فهرست مطالب مرتضی خاقانی زاده

The first aid workers in critical situations are the military medical groups and nurses. The main difference between military and civilian nurses is the ability to work independently and in harsh, unpredictable and challenging environments. This activity requires military nurses to be fully prepared for such situations.

This systematic review study was conducted on the articles and researches in the field of necessary preparations for military nurses in war zones. Searches in examining the role of military nurses in war zones were performed using the keywords, war preparation and nurses or military nursing and the role of military nursing, which were selected based on the vocabulary of the Medical Subject of Heading (Mesh); The papers in Persian and English were selected using the keywords in the title and abstract from the targeted search of reputable databases Scopus, Elsevier, PubMed, ISI Web of Science SID and Cochrane Library, ProQuest. Google Scholar from 2000 onwards.

A total of 235 articles obtained in the first stage by searching for the mentioned keywords. Then, after omitting the articles unrelated to the subject of study and complying with inclusion and exclusion criteria, 83 titles were approved. Finally, after removing duplicate studies and conducted on other incidents, 12 articles related to the purpose of the study were reviewed in the study.

The findings of this study showed that nurses need to get prepared before entering war zones to provide better services. These preparations enable them to provide better health care services. Familiarity with the conditions of war-torn areas is essential for preparing nurses. The awareness of nurses in facing the possible incidents on the battlefield prepares them to provide highquality services and save the lives of the wounded

Providing palliative care to the elderly and dying patients is a now and the future challenge. Nurses are the first group that provided palliative care and access and identifying the pain and suffering of patients is their first professional care. Therefore, palliative care education to nursing students can help to better care of these patients. The aim of this study was to determine the elements of palliative care curriculum for nursing students.

In this narrative review study, database of Magiran, SID, PubMed, Science Direct and Springer were searched. Articles were searched from 2000 to 2017 using keywords such as education, curriculum, palliative care and nursing.

A total of 1024 articles were found. 9 papers were selected for analysis. Four elements of curriculum including goal, content, teaching methods and evaluation of palliative care curriculum were accessed. The goal of this curriculum is to educate nursing students about end of life care and palliative care. Educational content emphasizes five categories including; the principles of palliative care, physical care, communication, ethics and psychosociocultural care. This curriculum used different methods for teaching and evaluating of students.

This curriculum emphasized the various aspect of the nursing palliative care with a review of the literature. Due to the need of nurses to palliative care such educational programs is necessary.

Spiritual self-care has played an important role in adapting nurses to stressful professional conditions, but has often been neglected by health systems.

The purpose of this study is to investigate spiritual self-care programs of nurses in Iran and other countries.

The present study is a narrative review and by searching the Persian and English databases, PubMed, SID, Iran doc, Magiran and a manual search in Google Scholar using the keywords nurse, health workers, spiritual self-care, self-care, spiritual health and health policy was done without time limit (until 2022). In total, out of 35309 articles obtained according to the inclusion criteria, 33 related articles were included in the study.

Despite the special place of spirituality in nursing, the implementation of spiritual self-care in nurses with individual barriers (lack of understanding of the concept of self-care and lack of evaluation, lack of motivation, ignorance of spiritual needs and misconception of spirituality) and organizational (selfish selfishness as a subset Nursing culture is associated with high workload with low salaries, lack of attention and planning of officials in this field. Health policymakers in countries such as the United States, Japan, Canada, the United Kingdom, Australia and Lebanon by implementing strategies such as developing national programs, forming associations and training programs and creating a requirement in self-care through ethical codes to raise the level of Nurses' spiritual self-care has helped. However, no program in this field is currently being implemented in Iran and no study has been found in this field.

It is suggested that health policymakers in Iran, by modeling the programs of leading countries in the field of spiritual self-care of nurses, help improve the spiritual self-care capacity of nurses.

Motivation is one of the most important issues affecting academic achievement. The aim of this study was to investigate academic motivation and its related factors in students of Baqiyatallah University of Medical Sciences.

