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| From
the Editor |
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Editorial
A. Abyad (Chief Editor) |
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Original contribution/Clinical Investigation
Diabetes Mellitus
- Knowledge, Management and Complications: Survey
report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah
Haider, Muhammad Masood Ahmad
Alanine aminotransferase
indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa
Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley
Pocock
Comparative Analysis of Antimicrobial Peptides
Gene Expression in Susceptible/Resistant Mice
Macrophages to Leishmania major Infection
Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani,
Amir Tavakoli Kareshk, Arash Asadi
Does
socio-economic status of the patients have effect
on clinical outcomes after coronary artery bypass
grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed
Kouhpyma
Comparison of the uterine
artery Doppler indices during pregnancy between
gestational diabetes and diabetes mellitus and
healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud
Jaafarnejhad,
Parisa Bahrami Kamangar
Survey single dose
Gentamicin in treatment of UTI in children with
range of 1 month to 13 years old in Jahrom during
2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab
Evaluation of control of
bleeding by electro cauterization of bleeding
points of amplatz sheath tract after percutaneous
nephrolithotomy (PCNL) in Jahrom Peymanieh hospital
during year 2015-2016
Ali Reza Yousefi , Reza Inaloo
Comparison of the three-finger
tracheal palpation technique with triple ID
formula to determine endotracheal tube depth
in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza
Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori
Effect of Sevoflurane
and Propofol on pulmonary arterial pressure
during cardiac catheterization in children with
congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza
Mohseni, Azim Zaraki
Population and Community Studies
Prevalence
and risk factors of obesity in children aged
2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud
Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal
Darwish
Study and comparison
of psychological disorders in normal students
and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad
Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani
Comparative
study of self-concept, physical self-concept,
and time perspective between the students with
multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad
Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani
Relationship
between Coping Styles and Religious Orientation
with Mental Health in the Students of the Nursing-Midwifery
Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid
Dastras, Shirzad Arianmehr
Tuberculosis in Abadan,
Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood
Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi,
Rahil Hojjati,
Parvin Gholizadeh
Family Stability and Conflict
of Spiritual Beliefs and Superstitions among
Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad
; Hassan Zareei Mahmoodabadi ; Hossein Tavangar
; Seyed Mojtaba Yassini Ardekani ; Ali Akbar
Vaezi
A comparative
study of the self-actualization in psychology
and Islam
Simin Afrasibi, Zakieh Fattahi
The effectiveness
of cognitive - behavioral therapy in reducing
the post-traumatic stress symptoms in male students
survivors of earthquake in the central district
of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh
Reviews
Effects and mechanisms
of medicinal plants on stress hormone (cortisol):
A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley
Pocock
Comparing Traditional
and medical treatments for constipation : A
Review Article
Mohammad Yaqub Rajput
A review of anti-measles
and anti-rubella antibodies in 15- 25 year old
women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab
Review of percutaneous
nephrolithotomy in children below 12 years old
in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo
Physical and
mental health in Islam
Bahador Mehraki, Abdollah Gholami
International Health Affairs
The Challenges of Implementation
of Professional Ethics Standards in Clinical Care
from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh
Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi
Cognitive Determinants
of Physical Activity Intention among Iranian Nurses:
An Application of Integrative Model of Behavior
Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki,
Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi
Effect of resilience-based
intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader
Aghakhani, Vahid Alinejad, Yaser Moradi
Education and Training
Calculation of Salaries
and Benefits of Faculty Members in the Ministry
of Health and Medical Education of Iran
Abdolreza Gilavand
The effect of education
on self-care behaviors of gastrointestinal side
effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram
Razie, Lila Nezam Abadi Farahani
Creating and
Validating the Faith Inventory for Students
at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein
Maktabi, Ehsan Moheb
Creating
and Validating the Adjustment Inventory for
the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi,
Ehsan Moheb
Evaluating
the Quality of Educational Services from the
Viewpoints of Radiology Students of Ahvaz Jundishapur
University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl
An Investigation
of Psychosocial aspect of Iranian Nursing Students'
Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari
Anbohi, Amir Almasi-Hashiani, Fariba Borhani
Clinical Research and Methods
Comparison of the
Antibacterial Effects of Chlorhexidine Mouth
washes with Jaftex Mouth wash on Some Common
Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi
Study of the effect
of plasma jet on Fusarium isolates with ability
to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi
Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss
The comparison of
anti-inflammatory effect in two methods of topical
dexamethasone injection and topical application
of ginger alcoholic extract after removing mandibular
wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran
Mirzaie, Ramin Seyedian, Narges Aria, Saman
Jokar
The effect of curcumin
on growth and adherence of major microorganisms
causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami,
Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab
|
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Chief
Editor -
Abdulrazak
Abyad
MD, MPH, MBA, AGSF, AFCHSE
.........................................................
