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October 2017 -
Volume 15, Issue 8
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View
this issue in pdf formnat - the issue
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Part
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| ........................................................ |
| From
the Editor |
|
Editorial
A. Abyad (Chief Editor) |
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Original Contribution/Clinical Investigation
Immunity
level to diphtheria in beta thalassemia patients
DOI: 10.5742/MEWFM.2017.93048
[pdf
version]
Abdolreza Sotoodeh Jahromi, Karamatollah Rahmanian,
Abdolali Sapidkar, Hassan Zabetian, Alireza
Yusefi, Farshid Kafilzadeh, Mohammad Kargar,
Marzieh Jamalidoust,
Abdolhossein Madani
Genetic
Variants of Toll Like Receptor-4 in Patients
with Premature Coronary Artery Disease, South
of Iran
DOI: 10.5742/MEWFM.2017.93049
[pdf
version]
Saeideh Erfanian, Mohammad Shojaei, Fatemeh
Mehdizadeh, Abdolreza Sotoodeh Jahromi, Abdolhossein
Madani, Mohammad Hojjat-Farsangi
Comparison
of postoperative bleeding in patients undergoing
coronary artery bypass surgery in two groups
taking aspirin and aspirin plus CLS clopidogrel
DOI: 10.5742/MEWFM.2017.93050
[pdf
version]
Ali Pooria, Hassan Teimouri, Mostafa Cheraghi,
Babak Baharvand Ahmadi, Mehrdad Namdari, Reza
Alipoor
Comparison
of lower uterine segment thickness among nulliparous
pregnant women without uterine scar and pregnant
women with previous cesarean section: ultrasound
study
DOI: 10.5742/MEWFM.2017.93051
[pdf version]
Taravat Fakheri, Irandokht Alimohammadi, Nazanin
Farshchian, Maryam Hematti,
Anisodowleh Nankali, Farahnaz Keshavarzi, Soheil
Saeidiborojeni
Effect
of Environmental and Behavioral Interventions
on Physiological and Behavioral Responses of
Premature Neonates Candidates Admitted for Intravenous
Catheter Insertion in Neonatal Intensive Care
Units
DOI: 10.5742/MEWFM.2017.93052
[pdf
version]
Shohreh Taheri, Maryam Marofi, Anahita Masoumpoor,
Malihe Nasiri
Effect
of 8 weeks Rhythmic aerobic exercise on serum
Resistin and body mass index of overweight and
obese women
DOI: 10.5742/MEWFM.2017.93053
[pdf
version]
Khadijeh Molaei, Ahmad Shahdadi, Reza Delavar
Study
of changes in leptin and body mass composition
with overweight and obesity following 8 weeks
of Aerobic exercise
DOI: 10.5742/MEWFM.2017.93054
[pdf
version]
Khadijeh Molaei, Abbas Salehikia
A reassessment
of factor structure of the Short Form Health
Survey (SF-36): A comparative approach
DOI: 10.5742/MEWFM.2017.93088
[pdf version]
Vida Alizad, Manouchehr Azkhosh, Ali Asgari,
Karyn Gonano
Population and Community Studies
Evaluation
of seizures in pregnant women in Kerman - Iran
DOI: 10.5742/MEWFM.2017.93056
[pdf
version]
Hossein Ali Ebrahimi, Elahe Arabpour, Kaveh
Shafeie, Narges Khanjani
Studying
the relation of quality work life with socio-economic
status and general health among the employees
of Tehran University of Medical Sciences (TUMS)
in 2015
DOI: 10.5742/MEWFM.2017.93057
[pdf version]
Hossein Dargahi, Samereh Yaghobian, Seyedeh
Hoda Mousavi, Majid Shekari Darbandi, Soheil
Mokhtari, Mohsen Mohammadi, Seyede Fateme Hosseini
Factors
that encourage early marriage and motherhood
from the perspective of Iranian adolescent mothers:
a qualitative study
DOI: 10.5742/MEWFM.2017.93058
[pdf
version]
Maasoumeh Mangeli, Masoud Rayyani, Mohammad
Ali Cheraghi, Batool Tirgari
The
