فصلنامه آموزش و اخلاق در پرستاری
سال یازدهم شماره 1 (بهار و تابستان 1401)

Clinical competence is one of the main goals of nurses' training which has a significant role on the quality of patient care. Therefore, identifying the related components can be effective in improving the quality of care. Spiritual health has also been considered as an important factor in the efficiency and success of nurses.The aim of this study was to determine the relationship between spiritual health and clinical competence of nurses working in teaching hospitals of Ahvaz Jundishapur University of Medical Sciences (2017).

Methods & Materials:

This descriptive-correlational study was performed with the participation of 165 nurses in teaching hospitals of Ahvaz by multi-stage sampling method in 2017. Data collection tools included a questionnaire of demographic characteristics, clinical competence and spiritual health. Data were analyzed using descriptive and inferential statistics in SPSS 22 statistical software.

The results showed that the level of clinical competence and spiritual health of the nurses was moderate. The results of Pearson correlation test showed that there is a significant and positive correlation between spiritual health and clinical competence of nurses (r=0.176, P=0.023) .Also, the field of quality assurance had the lowest average score and the field of education and management had the highest average score of clinical competence.

Considering the significant relationship between spiritual health and clinical competence of nurses, it is necessary to design appropriate educational programs for nurses' empowerment and in order to promote spiritual health and clinical competence of nurses.

Moral intelligence has special importance among nurses considering human and moral nature of their profession. Moral intelligence can provide a framework for the proper functioning of human beings and is considered as a predictor of behavior. The aim of this study was to investigate the relationship between moral intelligence and attitude toward patient safety among nurses working in Dezful teaching hospital in 2021.

This was a cross-sectional study. The statistical population included 200 nurses working in Ganjavian teaching hospital of Dezful in 2021 and participants were selected by convenience sampling method. Data collection instruments included demographic characteristics questionnaire, Lennick's & Kiel's Moral Intelligence Questionnaire and the Safety Attitude Questionnaire (SAQ). Data analysis was carried out using descriptive and analytical statistics (Pearson correlation coefficient and regression analysis in SPSS ver. 21 and P-value<0.05 was considered as the significance level.

The results showed that, 73% of 200 nurses were female and 27% were male. The mean± SD of nurses' moral intelligence and attitude towards patient safety was 156.21±24.19 and 107.05±15.53, respectively. The results of Pearson correlation coefficient showed a positive and significant correlation between all dimensions of moral intelligence and nurses' attitudes toward patient safety (r=0.431, p<0.0001). The results of regression test showed that moral intelligence plays a role in explaining the variable of nurses' attitudes toward patient safety (R2 = 0.185).

Moral intelligence plays a role in predicting nurses 'attitudes toward patients' safety. Therefore, it seems that nurses 'attitudes toward patients' safety can be improved by increasing moral intelligence through training workshops.

The purpose of this study was to determine the status of respecting pregnant women and factors related to their hospitalization in Besat Hospital in    Sanandaj (2019) Respecting mothers by health care providers includes three dimensions of quality of care, safety, and observance of mothers' rights, which ultimately leads to their positive experience of childbirth. The aim of this study was to determine the status of the respecting pregnant women and the factors related to their hospitalization in Besat Hospital in Sanandaj 2019.

This cross-sectional, correlational study was performed in the postpartum ward of Besat hospital in Sanandaj from January to May (2018). The study population consisted of all the women who gave birth in the postpartum ward. The sample size was estimated to be 345 individuals. Data were collected using a four-part questionnaire including 1-demographic characteristics (7 questions), 2- midwifery (12 questions), 3- delivery characteristics (15 questions), and 4- the Mothers on Respect (MOR) index (14 questions). After finishing the sampling, the data were analyzed using SPSS 20 software. In this study, Descriptive statistics and T-test, analysis of variance were used (P <0.05 0 was considered significant).

The results of this study indicated an average total respect score of 64.4 ± 9.6 and it was medium. The results also showed that there was a statistically significant correlation between respectful maternity care with income (P<0.018), type of health insurance (P<0.046), childbirth method (P<0.02), responsible for birth (P<0.014), and breathing techniques for pain relief during childbirth (P<0.034).

This study showed that respectful maternity care has a direct relationship in respectful maternity care and childbirth method, responsible for birth, and breathing techniques during labor and childbirth.

