Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 94 94 EN Maliheh Kadivar Professor, Department of Pediatrics, Division of Neonatology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Ziba Mosayebi Associate Professor, Department of Pediatrics, Division of Neonatology- Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Pari Zarrini Neonatologist, Department of Pediatrics, Division of Neonatology- Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians’ and nurses’ perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients’ rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients’ rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/94 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/94/77

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 100 100 EN Mohammadreza Ardalan Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Kazem Khodadoust Philosophy and History of Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Elmira Mostafidi Kidney Research Center, and Department of Pathology, Imamreza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 14 2015 10 14 T Ferdous al-Hekma (Paradise of Wisdom) is one of the oldest medical texts in the Islamic world written in Arabic in 850 AD by Ali ibn Raban Tabari. He was a Persian physician who moved from Tabaristan (Mazandaran province of modern day Iran) to Samarra during the reign of the Abbasid Caliph al-Mutawakkil (847-861 AD). We studied the book of Ferdous al-Hekma fil-Tibb, in an attempt to comprehend its general outlook on diseases of different organs, their classifications and the associated signs and symptoms. The book is one of the earliest medical pandects of the period of translation, adaptation and expansion of knowledge in the Islamic world during the 9 th  century AD. Tabari was mainly influenced by Hippocrates, Galen and Aristotle, as well as his contemporaries Johanna ibn Massavieh and Hunayn ibn Ishaq. The book is written in thirty chapters in a total number of 308 subtitles. In each part there is an introduction to the symptomatology, followed by organ specific diseases and therapeutic recommendations. Symptoms and physical signs of different diseases are vividly described in Ferdous al-Hekma, and some of them are even understandable for contemporary medical students.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/100 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/100/83

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 134 134 EN Omid Asemani Assistant Professor, Department of Medical Ethics and Philosophy of Health, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2015 11 03 2015 11 10 No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/134 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/134/109

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 95 95 EN Fariba Borhani Associate Professor, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Somayeh Mohammadi MSc in Nursing, Shahrekord University of Medical Sciences, Shahrehkord, Ira. Mostafa Roshanzadeh Mentor, Surgical Care Research Centre, Birjand University of Medical Sciences, Birjand, Iran. 2015 10 14 2015 10 14 Special characteristics of care environments have always presented nurses with some challenges. One particular situation is futile care, which is frequently accompanied by countless moral and legal challenges. The dominant atmosphere in futile care may cause moral distress to nurses and lead to a sense of guilt, pain, suffering, job dissatisfaction, and eventually cause nurses to leave the job. This descriptive-analytical study attempted to investigate the relationship between futile care and moral distress in intensive care nurses. Study subjects were 300 nurses in intensive care units in Kerman, Iran and were selected by convenience sampling based on inclusion criteria. Study tools included Corley’s 21-item questionnaire on moral distress and a researcher-made 17-item questionnaire on futile care. Data analysis was performed using SPSS version 16 and suitable analytical and descriptive tests. The results showed a significantly positive relationship between moral distress and futile care ( P  = 0.03, r = 0.4). Based on the   obtained results, futile care can create conditions that may lead to moral distress in nurses and therefore strategies should be devised to prevent these conditions. Moreover, distress in nurses should be identified by periodical counseling so that it can be managed more efficiently.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/95 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/95/78

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 96 96 EN Tannaz Ahadi Assistant Professor, Department of Physical Medicine and Rehabilitation, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Elaheh Mianehsaz Clinical Research Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran. Gholamreza Raissi Associate Professor, Department of Physical Medicine and Rehabilitation, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. SeyedAlireza Moraveji Associate Professor, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran; 5Medical Student, Iran University of Medical Sciences, Tehran, Iran. Vahid Sharifi Medical Student, Iran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Professionalism is the foundation of trust on which the doctor-patient relationship is built. This study was performed to measure professionalism in Iranian physical medicine and rehabilitation residents as a baseline assessment tool for future studies. This was a descriptive study. The Persian version of the American Board of Internal Medicine (ABIM) questionnaire was distributed among all the second and third-year residents of the medical state universities of Iran (n=43). Data were summarized as mean (SD), and independent samples t-test was used for comparison of means between genders, and also between the second and third-year residents. Forty questionnaires were analyzed. The mean (± SD) age of respondents was 29.95 (± 2.37) years. The mean score (SD) for the overall score was 115.15 (± 17.36) out of 150, and the mean score (± SD) for all items was 7.67 (± 1.15) out of 10. The respondents averaged 5.88 (± 1.69) for items forming the ‘excellence’ factor, 7.98 (± 1.48) for items in ‘altruism/respect’ and 8.92 (± 1.26) for items in the ‘honor/integrity’ subscale. These data may serve as a baseline for future research in this field. The lowest score pertained to excellence, which needs more focus in future studies. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/96 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/96/79

