Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 03 08 1150 1150 EN Saleheh Tajalli Researcher, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Mansoureh Ashghali Farahani Professor, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Mazlome Hamzekhani Instructor, Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. Azam Shirinabadi Farahani Assistant Professor, Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Nima Pourgholam Amiji Researcher, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Martina Mavrinac Professor, Department of Medical Informatics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia. Roqayeh Aliyari Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran. 2021 11 08 2022 03 08 This study aims to assess the psychometric properties of the Persian version of the Attitudes Toward Plagiarism Questionnaire (ATPQ) among Iranian medical sciences postgraduate students and faculty members. In this study, the ATPQ developed by Mavrinac et al. in 2010 was translated into Persian. After assessment of face and content validity, we distributed the ATPQ draft among 286 Iranian medical science postgraduate students and faculty members. Explanatory and confirmatory factor analysis were applied, and Cronbach's alpha was used to measure the reliability of the ATPQ. All the items of our English version of the ATPQ were approved by the developer of the original ATPQ, and two were revised in the cognitive interview. Construct validity assessment showed that three items were not seriously involved in the extracted factors. The Persian version of the ATPQ had 26 items, five factors and a Cronbach's alpha of 0.81%, and the combined value explained 38.24% of the total variance of this scale. Two new factors of “perceived control” and “attitude toward self-plagiarism” were extracted and incorporated into the Persian version. To conclude, the ATPQ is a valid, reliable, and convenient instrument to determine attitudes toward plagiarism among Iranian medical science postgraduate students and faculty members. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1150 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1150/394

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 10 25 1193 1193 EN Negar Aghighi PhD candidate in Health Services Management, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Aidin Aryankhesal Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Science, Tehran, Iran. Pouran Raeissi Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2022 02 09 2022 10 25 Due to the high value of human life, the occurrence of even one error that leads to death or complications is of great consequence and requires serious attention. Although significant efforts have been made to ensure patient safety, serious medical errors continue to exist. This study aimed to identify the factors associated with the recurrence of medical errors and strategies to prevent them through a scoping review.Data were gathered through a scoping review of PubMed, Embase, Scopus, and Cochrane Library databases during August 2020. Articles related to factors influencing the recurrence of errors despite the available information, as well as articles related to measures taken worldwide to prevent them, were included in study. Overall, 32 articles were selected out of the 3422 primary papers. Two main categories of factors were identified as influential in error recurrence: human factors (fatigue, stress, inadequate knowledge) and environmental and organizational factors (ineffective management, distractions, poor teamwork).The six effective strategies for preventing error recurrence included the use of electronic systems, attention to human behaviors, proper workplace management, workplace culture, training, and teamwork.It was concluded that using a combination of methods related to health management, psychology, behavioral sciences and electronic systems can be effective in preventing the recurrence of errors. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1193 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1193/400

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1255 1255 EN Mahshad Noroozi Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Bahmani Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Kazem Mousavizadeh Professor, Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Saeedeh Saeedi Tehrani Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Akram Hashemi Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mina Forouzandeh Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2022 08 11 2022 12 28 Using genetic tests on deceased patients’ samples for diagnostic purposes affects the family members' health and lives but raises some ethical issues in today’s practice of medicine and research. In this paper, we address a common ethical dilemma of clinicians regarding whether to perform genetic tests on a deceased patient’s sample upon a request from first-degree relatives against the patient's wishes in the last days of life. In this paper, a real case scenario is presented that echoes the above-mentioned ethical challenge. Reviewing the genetic basis of the case, the ethical arguments for and against the reuse of genetic material in a clinical context are discussed. An ethico-legal analysis of the case is proposed based on Islamic medical ethics resources. As reusing stored samples of expired patients without their consent also challenges the researchers in the field of genetics, a debate is included on the post-mortem use of genetic data and samples for research.Finally, defining the special features of the presented case and positive benefit-risk ratio, it is concluded that reusing the patient's sample may be justified if the first-degree family members insist on genetic testing and are comprehensively informed about the benefits and harms. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1255 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1255/406

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 03 15 1186 1186 Mohammad Kiasalar PhD Candidate of Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Younes Shokrkhah Assistant Professor, Department of European Studies, Faculty of World Studies, University of Tehran, Tehran, Iran. Saharnaz Nedjat Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Namazi Assistant Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of History of Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran. 2022 01 29 2022 03 15 Media is an opportunity for health professionals; however, it is not free of threats. Fixing the threats requires professional systematization through developing practical guidelines, which brings us to the goal this study was designed to achieve. The study was conducted qualitatively through literature review, semi-structured interviews, and a focus group discussion with health and media experts, as a result of which 486 codes were extracted and classified into 4 groups. The first group was addressed to media professionals and contained 126 codes in 5 categories: seeking and reporting the truth, harm minimization, integrity, independence, and respect for the rights of others. The second and third groups were addressed to health professionals, the former (150 codes) dealing with formal media, and the latter (190 codes) dealing with cyberspace. These groups were both categorized into 6 categories: scientific demeanor, beneficence, harm minimization,integrity, maintaining the dignity of the profession and professionals, and respect for the rights of others. The fourth group was addressed to the public audience and contained 20 codes categorized into 2 categories: ethics of belief, and ethics of (re-)publishing. Since the study was conducted during the pandemic/infodemic, the proposed codes can help reduce possible conflicts in similar future situations. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1186 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1186/395

