Moral distress and compassion fatigue in patient care: a correlational study on nurses

Moral distress is one of the ethical challenges that nurses face due to the nature of their career. Nurses' frequent confrontation with this phenomenon can have different outcomes such as frustration and boredom in providing patient care. This will lead directly to a decline in care quality and can hamper the accomplishment of health goals. Therefore, the present study examined the relationship between moral distress and compassion fatigue in nurses. This cross-sectional study was conducted on 260 nurses of intensive care units in Kerman who were selected through convenience sampling method. In this study, Corley’s moral distress scale and Figley’s Compassion Fatigue Scale were used for data collection. The collected data were analyzed using the SPSS software and descriptive and analytical statistics. The results of this study indicate that there is a significantly positive relationship between moral distress and compassion fatigue (P<0.05). From a total range of 0 to 5, the average score of moral distress was 3.5±0.8 in terms of intensity, and 3.9±0.55 in terms of frequency. The mean of compassion fatigue score was 3.5±0.68 from a range of 0 to 5. Moral distress and its association with compassion fatigue suggest that conditions contributing to moral distress can have an important role in the quality of care. It is clear that strategies should be adopted to prevent the occurrence of these conditions. Informing nurses about moral distress and its consequences as well as periodic consultations will play an important part in the identification and management of moral distress and its consequences

Development and demonstration of a pico-Watt calorimeter for optical absorption spectroscopy

An optical calorimeter for sensitive absorption measurements of non-radiative samples at 4 K was designed, built, and demonstrated. It consists of a cryostat cooled by a commercial pulse tube (PTC) refrigerator, a measurement chamber housing the sample and thermometers, and various fiber-coupled light sources. By employing measures to damp mechanical noise from the environment and active temperature stabilization of critical components of the instrument temperature noise as low as 6 nK/√Hz at 50 mHz was achieved under 15 mW of optical excitation. An optical absorption induced temperature increase of the sample as small as 2.5 nK could be resolved using paramagnetic temperature sensors with SQUID (Superconducting Quantum Interference Device) readout. This resulted in an absorption sensitivity of 0.3 ppm and 0.6 ppb for tunable 30 μW optical excitation from 330 nm to 1700 nm and for 15-mW laser excitation, respectively. The instrument was applied to the characterization of stacks of dielectric films for material science studies and laser mirror development

The relationship between psychological empowerment and psychological strain among clinical nurses in educational hospitals

مقدمه: تنشهای روانی جزء اجتناب ناپذیری از حرفه پرستاری بوده که میتواند پیامدهای مهمی را همانند نارضایتی پرســتاران و افت کیفیت مراقبت بهدنبال داشــته باشند. در این میان توانمندی روانشناختی پرستاران از طریق افزایش کارایی، انگیزه شغلی و بروز رفتارهای خالقانه در آنها خواهد توانست نقش مهمی در کاهش تنشهای روانی آنها در محیطهای درمانی داشته باشد. هدف: مطالعه حاضر با هدف تعیین ارتباط بین توانمندی روان شناختی و تنشهای روانی در پرستاران بیمارستانهای آموزشی شهرکرد انجام شده است. مــواد و روشها: مطالعه حاضر پژوهش توصیفی- تحلیلی بوده که بر روی 200 نفر از پرســتاران بیمارستانهای آیت الله کاشانی و هاجر شهرکرد در بهمن ماه )1392 )انجام شده است. پرستاران به روش نمونهگیری سهمیهای انتخاب شدند. دادهها با استفاده از پرسشنامههای توانمندی روان شناختی اسپریتزر )1995 ,Spreitzer )و تنش روانی اوسیپو )2001,Osipow )که دارای پایایی محاسبه شده به روش آلفای کرونباخ )90/0 )بودند؛ جمعآوری و توســط نرم افــزار Spss16 و آزمونهای آماری توصیفی و تحلیلی)تی تست، آنالیز واریانس و ضریب همبستگی پیرسون( مورد تجزیه و تحلیل قرار گرفتند. یافتهها: نتایج حاکی از آن اســت که فقط بعد »معنــیداری کار« از میان ابعاد مختلف توانمندی روان شناختی با تنش روانی رابطهی معنیداری داشته است)05/0>P .)میانگین نمرهی توانمندی روان شــناختی و تنش روانی در پرستاران نیز در حد متوسط به باالبوده است. نتیجهگیری: با توجه به اهمیت بعد »معنیداری کار« از میان ابعاد مختلف توانمندی روان شــناختی میتوان گفت که ارتقاء احساس ارزشمند بودن در پرستاران و همچنین در نظر گرفتن راهکارهایی برای افزایش این احساس میتواند در کاهش تنش های شغلی در آنان و اثر بخشی بیشتر آنان در سیستمهای بهداشتی نقش مهمی داشته باشد