In the present cross-sectional descriptive study, 180 students were randomly selected. The study survey consisted from the demographic section, academic motivation questionnaire and a four-item section related to satisfaction with welfare and educational status, job future and field of study. Significance levels was considered less than 0.05.

The students were 50 medical, 34 nursing, 24 operating room, 43 anesthesia and four pharmacy students participated. The mean (SD) age of subjects was 21.66 (1.55). In addition, out of them, they were 82.2% male, 90.6% single, 51.1% undergraduate, 93.3% non-scholarship holders and 88.3% dormitories' residents. The mean (SD) scores of internal and external motivation, lack of motivation, and total academic motivation were 52.77 ± 13.90, 55.08 ±14.07, and 14.98 ± 6.32, and 122.84 ± 29.48, respectively. Academic motivation was statistically significant with respect to different age levels (p ‹ 0.05). External motivation also showed a significant correlation with job satisfaction (p ‹ 0.05) and satisfaction with the field of study (r = 0.15) (p ‹ 0.05).

Findings showed that students' academic motivation is not desirable and needs attention. Providing a basis for students to study in the field of interest, paying more attention to the welfare of students can be effective.

Paying attention to efficient policies in the field of nursing education and checking their quality will lead to the institutionalization of an efficient educational system in the field of nursing. For this purpose, a comparative study was conducted in this field with other countries in order to find out the existing strengths and gaps. This study was conducted with the aim of comparative comparison of nursing education policies in Iran, Canada, America, and Nepal.

The present article was carried out with a descriptive-analytical and comparative method in 2022. Searching texts without  a time limit with Farsi and English keywords: "Comparative comparison", "policy making", and "nursing education" in sites and databases related to nursing education policy.Google and Google Scholar search engines were used. 25 studies in Farsi or English were included in the study with full access to the text of the article. To make a comparative comparison, Bereday's Brady model was used in 4 stages description, interpretation, contiguity, and comparison.

The comparison of the policies of four countries showed that policymaking in Canada on nursing education was responsive according to the needs of the society and in the United States educational policies were based on law and activities. In Nepal, despite the evolution of educational policies, there are still deficiencies in this field. In Iran, the transformation and innovation program in medical science education has been developed with an eye on the future.

Based on the results, in order to promote and improve policymaking in the field of nursing education, the development of human resources and the support of the clinical, teaching, and student staff, as well as their participation in the formulation of policies, will increase its effectiveness and implementation capability. Periodic review and identification of required policies based on the needs of society and transfer of knowledge to the hospital by establishing a strong relationship between the nursing schools and hospitals will help the professionalization of the nursing force.

Background and Object:

 Nurses play a vital role in dealing with the COVID-19 crisis, considering that the high level of knowledge and ability of nurses in dealing with this crisis accelerates the recovery process of patients and promotes the health level of the community. Therefore, this study aimed to determine the effectiveness of virtual training package for nurses' scientific empowerment against covid-19 crisis.

The study consisted of descriptive cross-sectional and semi-experimental two phases study population including 256 nurses in spring 2021 in one of the selected hospitals in Tehran. Data collection scales, were demographic questionnaires and four-choice test Researcher made. Virtual training package was prepared with the purpose of nurses understanding of COVID-19, prevention, diagnostic, Treatment and nursing care methods and education during discharge in the form of multimedia educational files. 63 nurses whose scores were lower than the average of the society were divided into two groups of 32 interventions and 31   controls by block random allocation method. One month after the intervention, post-test was performed and the data were analyzed using descriptive-analytical statistics using SPSS software version 26.  

The scores of nurses' empowerment in the experimental group before the intervention was 7/96(2/96)   and after the intervention was 23/96(1/28) and in the control group before the intervention was 8/96(2/58) and after the intervention was9/62(2/47). according to the results, the scores of both groups before the intervention were not significantly different (P=0/169(but after the intervention, there was a significant difference (P<0/001) the score of nurses who used virtual training package had a significant increase.

