Background Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress. Aim The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran. Study design This is a qualitative study with a content analysis approach. Participants and research context The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical (...) Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study. Ethical considerations This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed. Finding The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment). Discussion The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees. (shrink)

RésuméLe célèbre savant Abū ʿAlī b. Sīnā montrait une maîtrise exceptionnelle de tous les sujets qu'il traitait. Il est surtout connu pour ses nombreux travaux en logique, en philosophie et en médecine. Son influence est telle que même en Europe ses travaux ont été étudiés jusqu’à l’époque moderne. Il comprenait parfaitement la structure interne de la tradition gréco-arabe ; il l'a transmise et a aidé son développement et sa transformation. En témoignent ses nombreux travaux, mais aussi plusieurs exposés explicites quant (...) aux sciences et à leurs divisions. Cet article contient l’édition d'un tel exposé, dont deux copies seulement ont été identifiées à ce jour. On expliquera que le texte en question a probablement été écrit a Boukhara quand Avicenne était encore jeune. De plus, on montrera que le texte peut très bien dériver de son célèbre Al-ḥāṣil wal-maḥṣūl, une encyclopédie philosophique en vingt volumes, perdue depuis longtemps. L'absence de l'algèbre, et un fondement des sciences plus philosophique que religieux, sont des indices importants révélant le point de vue d'Avicenne sur les sciences rationnelles à une période précoce de son activité. (shrink)

BackgroundKeeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care.MethodsThis qualitative study was conducted from June to December 2018. Eighteen hospital (...) nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach.ResultsThe data analysis in this study resulted in four main categories and 11 subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences.ConclusionResults of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care. (shrink)