Background Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention. Objective This study aimed to identify and explain the processes of the nursing profession’s participation in establishing social justice in healthcare system. Research design and methods This qualitative study was conducted using the grounded theory method. Participants and research context Data were collected (...) through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss’ 2015 method. Ethical considerations The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. Findings The “Professional Dynamics in the Path of Justice” was the study’s core category. This theory is the result of nine main categories: “inefficient professional authority,” “social justice, a neglected component in education,” “clinical concerns, barriers to nurses’ presence in society,” “individual input reserves to facilitate social justice,” “inadequate maturity of the profession in the path of equity in health,” “promoting justice in clinical practice,” “a tendency to community-oriented profession,” “use of personal approaches for justice promotion,” and “emerging justice-expanding nursing.” These categories cover the underlying factors, strategies, and outcomes of the nursing profession’s participation in establishing social justice process in healthcare. Conclusion The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended. (shrink)

PurposeAlthough an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard therapeutic and prophylactic modality in patients with brain tumors. This review was aimed to abstract and evaluate the prediction models for radiation-induced neurocognitive decline in patients with primary or secondary brain tumors.MethodsMEDLINE was searched on October 31, 2021 for publications containing relevant truncation and MeSH terms related to “radiotherapy,” “brain,” “prediction model,” and “neurocognitive impairments.” Risk of bias was (...) assessed using the Prediction model Risk Of Bias ASsessment Tool.ResultsOf 3,580 studies reviewed, 23 prediction models were identified. Age, tumor location, education level, baseline neurocognitive score, and radiation dose to the hippocampus were the most common predictors in the models. The Hopkins verbal learning and the trail making tests were the most frequent outcome assessment tools. All studies used regression as machine learning method. All models were judged to have a high risk of bias mainly due to issues in the analysis.ConclusionExisting models have limited quality and are at high risk of bias. Following recommendations are outlined in this review to improve future models: developing cognitive assessment instruments taking into account the peculiar traits of the different brain tumors and radiation modalities; adherence to model development and validation guidelines; careful choice of candidate predictors according to the literature and domain expert consensus; and considering radiation dose to brain substructures as they can provide important information on specific neurocognitive impairments. (shrink)

With rapid changes in urban living today, peoples’ behavioural patterns and spatial practices undergo a constant process of adaptation and negotiation. Using “house” as a laboratory and everyday life and spatial relations of residents as a framework of analysis, the paper examines the spatial planning concepts in traditional and contemporary Iranian architecture and the associated socio-cultural practices. Discussions are drawn upon from a pilot study conducted in the city of Kerman, to investigate ways in which contemporary housing solutions can better (...) cater to the continually changing socio-cultural lifestyles of residents. Data collection for the study involved a series of participatory workshops and employed creative visual research methods, participant observation and semi structured interviews to examine the interlacing of everyday socio-spatial relations and changing perception of identity, belonging, socio-cultural and religious values and conflict. The inferences from the study showcases the emerging social and cultural needs and practices of people manifested through the complex relationship between residents, the places in which they live, and its spatial planning and organisation. For a better understanding of this complex relationship, the paper argues the need for resituating spatiality as a socio-cultural paradigm. (shrink)

IntroductionOne of the most important duties of hospital ethics committees is to provide medical ethics consultation to the staff and patients. This study was conducted with the aim of the needs assessment of the staff for optimal provision of medical ethics consultation services.Materials and methodsThe data collection tool was a self-administered questionnaire. Hospital managers, chief nursing officers, ward managers, and head nurses of all hospitals affiliated with Tehran and Iran University of Medical Sciences entered the study. The questionnaire together with (...) an invitation letter was sent to the samples. In the next stage, telephone follow-up of the incomplete forms was performed by the research team.ResultsA total of 448 persons participated in this study (response rate: 54.2%). The mean frequency of the need for ethics consultation in each ward was 5.2 times in the last 3 months with a median of 3. The highest needs for consultation, which were common in all wards, were observed in treatment rejection by the patient, providing necessary information to obtain informed consent and obtaining consent to high risk procedures, conflict between the decisions made by the patient and the family members, decision making for the high risk patient, request for futile or inappropriate treatments, giving bad news, and decision making for the incompetent patient.ConclusionThe prevalence of ethical issues in clinical wards is variably high. The ethical issues in the clinical setting are mainly related to respect for the patient’s autonomy and competency for decision making. (shrink)