Virtual education is an irreplaceable opportunity to face the limitations of face-to-face education, achieve the ideal of education for all and lay the groundwork for sustainable and balanced development in the country. The use of virtual education methods in medical sciences in recent years, especially with the prevalence of this disease in the country has increased significantly. This study expresses the training program and empowerment of teachers and students based on the Kern's change model and evaluates the training program of this period based on the Kirkpatrick Model.

This study is a cross-sectional study that was performed on 6 groups of students from different educational fields during the two years of implementing the virtual education program in Jahrom University of Medical Sciences. The research population consists of 1000 students of different fields in different group. The educational design and empowerment of professors and students has been examined through the stages of change and its review based on Kern's change model.  Also, the evaluation of the program was done using the Kirk Patrick model at different levels. Also, in this regard, quantitative-qualitative evaluation of students and professors was done by using the measurement of thermic learning scores and individual interviews and focused groups from different disciplines. The students' satisfaction score regarding the effectiveness of virtual education courses is from a minimum of 51.2 related to the organization of course materials to a maximum of 61.7 in the design of pages in the course of virtual training and the grades of professors, from a minimum of 70.9 in the area of ​​organizing course materials to a maximum of 3. 81 has been variable in the field of page design during virtual education. The grade point average of the student increased, but did not have significant values ​​in different semesters.

Examining the mentioned program, based on the Kirkpatrick model at different levels and then measuring the attitudinal/functional and behavioral changes, shows that it is necessary to draw optimal conditions for the future of education by using opportunities and avoiding threats. By using the experiences gained during these days, he improved the quality of education and promoted the experiences gained during this period.

Nurses face many ethical challenges in providing care to patients. Scenario-based  learning along  with the use of  reflection can be an interactive, dynamic, and expansive learning strategy in ethics education that enhances students' decision-making skills and self-learning abilities. The aim of this study was to investigate the effect of reflective learning based on clinical scenarios on students' moral sensitivity in the course of professional communication and nursing ethics.

This study was a semi-experimental pre-test-post-test single group study that was performed on nursing students of Fasa University of Medical Sciences during the academic year of 2018-2019 in three stages of design, implementation and evaluation to assess students' moral sensitivity. In this study, all second semester nursing students including 48 people participated in the study. To collect data, the Persian version of the Lutzen Ethical Sensitivity Questionnaire (2006) was used. Data were analyzed in SPSS software version 21 at the level of descriptive and analytical statistics (paired t).

In this study, there was no significant difference between the mean of the total score of moral sensitivity before and after the intervention (p value> 0.05). Also, the results of paired t-test did not show a significant difference before and after the educational intervention in the subscales of moral sensitivity (Sense Of Moral Burden,  Moral Strength, Moral Responsibility) (p value> 0.05).

The present study, considering the non-significant difference between students 'moral sensitivity scores before and after the intervention, suggests that despite the place of reflective activities in the development of students' learning, especially in Western studies, and also applying such new approaches, especially by considering different cultural pedagogies, can take on more complex dimensions in order to be effective. Therefore, further studies on the effectiveness and dimensions of using reflection activities in ethics education are recommended to undergraduate nursing students in Iran.

The global approach to health care quality has led to efforts to manage resources and services more effectively, taking into account rising costs, competitive advantages in marketing, and patient safety. One of the main tools of health care quality and its improvement is accreditation. This research was conducted with the aim of investigating the challenges and strengths of implementing the educational accreditation process of hospitals from the perspective of the employees of Jahrom University of Medical Sciences.

This descriptive cross-sectional study using the census method on 51 employees involved in the implementation of educational accreditation of Jahrom University of Medical Sciences using a two-part questionnaire consisting of general and professional information of the employees involved in the implementation of educational accreditation and 27 The component was carried out to measure the opinions of employees regarding the implementation of the accreditation process in the education sector in Jahrom city. Data analysis was done using spss software version 21 and descriptive statistical tests (mean, percentage and standard deviation).

The results showed that out of 51 employees, 66% were women and the rest were men. The average score of the implementation of the accreditation process in the university was 14.3 ± 0.75, which was almost at the average level. The majority of the staff believed that the accreditation program made the university more dynamic and efficient and had the highest score. The lowest score was given to the item "in the accreditation program, the tasks and tasks are fairly and equitably divided among the university staff".

Modifying the accreditation evaluation method can increase the credibility and trustworthiness of Iranian hospital accreditation results. Considering the mutual influence of strengths and challenges on each other, it is necessary to train and develop teamwork culture, budget allocation and planning and strategy design in the context of its implementation, creating appropriate information systems, clarifying information and changing the overall attitude of the organization. to be laid

Nurses' sensitivity to ethical issues and their way of reasoning at the bedside is one of the professional principles in nursing that needs special attention. Therefore, the current research was conducted with the aim of determining the effect of the narrative method on the reasoning and moral sensitivity of nursing students through simulation.