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1270 1270 Mamak Tahmasebi Palliative Medicine Fellowship; Cancer Institute of Iran; Imam Khomeini Hospital Complex; Tehran University of Medical Sciences; Tehran; Iran. 2022 11 07 2022 12 28 No AbstractNo AbstractNo AbstractNo Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1270 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1270/409

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 06 01 1205 1205 Arshia Zardoui Researcher, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mir Saeed Yekaninejad Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemian Associate Professor, Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Parsa Assistant Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2022 03 09 2022 06 01 Breaking bad news to patients is an essential aspect of the physician-patient relationship, but in Iran, this relationship is often disrupted by patients’ families. This study investigates the views of patients' companions on breaking cancer news. In this descriptive-analytic cross-sectional study, we conducted research on 170 cancer patients’ companions and 170 non-cancer patients’ companions. We designed a questionnaire to investigate the subjects’ opinions and used CVI, CVR, Cronbach's alpha and ICC for evaluation. In order to compare groups, we used Mann Whitney, Kruskal-Wallis, Chi-square tests and Spearman’s correlation. Most participants believed that patients should be informed of their diagnosis. Cancer patients' companions were more willing to learn the bad news in case they were diagnosed with cancer and were less likely to choose “despair” as the reason for non-disclosure (71% vs. 44%).There was no difference between the two groups in willingness to break the cancer news to patients, choosing who should be informed first, and the reasons for non-disclosure. Most participants believed the family should be the first to know the diagnosis. In this study, most participants believed that patients should be informed of their diagnosis. However, they preferred to learn about the diagnosis before the patient, which confirms the importance of educating the families about autonomy. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1205 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1205/396

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 08 10 1200 1200 Fatemeh Molaei Tavani Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran; Medical and Surgical Nursing, MSc Student Faculty of Nursing-Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. Mozhgan Behshid Assistant Professor, Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Azad Rahmani Assistant Professor, Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran. Saeid Mousavi Assistant Professor, Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Mehran Seif-Farshad Assistant Professor, Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Parvin Rahmani Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran; Medical and Surgical Nursing, MSc Student Faculty of Nursing-Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. 2022 02 27 Researcher, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Sayarifard Associate Professor, Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran. 2020 07 29 2021 02 16 Providing care for terminally ill neonates is an important issue in NICUs. This research aimed to determine nurses’ attitudes toward providing care for terminally ill neonates and their families. A total of 138 nurses working in neonatal intensive care units (NICUs) affiliated to Tehran University of Medical Sciences participated in this cross-sectional study via convenience sampling in 2019. The Data collection tool was the Frommelt attitudes toward caring for terminally ill persons and their families scale. The nurses in this study had the most positive attitudes toward the items “nursing care should include the family of the terminally ill patient, too” (4.2 ± 0.6) and “the care provider can prepare the patient or his/her family for death” (4.1 ± 0.7). The nurses had the least positive attitude toward the item “the time spent on caring for terminally ill patients creates a sense of frustration in me” (1.06 ± 1). The mean score of the attitudes of NICU nurses toward caring for terminally ill neonates and their families indicates the necessity of improving this attitude. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/806 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/806/361

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 12 01 990 990 Masoud Kasiri Assistant Professor, Department of History, Faculty of Literature and Humanities, University of Isfahan, Isfahan, Iran. 2021 03 06 2021 12 27  No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/990 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/990/378

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 07 13 825 825 Raditya Wicaksono Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia. Miko Ferine Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia. Diyah Lestari Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia. Arfi Hidayah Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia. Amalia Muhaimin Lecturer, Department of Bioethics and Humanities, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia; Researcher, Department of Ethics, Law, and Humanities, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands. 2020 08 29 2021 07 12 Although ethics is an essential part of medical education, little attention has been paid to ethics education during the clerkship phase, where medical students observe how physicians make decisions regarding various ethical problems. Specific nuances and cultural contexts such as working in a rural setting can determine ethical issues raised. This phenomenology study aimed to explore ethical issues experienced by Indonesian students during clinical clerkship in a rural setting. In-depth interviews were used to explore students’ experiences. Participants were ten students, selected on gender and clerkship year variations. Data saturation was reached after eight interviews, followed by two additional interviews. Thematic analysis was used in this study, and trustworthiness was ensured through data and investigator triangulation, member checking, and audit trail. Three main themes found in this study were limited facilities and resources, healthcare financing and consent issues, as well as unprofessional behavior of healthcare providers. Many ethical issues related to substandard care were associated to limited resources and complexities within the healthcare system in the rural setting. Early exposure to recurrent ethical problems in healthcare can help students prepare for their future career as a physician in a rural setting. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/825 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/825/368