Emergency care providers regularly deal with ethical dilemmas that must be addressed. In comparison with in-hospital nurses, emergency medical service personnel are faced with more problems such as distance to resources including personnel, medico-technical aids, and information; the unpredictable atmosphere at the scene; arriving at the crime scene and providing emergency care for accident victims and patients at home. As a result of stressfulness, unpredictability, and often the life threatening nature of tasks that ambulance professionals have to deal with every (...) day, ethical decision-making has become an inevitable challenge. The content analysis approach was used to conduct the present qualitative study in Iran. The participants consisted of 14 EMS personnel selected through purposive sampling, which continued until the data became saturated. Data were collected using semi-structured interviews and analyzed concurrently with their collection through the constant comparison method. The process of data analysis resulted in the emergence of 3 main categories “respecting client’s values”, “performing tasks within the professional manner”, “personal characteristic”, and the emergence of eight sub-categories signifying participants’ experiences with regard to EDM. According to the results, when EMS personnel are faced with ethical dilemmas, they consider the client’s values and professional dignity, and perform the assigned tasks within the framework of the regulation. The findings also suggest that pre-hospital care providers assess legal consequences before making any decision. Further studies should be conducted regarding the experiences of the subordinates and other related parties. (shrink)

Background:Emergency care providers are frequently faces with situations in which they have to make decisions quickly in stressful situations. They face barriers to ethical decision-making and recognizing and finding solutions to these barriers helps them to make ethical decision.Objectives:The purpose of this study was to identify barriers of ethical decision-making in Iranian Emergency Medical Service personnel.Methods:In this qualitative research, the participants (n = 15) were selected using the purposive sampling method, and the data were collected by deep and semi-structured interviews. (...) Finally, the data are analyzed using the content analysis approach.Ethical considerations:Permission to conduct the study was obtained from the Ethics Committee of the Shahid Beheshti University of Medical Sciences. The objectives of the study were explained to the participants and written consent was received from them. Also, participants were assured that necessary measures were taken to protect their anonymity and confidentiality.Findings:The results of the analysis are classified in five main categories. It encompasses the following areas: perception of situation, patient-related factors, input and output imbalance, uncoordinated health system, and paradoxes.Conclusion:Emergency Medical Service personnel make ethical decisions every day. It is important that prehospital personnel know how to manage those decisions properly so that clients’ moral rights are respected. Hence, by identifying the dimensions and obstacles of ethical decision-making in Emergency Medical Service personnel, it is possible to enhance the moral judgment and ethical accountability of the personnel and develop the strategies necessary for ethical decision-making in them. (shrink)

Human beings as imperfect rational beings face continuous challenges, one of them has to do with the lack of recognizing and respecting our inner dignity in present times. In this collective paper, we address the overall theme—Philosophy of Education in a New Key from various perspectives related to dignity. We address in particular some of the constraints and possibilities with regard to this issue in various settings such as education and society at large. Klas Roth discusses, for example, that it (...) is not uncommon that the value of human beings has to do with their price in, inter alia, their social, cultural, political and economic settings throughout the world. He argues that such a focus does not necessarily draw attention to the inner dignity of human beings, but that human beings ought to do so in education and society at large. Lia Mollvik discusses views of inner and outer dignity, and argues that there needs to be a balance in between them, and that the balance ought to be acknowledged in education. Rama Alshoufani discusses the classification of human beings in terms of various diagnoses related to the asserted dysfunction of the brain, and she argues that such classification does paradoxically not necessarily respect people with such diagnoses as ends in themselves. On the contrary, she argues that their inner dignity is not respected, but that it should be. Other such failures are due to the lack of inner dignity when it comes to Children’s rights as discussed by Rebecca Adami, and to the lack of recognition of human beings’ vulnerability as discussed by Katy Dineen. Fariba Majlesi criticizes a too strong emphasis on substantive notions of humanist education, which seem to hinder new ways of thinking; she argues that it is necessary to acknowledge the latter in and through education in order to preserve the dignity of human beings. Dignity, it is argued throughout the paper, has an inner moral worth, and is beyond price. (shrink)

