Ethical Challenges Associated with Caring for Sick Children Based on the Experiences of Nursing Students in Pediatric Wards: A Qualitative Content Analysis

Background: Nurses working in pediatric wards face many challenges when caring for sick children of different ages due to their physical and mental needs, especially if they have not been trained professionally. Nursing students and nurses are faced with ethical challenges in pediatric wards, hence their experiences can help identify the ethical problems in the healthcare setting. Since the explanation of ethical challenges depends on the context and factors such as values, beliefs, and hospital culture, this study aimed to explain the ethical challenges associated with caring for sick children based on the experiences of nursing students.Methods: This qualitative study used conventional content analysis to investigate the experiences of undergraduate and postgraduate nursing students and nurses working in pediatric wards selected by purposive sampling. Data collection tools were interviews and field notes. Data were categorized via MAXQDA10 and analyzed using conventional content analysis.Results: The participants included 3 pediatric nurses and 17 nursing students. The mean age of the participants was 24.9 ± 1.2. The findings of the study revealed the main theme i.e., ethical challenges associated with caring for sick children, was classified into two main categories including care challenges and organizational constraints. Care challenges were classified into the following subcategories: feeling worried when caring for sick children, compassionate care, emotional needs of children, inattention to family-centered care, and insufficient capability of the healthcare team. Organizational constraints were classified into facility constraints and hospital managers’ inattention to the environmental design of pediatric wards.Conclusion: The results of the study showed that the ethical challenges associated with caring for sick children were related to the healthcare team and organizational management. With the provision of appropriate training for nurses, as well as proper planning and implementation of policies to standardize the pediatric wards, nurses can provide nursing care to this age group with the least amount of moral distress

The association between diabetes and age at the onset of menopause: a systematic review protocol

Abstract Background Age at the onset of menopause is the most important determinant of women’s future health outcomes. While the basic mechanisms contributing to the onset of menopause are still not fully understood, age at menopause depends on a complex set of various factors. In this regard, the effects of diabetes (DM I/II) on the age at the onset of menopause have received little attention. Methods and analysis Electronic databases including PubMed/MEDLINE, Web of Science, Scopus, EMBASE, and Google Scholar will be searched for articles published during January 2000 to August 2018 and containing combinations of related MeSH terms, i.e., “age at menopause” and “diabetes.” Additional studies will also be extracted from the reference lists of the selected papers, gray literature, and key journals in the field. A set of inclusion criteria will be defined, and all eligible observational studies will be included. Two reviewers will independently conduct the study selection, data extraction, and quality assessment of the selected studies. All cases of disagreement will be resolved through consensus. The methodological assessment of the primary studies will be performed based on the Newcastle-Ottawa Scale (NOS). In case of the availability of sufficient data, fixed or random effects models will be used to combine all data. Heterogeneity will be assessed by I 2 statistic and chi-square test. Stata V.11.1 will be used for data analysis (CRD42017080789). Ethics and dissemination This systematic review will not raise any ethical issues. Journal publication and conference presentations will facilitate the wide dissemination of the findings to relevant clinicians and researchers