Effectiveness of Cognitive-Existential Group
Therapy on Reducing Existential Anxiety in the
Elderly
DOI: 10.5742/MEWFM.2017.93059
[pdf
version]
Somayeh Barekati, Bahman Bahmani, Maede Naghiyaaee,
Mahgam Afrasiabi, Roya Marsa
Post-mortem
Distribution of Morphine in Cadavers Body Fluids
DOI: 10.5742/MEWFM.2017.93060
[pdf
version]
Ramin Elmi, Mitra Akbari, Jaber Gharehdaghi,
Ardeshir Sheikhazadi, Saeed Padidar, Shirin
Elmi
Application
of Social Networks to Support Students' Language
Learning Skills in Blended Approach
DOI: 10.5742/MEWFM.2017.93061
[pdf
version]
Fatemeh Jafarkhani, Zahra Jamebozorg, Maryam
Brahman
The
Relationship between Chronic Pain and Obesity:
The Mediating Role of Anxiety
DOI: 10.5742/MEWFM.2017.93062
[pdf
version]
Leila Shateri, Hamid Shamsipour, Zahra Hoshyari,
Elnaz Mousavi, Leila Saleck, Faezeh Ojagh
Implementation
status of moral codes among nurses
DOI: 10.5742/MEWFM.2017.93063
[pdf
version]
Maryam Ban, Hojat Zareh Houshyari Khah, Marzieh
Ghassemi, Sajedeh Mousaviasl, Mohammad Khavasi,
Narjes Asadi, Mohammad Amin Harizavi, Saeedeh
Elhami
The comparison
of quality of life, self-efficacy and resiliency
in infertile and fertile women
DOI: 10.5742/MEWFM.2017.93064
[pdf version]
Mahya Shamsi Sani, Mohammadreza Tamannaeifar
Brain MRI Findings in Children (2-4 years old)
with Autism
DOI: 10.5742/MEWFM.2017.93055
[pdf
version]
Mohammad Hasan Mohammadi, Farah Ashraf Zadeh,
Javad Akhondian, Maryam Hojjati,
Mehdi Momennezhad
Reviews
TECTA gene function and hearing: a review
DOI: 10.5742/MEWFM.2017.93065
[pdf version]
Morteza Hashemzadeh-Chaleshtori, Fahimeh Moradi,
Raziyeh Karami-Eshkaftaki,
Samira Asgharzade
Mandibular
canal & its incisive branch: A CBCT study
DOI: 10.5742/MEWFM.2017.93066
[pdf
version]
Sina Haghanifar, Ehsan Moudi, Ali Bijani, Somayyehsadat
Lavasani, Ahmadreza Lameh
The
role of Astronomy education in daily life
DOI: 10.5742/MEWFM.2017.93067
[pdf
version]
Ashrafoalsadat Shekarbaghani
Human brain
functional connectivity in resting-state fMRI
data across the range of weeks
DOI: 10.5742/MEWFM.2017.93068
[pdf version]
Nasrin Borumandnia, Hamid Alavi Majd, Farid
Zayeri, Ahmad Reza Baghestani,
Mohammad Tabatabaee, Fariborz Faegh
International Health Affairs
A
brief review of the components of national strategies
for suicide prevention suggested by the World
Health Organization
DOI: 10.5742/MEWFM.2017.93069
[pdf
version]
Mohsen Rezaeian
Education and Training
Evaluating
the Process of Recruiting Faculty Members in
Universities and Higher Education and Research
Institutes Affiliated to Ministry of Health
and Medical Education in Iran
DOI: 10.5742/MEWFM.2017.93070
[pdf
version]
Abdolreza Gilavand
Comparison
of spiritual well-being and social health among
the students attending group and individual
religious rites
DOI: 10.5742/MEWFM.2017.93071
[pdf
version]
Masoud Nikfarjam, Saeid Heidari-Soureshjani,
Abolfazl Khoshdel, Parisa Asmand, Forouzan Ganji
A
Comparative Study of Motivation for Major Choices
between Nursing and Midwifery Students at Bushehr
University of Medical Sciences
DOI: 10.5742/MEWFM.2017.93072
[pdf
version]
Farzaneh Norouzi, Shahnaz Pouladi, Razieh Bagherzadeh
Clinical Research and Methods
Barriers
to the management of ventilator-associated pneumonia:
A qualitative study of critical care nurses'
experiences
DOI: 10.5742/MEWFM.2017.93073
[pdf version]
Fereshteh Rashnou, Tahereh Toulabi, Shirin Hasanvand,
Mohammad Javad Tarrahi
Clinical