Virtual training is a suitable method for empowering nurses against with COVID-19 crisis. This study was conducted to meet the needs of medical and educational centers to improve nurses' knowledge and capability against COVID-19 crisis. In this study, while determine the level of nurses' scientific empowerment, the effectiveness of virtual training on nurses' empowerment in these conditions was investigated and confirmed.

Considering the importance of communication skills in nursing educators, in terms of having educational and practical experiences and amenability as well as student acceptance as a mentor, have an important role in shaping students’ behavior including emotional growth behaviors. The aim of this study was to improve the emotional growth of nursing students based on growing up and role modelling theories.

The present study was a collaborative action research. All of freshmen undergraduate nursing students from the faculty of nursing in 2015(n=30), Baqiyatallah University of Medical Sciences, entered into the study. After developing a standard and valid questionnaire, the emotional development was assessed. Strategies for improving emotional growth were identified by relevant literature reviews, interview sessions with faculty members and group discussions with target student. In the implementation step, some of the feasible strategies were conducted. Students' emotional development was measured in 4 times (at the beginning of the study (March 2015), twice during the study and once at the end of the study (February 2017)).

The total score of emotional growth of students was 90.9± 18.9. In the planning phase, after conducting directed content analysis of interviews and group discussions, solutions were identified. The main strategies identified were effective communication, motivation, self-esteem and positive identity. After completing some strategies at the implementation stage, finally their emotional growth scores in the areas positive identity, effective communication and motivation, as well as the total score of emotional development of students at different times were higher than baseline. Over the two years the total score of students' emotional growth was increased from 90.9±18.9 to 97.9±11.9.

Using effective strategies such as creating a suitable environment for effective interaction between lecturers and students, and helping to increase self-esteem and motivation in students can be helpful in students' emotional growth improvement.

Imam Khomeini says that every step that a student takes to acquire knowledge must also take a step to acquire moral virtues. The purpose of this study was to explain the concept of student ethics from the perspective of medical students. Student ethics is one of the most important professional dimensions in the field of medical sciences. Findings of related studies show that despite the importance of this issue, there are many problems in defining and explaining the dimensions of this concept. This study was conducted to explain the indicators of student ethics based on the experiences of medical students.

In this qualitative study, 43 students from 4 faculties (medicine, nursing, pharmacy and hygiene) of the selected military university of medical sciences were interviewed semi-structured. Purposeful sampling was performed with maximum diversity in the research. Semi-structured individual interviews were used to achieve data saturation. Exploration questions were used to deepen the interviews and extract experiences. The interviews were handwritten line by line and analyzed according to the qualitative content analysis approach. Oral consent was obtained to participate in the study and recording of the sound.

Student commitment, professional skills and revolutionary idealism were the main themes extracted in this research. Participants described the concept of student ethics as having revolutionary and socialist behaviors on campus, and that community-unfavorable behavior was contrary to student ethics. Participants described the university environment as a society in which respectful behavior of students should take place, because the influence of the behavior of professors and students is very effective in shaping the personality of students.

Findings of this research can be used in the development and promotion of medical education programs and continuing education. Paying attention to these indicators in the development of student ethics can lead to a correct understanding of the student's duties in order to provide better quality treatment and care, prevent mistakes and be effective in ensuring the rights of students, professors and clients.

The military personnel face many stressors. This study aimed to identify coping mechanisms in the face of stressors in military personnel.

This is a cross-sectional study and the sample was 384 of staffs affiliated to Iranian Navy Force, who were selected by cluster random sampling. Data collection tools were demographic questionnaire, a military stressors questionnaire developed by Azad Marzabadi and Lazarus-Folkman's coping mechanisms questionnaire. Stressors were evaluated in six areas (factors related to the region of workplace, social, occupational, personal, familial and military-related factors) and coping mechanisms in eight subscales including; confronting coping, distancing, self-controlling, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive reappraisal.