ObjectiveTo evaluate the knowledge and performance of surgical residents regarding the person from whom informed consent should be taken for surgery and from whom the consent is taken in practice.Materials and methodsThis study was done in 2013. The population of this study was all residents of urology, surgery, orthopaedic surgery and gynaecology of Tehran and Iran University of Medical Sciences. The study tool was a self-administered questionnaire, containing questions on their knowledge and performance regarding informed consent acquisition from patients with (...) different conditions in terms of age, sex, marital status and their capacity to make treatment decisions.ResultsA total of 213 residents participated in the study. The mean score of the participants’ knowledge was 72.95 out of 100. There was no significant correlation between the residents’ knowledge and performance. Regarding a competent married male patient, 98.2% of the residents knew that the person’s consent was enough, but only 63.6% obtained informed consent only from the patient. These percentages were 69% and 19.7% for a competent married female patient, respectively. For a competent single male patient, 90.9% of the residents were aware that the patient’s consent was enough, while only 40% of the residents obtained informed consent only from the patient. These percentages were 65.3% and 16% for a competent single female patient, respectively.ConclusionDespite the residents’ average knowledge of patient autonomy, this right is not observed for female patients, and their treatment is subject to consent acquisition from other family members. (shrink)

The metaparadigm concept of person as a core emphasis for nursing theorizing has attracted considerable attention in western literature, but has received less attention in the context of eastern philosophical contexts. In this philosophical inquiry, we sought to clarify the concept of what it is to be a human being according to ideas deriving from Islamic tradition, drawing on concept analysis as general approach to advance an understanding of how nursing within an Islamic context might operationalize metaparadigm conceptualization. Specifically, we (...) considered person as human being on the basis of its definition, attributes/characteristics and boundaries to explore the anatomy of the concept in this context. Our analysis revealed that Islamic thought is relevant to two distinct understandings of the holistic concept of human being. Reciprocal interaction worldview organizes the dimensions of being human (cognitive, emotion, social and spiritual) into a whole. Simultaneous action worldview emphasizes that the human is a coherent and unified creature in harmony with the universe. In Islamic thought, these two worldviews are integrated and operate concurrently. Nurse–patient interactions arising from an integrated perspective that aligns both of these worldviews will allow for informed applications of knowledge to practice and enhanced patient care. (shrink)

Today, nurses are required to have knowledge and awareness concerning professional values as standards to provide safe and high-quality ethical care. Nurses’ perspective on professional values affects decision-making and patient care. Therefore, the present study aimed to investigate the importance of professional values from clinical nurses’ perspective. The present cross-sectional study was conducted in 2016 in four educational hospitals of Kerman University of Medical Sciences, Iran. Data were collected via the Persian version of Nursing Professional Values Scale-Revised by Weis and (...) Schank. Sampling was conducted through the use of stratified random sampling method and 250 clinical nurses participated in the study. Results indicated that the total score of the nurses’ professional values was high.. From nurses’ perspective items such as “Maintaining confidentiality of patients” and “Safeguarding patients’ right to privacy” had more importance; however, “Recognizing role of professional nursing associations in shaping healthcare policy” and “Participating in nursing research and/or implementing research findings appropriate to practice had less importance. A statistically significant relationship was observed between NPVS-R mean scores and nurses’ age, work experience as well as participation in professional ethical training. Although the total score related to the clinical nurses’ perspective on professional values was high, the importance of certain values was at a lower level. Owing to the emerging ethical challenges, it is indispensable to design educational programs in order to improve nurses’ awareness and understanding of the comprehensive importance of professional values. Furthermore, it is recommended that mixed methods studies should be conducted in order to design an instrument to evaluate the use of values in nursing practice. (shrink)

