The attitude of Iranian nurses about do not resuscitate orders

Background: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses′ attitudes towards DNR orders. Aims: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. Materials and Methods: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. Results: Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. Conclusions: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education

Comparison of ethical reasoning in nursing students and nurses in

AbstractBackground and aimHigh ethical reasoning ability is one of the main requirements of nursing profession. This ethicalreasoning should be improved in nursing student during educational period. It should be furtherevolved during their independent clinical work as a nurse. Limited evidences are exist about thelevel of ethical reasoning of nursing students and nurses in Iran. Therefore, the purpose of this studywas to compare the ethical reasoning of nursing students and nurses in Tabriz University of MedicalSciences .Materials and MethodsThis descriptive-comparative study was performed on 115 nursing students and 269 nurses whowere selected by census. Nursing Dilemma Test NDT questionnaire was used for data collection. Itconsists of 6 scenarios. Ethical reasoning score (Nursing Principled Thinking NP) was the sum ofscores of fifth and sixth levels of Kohlberg ethical development questionnaire. The scores variedfrom 18 to 66. The data were analyzed using SPSS and by descriptive and inferential statistics.FindingsEthical reasoning score of nursing students (48.9±6.5; mean±SD) was significantly higher than thescore of nurses (46.6±6.7) (p=0.02). Also it was found that NP scores of nurses working in medicalwards are significantly higher than scores of other wards nurses (p=0.02). NP scores were declinedby increasing of clinical experience (p= 0.04).ConclusionLower NP scores of nurses comparing with NP scores of nursing students is an alarm for nursingmanagers and need a special attention.Keywords: Ethic, Ethical reasoning, Kohlberg, Nurses, Nursing students.*Corresponding author: Azad rahmani. PhD student in nursing education, Faculty of Nursing andMidwifery, Tabriz University of Medical Sciences, Tabriz, Iran.E-mail: [email protected] J Suominen T Leino-Kilpi H et al (2004). The development of moral judgment during nursing education inFinland. Nurse Education Today. 24 (7) 538-546.-Bandman E Bandman B (1990). Nursing Ethics through the Life Span. Washington: Appleton & Lange Company.-Borhani F Abbaszadeh A Kohan M et al (2010). [Comparison of the moral reasoning ability of nurses and nursingstudents at Kerman University of Medical Sciences in dealing with ethical problems]. Journal of Medical Ethics andHistory. 4 (1) 74-76. (Persian)-Burnard P Chapman C (2003). Professional and Ethical Issues in Nursing, Edinburgh, Bailliere Tindall co.-Chinn PL Kramer MK (1999). Theory and Nursing: Integrated Knowledge Development. St. Louis: Mosby.-Fry S (1989). Towards a theory of nursing ethics. ANS Advances in Nursing Sciences. 11 (4) 9-22.-Fry S (2002). Defining nurse's ethical practices in the 21st century. International Nursing Review. 49 (1) 1-3.-Ham K (2002). A comparison of ethical reasoning abilities of senior baccalaureate nursing students and experiencednurses (doctoral dissertation). The University of Memphis, United States of America.-Krawczyk R (1997). Teaching ethics: Effect on moral development. Nursing Ethics. 4 (1) 56-65.-Kelly B (1998). Preserving moral integrity: A follow up study with new graduate nurses. Journal of Advanced Nursing.28(5) 113-45.-Ketefian S (1981). Moral reasoning and moral behavior among selected groups of practicing nurses. Nursing Research.30(3) 171-76.-Kudzma EAC (1980). Moral reasoning of nurses in the work setting (dissertation) Massachusetts, Boston UniversitySchool of Nursing.-Mayberry M (1986). Ethical decision making: A response of hospital nurses. Nursing Administration Quarterly. 10 (3)75-81.-Murray N (1995). Moral reasoning in male and female nurses: A care perspective (dissertation). New Jersey: StateUniversity of New Jersey.-Negarandeh R Ghobadi S (2001). [Examination of knowledge and attitudes of nurses and midwives in Zanjan hospitalstoward ethical issues]. Journal of Zanjan University of Medical Sciences and Health, 36, 55-58. (Persian)-Newfield S Newfield N Sperry J et al (2002). Ethical decision making among family therapists and individual therapist.Family Process. 39 (2) 177-88.-Numminen O Leino Kilpt H (2007). Nursing student's ethical decision making: A review of literature. Nurse EducationToday. 27 (7) 796-801.-Pike AW (2010). I don’t know how ethical I am: An investigation into the practices nurses use to maintain their moralintegrity (dissertation) Massachusetts: Boston University.-Rodney P Varcoe C Storch J et al (2002) Navigating towards a moral horizon: A multisite qualitative study of ethicalpractice in nursing. Canadian Journal of Nursing. 34 (3) 75-102.-Schroter K (2002). Ethic in preoperative practice- principles and application. AORN J. 75 (4) 818-24.-Schroeter K (2002). Ethics in preoperative practice- patient advocacy. AORN J. 75 (5) 941-

Perceptions of Iranian cancer patients regarding respecting their dignity in hospital settings

Background: There are several factors that threaten the dignity of cancer patients in hospital settings. However, there is limited literature regarding the degree to which dignity of cancer patients is actually respected in daily clinical practice. The aims of this study were therefore to explore cancer patient perceptions of respecting their dignity and related variables in an Iranian cancer specific center. Materials and Methods: This descriptivecorrelational study was carried out among 250 cancer patients admitted to a cancer specific center in East Azerbaijan Province, Iran. These patients were selected using a convenience sampling method. The Patient Dignity Inventory (PDI) was used for data collection. Descriptive and inferential statistics were used for data analysis. Results: The patients' scores in 18 out of 25 items of PDI were 3 or greater which indicate the importance of considering these items in clinical settings. Also, the score of patients in three sub-scales of PDI including illnessrelated concerns, personal dignity, and social dignity were 74, 65 and 57, respectively (based on a total 100). The overall score of PDI was statistically associated with age, history of disease recurrence, education, employment and economic status of participants. Conclusions: According to the study findings the dignity of Iranian cancer patients is not completely respected in clinical settings which require special considerations. As nurses spend more time at patients' bedsides, they have an important role in maintaining and promoting dignified care