Among the stressors, the highest level of stress was related to the military with an average of 17.95. The most common coping mechanism was positive reappraisal with an average of 10.65. The mean use of problem-oriented mechanisms was significantly higher than emotion-driven mechanisms (P<0.001). There was a direct and positive relationship between most stressors factors and emotion-driven mechanisms and negative and reverse relationship with problem-oriented mechanisms.

The study found that participants were more likely to use problem-oriented mechanisms in coping with stressors. However, it is necessary to take appropriate measures to reduce the use of emotion-based solutions and also to strengthen the use of problem-oriented coping mechanisms.

Moral courage is the ability to overcome fear and performing the right action based on moral beliefs despite the potential danger. Nurses, as moral agents, need moral courage to properly manage moral problems and make a professional commitment to patients. Therefore, the above study was conducted to investigate the moral courage of nurses and related factors. In this descriptive cross-sectional study conducted in 2019, the research population was all nurses working in Baqiyatallah Hospital. After explaining the objectives of the study and obtaining the consent of the research, 220 nurses were selected as available samples. The data collection tool was Sadooghiasl questionnaire. After completing the questionnaire, they completed 187 sample questionnaires. SPSS software was used to analyze the data. The results of the study showed that the mean score of nurseschr('39') moral courage was 413.37 with a standard deviation of 46.70. Thirty percent had moderate moral courage and 69.5% had high moral courage. The results of the independent T-test and ANOVA showed that there is a statistically significant relationship between the variable employment status and the moral courage of nurses. Considering the results of this study and the many ethical challenges that exist in the nursing profession, the issue of moral courage and related factors and providing solutions to improve it, should be at the forefront of the health organization and nursing managers.

Considering the importance of job stress and its effects on the performance of military forces, this study investigated the level of occupational stress and its relationship with some demographic and employment parameters in some Iranian Navy personnel.

This cross-sectional descriptive study was performed on a group of Navy personnel in Iran in 2013. Samples were selected by cluster sampling. The Osipo Job Stress Questionnaire and Demographic Questionnaire was used for data gathering. Data were analyzed using SPSS 18 software.

There were 384 Navy personnel with a mean age of 29.6±4.2 years. The mean score of job stress in all subjects was 163.2±26.1, which is the normal level of job stress. Overall, 13.3% of subjects had no stress, 85.2% had normal stress, 1.3% had moderate stress and 0.3% had severe stress. Severe stress was recorded among senior officers and those employed in official hiring. The highest level of job stress was related to the physical environment with an average of 68.8% and the lowest level of job stress was in ambiguity with an average of 24.2%.

Although 85 % of Navy personnel experience a normal level of stress, severe stress was recorded in senior officers and those employed in official hiring. Also, the highest level of stress was in the physical environment, which required measures to improve work environment conditions and reduce stress in this area.

The achievement of individual, organizational-institutional, and social goals defined for educational systems, as well as solving challenges, ultimately depend on learners’ cognitive, skill, and attitudinal development. Guidance, as a strategy of interactional approach aiming at helping the learners and supporting them, plays an important role in educational and professional success, by helping students and providing support to them. This research is an attempt to identify the components of Islamic guidance in the Islamic scriptures. Employing thematic analysis method, the researchers identified the verses of the Holy Qur’an, the sayings and traditions of the infallibles in the reliable educational sources, and the related researches were selected and analyzed and the components of Islamic guidance were. The analyses were conducted in three stages using Straus Corbin method. In the first stage, definitions, concepts, and the characteristics were identified from which more than 300 initial codes were explored. These codes were classified into 25 main categories in the second stage. Having integrated and having combined these categories, 9 core themes were identified as core components of the Islamic guidance. They included modeling, challenging, instructing, counseling, supporting, encouraging and punishing, dignifying and paying attention, kindness and simplicity, and scientific-professional networking. These nine core themes are closely interrelated and emerge in the Islamic texts together. They are consistent with the inherent integrity of the instructions and Islamic concepts. The application of these results in teaching contributes to the continuity, consistency and integrity of the community, educational system and educational administrators, and the learners.