The Effect of Educational Intervention Based on Orem Self-Care Model on Family Caregiver's Burden of Patients with Spinal Cord Injuries

هدف افراد خانوادهمراقبت‌کنندهازبیماراندارایصدماتنخاعیبه‌دلیلماهیتوروند طوالنیمراقبتدراینبیماران،درجاتمتفاوتیازرنجو مشقترا تجربه می‌کنندکه اینشرایطمی‌تواندعواقبمتفاوتیرا برایاینمراقبت‌کنند‌گانبه‌دنبالداشته باشد.یکیازعواملمهمدرروندرنج ومشقتاینافراد سطحآگاهی‌شاندرموردروند مراقبتازبیمارشاناست؛ بنابراین،مطالعه حاضرباهدفبررسیتأثیرآموزشمطابق»الگوی خودمراقبتی ِ اورم« بر سطح مشقتورنج افراد خانوادهمراقبت‌کنندهازبیماردارایصدماتنخاعیانجامگردید. روش بررسی مطالعه نیمه‌تجربی حاضربا طرح پیش‌آزمون-پس‌آزمون و باگروهکنترل، روی70 نفراز اعضای اصلی خانواده مراقبت‌کننده از بیماران صدمات نخاعی استان خراسان جنوبی صورت گرفت. واحدهای موردپژوهش به روش تصادفی انتخاب و به دو گروه مداخله و کنترل تقسیم شدند. گروه مداخله مطابق با برنامه آموزشی اورم در بیماران دارای صدمات نخاعی، در طول 8 جلسه 40 دقیقه‌ای در محل مرکز تحت‌آموزشقرارگرفتند. به‌منظوربررسیرنج ومشقتمراقبت‌کنند‌گان ازپرسشنامه22 سؤالی َ»زریت« با شاخصرواییمحتوایی)CVI)80 درصد وآلفایکرونباخ79/0 استفادهوپرسشنامه، قبلوبعد ازمداخله درگروهمداخله وکنترلتکمیلشد. نتایجپژوهشبا نسخه16 نرم‌افزار SPSS وآزمون‌هایآماریتوصیفی)فراوانی،درصد فراوانی،میانگینوانحرافمعیار(وتحلیلی)آزمون تی، تحلیلواریانسوضریبهمبستگی پیرسون(موردتجزیه وتحلیلقرارگرفت. یافتههامیانگین رنج ومشقت درمراقبت‌کنند‌گان قبل ازمداخله بین دوگروه تفاوتمعنی‌دارینداشت، اما بعد ازمداخله بین دوگروه تفاوت معنی‌داریمشاهده شد )05/0>P .)تفاوتمیانگینرنج ومشقتقبل)33/0±2/3)وبعد ازمداخله )66/0±11/3)درگروهمداخله معنی‌داربود )05/0>P)که ازتأثیرمثبتآموزشدراینزمینه حکایتدارد. افزایشسنو طولمدتمراقبتوهمچنینسطحدرآمد پایینوبیکاریبه‌طور معنی‌داریبا افزایشسطح رنج ومشقت مراقبت‌کنند‌گان همراهبود)05/0>P .)نتایج به‌دست‌آمدهدرزمینه ارتباطبینمیانگینرنج ومشقت در افرادمراقبت‌کننده با متغیرهای جمعیت‌شناختی حاکی از آن است که بین رنج و مشقت افرادمراقبت‌کننده با میزان درآمد و شغل، قبل و بعد از مداخله دردوگروه ارتباط معنی‌داری وجوددارد)05/0>P.)همچنین نمره مشقت با طول مدتمراقبت از فرد صدمه‌دیده رابطه مثبت معنی‌داری را نشان می‌داد.هرچه افرادمدت‌زمان بیشتری از فرد صدمه‌دیده مراقبت می‌کردند، نمره مشقت آنها باالتربود)3/0=r و 05/0>P.) همچنیننمرهمشقت با افزایشسن،رابطه مثبت ومعنی‌داریداشته است )3/0=r و 05/0>P .)بیندیگرمتغیرها با نمرهرنج ومشقت ارتباط معنی‌داریمشاهدهنشد )05/0>P.) نتیجهگیرینتایجاینمطالعه نشانمی‌دهدکه آموزشفردمراقبت‌کنندهازبیماردارایصدماتنخاعیدرقالبالگویخودمراقبتیاورممی‌تواند نقشمهمیدرکاهشرنجومشقتتجربه‌شدهدرمراقبت‌کنند‌گاندرطولدورهطوالنیمراقبتداشته باشد.عالوه‌براین،شرایطمالیواشتغال افرادمراقبت‌کننده نیزمی‌تواند عامل ارتباطی مثبتی در میزان رنج و مشقت آنها باشد؛ بنابراین، توصیه می‌شودکه خانواده‌های مراقبت‌کننده از این بیماران تحت‌حمایت و نظارت سازمان‌های حمایت‌کننده اجتماعی ودرمانی قرارگیرند.همچنین با توجه به مراقبت طوالنی موردنیاز این بیماران می‌توان اقداماتی مانند مراقبت درمنزل با حمایت وپشتیبانی مراکز صدماتنخاعی انجامدادتا از فشارمراقبت براعضایخانواده مراقبت‌کنندهکاستهشود

