فصلنامه اخلاق پزشکی
پیاپی 23 (بهار 1392)

Considering patient's rights in field of health services play important role in improving and regulating the nurse-patient relationship and have high importance in managing health system. Health care quality and service excellence are major differentiating features between health care organizations. Nurses play a pivotal role in patient care. Forgiveness is relevant to the medical community and has implications for the health and well-being of patients and nurses. The current research has been done to investigate the role of forgiveness in physical and mental health and nurse-patient relationship.Data bases of Science direct, Oxford journal, Springer, Sage, Taylor & Francis and Google scholar were searched to retrieve the related literature. The main criteria for entry were, the literature published in English language in the disciplines of nursing and health care sciences. Literature search was limited to 1980-2013 with the keywords of "Nursing ", "Forgiveness", "Mental and physical health" and "Medical practice" in the title of texts. The initial search resulted in 1175 texts, 315 of them deemed relevant to our analysis. Then 50 texts (25 percent of those) were selected and considered.The results of this study indicate the forgiveness have critical role in promoting mental and physical health; improve the patient-nurse relationship and interaction with physician in care settings. Patients occasionally create un forgiveness toward physicians whose decisions, and often mistakes, result in suffering by the patients or their families.The results of this study indicate the importance of forgiveness role in clinical setting, and the necessity of attention to this component in training nurses as major members of medical care team.

Economic and social development of developing countries, national, is only possible with the help of efficient human resource Nurses are the largest health care organizations in human resources, the importance of health promotion Community and organizational commitment as the basis for their loyalty and service to society resulted in an energy Service quality and economic development. This cross-sectional study of 400 participants to examine the organizational commitment of nurses on Nurses working in health centers of Shiraz University of Medical Sciences in 1391 was designed and implemented. Sampling was random and demographic information questionnaire for data collection and the obligation Statistical software used in enter-prise and data were analyzed using descriptive statistics SPSS16 Were analyzed. The overall mean of organizational commitment than 52/6%, respectively. Of the total sample, the prevalence of very low commitment, low commitment, dedication and commitment to the very top, 2/3 percent (n=9), 64/5 percent (258 patients), 32/5 percent (130 cases) and 0/8% (n 3), respectively. The average organizational commitment of nurses, managers is re-quired to consider the factors affecting organizational commitment.

The establishment of ethics committees in universities was notified by a circular in 1377 to achieve special aims. Ethics Committee of Shahrekord University of Medical Sciences was formed in 1379. The purpose of this descriptive study was to examine the legislations of this committee, and offer some suggestions to empower the members of faculty based on the findings of this study. Having obtained permis-sion of Ethics Committee of the university, we reviewed all the pro-ceedings of this committee during the previous 10 years and extracted the points suggested by this committee to each researcher. Totally, during the 10-year period 80 meetings were held, 610 legislations were recorded, and the number of notes and recommendations was 347. Most of the cases in the legislations included recommendations on getting informed consent and written permission and the least of them was related to the rejection of proposed research projects. Final-ly, according to the frequency of the legislations it is suggested that some training be offered to faculty members and university research-ers through holding workshops, virtual training, short-term training, etc.

Nurses are the largest group of service providers in the health care system and have a great impact on the quality of health care - a health and ethical factors to improve the performance of nurses in providing quality care to be. The main objective of this study was to compare the patient's attitudes (health care recipients) and nurses (health care pro-viders) about the values and principles of nursing ethics in a Teaching hospital in Tehran University of Medical Sciences. This study is a cross-sectional study and in the first semester of 1391 in a hospital of Tehran University of Medical Sciences has been. This questionnaire consisted of demographic information and 37 questions about the values and principles of nursing ethics that were completed by 100 patients and 100 nurses. To determine the validity of the ques-tionnaire used the content validity and also Cornbrash’s alpha coeffi-cient was used to determine the reliability of the method (0/89). In-formation obtained by the application «SPSS» Edition 16 cases was analyzed. The results showed that the average level of moral principles and val-ues nurses nursing perspective is higher from patient perspective and this difference was significant (P 0/001). Based on the results observed from the perspective of patients and nurses in nursing ethics the values are different, Therefore, regular training program and the importance of ethics in nursing is offered in hospitals Because the moral performance is one of the main compo-nents of quality and competent care to patients.

Nursing’s clinical practice substance is to provide convenience and healthy patients through attention to needs physical, emotional and spiritual. Nursing and provide care in connection with humans and ethics of care meaning respect for their human and care for is people ethical practice. The aim of this study was to explain the student's ex-periences of Confidentiality in clinical practice. In this qualitative study semi-structure interviews conducted with 20 nursing students in different course in 2010.The sampling method was purposeful and with maximum variation. Students were asked discuss about the Confidentiality of your experience in the clinical environ-ment (patients, colleagues and staff).The interviews were recorded, transcribed verbatim and analyzed using content analysis method. The oral informed consent obtained for the participation and voice record-ing. Themes derived from the "effective communications channels" is a sub-concepts "to deliver news to key personnel", "referral to a special-ist and consultant," "giving it normal look" is explained. The emerging concept of confidentiality in relation to classmates and staff "cover to clinical error" was. Students in the face of "errors" as a classmate and the staff knew so Confident kept them covered. In this study the role of student nurse were recognized at the clinical the patient as a confidential But in relation to classmates and staff clinical errors "Confidentiality” for reasons such as thought and confi-dence in their future classmates and staff error disclosure would avoid it.