Due to the potent role of teachers’ emotion regulation in effective teaching, it seems essential to see how emotion regulation can contribute to other relevant teaching constructs. In this regard, the present study is intended to probe into the causal relationship among teacher emotion regulation, self-efficacy beliefs, engagement, and anger. In so doing, the Language Teacher Emotion Regulation Inventory, The Teacher Sense of Efficacy Scale, The Engaged Teacher Scale, and The Teacher Anger Scale were administered to 581 English as a (...) Foreign Language teachers in Iran. To gauge the causal relationships among the variables, confirmatory factor analysis and structural equation modeling using LISREL 8.80 were conducted. The results indicated that language teacher emotion regulation could positively and significantly predict teachers’ self-efficacy beliefs and engagement at work. Moreover, the influence of language teacher emotion regulation on the teacher’s anger is significantly negative. That is, the stronger emotion regulation is implemented the better teachers can manage their anger. The implications of this study may uncover new prospects for effective teaching, especially during the COVID-19 pandemic. (shrink)

BackgroundOrganizational commitment is one of the most important elements in improving the quality of services provided by individuals and is more important in the nursing profession. Moral intelli...

In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster. According (...) to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers. (shrink)

Introduction Errors are inevitable in medical practice and this issue has attracted the attention of healthcare systems worldwide. Therefore, it is of utmost importance to pay attention in educational systems. The present study aimed to investigate the frequency and cause of nursing students’ errors. Methods This descriptive study conducted based on a cross-sectional design. The researcher provided nursing students with a questionnaire. The participants were selected through a purposive sampling method. Eventually, the collected data were analyzed by SPSS17. Results The (...) mean value of errors in students was 32.83 ± 28.5 and the prevalence rate of the errors ranged from 0 to 175. In total, 2922 errors were reported by the students, the most frequent of which were wearing the same pair of gloves for the care of more than one patient, negligence to wash the hands and clean the thermometer before utilization. Moreover, errors in oxygen therapy and medication obtained the lowest frequency. Furthermore, most of the students’ errors were due to not having enough knowledge about medicines, lack of appropriate equipment, and poor clinical skills. Discussion and conclusion: The most frequent nursing students’ errors are related to hand hygiene and personal protection. In addition, the lack of enough skills and appropriate equipment are prevalent causes of nursing students’ errors. Authorities in this field should attend to these errors in nursing education, clinical practice, and nursing studies in order to promote this profession in all of these three dimensions. (shrink)

The purpose of this study was to examine how ethical approval and competing interests are addressed by medical journals in Iran. In a cross-sectional study, 151 journals accredited by the Publications Commission of the Ministry of Health and Medical Education were reviewed. Data collection was carried out by assessing journal guidelines and conducting structured phone interviews with journal managers, focusing on how ethical considerations and conflicts of interest (COI) are addressed. Overall, 135 of the 151 journals (89.4 percent) examined some (...) aspect of ethical considerations of submitted articles. Authors were required to disclose their financial sponsors by 98 journals (64.9 percent), while COI disclosure was required by 67 journals (44.4 percent). We conclude that the rate of addressing ethical considerations is not far from ideal, but the requirement for COI disclosure needs more attention. (shrink)

IntroductionUrinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence.MethodsThis qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously (...) and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman.ResultsThe results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: “problem incompatibility with the disease,” “mental impasse,” “facing social restrictions,” and “concealment and social escapism.”ConclusionThe findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life. (shrink)

Developing World Bioethics, Volume 22, Issue 3, Page 126-139, September 2022.