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Office -
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| November 2017
- Volume 15, Issue 9 |
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|
The Challenges of Implementation
of Professional Ethics Standards in Clinical
Care from the viewpoint of Nursing Students
and Nurses
Saeedeh Elhami (1)
Kambiz Saberi (1)
Maryam Ban (2)
Sajedeh Mousaviasl (2)
Nasim Hatefi Moadab (3)
Marzieh Ghassemi (2)
(1) Student
research committee, Abadan school of medical
sciences, Abadan, Iran
(2) Abadan school of medical sciences, Abadan,
Iran
(3) Student research committee, Kermanshah university
of medical sciences, Kermanshah, Iran
Corresponding author:
Marzieh
Ghassemi
Abadan School of Medical Sciences,
Abadan, Iran
|
Abstract
Background and Objectives:
Observing the professional ethics in providing
nursing care is an inseparable part of
this profession as overstepping it influences
patient satisfaction and recovery, quality
of care, standards of nursing care and
promotion of occupation. Therefore, this
study was conducted aiming to determine
the barriers of observance of professional
ethics standards in clinical care from
the viewpoint of nursing students and
nurses.
Methods:
In this descriptive cross-sectional study,
viewpoints of 180 nurses and nursing students
of Abadan Faculty of Medical Sciences
regarding the barriers of observance of
professional ethics standards in clinical
environment were collected using demographic
information questionnaire and barriers
of observance of professional ethics criteria
in three domains including Managerial,
environmental and individual care were
collected and analyzed using SPSS software.
Results:
In both groups of nursing students and
nurses, the highest average of management,
environmental, and personal care services
area are related to the environmental
domain (p <0.005).
Conclusion:
Observance of the professional ethics
standards in nursing practice, especially
factors related to environmental dimension
which is one of the most important barriers
to professional ethics, can play an important
role in improving and restoring the health
of patients. Therefore, the management
system and health system managers can
play effective roles in observance of
the best criteria of professional ethics
through accurate planning and providing
human resources and improving the conditions
of service for medical personnel, including
improving the conditions of sectors and
satisfying their expectations in different
fields.
Key words:
Nursing Ethics, Clinical Care, Nursing
Students, Nurses
|
Adherence to professional ethics in the provision
of nursing care has always been emphasized.
But it seems that due to the changing viewpoints
on health and changes in the health system,
the ethical approach in healthcare professions
has changed from a request and recommendation
to an undeniable necessity (1). Nursing ethics
is the observance of professional ethics in
the provision of nursing care and also the inseparable
part of the nursing profession (2). Any nursing
ethical impairment can affect the most scientific
and best nursing care (3). Nurses are responsible
for caring for the patients as members of the
healthcare team. Members of this team spend
a lot of time with the clients and have a lot
of contact with them due to the nature of their
work. Therefore, care involves human and moral
relationships as the central concept of nursing.
Caring for the clients in all its dimensions
has an ethical nature, so that the subject of
ethics and nursing are thought to be two basic
elements, and historically, nursing is one of
the first professions that have addressed ethical
issues (4).
Many years have passed from establishment of
the codes of ethics for the nursing profession,
which shows the importance of ethics as one
of the main elements of this field (4). However,
the issue of ethics and ethical competence of
nurses still maintains its importance in various
educational, management and research dimensions.
In other words, the establishment of codes of
ethics alone cannot provide the necessary moral
excellence in the various dimensions of nursing
services. Many nurses consider ethical codes
of professional ethics in regard to ethical
issues, but do nothing about it.
In many cases, they do not have enough power
and support to show their reaction, and sometimes
they do not know what to do (6). The results
of studies in the field of ethics indicate weakness
in the ethical decision-making of nurses (7).
Zirak et al. in their research stated that only
about half of the students are at an acceptable
level of moral development (8). According to
the studies, the average score of moral reasoning
in nurses abroad was 51.74 and in Iran was 42/16
(9). Sokhanvar states that “The rate of
observance of ethical principles in clinical
decision making is not desirable, and nurses
have no ability to apply ethical knowledge in
the real environment.” Therefore, it is
necessary to monitor the rate of observance
of nursing ethics codes from the source of nursing
ethics education, that is, nursing schools,
in order to determine the extent to which students
have weaknesses so that nursing managers provide
more complete education in that dimension. The
importance of nursing schools in nursing ethics
education is as extent as Kelly in his research
concluded that colleges are the most influential
force in shaping ethics in nursing students
(10). The results of a study in 2007 on the
study of nursing ethics training in Turkey revealed
that inappropriateness of the trained teaching
methods of ethics and ethical content is one
of the most important barriers to the development
of nursing students’ abilities to deal
with ethical issues (11).
Borhani et al, reviewed the perception of nursing
students about the barriers to professional
ethics. In their results, they referred to eight
themes: lack of motivation and interest in nursing
profession, inadequate self-awareness, lack
of ethics teachers, lack of curriculum, using
inappropriate methods in ethics training, ethical
evaluation problems, weakness of interpersonal
communication, and constraints of clinical environment
(12).