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 97 97 EN Fariba Borhani Associate Professor, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Keshtgar MSc in Nursing, Nursing Department, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abbas Abbaszadeh Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences; and Academy of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Nurses are often faced with serious situations that require high levels of legal and ethical knowledge, and should therefore be sensitive to the moral issues in their profession in the decision making process. Some studies have investigated nurses’ moral self-concept as an effective factor in moral sensitivity, but there is not sufficient evidence to support this. The purpose of this study was to determine the correlation between moral sensitivity and moral self-concept in nurses employed in the teaching hospitals in Zahedan, Iran. This cross-sectional descriptive study aimed to study the relationship between moral self-concept and moral sensitivity in nurses employed in the teaching hospitals affiliated with Zahedan University of Medical Sciences. Chang’s Moral Self-Concept Questionnaire and Lutzen’s Moral Sensitivity Questionnaire were used for data collection. Data analysis was performed using SPSS software version 17. A total of 188 nurses participated in this study. The results showed that there was a positive and significant relationship between moral self-concept and moral sensitivity ( P  < 0.05). Based on our findings, an individual's attention to moral issues can lead to greater sensitivity and result in morally responsible behavior at the time of decision making. Consequently, promotion of moral self-concept through personal effort or education can increase moral sensitivity, which in turn leads to behavioral manifestations of ethical knowledge.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/97 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/97/80

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 98 98 EN Akram Hashemi PhD candidate, Department of Medical Education, Iran University of Medical Sciences, Tehran, Iran. Habibeh Yeketaz MD, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Associate professor,Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Clinical education is an essential part of medical trainees’ education process, and curriculum planners agree that it should be based on ethical standards and principles in the medical field. Nevertheless, no explained and codified criteria have been developed for ethics in clinical teaching. This study was aimed to develop an ethical guideline for medical students and teachers as the first and most important step in respecting patients' rights in educational centers. The initial draft included the codes of ethics in clinical education and was developed based on library studies. Subsequently, it was improved through a qualitative study using semi-structured interviews and focus group sessions with medical students, patients, and medical teachers in educational hospitals affiliated to Tehran University of Medical Sciences. The improved draft was reviewed and validated by a medical expert panel to prepare the final draft. The codes derived from this study included patients’ choices and rights in purely educational procedures, and special considerations for a) obtaining informed consent for educational procedures; b) performing procedures on deceased persons, patients under anesthesia and those lacking decision making capacity; c) educational visual recordings of the patients; and d) safety monitoring in clinical education. The guideline developed in this study incorporates codes of ethics into clinical training. Therefore, in addition to providing efficient education, the interests of patients and their rights are respected, and the ethical sensitivity of learners in primacy of patients’ best interests will be preserved and enhanced. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/98 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/98/81

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 99 99 EN MohammadAli Cheraghi Associate Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Arpi Manookian Assistant professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Alireza d"> 2022 08 10 Ethical decision-making and professional behavior are essential skills in nursing profession, hence educational programs should be designed to enable future nurses to tackle problems related to ethical decision-making. This descriptive, correlational and analytical study aimed at determining the ability of Iranian nursing students to make ethical decisions as well as relationship between such decisions and professional behavior. The present study used census to select 140 freshmen from the School of Nursing and Midwifery of Tabriz University of Medical Sciences, Tabriz, Iran. Data collection tools included a demographic questionnaire, the Nursing Dilemma Test (NDT) comprising two indices of “nurse’s principled thinking” and “practical consideration”, as well as the Nursing Students Professional Behaviors Scale (NSPBS). The mean scores obtained were 41.3±5.7 for “nurse’s principled thinking”, 21.3±3.7 for “practical consideration”, and 119.07±11.79 for professional behavior. Relationships of professional behavior with “nurse’s principled thinking” and “practical consideration” were insignificant (P>0.05). According to the present study’s findings, nursing students’ weakness in applying ethical concepts to decisions and professional behaviors was due to a gap between scientific material learned and clinical practice. Hence, novel training strategies and programs should be designed to reduce such theory-practice gap https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1200 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1200/397

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 10 25 1176 1176 Marzieh Azadian PhD Candidate of Nursing, Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran; Instructor, Department of Nursing, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran. Tahereh Nasrabadi Associate Professor, Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran. Abbas Ebadi Professor, Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. Jamileh Mokhtari Nouri Professor, Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2021 12 30 2022 10 25 Role modeling is one of the most influential components of teaching professional behaviors to nursing students. The Role Model Apperception Tool (RoMAT) was designed in the Netherlands to measure role modeling behaviors in clinical educators. The aim of this study was assess the psychometrics of the Persian version of this tool.In a methodological study, the Persian version of the RoMAT tool was developed using the forward-backward translation method. Face validity was confirmed through cognitive interviews, and content validity was done by a panel of 12 experts. Construct validity was assessed through exploratory factor analysis (n = 200), and confirmatory factor analysis (n = 142) was evaluated after the tool was completed online by undergraduate nursing students. Reliability was confirmed using internal consistency and test and retest methods. Furthermore, ceiling and floor effects were assessed.The two components of "professional competencies" and "leadership competencies" emerged with a cumulative variance of 62.01%, a reliability with Cronbach's alpha of 0.93 and 0.83, and an intraclass correlation of 0.9 and 0.78, respectively. It was concluded that the Persian version of the Role Model Apperception Tool is a valid and reliable tool and can be used to investigate the role modeling behaviors of clinical instructors of nursing students. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1176 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1176/398