Risk Index for Neonates II score for the prediction
of mortality risk in premature neonates with
very low birth weight
DOI: 10.5742/MEWFM.2017.93074
[pdf
version]
Azadeh Jafrasteh, Parastoo Baharvand, Fatemeh
Karami
Effect
of pre-colporrhaphic physiotherapy on the outcomes
of women with pelvic organ prolapse
DOI: 10.5742/MEWFM.2017.93075
[pdf
version]
Mahnaz Yavangi, Tahereh Mahmoodvand, Saeid Heidari-Soureshjani
The
effect of Hypertonic Dextrose injection on the
control of pains associated with knee osteoarthritis
DOI: 10.5742/MEWFM.2017.93076
[pdf
version]
Mahshid Ghasemi, Faranak Behnaz, Mohammadreza
Minator Sajjadi, Reza Zandi,
Masoud Hashemi
Evaluation
of Psycho-Social Factors Influential on Emotional
Divorce among Attendants to Social Emergency
Services
DOI: 10.5742/MEWFM.2017.93077
[pdf
version]
Farangis Soltanian
Models and Systems of Health Care
Organizational
Justice and Trust Perceptions: A Comparison
of Nurses in public and private hospitals
DOI: 10.5742/MEWFM.2017.93078
[pdf
version]
Mahboobeh Rajabi, Zahra Esmaeli Abdar, Leila
Agoush
Case series and Case reports
Evaluation
of Blood Levels of Leptin Hormone Before and
After the Treatment with Metformin
DOI: 10.5742/MEWFM.2017.93079
[pdf
version]
Elham Jafarpour
Etiology,
Epidemiologic Characteristics and Clinical Pattern
of Children with Febrile Convulsion Admitted
to Hospitals of Germi and Parsabad towns in
2016
DOI: 10.5742/MEWFM.2017.93080
[pdf
version]
Mehri SeyedJavadi, Roghayeh Naseri, Shohreh
Moshfeghi, Irandokht Allahyari, Vahid Izadi,
Raheleh Mohammadi,
Faculty development
The
comparison of the effect of two different teaching
methods of role-playing and video feedback on
learning Cardiopulmonary Resuscitation (CPR)
DOI: 10.5742/MEWFM.2017.93081
[pdf
version]
Yasamin Hacham Bachari, Leila Fahkarzadeh, Abdol
Ali Shariati
Office based family medicine
Effectiveness
of Group Counseling With Acceptance and Commitment
Therapy Approach on Couples' Marital Adjustment
DOI: 10.5742/MEWFM.2017.93082
[pdf
version]
Arash Ziapour, Fatmeh Mahmoodi, Fatemeh Dehghan,
Seyed Mehdi Hoseini Mehdi Abadi,
Edris Azami, Mohsen Rezaei
|
|
Chief
Editor -
Abdulrazak
Abyad
MD, MPH, MBA, AGSF, AFCHSE
.........................................................
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Office -
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Institute
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Email:
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| October 2017 -
Volume 15, Issue 8 |
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|
Implementation status
of moral codes among nurses
Maryam Ban (1)
Hojat Zareh Houshyari Khah (2)
Marzieh Ghassemi (1)
Sajedeh Mousaviasl (1)
Mohammad Khavasi (1)
Narjes Asadi (3)
Mohammad Amin Harizavi (1)
Saeedeh Elhami (1)
(1) Abadan School of Medical Sciences, Abadan,
Iran
(2) Abadan school of medical sciences, Abadan,
Iran and Guilan University of Medical Sciences,
Guilan, Iran
(3) Baghiatallah Hospital, Tehran, Iran
Correspondence:
Saeedeh
Elhami
Student Research Committee, Abadan School of
Medical Sciences,
Abadan, Iran
Email: S_elhami@yahoo.com
|
Abstract
Background and objective:
Nurses should have an appropriate level
of ethical development to perform their
daily care. Ethical codes should be understood
by nurses and used in each dimension of
nursing practice. Therefore, this study
aimed to investigate the implementation
status of nurses’ ethical codes.