Considering the developments of the third millennium in the field of health, creating the ability of inter-professional collaboration and teamwork among students is one of the most important tasks of educational organizations. The aim of this study was to investigate the effectiveness of the educational workshop based on inter-professional approach to changing the attitudes of health science students toward inter-professional learning and collaboration.

Quesi-experimental study was done in 2018 at Baqiyatallah University of Medical Sciences. Sixty-five students from medical and nursing participated in this study. Primary sampling was done by available method, then the samples were randomly assigned to two groups of control and experimental. The intervention was developed as an interactive workshop based on interprofessional approach with educational content of communication and inter-professional collaboration. Data were gathered using readiness and attitude to inter-professional learning scale (RIPLS) with Reliability 0.8 , and was analyzed with SPSS 22 software.

There was no significant difference between the two groups regarding the attitude toward inter-professional learning and collaboration before intervention (p> 0.05); after intervention, the Students’ attitude was in the experimental group with a mean of 80.8 and standard deviation 8.59 and control group with a mean of 59.72 and standard deviation 8.29, so significant difference was observed between the two groups (P < 0.001).

results indicate the availability of an appropriate motivation and perspective for integrating inter-professional education in health sciences in the health science. Educational organizations, for empowerment labor for responding to present and future generation health needs, should design and implement inter-professional education in the field of health from now.

According to the nature of the nursing profession, the education process is based on two parts of theory and practice. To educate nurses who can provide proper care by health standards, attention to both sectors is essential. However, the gap between the theories of practice is one of the challenges posed in nursing education. So that the approaches of studies in the field of nursing education are also focused on the pathology of this challenge and provide a suitable strategy. This study aimed to provide a solution to close the gap between theory and practice in nursing education. This integrative review uses the key words of nursing education, theory, and practice, a wide search of resources at the WOS, Pub med, Science Direct, Scopus, Iranmadex, Magiran, SID and Google scholar from 2003 to 2018, in English and Persian. Ultimately, 7 articles were included. Data were analyzed based on whitehorse and Knafl (2005) strategy. Based on the results of the studies, reviewing of curriculum, Motivation, cultural competence, appropriate communication between instructors and students, increasing the critical thinking skills of faculty members and students, enhancing the clinical skills of faculty members and using various educational methods, among the effective factors in reducing the gap between theory and practice in nursing education. According to the results of the study, reviewing of curriculum, increasing the critical thinking skills of students and faculty members, enhancing the clinical skills of faculty members and using various education methods in nursing recommended.

 Nurses, as one of the main sources of organizational knowledge and main elements of knowledge transfer in hospitals, can play a key role in organizational learning process. The present study was performed due to the importance of organizational learning capabilities of nurses.  This study aimed to investigate the effectiveness of decision-making through brainstorm on organizational learning capability in nurses.
Material and  This study was conducted in two stages: In the first stage, learning capability of all nurses in internal-surgical section (18 departments) of Baqiyatallah Hospital was measured by census method (281 persons). In the second stage, eight sections with no significant differences in organizational learning were determined and randomly divided into test and control groups. A theoretical and practical training workshop was held to train other personnel and head nurses how to implement the brainstorming method for decision making. Then, after four months, the Organizational Learning Questionnaire was distributed in control and test groups. Data analysis was done through descriptive statistics including mean±standard deviation (SD) and analytical statistics including Chi-square, Mann-Whitney, Wilcoxon, T-test and ANOVA using SPSS.19.  The results of the first stage showed that the mean of total score for organizational learning capability of nurses was 58.04 (8/98), which according to Likert scale, was average. Also, the mean of scores for areas of management commitment, system and knowledge transfer was 19.02 (33.23), 11.44 (1.88) and 13.67 (3.05), respectively which was average, while that was 13.89 (2.80) for the fields of open space and experiment, which was at the lowest level. The results of the second stage of the study showed that the meanof total score in entire area of organizational learning capability in nurses increased and was significantly different before and after running the intervention and brainstorming in the test group.For example, the standard deviation of the entire organizational learning capability in nurses was p = 0.012 after the intervention. Also, the standard deviation of areas of management commitment,, System Attitude and knowledge transfer was p=0/044, p=0/000, and p=0/003, respectively, that were all significant, but no difference was observed in the control group. Discussion and Conclusion:  According to the results of this study and the effectiveness of brainstorming method on boosting the organizational learning capability of nurses and improving the quality of nursing care and nursing services, it is recommended that the nursing managers implement this method in health care departments.