The present research is a clinical trial on 60 undergraduate students in the field of nursing who were divided into 2 intervention and control groups by throwing dice. Demographic questionnaires, Kohlberg's moral reasoning and Latzen's moral sensitivity were completed for data collection in 3 times before and after the intervention and one month later. The intervention was conducted during 4 sessions of 3 hours based on 10 narrated scenarios, with the theme of ethical challenges in nursing and 2 sessions in the form of expressing students' experiences, in the clinical environment. The data were analyzed by SPSS version 16 software and using chi-square, Fisher's exact and ANOVA statistical tests.

The results of the study showed that the group had no significant difference before the intervention and were harmonious in terms of demographic variables, the level of reasoning and moral sensitivity. After the intervention, the moral reasoning of the control group was 39.23±6.88 and the intervention was 49.03±7.55, which showed a significant difference between the two groups at P<0.001, which indicated that there is a significant difference in the follow-up. Moral sensitivity after the intervention was 32.56±24.03 in the control group and 84.36±14.14 in the intervention group, with P<0.001, a significant difference was observed between the two groups.

Storytelling through simulation can be an effective method to increase the sensitivity and moral reasoning of nursing students. Therefore, the results showed that the evolution in ethics education methods will increase the moral capabilities of nursing students.

Respecting human dignity is one of the moral principles and professional duty of a nurse. This research was conducted with the aim of determining the level of respect for the dignity of patients in the emergency departments of medical education centers in Tabriz from the point of view of nurses and patients.

This research is descriptive-cross-sectional; which was carried out from December to February (2019) in 9 teaching hospitals of Tabriz city. 100 nurses and 165 patients from emergency departments were randomly included in this study. Questionnaires of personal and social information, dignity of patients from the point of view of nurses and patients were used and the results were analyzed using spss 22 software.

59 (59%) nurses and 92 (55.7%) patients were females. The overall mean score of respect for patients' dignity from the nurses' point of view was 2.266 ± 0.385 and from the patients' point of view was 1.916±0.369 (the lowest score was 0 and the highest score was 3), both of which indicate the desired status of respect for patients' dignity. Contrary to the desired level of respect for patients' dignity by nurses, there was a significant difference between the views of nurses and patients (P<0.05).

The results of this research showed that the level of respect for patients' dignity is optimal from the point of view of nurses and patients. Therefore, it is necessary for the survival of this situation and for the better respect of the patients' dignity and dignity, the nurses of the emergency departments should be encouraged and supported by the authorities. In this way, the weak and dull aspects of respect for the patient's dignity will be improved and the strong points will remain stable.

The operating room is a space dedicated to anesthesia and surgery teams for performing surgeries, and providing quality services in it requires a wide range of training and professional principles. The present study tries to take a step towards improving medical ethics and solving the problems of professional ethics by explaining and analyzing the clinical experiences of the anesthesiology and operating room students of Jahrom University of Medical Sciences in relation to professional ethics in the operating room environment.

The design of this study is a descriptive qualitative study with the method of conventional content analysis, which was done with in-depth semi-structured interviews and using open-ended questions from the students of the operating room and anesthesiology departments of Jahrom University of Medical Sciences, who have at least two internships in the operating room field. The collected data were analyzed based on the model proposed by Elo and Kingas.

In total, 255 semantic units were extracted from 10 interviews that were conducted with the participants; The classification of the codes led us to 6 main categories and 24 subcategories. The main topics are: 1- Understanding the concept of medical ethics and professional ethics 2- Frequently used ethical issues in the operating room 3- The most examples of violations of professional ethics in the operating room 4- Individual factors affecting compliance or violation of ethics in the operating room 5- Management and organizational factors affecting compliance or violation of ethics in the operating room 6- Environmental and physical factors affecting compliance or violation of ethics in the operating room

The clinical experience of operating room and anesthesiology students showed that they have a correct understanding of the concept of medical ethics and professional ethics, and they recognize well the factors affecting compliance or violation of professional ethics; If this topic is accompanied by the guidance of professors; It can help to improve the moral status of the operating room. It can also provide good suggestions to hospital managers for the moral improvement of medical centers, which the findings of the present study are in this direction.