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One of the main issues in nursing education that teachers and students frequently encounter is uncivil behaviors. This type of behavior is destructive for the teaching and learning environment. As teachers play an important role in nursing students' educat ion and are ultimately their role models, the identification of these behaviors in nursing teachers appears to be essential. This study was conducted to determine nursing students' perceptions of their teachers' uncivil behaviors. The present study was conducted using a qualitative approach and content analysis. A total of 13 nursing students were selected through purposive sampling, and deep and semi structured interviews were conducted with them. Content analysis was performed using an inductive approa ch. Three main categories were obtained through data analysis; disruptive behaviors affecting communication climate (subthemes: humiliation, the lack of supportiveness, and distrust), disruptive behaviors affecting ethical climate (subthemes: self centeredness, coercion and aggression, and harassment), and disruptive behaviors affecting learning climate (subthemes: poor teaching skills, poor time management, and indiscipline). Given that human dignity takes precedence over education, any actio n causing humi liation and embarrassment can have inverse effects on the students and may harm them. These behaviors taint the educational role. Since students select their teachers as their role models, the impact of teachers' uncivil behaviors on stu dents cannot be neg lected. Neglecting these behaviors might lead to their persistence in the clinical setting and irreparable damage to patients, who are the ultimate recipients of care. [ABSTRACT FROM AUTHOR]

As future providers of health services, nursing students should learn about ethical concepts over the course of their education. These concepts are currently taught in nursing schools, yet the degree of moral sensitivity in nursing students before entering clinical settings is a topic of controversy. This was a cross-sectional study on the nursing students studying for a bachelor's degree in Qazvin University of Medical Sciences selected through census sampling (n = 205). Data were collected by Lutzen's Moral Sensitivity Questionnaire and analyzed through statistical tests using SPSS 16. The level of significance was P < 0.05. In order to conduct the study, permission was obtained from the Ethics Committee of Shahid Beheshti University of Medical Sciences. The mean of moral sensitivity was found to be 66.1 + 8.1, which is a moderate level. Of all the dimensions of moral sensitivity, "expressing benevolence" had the highest (16.9 ± 4.04) and "structuring moral sense" had the lowest (5.2 ± 1.45) mean scores. Among demographic variables, age was found to have a significant positive correlation with the score of moral sensitivity (r = 0.2, P = 0.01). Nursing students are relatively familiar with the ethical concepts of patient care, but that does not seem to be sufficed, as moral sensitivity is an extremely crucial factor in care. It is therefore recommended that the necessary training be provided to develop moral sensitivity in nursing students both in educational and practical environments. [ABSTRACT FROM AUTHOR]

The human dignity of patients with cardiovascular disease (CVD) is an important issue, because of patients' dependence upon caregivers, and because it impacts all aspects of their quality of life (QOL). Therefore, understanding and improving the status of dignity among these patients is of great importance. This study aimed to determine the status of dignity in patients with CVD admitted to cardiac intensive care units (CICUs) in Iran. This cross-sectional descriptive study was performed in 2015 on 200 patients admitted to the CICUs of hospitals affiliated to Kerman University of Medical Sciences, Iran. The participants were selected using random sampling method. Patients' understanding of dignity was assessed through the reliable and valid Persian version of the Patient Dignity Inventory (PDI). Patients who were able to read and write or speak Persian and were conscious were included in the study. Data were analyzed using descriptive statistics tests, independent t-test, and one-way ANOVA in SPSS software. The mean age of the study participants was 59.0 ± 17.0. The mean score of human dignity was 3.60 ± 1.39. The mean scores of the factors of loss of independence, emotional distress and uncertainty, changes in ability and mental image, and the loss of human dignity were 3.94 ± 1.06, 3.63 ± 1.37, 3.57 ± 1.20, and 3.30 ± 2.08, respectively. A significant statistical correlation was observed between human dignity and the demographic characteristics of gender and frequency of hospitalizations in a CICU and a significant difference between those who lived alone and those who lived with family was observed (P < 0.05). Patients hospitalized in CICUs experience numerous problems associated with human dignity in each of its four dimensions. It is recommended that a study be conducted to investigate the relationship between the human dignity of patients with CVD and their QOL, anxiety, and depression. [ABSTRACT FROM AUTHOR]

One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. [ABSTRACT FROM AUTHOR]

Maintaining dignity and respect is among patients' most fundamental rights. The importance of patient dignity, the status quo, patients' needs, and a shortage of survey studies in this area were the underlying incentives for conducting this study. This was a cross-sectional descriptive study in which data were collected through Patient Dignity Inventory (PDI). The questionnaire was completed by 280 inpatients in 2012 to determine their perspectives on their personal state of human dignity. In this study, the mean score of patients' dignity was 1.89 out of 5 (SD = 0.81). Results indicated a significant relationship between type of hospital and the distress caused by disease symptoms, peace of mind, and social support (P < 0.05). There were also relationship between type of ward and dependency (P < 0.05), type of disease and dependency (P < 0.05), gender and social support (P < 0.05), household size and peace of mind (P < 0.05). The person's satisfaction with household income showed significant relationship with symptom distress, dependency and existential distress (P < 0.05). Results showed a significant inverse correlation between age and patient dignity (P = 0.005, r = - 0.166). However, the relationship between employment status, health insurance, education level and the above factors were insignificant. Studies indicate that there is a relationship between patients' dignity and mental distress, and therefore policy makers and health services officials should establish and implement plans to maintain and enhance patients' dignity in hospitals. Educating the health team, particularly the nurses can be very effective in maintaining patients' dignity and respect. [ABSTRACT FROM AUTHOR]

Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of Iranian nurses on breaking bad news to patients and their families. In this research, a qualitative approach was adopted. Indepth and semi-structured interviews were conducted with 19 nurses who had at least one year work experience in the ward, and content analysis was performed to analyze the data. Five major categories emerged from data analysis, including effective communication with patients and their families, preparing the ground for delivering bad news, minimizing the negativity associated with the disease, passing the duty to physicians, and helping patients and their families make logical treatment decisions. The results of this study show that according to the participants, it is the physicians' duty to give bad news, but nurses play an important role in delivering bad news to patients and their companions and should therefore be trained in clinical and communicative skills to be able to give bad news in an appropriate and effective manner. [ABSTRACT FROM AUTHOR]

Considering the advances in today's world, the increased complexity of diseases and longer life expectancy, nurses experience a great deal of moral distress. One factor that is likely to contribute to the development of moral distress is the ethical climate prevailing in hospitals. This study aimed to assess the relationship between nurses' perceptions of moral distress and the ethical climate in Shahid Sadoughi University of Medical Sciences in Yazd. This correlational descriptive study used the Moral Distress Scale (MDS) and Hospital Ethical Climate Survey (HECS) to examine 370 nurses working in a number of hospitals including Shahid Sadooghi, Shahid Rahnemun, Shahid Afshar and Savaneh Sukhteghi. Data analysis was performed using SPSS18 and descriptive and analytical statistics. Findings showed that the intensity of perceived moral distress among nurses was 3.41±1.28, and their perceptions of the ethical climate were 3.22±0.78. There was a significant negative relationship between nurses' perception of moral distress and the ethical climate (P=0.00). The findings of this study suggest that development of plans to improve the ethical climate prevailing in hospitals might decreases nurses' perceived moral distress. [ABSTRACT FROM AUTHOR]

Moral distress and professional stress are common problems that can have adverse effects on nurses, patients, and the healthcare system as a whole. Thus, this cross-sectional study aims to examine the relationship between moral distress, professional stress, and intent to stay in the nursing profession. Two hundred and twenty full-time nurses employed at teaching hospitals in the eastern regions of Iran were studied. A 52-item questionnaire based on Corley's Moral Distress Scale, Wolfgang's Health Professions Stress Inventory and Nedd Questionnaire on Intent to Stay in the Profession was used in the study. Additionally, demographic details of the study population were collected. No significant correlation was observed between the intensity and frequency of moral distress, professional stress, and intent to stay in the profession among nurses (P > 0.05). There was a significant correlation between moral distress, professional stress, and age, number of years in service and work setting (P < 0.05). Given the important effect of moral distress and professional stress on nurses, in addition to the educational programs for familiarization of nurses with these concepts, it is recommended that strategies be formulated by the healthcare system to increase nurses' ability to combat their adverse effects. [ABSTRACT FROM AUTHOR]

The high turnover of nurses has become a universal issue. The manner in which nurses view their organization's ethical climate has direct bearing on their job satisfaction. There is little empirical evidence confirming a relationship between different sorts of ethical climate within organizations and job satisfaction in Iran. The aim of this study was to determine the correlation between nurses' perception of ethical climate and job satisfaction in the Teaching Hospital of Kerman University of Medical Sciences. A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in 4 hospitals affiliated with the Kerman University of Medical Sciences. The instruments used in this study included a demo-graphic questionnaire, Ethical Climate Questionnaire (ECQ), and Job Satisfaction Scale (JS). Data analysis was carried out using Pearson's correlation, one-way ANOVA, T-test and descriptive statistic through Statistical Package for Social Science (SPSS), version 16. Across the five dimensions of ECQ the highest mean score pertained to professionalism (mean = 13.45±3.68), followed by rules climate (mean = 13.41±4.01), caring climate (mean = 12.92±3.95), independence climate (mean = 11.35±3.88), and instrumental climate (mean = 8.93±2.95). The results showed a positive correlation among ethical climate type of: professionalism (p=0.001), rules (p=0.045), caring (p=0.000), independence (p=0.000) with job satisfaction, and no correlation was found between instrumental climate and job satisfaction. The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate and job satisfaction. Therefore managers of hospitals can promote nurses' job satisfaction by providing ethics training programs that establish a working team and a culture that strengthens team spirit among nurses. [ABSTRACT FROM AUTHOR]

Teaching ethics to nurses leads to their involvement in providing high quality care, enable them to duly encounter ethical issues. One of the key elements of educational systems is nursing instructors. Even though lots of studies show the role of instructors in students' learning, their role in promotion of professional ethics has been attended to less. The objective of this study is surveying the experience of nursing students with respect to the role of instructors in promotion of professional ethics. This qualitative study enrolled 15 undergraduate nursing students from three nursing schools in Teheran whom depth interview was performed. The interview was semistructured with open ended questions. The analysis was accomplished by use of qualitative content-analysis method. Data analysis demonstrated 2 main themes and 7 subcategories in regard to the role of instructors in promotion of professional ethics in nursing students including: 1) the effective professional role model 2) facilitating creative learning. The effective professional role model encompasses individual characteristics and beliefs, clinical skills and professional commitment of role model. Creative learning facilitates by encouraging critical thinking and decision-making, Providing supportive learning conditions, providing proper space for sharing knowledge followed by evaluation and creative feedback. The findings of this study provides a background for strengthening the role of instructors in promotion of professional ethics with more emphasis on research which increase capability of instructors at nursing education centers [ABSTRACT FROM AUTHOR]