Methods:
This descriptive-analytic study was carried
out on 202 nurses working in internal
and surgical wards using easy sampling
in educational hospitals of the Faculty
of Medical Sciences, Abadan. The implementation
status of ethical codes was investigated
using a researcher-made questionnaire
and the obtained data were analyzed using
SPSS ver. 16.
Results: There
was a statistically significant difference
between the level of ethical performance
of nurses with cases such as organizational
positions, work shift, academic education,
and ethics retraining courses and work
experience (p< 0.005). This difference
was not observed in relation to gender,
marital status, educational degree, history
of presenting complaints and job satisfaction
and the workplace (p>0.005).
Conclusion:
Results of this study showed that nurses
should firstly recognize the dimensions
and ethical issues in their profession
for the ethical performance of professional
nursing; therefore, it is recommended
to maximize the efficiency and quality
of health care by educating the medical
staff and raising their awareness of professional
ethics.
Key words:
Professional Ethics, Code of Ethics, Nurses
|
The health care system consists of a variety
of components, each of which plays its role
in some way. Among the components of this system,
nursing is one of the most important pillars,
so that the services provided by this component
directly affect health and disease related indicators
and related outcomes (1). Although observance
of professional ethics is necessary in all occupations,
this factor is more necessary in the nursing
profession because spiritual behavior along
with the responsibility of nurses with patients
plays an effective role in their health improvement
and recovery. Therefore, the nursing profession
is based on ethics (2-3). Nursing ethics refers
to the observance of professional ethics in
providing nursing cares (4) which leads to conscientiousness
towards the patient and the health organization
(2-3). Any problem in observing nursing ethics
can affect the most scientific and best nursing
care (5). Although nursing knowledge has been
significantly expanded and great emphasis has
been placed on nursing technical competencies
as well, the issue of ethical competence in
care or care ethics has been some times neglected
(6). With increasing attention to ethical issues
and challenges in care settings, health care
providers have been facing complex situations
due to ethical issues (7). The working environment
of nurses and their daily exposure to death
lead to ethical tension among them (8). In fact,
ethical tension occurs when a person knows what
is right but the work constraints hinder proper
work (9). According to existing studies, about
11% of and 36% of nurses face ethical challenges
and problems every day and every few days, respectively
(10-11). In the clinical environment, the ethical
action factor, which means thinking, practicing,
and accepting the responsibility of the performed
act, may be confused with the contradictory
values existing in it (12). There is also the
fact that it seems nursing ethical values are
not always clear (13), and the health services
providing working environment undergo constant
changing affecting the ethics factor (14). This
issue leads to more complexity of the subject.
The evident fact in recent years is that although
nurses are trained on ethical issues, one of
their major concerns is that they do not know
how to deal with different ethical situations
and problems (15). The results of studies in
the ethics field indicate weakness in nursing
ethical decision making (16). According to the
studies, the mean score of ethical reasoning
was reported to be 51.74 and 16.42 among nurses
in other countries and Iran, respectively (17).
Many investigations in different societies have
led to the recognition of different aspects
of ethical sensitivity (18). However, there
are limited studies on ethical sensitivity,
and this issue has not been adequately addressed
by the researchers as to the importance it has
in clinical practice. Kim et al. believe that
the outcomes of previous research on the subject
of ethical sensitivity are limited and of little
depth (19). Therefore, it seems that a comprehensive
view of this important issue can be valuable.
Given the inadequate studies on nursing ethics,
and since one of the important achievements
of observance of ethical codes is to facilitate
the implementation of clinical governance, which
includes cases such as taking steps to minimize
the risk to employees and patients, paying attention
to patients’ complaints and use of the
best evidence in clinical decision making (20),
this study aimed to investigate the implementation
status of ethical codes in nurses.