LEGISLATIVE RESTRICTIONS OF THE ISLAMIC CONSULTATIVE ASSEMBLY DUE TO THE LEGISLATIVE JURISDICTION OF OTHER AUTHORITIES IN THE PROCEDURE OF THE GUARDIAN COUNCIL

Purposes: In the Constitution of the Islamic Republic of Iran, in accordance with Article 71, legislation is the responsibility of the Islamic Consultative Assembly and has general jurisdiction which does not mean that the Islamic Consultative Assembly has no restrictions on legislation, but has limitations in terms of the various Constitutional principles including, the exclusive and particular jurisdiction of other authorities to legislate the law. The Islamic Consultative Assembly cannot legislate in the jurisdiction of these institutions. In the Constitution, a series of authorities have got the right to legislate. Methodology: Using an analytical descriptive method, the present article seeks to examine the question of what are the legislative constraints of the Islamic Republic Consultative Assembly in the Guardian Council's procedure. Results: In the procedure of the Guardian Council, other authorities, such as the Assembly of Experts of the Leadership, the Expediency Discernment Council of the system, the Supreme National Security Council, the Supreme Council of the Cultural Revolution, etc. have found the right to legislate. In other words, this general jurisdiction has been assigned in a way. Implications/Applications: The application of this study is to introduce the laws of the Islamic Republic of Iran. The exercise of this jurisdiction by the Islamic Consultative Assembly has a framework that cannot be explained except by referring to the Constitutional principles Novelty/Originality: In the Constitution of the Islamic Republic of Iran, due to the nature and type of government and the particular aspirations pursued, other legislative authorities include the Assembly of Experts, the Expediency Council, the Supreme National Security Council. It is accepted that by referring to the views of the Guardian Council as the Constitutional body, they have protected them in cases where the jurisdiction of these authorities has been invaded

Moral distress in students: A cross- sectional study in educational environment

Moral distress in educational environments can be associated with multiple effects. Students who faced with this ethical challenge feel insecurity and dissatisfaction and so school dropout and failure will be increased in them. Low quality of teaching in these conditions could potentially cause a lack of scientific and clinical sufficiency and thus the performance of health systems to achieve the health goals will be at risk. This study aimed to assess the students' moral distress in Birjand paramedical school students. The Cross - Sectional study took on 600 students of paramedical school who were selected by census. To collect data, it was used a questionnaire of 20 questions. The validity and reliability of this questionnaire was evaluated and Cronbach's Alfa was calculated 81 percent. Data were collected by Spss16 software and were analyzed with descriptive and inferential statistics. The findings showed that the average of moral distress from total score was 0-5, (3/12±0/88) in the intensity and (3/5±1/2) in the frequency. There was a significant relationship between moral distress with years of educations and sex (P>0/05). Moderate level of moral distress in students requires the planning and some actions as students’ awareness to this phenomenon. Identification and control of this phenomenon in educational environments and investigating its reasons may play an important role in the control of this phenomenon and the prevention of its adverse effects in future