Today along with increasing nursing knowledge, paying attention to ethical issues in the nursing environment of work is of particular im-portance. Nurses are needful of recognition of ethical dilemmas and making suitable decisions. And this fact requires high ethical stand-ards. There are evidences that ethical self-concept is one of effective factors to ethical decision making in clinical setting. Regarding to the lack of study in the moral self-concept and the highlighted role of this variable in ethical decision making we have decided to do this re-search. This research is a sectional descriptive study with the purpose of survey the degree of nurse’s ethical self-concept who are employed in didactic hospitals dependent to the Medical Science University of Zahedan. The research environment was in Imam Ali and Tamin ejtemaee hospitals of Zahedan. Data collection has been done by using ethical self-concept questionnaire made by Chung (1965) also data analysis has been done by using SPSS Software VERSION 17. Find-ings in this research have shown that from 200 participants, 188 ones cooperated and we have 12 sample of inset. In this study, degree of nurse’s ethical self-concept was the average of 3.52 from five. There was no significant relationship between demographic and ethical self-concept features. Results in this survey have been shown that nurse’s ethical self concept is in relatively high level, but it is far than the ide-al limit, so that educational system and nursing service should follow the ways to which increase ethical self-concept and consequently in-volve other effective factors in ethical environment decision making in bedsides.

Nursing advocacy is the essence of nursing ethics. In this role, Nurses attempts to protect patients’ autonomy and help clients for consciously self-determination in suitable condition. It seems correlation between nurse's perception and attitudes is direct and it shows in nurse's behav-ior. This study aimed to assess the correlation between nurse's percep-tion and attitudes towards patient advocacy, amongst 385 nurses by Quota sampling in Gorgan, Iran; hence, a three-part questionnaire was applied: a demographic data sheet, attitude measuring instrument and perception measuring instrument in nursing advocacy and analyzed using the SPSS including Descriptive & Inferential Statistics. The re-sults showed that fairly positive attitudes and perception were found amongst the participants, and nurses’ attitudes, in general, were posi-tively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers.

Patient rights one of axes index in defining standards for the govern-ance of clinical services. The emphasis on human rights in health care, especially maintaining the patient dignity as a human it is important when the patient harm him easily exposed violations and weaknesses in health systems puts. The present study aimed to determine factors or-ganizational associated with patient's right from the perspective of nurs-es and patients. Through a descriptive cross-sectional study in 2011, all nurses and pa-tients available at the internal and surgical wards of educational hospi-tals affiliated to the Ilam University of Medical Sciences were recruited using a census sampling method. A validated and reliable questionnaire including 40 questions for patients and 36 self-completed questions for nurses was used for data gathering. Demographic and particular ques-tions about patient's rights were asked by questionnaires. Content valid-ity and test re-test methods were used to approve the validity and relia-bility of the questionnaires respectively(r = 0/90 – 0/92). SPSS version 16 was used for all analysis. The results showed that the nurse's perspectives care delivery in a time-ly manner with a mean weight of 2.80 (86.7 %) And the patient's per-spectives care delivery with respect to the mean weight of 2.49 (73.1) were more important. The organizational most important factors associ-ated with patient rights of views nurses the appropriateness nurse num-ber of patient with a mean weight of 2.90 (91.7percent) at whereas phrase that feeling of security mental in nurses on patients’ rights with a mean weight of 2.91 93.1 percent) are the most important. The results of the present study shows that between views nurses and patients the studied of patient rights and organizational factors associated with patient rights there are differences. The views of nurses and patients in particular on the Rights Charter as well as patient rights were different significantly. The concepts of pa-tient's rights are still unknown and controversial in Iran and therefore need to be more discussed and studied. Taking any step and clarifica-tion toward the concept of patient's rights can help patients to receive enhanced cares based on human and emotional legislations.

The status of providing medical services to patients in the emergency wards can be indicator of medical service delivery in every part of hospital. The objective of this study is to determine the rate of satis-faction of the emergency patients in Vali-e-Asr Hospital of Fasa. The study was application and descriptive and analytical. Designed questionnaire in five part Likert scale has completed through inter-view. 470 Patients were interviewed. Collected data through SPSS 18 and Minitab16 software is analyzed by using appropriate tests. Validi-ty of questionnaire is provided through structural and content method. To determine reliability, Cronbach alpha is calculated which 0.91 is. The results showed that 50.1% of the studied samples were men. Among the demographic and contextual variables, there was statisti-cally meaningful relationship between satisfaction and education (p <0.001). Exploratory factor analysis showed that the questionnaire contains five factors which are: "facilities and equipment", "Environ mental health", "Access", "Care" and "behavioral aspects". The satis-faction of "facilities and equipment" 3.41, "Environmental health" was 2.69, the "Access" was 3.77, and “Care” was 3.15 and the satisfaction to behavioral aspects” was 3.11 The findings highlight the need to improve the quality of emergency services. It appears that by reforming system's defects based on Pa-tients’ opinions higher satisfaction would be obtained.