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 10 25 1219 1219 Setareh Tajdari PhD Candidate of Nursing, Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. Alireza Irajpour Professor, Social Determinants of Health Research Centre, Critical Care Nursing Department, School of Nursing and Midwifery, Nursing and Midwifery Care Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran. Mohsen Shahriari Professor, Adult Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. Mahmoud Saghaei Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 2022 04 03 2022 10 25 In intensive care units (ICUs), patient privacy is of particular importance due to the structure of the ward environment and the critical situation of the patients. The aim of this study was to identify the dimensions of patient privacy in ICUs. For this purpose, a descriptive-qualitative-exploratory study was performed. The data collection methods included observations and interviews, which were handwritten and analyzed using qualitative content analysis with a conventional approach. A total of 27 participants were selected based on purposeful sampling and with maximum diversity of health-care providers and recipients. The study environment was the ICUs of two selected hospitals affiliated to the medical sciences universities of Isfahan and Tehran, Iran. The data were analyzed into 4 classes and 12 subclasses. The classes included physical, informational, psychosocial, and spiritual-religious privacy. Findings of the present study identified hidden layers of patient privacy as a multidimensional concept that is influenced by various factors. In order to provide holistic care, preparing the grounds for patient privacy ‎and familiarizing the staff with its various dimensions seem necessary. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1219 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1219/399

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 10 29 1206 1206 Fatemeh Keshmiri Associate Professor, Medical Education Department, Education Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Azam Hosseinpour Instructor, Department of Operating Room, School of Allied Medical Sciences, Qom University of Medical Sciences, Qom, Iran. 2022 03 09 2022 10 29 Professionalism has been recognized as an essential component of inter-professional collaboration (IPC), and hence this study aimed at exploring elements of inter-professional professionalism (IPP) affecting IPC among surgery teams. This qualitative study had been conducted from 2019 to 2021. Fifteen participants in surgery teams including surgeons, anesthesia nursing, and surgical technology nursing at hospitals of Shahid Sadoughi University were contributed to this study. Data was collected through semi-structured interviews and analyzed through inductive content analysis, an approach introduced by Lundman and Graneheim. Data analysis process included the following: (i) Developing verbatim transcription of interview, (ii) Extracting semantic units and classifying them under the top compact unit, (iii) Summarizing and classifying the compact units and selecting appropriate labels for them, and (iv) Sorting subcategories according to their similarities and differences. Two hundreds and forty-two codes, five sub-categories, two categories, and a theme entitled "reciprocal accountability in IPP” were extracted. The barrier category was named “weakness in accountability to team-based values" and the facilitator category was called "responsibility of maintaining empathetic relationship within the IP team".Development of IPP and professional values (e.g., altruism, empathetic communication, and accountability to individual’s and team’s roles) can facilitate collaborative processes among different professions. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1206 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1206/401

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1247 1247 Seyed Kazem Mousavi Researcher, Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran. PhD Candidate of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran. Mohsen Kamali Researcher, Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran. PhD Candidate of Medical Education, Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zeinab Bahrami Eyvanaki Researcher, Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran. 2022 06 28 2022 12 28 Emergency medical technicians (EMTs) are very likely to leave the profession due to their obligation to work in critical situations such as the COVID-19 pandemic. This study aimed to investigate the relationship between the ethical work climate and the intention to leave the service among EMTs. In this descriptive correlational study, 315 EMTs working in Zanjan province were surveyed using the census method in 2021. The research tools included the Ethical Work Climate and the Intention to Leave the Service questionnaires. Data were analyzed using SPSS software version 21. We found the mean (SD) score of the organization's ethical work climate to be 73.93 (±12.53), and the intention to leave the service 12.54 (±4.52), which are at a moderate level. A statistically significant positive correlation existed between these variables (r = 0.148, P = 0.017). Also, there was a statistically significant relationship between age and employment status among the demographic variables, and the ethical work climate and the intention to leave (P < 0.05). Our findings indicate that ethical work climate is one of the influential but less noticed factors that affect the performance of EMTs. Therefore, it is suggested that managers implement measures to develop a positive ethical work climate to reduce the tendency to leave the service among EMTs. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1247 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1247/402

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1198 1198 EN Mahboobeh Khabaz Mafinejad Associate Professor, Health Professions Education Research Center, Department of Medical Education, Education Development Center, Tehran University of Medical Sciences, Tehran, Iran. Maliheh Kadivar Professor, Division of Neonatology, Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zeinab Jannat Researcher, MSc of Neonatal Intensive Care Nursing, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Nastaran Hadizadeh Researcher, Department of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2022 02 20 2022 12 28 The present study aimed to compile and develop a professional guideline for health-care providers in Iran regarding cyberspace usage. This was a mixed-methods study, conducted in three phases. In the