The present research is a descriptive-analytic
study which was conducted in 2016. The research
population consisted of nurses working in hospitals
affiliated to the Abadan Faculty of Medical
Sciences who were selected using convenience
sampling method. Inclusion criteria included
having a bachelor’s degree in nursing and
above, employment in one of the internal and
surgical wards, having at least six months of
work experience and informed consent for participation
in the study. After obtaining permission from
the Research Ethics Committee of Abadan Faculty
of Medical Sciences, and presenting an introduction
letter from Research Management to the head
of target hospitals, the questionnaires were
distributed by the researcher after repeated
referring to the wards at the right time, explaining
the research objectives, the method of filling
in the questionnaire and obtaining informed
consent. It should be noted that the samples
completed the questionnaire freely and without
direct supervision of the researcher, then the
completed questionnaires were collected by the
researcher. Two questionnaires were used to
collect information. A) Demographic information
questionnaire including age, sex, marital status,
educational level, organizational post, work
shift, ethics education, retraining courses
during recruitment, the history of a patient’s
legal complaint from a nurse, professional satisfaction,
work experience and the workplace.
B) To investigate the nurses’ performance
to the nursing ethics of Iran, a researcher-made
questionnaire, by Mohajl Moghadam et al. (5),
was used. In this questionnaire, according to
Iran’s Nursing Ethics, ethical guidelines
have been developed in five areas of nurses
and community, nurses and professional commitment,
nurses and cares provision, nurses and the therapeutic
team colleagues, nurse and education, and have
35 statements per area. Options, including Always,
Often, Occasionally, Rarely, Never, and not
experienced were considered in each statement.
Cronbach’s alpha coefficient for the reliability
and internal consistency of the questionnaire
was calculated 0.79 by Mohajl Moghadam et al
(5). Face and content validity of the questionnaires
were also evaluated in this study (5) by the
professors of medical ethics, social medicine,
Islamic education and nursing. SPSS ver. 16
is used in this research. For statistical analysis
of data, descriptive statistics were used for
obtaining basic information such as frequency,
frequency percentage, mean, minimum and maximum,
number of data and standard deviation. In inferential
statistics, the Kolmogorov Smirnov test was
used for normality of variables and independent
t-test, Mann-Whitney U test, Kruskal-Wallis
and Pearson correlation were also used. It should
be noted that all ethical considerations, including
obtaining the code of ethics (IR. ABADANUMS.REC.
1395. 133), obtaining informed consent from
the participants, confidentiality of information,
the possibility of withdrawal from the continued
participation of nurses if desired and the publication
of the results as a group study were considered.
69.3% of the participants in this study were
women and 52% were married. 93.6% had ethical
education and 86.6% had passed retraining courses
in this field. Moreover, 86.6% had no history
of making complaints, 67.3% of them are satisfied
with their professions, and the average age
is 32.396±7.335. Other information on
demographic variables is presented in Table
1.
Table 1: Descriptive statistics of demographic
variables
Comparison of the nurses’ performance
to the Iranian nursing ethics in each of the
demographic variables is presented in Table
2. Considering the normality or non-normality
of distribution of the sample, the appropriate
test has been used. There was no statistically
significant difference between the distribution
of performance to Iran’s nursing ethics
with gender, marital status, educational level,
complaints history and having job satisfaction
and workplace (p>0.005).
Click here for Table
2: The relationship between the socio-demographic
characteristics of nurse with their performance
to the nursing ethics of Iran
Table 3 shows the frequency percentage of distribution
of nurses’ performance to the nursing ethics
of Iran from their point
Click here for Table
3: Frequency percentage of distribution of nurses’
performance to the nursing ethics of Iran from
their point of view
|
DISCUSSION
AND
CONCLUSION
|
Based
on
the
findings
of
this
study,
the
variables
such
as
age,
sex,
level
and
type
of
education
have
no
effect
on
the
ethical
development
of
nurses
and
this
has
been
emphasized
by
Zirk
et
al.
(21)
and
Ghoorchiani
et
al.
(22);
however,
Dehghani
et
al.
(23)
and
Sokhanvar
et
al.
(24)
opposed
to
the
lack
of
correlation
between
these
variables.
Also,
there
was
no
significant
statistical
difference
between
married
and
non-married
nurses
in
terms
of
ethical
performance,
which
was
also
emphasized
in
other
studies
(23,
25).
The
organizational
position
of
nurses
has
had
a
significant
effect
on
their
ethical
performance
in
this
study,
so
that
head
nurses
who
often
have
a
better
a
history
of
work
and
a
sense
of
responsibility
towards
their
work,
had
best
performance,
though
it
is
not
confirmed
in
some
studies
(23
and
25).
