interviews with 14 consenting families and 12 who declined to donate organs. A purposeful sampling process began in October 2009 and ended in October 2010. Data analysis reached 10 categories and two major themes were listed as: 1) serenity in eternal freedom; and 2) resentful grief. The central themes were peace (...) and honor versus doubt and regret. The findings indicated that the families faced with an organ donation request of a brain-dead loved one experienced a lasting effect long after the patient's demise regardless of their decision to donate or refusal to donate. In conclusion, this study highlights the importance of family support and follow-up in an efficient healthcare system aimed at developing trust with the families and providing comfort during and after the final decision. (shrink)