Moral distress and its relationship with professional stress in nurses

Moral distress is an important issue in the field of medical ethics that can have serious effects on nurses, patients and health organizations. One of the most common effects of this phenomenon is professional stress in nurses. Stressful situations in nurses’ job environment lead to burnout and dissatisfaction, and adversely affect the quality of care. This was a cross-sectional study aimed to determine the relationship between moral distress and professional stress in 220 nurses of educational hospitals in the city of Birjand. Data were collected using a 51-item questionnaire based on Corley’s Moral Distress Scale and Wolfgang’s Health Professions Stress Inventory. Reliability and validity of the questionnaire were assessed by the researchers, and its reliability was calculated using Cronbach’s alpha (93%). The results indicated a positive relationship between moral distress and professional stress (P<0/05, r = 0/8). Intensity and frequency of moral distress and professional stress were reported average. Moral distress and professional stress were reported at a frequency and severity of moderate size. Findings of this study can provide guidelines for educating nurses on this phenomenon and the conditions leading to it. They may also be used to develop management strategies and establish organizations to prevent and minimize the consequences of these phenomena in nurses

Moral distress and relationship between Physician and nurses

Background and Aim: Phenomenon of moral distress in critical care environments, have different effects on the quality of care and good communication between members of caring team, especially Physician and nurses could to be effective in prevention of moral distress in nurses through creating desirable ethical atmosphere. This study aimed to determine the relationship between moral distresses with the Physiciannurses relationship in ICUs of the South Khorasan province. Materials and Methods: 215 nurses were recruited to the study by convenience method. Corly moral distress questionnaire and Shortell questionnaire of communication assessment between physician and nurses in ICUs were used for data collection. Data were analyzed by SPSS 16 software and using descriptive and inferential statistics. Ethical Considerations: Participants verbal consent was obtained and anonymously and confidentiality of the completing questionnaires was assured to them. Findings: The mean scores of moral distress severity, moral distress frequency and Physician-nurses relationship were 3±0/59, 3/66±0/5 and 3/2±1/1, respectively. There was significant direct correlation between mean score of communication between physician and nurses with moral distress frequency (r=-0/34, P<0/05). But there was not any correlation between Physician-nurses relationship moral distress severity. Conclusion: regarding undeniable role of good communication between physician and nurses in reducing the frequency of moral distress, it is necessary to determine the effective factors on this relationship and also provide strategies to promote desirable ethical atmosphere, in order to diminish of this phenomeno

Clinical Evaluation Tool for Operating Room Students: Development and Measurement of Reliability and Validity

Introduction: In order to ensure the achievement of goals in clinical training, having the right tool with good reliability and validity is essential. Given the fact that no proper tool has ever been developed for evaluation of operating room students, this study aimed to develop and measure the validity and reliability of the evaluation tool for these students. Methods: This descriptive study was conducted in 2014 in Birjand University of Medical Sciences. After defining the concepts and behaviors to be measured using interviews and review of relevant literatures, the primary tool was developed and its face validity and content validity were verified both qualitatively and quantitatively (using experts’ opinions, CVR, and CVI). The reliability was calculated through interclass reliability and Cronbach’s alpha. Results: The final tool consisted of 62 items in 7 different subscales (professional characteristics, communication, examining the patient, training patients and families, submitting reports, clients’ safety, and clinical competence). The content validity index of the whole questionnaire was 0.84 and content validity ratio for each item was reported 0.62 and higher. With a sample size of 28 students, Cronbach's alpha of the whole questionnaire was 0.82. Also, interclass reliability was 0.45. Conclusion: The results indicated that the developed tool has adequate reliability and validity and that it can be used as a tool for clinical evaluation of operating room students

Relationship between moral distress and moral courage in nurses

In the nursing profession, moral distress is a challenge thatc an have different consequences. The nurses’ moral courage to make the right decision can play an important role in the prevention of moral distress, and thus promote moral comfort. The present study examined the relationship between moral distress and moral courage in nurses. In this study, 313 nurses from hospitals in southern Khorasan Province were selected through quota sampling, and Corley’s Moral Distress Scale and the Professional Moral Courage Scale by Sekerka, et al. were used for data collection. The collected data were analyzed by descriptive and analytical statistics. The findings showed a significant relationship between the intensity of moral distress and moral courage (P = 0.03, r = - 0.44). From a range of 0 - 5, the mean of moral distress was 3.7 ± 0.5 in terms of intensity, and 3.55 ± 0.86 in terms of frequency. The mean score of moral courage was calculated at 3.33 ± 0.46 from a range of 1 - 5. The significant correlation between moral distress and moral courage strongly suggests that high levels of moral courage in nurses can play an important role in controlling moral distress. Determining the factors that create moral courage and developing strategies and circumstances such as promoting an appropriate moral climate could play a major role in encouraging moral behavior and controlling moral distress