Since
the
ethical
principles
in
human
encounters
with
patients
and
ethical
laws
are
the
same,
in
this
research,
the
service
area
has
not
had
an
effect
on
the
level
of
ethical
development
of
nurses,
which
is
consistent
with
the
study
by
conducted
by
Zirk
et
al.
(21).
There
was
a
significant
relationship
between
the
shift
work
of
nurses
and
the
quality
of
professional
ethics
performance
and
other
studies
achieved
similar
results
(23).
Morning
nurses
have
had
a
better
ethical
performance
than
working
shift
nurses.
The
work
environment
and
various
shifts
lead
to
nursing
burnout,
which
in
turn
leads
to
a
decrease
in
the
ethical
development
level
in
nurses.
Therefore,
it
seems
necessary
to
make
some
changes
in
nurses’
work
shifts
in
order
to
reduce
the
effect
of
fatigue
due
to
long
working
hours.
Variables
of
passing
the
retraining
course
and
university
education
were
significantly
related
with
the
level
of
ethical
development.
Individuals
with
both
trained
ethics
as
well
as
in-service
training
were
more
likely
to
use
ethical
resources
and
institute
ethical
performance.
In
an
environment
where
this
training
is
not
given
much
importance,
ethical
issues
are
overlooked
over
time
and
individuals
only
consider
themselves
to
be
bound
to
comply
with
institutional
policies
and
clinical
considerations.
Since
the
studies
of
other
researchers
(26,
21,
23,
5)
have
also
confirmed
the
effect
of
this
training,
it
is
necessary
to
pay
close
attention
to
educating
ethical
concepts,
especially
using
new
teaching
methods
in
nursing
education
programs
and
in-service
nursing
programs.
Hundert
points
out
that
there
is
a
small
probability
that
students
who
are
not
familiar
with
ethical
theories
before
being
in
a
clinical
position
can
identify
ethical
problems
(27).
Erdil
and
KorkMazz
agree
with
this
idea
(28).
Their
undesirable
performance
requires
a
change
in
the
content
of
the
curriculum
and
the
method
of
teaching
professional
ethics
in
the
nursing
baccalaureate
and
before
entering
the
clinical
field
(29).
Perhaps
one
of
the
challenges
facing
ethics
education
is
the
provision
of
qualified
instructors
in
the
teaching
of
ethical
issues
that
have
been
referred
to
in
research
(30),
because
learning
situational
ethics
has
a
considerable
impact
in
increasing
the
internal
motivation
of
individuals
for
ethical
performance.
Also,
it
was
shown
in
this
study
that
as
the
clinical
experience
of
nurses
increases,
the
ethical
development
of
nurses
decreases,
which
is
consistent
with
the
results
of
the
Ham
and
Dean
Mohammadi
(31-33).
However,
there
are
obstacles
to
implementing
these
codes,
which
should
be
addressed
first,
so
that
they
can
be
expected
to
be
implemented
well
in
the
clinical
field.
Implementation
of
these
codes
requires
the
coordination
and
cooperation
of
all
nursing
practitioners
and
authorities
such
as
the
Ministry
of
Health,
the
Nursing
Organization,
the
National
Medical
Sciences
Universities,
the
Nursing
Board
and
other
nursing
organizations,
which
must,
with
the
participation
of
each
other,
eliminate
structural
barriers
to
the
implementation
of
nursing
ethical
codes
so
that
it
will
be
turned
into
a
charter
applicable
to
hospitals.
One
of
the
limitations
of
this
research
is
the
fact
that
only
nurses’
views
have
been
investigated,
but
it
seems
that
a
more
comprehensive
view
on
solving
ethical
problems
in
a
clinical
setting
can
be
achieved
by
investigating
the
viewpoints
of
patients
and
nursing
students.
Data
were
also
collected
by
self-reporting
questionnaire,
in
which
participants
may
not
report
their
actual
data.
Acknowledgments
This
article
is
based
on
the
research
project,
approved
by
the
Faculty
of
Medical
Sciences
Abadan
with
the
code
95st-0089.Finally,
the
authors
appreciate
all
those
who
sincerely
have
collaborated
with
researchers
in
this
research,
particularly,
the
Vice
chancellor
for
Education
and
Research
of
Abadan
Faculty
of
Medical
Sciences
as
well
as
respected
authorities
in
selected
clinical
departments
in
this
study
for
their
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