فصلنامه اخلاق پزشکی
پیاپی 31 (بهار 1394)

Moral distress in educational environments can be associated with multiple effects. Students who faced with this ethical challenge feel insecurity and dissatisfaction and so school dropout and failure will be increased in them. Low quality of teaching in these conditions could potentially cause a lack of scientific and clinical sufficiency and thus the performance of health systems to achieve the health goals will be at risk. This study aimed to assess the student's moral distress in Birjand paramedical school students. The Cross - Sectional study took on 600 students of paramedical school who were selected by census. To collect data, it was used a questionnaire of 20 questions. The validity and reliability of this questionnaire was evaluated and Cronbach's Alfa was calculated 81 percent. Data were collected by Spss16 software and were analyzed with descriptive and inferential statistics. The findings showed that the average of moral distress from total score was 0-5, (3/12±0/88) in the intensity and (3/5±1/2) in the frequency. There was a significant relationship between moral distress with years of educations and sex (P>0/05). Moderate level of moral distress in students requires the planning and some actions as students’ awareness to this phenomenon. Identification and control of this phenomenon in educational environments and investigating its reasons may play an important role in the control of this phenomenon and the prevention of its adverse effects in future.

Training ethical concepts has a crucial role in promotion of moral sensitivity in nurses. Debate to select most effective method of teaching ethics in nursing continues. Present study was aimed to compare the effects of ethical training based on two

narrative ethics and lecturing on moral sensitivity of nurses. Fifty-six nurses from two educational hospitals in Birjand participated in this randomized control field trial research. The demographic characteristics questionnaire, and Lutzen's Moral Sensitivity Questionnaire were completed by nurses in the three Tims (before, after and three month after the intervention). Then four sessions (each 3 hours) of ethical training with one week interval for two groups of narration (28 participants) and lecture (28 participants) were conducted. Data were analyzed by SPSS-16 software.Two methods of narration and lecture significantly increased the nurse's moral sensitivity in each group (respectively p<0.001, p=0.01). Despite the higher mean score of moral sensitivity in narration group rather than the lecture group, moral sensitivity did not show a significant difference (p=0.70). The mean score of moral sensitivity 3 months after the intervention showed a statistically significant decrease than after it in both groups. (P=0.00) Concerning the results of this study, a combination of these two methods can lead to useful outcomes.