Nurses can play a major role in the process of organizational learning as one of the major sources of organizational knowledge and important elements of knowledge transfer in hospitals. The aim of this study is to determine the learning ability in a military hospital (Baqiyatallah). In this analytical/descriptive study, the research community was 281 nurses working in a sub-specialty hospital in Tehran . Which meets the criteria for entering the study They were entered into the study by census method in 1396. The data collection tool is a questionnaire. The first part of the questionnaire is the collection of individual information. The second part is the Questionnaire Gomez(2005) Organizational Learning . And in the present study, its reliability was resumed in a preliminary study.
After collecting the information based on the type of variables, descriptive statistics including mean standard deviation and analytical statistics were considered significant level of 0.05. Using SPSS version 19, and the normalization of the data, Kolmogorov-Smirnov test , were analyzed and analyzed. Considering the importance of organizational learning in survival of organizations and the results obtained in this study, organizational learning capability in three areas of management commitment, open space, experimentation, and knowledge transfer was moderate below. According to the results of this research, it is necessary to pay attention to the transferability and integration of knowledge of nurses in order to increase organizational knowledge of the staff. Nursing managers are also required to explore ways to improve nurses' learning through new methods, and provide knowledge transfer and transfer experience for nurses. In the end, they will have decent and close services to the global standards at the clinic

Service-based learning, as a kind of experiential learning, connects nursing education to the real world. The purpose of the present study was to examine the concept of service-based learning in nursing by Rodgers's Evolutionary Concept Analysis Method.
In this review study, English-language databases including Science Direct, Medline, Cochrane library and CINAHL, and Persian-language databases like Scientific Information database were searched by a three-step searching method from 2005 to 2015. To demonstrate a conceptual model of service-based learning, Rodgers's Evolutionary Concept Analysis Method was used.
Of a total of 6543 articles identified, 165 were included into the second step, of which only 32 were relevant to the field of nursing. Using the given answers to the 9 questions raised in the study, the new approach to the service-based learning model was developed.
According to the growing demands of societies from educational centers on graduate students who are able to work in real social life settings, recommends the necessity of focusing in this new educational approach. For more objective evaluations of this new educational approach, it is advisable to use its specialized check list.

Speed of service delivery in health centers, especially in emergency ward, is very important in reducing mortality and disabilities. One of the most important indicators in evaluating emergency centers is the waiting time. This study aimed to evaluate the effect of nurses’ triage education based on stabilization model on the patient’s waiting time in the emergency department of selected hospital in 2015.
In this quasi-experimental before-and-after study, the waiting time for 35 patients admitted to the emergency department, was recorded using a certain timer device before the intervention. Triage training was taught to nurses based on stabilization model in a 2-hour face-to-face lecture in the triage room of emergency department for one week. After a week, the patients’ waiting time in different shifts was measured using the same timer. Data were analyzed by descriptive and inferential statistical tests through the SPSS software version 19.
There was a significant difference between the mean waiting time before and after the intervention. In a way that the mean of first waiting time before the intervention was 15.34 minutes that reduced to 8.42 minutes after the intervention (P Nurses’ triage training based on stabilization model reduces the patient’s waiting time in the emergency department and in turn, accelerates service delivery. Therefore, we emphasize providing triage education to the emergency nurses.