Most nurses agree with each other and their
viewpoint is that they have some barriers to
ethical performance in their work environment
that disturbs their ability to provide competent
and quality care [13]. Lack of observance of
the professional ethics in the health system
by nurses affects patient satisfaction and recovery,
quality of care, nursing care standards and
promotion of care (14). Researchers have also
considered moral sensitivity to be influenced
by the education, culture, religion, education,
and life experiences of individuals (15). Naturally,
cultural contexts influence the crucial issues
of moral sensitivity. Accordingly, barriers
are no exception to this rule. Therefore, multiple
studies in different societies have led to the
recognition of different aspects of moral sensitivity
(16). However, due to the lack of studies on
the barriers of professional ethics in nursing
performance and since one of the important achievements
of codes of ethics is the facilitation of the
implementation of clinical governance, which
involves taking actions to minimize the risk
for employees and patients, paying attention
to patient complaints and using the best evidence
available in clinical decision making (17),
and also, identification of ethical barriers
and appropriate ethical decision making leads
to positive psychological responses such as
satisfaction, increased motivation and sense
of competence in nurses and patients (18). The
aim of this study was to determine the barriers
of observance of professional ethics standards
in clinical care from the viewpoint of nursing
students and nurses. It seems that a comprehensive
view of this important issue can be valuable.
The
present
study
is
a
cross-sectional
descriptive
study.
The
research
population
includes
full-time
nurses
occupied
in
Abadan
Faculty
of
Medical
Sciences
and
nursing
students
of
Abadan
Faculty
of
Medical
Sciences
who
have
inclusion
criteria
such
as
the
baccalaureate
degree
in
nursing,
employment
in
one
of
the
Internal
surgical
departments,
at
least
six
months
of
working
experience,
lack
of
responsibility
at
managerial
posts,
for
nurses
and
students
who
have
at
least
the
first
year
of
study.
Sampling
was
conducted
as
a
convenience
sample
from
a
total
of
180
students
and
nurses
participating
in
the
study.
After
obtaining
the
necessary
permission,
the
questionnaires
were
distributed
by
the
researcher
through
the
expression
of
the
goals
of
the
research
and
obtaining
informed
consent
and
frequent
attendance
at
the
appropriate
time.
It
should
be
noted
that
the
subjects
completed
the
questionnaire
freely
and
without
direct
supervision,
and
then
the
completed
questionnaires
were
collected
simultaneously
by
the
researcher.
The
questionnaire
consisted
of
two
sections:
demographic
information
and
barriers
to
observance
of
the
professional
ethics
criteria
in
three
areas
of
management,
environment
and
personal
care.
Demographic
data
including
age,
gender,
place
name
and
work
experience,
and
questionnaire
of
evaluation
of
the
barriers
of
the
observance
of
professional
ethics
criteria
including
33
questions
(14
questions
related
to
the
management
domain,
5
questions
related
to
environmental
domain,
14
questions
related
to
the
field
of
care).
Items
were
answered
with
a
five-point
scale.
Selection
of
the
options
of
“I
totally
agree”
or
“I
agree”
indicates
that
the
raised
item
is
a
barrier
to
the
observance
of
professional
ethics
standards.
Selection
of
“I
am
opposite”
option
indicates
that
the
raised
item
does
not
impede
the
observance
of
professional
ethics
standards
from
nurses’
viewpoint.
Selection
of
the
“I
have
no
idea”
option
indicates
that
the
lack
of
knowledge
of
the
effect
of
the
variable
(question)
in
question
is
inadequate
to
professional
ethics.
Cronbach’s
alpha
coefficient
for
the
reliability
and
internal
consistency
of
the
questionnaire
has
been
calculated
by
Dehghani
et
al.
(19)
(89).
The
demographic
variables
included:
age,
gender,
and
work
record,
and
the
results
are
presented
in
Table
1.
The
average
age
was
377/4
227/24.
Table
1:
Descriptive
statistics
of
demographic
variables
Comparison
of
the
barriers
of
the
observance
of
the
standards
of
professional
ethics
in
clinical
care
from
the
viewpoint
of
nursing
students
with
nurses
of
the
Faculty
of
Medical
Sciences
of
Abadan
are
presented
in
Table
2.
Due
to
the
normal
or
non-normal
distribution
of
the
sample,
the
appropriate
test
was
used.
Click
here
for
Table
2:
Comparison
of
the
barriers
of
observance
of
the
Professional
Ethics
Standards
in
General
and
on
the
basis
of
the
areas
(Managerial,
Environmental,
Individual
Behaviors)
in
Clinical
Care
from
the
viewpoint
of
nursing
students
of
the
Faculty
of
Medical
Sciences
of
Abadan
Comparison
of
the
viewpoints
of
nursing
students
and
nurses
on
three
areas
including
managerial,
environmental,
and
individual
with
regard
to
the
non-normal
distribution
of
managerial
and
environmental
domains
was
conducted
using
Kruskal-Wallis
test
and
the
results
are
presented
in
Table
3.
Click
here
for
Table
3:
Comparison
of
Managerial,
Environmental,
and
Individual
Behaviors
Barriers
Observing
Professional
Ethics
Standards
in
Clinical
Care
from
the
Viewpoint
of
nursing
students
and
nurses
of
the
Faculty
of
Medical
Sciences
of
Abadan
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