A major reason for professional ethics education for the nurses is increasing their awareness about ethical dimensions and moral sensitivity. This study was conducted to recognize developmental strategies of nursing ethics education.
In this review, the systematic search method was used. Using the keywords of "education, teaching, professionalism, ethics, nursing and medicine" separately and then in combination, in "Science Direct, Scopus, Ovid, Proquest, Eric, Pubmed, SID, Irandoc, Iranmedex" databases, English and Persian articles dating from 2005 to 2016 were searched. 1648 articles were identified. After removing the duplicate and irrelevant papers according to the study inclusion and exclusion criteria, eventually 16 papers were selected and entered the analysis.
Ethical Considerations: Honesty and integrity were considered in reporting the results and citation of the texts.
Findings: The findings indicats that multiple strategies are involved in nursing ethics education, which are introduced under four main nursing ethics education development strategies: nursing ethics curriculum with an integrative perspective, nursing ethics education at all educational levels (Associate, Bachelor, Master and PhD), nursing ethics inter-professional education, and professional ethics education at the bedside.
Paying attention to the impact of students’ learning on the current method of nursing ethics education, using the modern methods of professional ethics education, and enhancing the teachers’ and students’ attitudes are among the most significant factors to be taken into account in the development of nursing professional ethics.

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

Type 2 diabetes mellitus is a major general health problem that causes widespread effects on the individual and social functions. The purpose of this study was to investigate the relationship between health literacy and general health in type 2 diabetic patients.
This cross-sectional study was done on 200 patients referred to the Diabetes Research Center, Tehran University of Medical Sciences in 1392. Data were collected using three questionnaires: demographic characteristics, health literacy (TOHFLA), general health (GHQ28 . Data analyses were done by using descriptive statistical tests, frequency distribution tables and tests (test t, ANOVA) using SPSS (Version 16).
More than half of participants (58%) didnt have adequate health literacy and their general health was average (average: 53/7 ± 58/48). There was a significant correlation between health literacy and public health (p: 0.007, r:-0.191). Health Literacy was statistically significant with three aspect of general health, anxiety and sleep disorders (p: 0/0029, -0/154), social functioning (p: 0/013, r:-0/176) and depression (p: 0/002, r:-0/218).
In general, chronic diseases, including diabetes type 2 has clinical, social and psychological problems, which leads to mental and physical limitations in these people. This study showed that inadequate health literacy and public health are common problems, which indicate that diabetic patients need more education to improve their level of health literacy and general health.

As a result of the changes made in health care systems, nurses nowadays are faced with more complicated ethical dilemmas. Therefore, they need to be familiar with ethical decision-making procedures and have the ability to perform ethical reasoning. The present study aimed to evaluate this ability in nurses and investigate its relationship with demographic characteristics in a subspecialized hospital in Tehran during 2015. This was a descriptive-analytical study, and the research population consisted of 245 qualified nurses selected by census. A demographic questionnaire and Crisham’s Nursing Dilemma Test were used to collect the data. Descriptive-analytical tests and SPSS software version 22 were used for data analysis. Based on the, the mean value of the nurses’ ethical reasoning was 40.81 ± 6.72, which is lower than the average score of the test. Furthermore, increased work experience led to a reduction in the mean value of ethical reasoning (P ≤ 0.05). Overall, single subjects scored higher in the mean ethical reasoning than those who were married (P ≤ 0.05), but no significant relationship was observed between other demographic characteristics and the mean of ethical reasoning. Due to the nurses’ low ability to perform ethical reasoning, further studies will need to be conducted on proper training methods to promote ethical decision-making in nurses. As regards the reduced ethical reasoning ability in nurses with more work experience, it is necessary to identify the reasons and devise appropriate solutions with the help of nursing managers and hospital ethics committees.