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 12 30 1174 1174 Gentian Vyshka Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Albania. Dritan Ulqinaku Department of Chronic Diseases, Institute of Public Health, Tirana, Albania. Tedi Mana Service of Psychiatry, University of Medicine in Tirana, Albania. 2021 12 23 2021 12 29 No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1174 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1174/391

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 07 13 731 731 EN Mahboobeh Khabaz Mafinejad Assistant Professor, Department of Medical Education, Education Development Center, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Taherahmadi Students' Scientific Research Center (SSRC), 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. Kobra Mehran Nia Assistant Professor, Department of Anatomy, Tehran University of Medical Sciences, Tehran, Iran. Saeeid Reza Mehrpour Associate Professor, Department of Orthopedics and Trauma Surgery, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Hassanzadeh Professor, Department of Anatomy, Tehran University of Medical Sciences, Tehran, Iran. Parisa Farahani Students' Scientific Research Center (SSRC), Tehran University of Medical sciences, Tehran, Iran. Reza Hosseini Dolama Students' Scientific Research Center (SSRC), Tehran University of Medical sciences, Tehran, Iran. 2020 03 28 2021 07 12 This study was designed to facilitate freshman medical students’ adaptation to the dissection room and familiarize them with the related ethical codes. Single-group post-test design research was conducted at Tehran University of Medical Sciences in 2018 - 2019. The program began with a brief explanation of the necessity of the subject, and after a documentary film was shown, the principles of professional and ethical behaviors in the dissection room were discussed by a panel of experts. In the end, a valid and reliable evaluation questionnaire (Cronbach's alpha coefficient = 0.89) was distributed among the students. A total of 129 questionnaires were completed and returned. Overall, 94.4% of the students believed that the program provided an excellent opportunity to reflect on professional behaviors during practical anatomy sessions. In addition, 92.8% of the students believed that they would use the ethical points mentioned in the program in the future. Content analysis of the open questions produced three main categories: "motivating learning", "application of theory in practice" and "changing the attitude toward responsibility". The results indicate that adequate preparation for cadaver dissection sessions and learning about professional behavior codes in the first exposure can help medical students to better understand the principles of professional behaviors.   https://jmehm.tums.ac.ir/index.php/jmehm/article/view/731 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/731/371

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 07 13 902 902 Hossein Dargahi Professor, Department of Management Sciences and Health Economics, School of Public Health, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Veysi Researcher, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. 2020 11 10 2021 07 12 High ideal hybrid intelligence of managers is among the factors that can improve employees’ organizational commitment. Therefore, this study aimed to determine the relationship between managers’ ideal hybrid intelligence and employees’ organizational commitment in the Vice Chancellors’ Headquarters of Tehran University of Medical Sciences. This was a descriptive-analytical and cross-sectional study conducted in 2017 - 2018. The research sample size consisted of 86 senior and middle-level managers selected through census method, as well as 181 employees, selected using the Kerjecie and Morgan table. The research tool was an ideal hybrid intelligence questionnaire consisting of 102 questions on cultural, moral and spiritual intelligence, and also Meyer and Allens’ organizational commitment questionnaire including 24 questions. Face validity and reliability of each questionnaire were confirmed by an expert panel and Chronbach’s alpha method. The data were analyzed by SPSS software, and descriptive results were shown through mean and standard deviation, and analytical results by inferential tests. The results showed that the ideal hybrid intelligence of the Vice Chancellors’ Headquarters managers and employees’ organizational commitment were at a desirable level. Also, there was a significant correlation between cultural, moral and spiritual intelligence as constituents of the ideal hybrid intelligence of managers and employees’ organizational commitment. We found that ideal hybrid intelligence may affect employees’ organizational commitment, but it should be mentioned that other forms of intelligence may also affect organizational commitment. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/902 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/902/369

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 07 13 1014 1014 Hakimeh Sabeghi PhD Candidate in Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shahram Yazdani Professor, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Abbas Foroutan Associate Professor, Permanent Member, Academy of Medical Sciences of Iran, Tehran, Iran. Seyed Masoud Hosseini Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Leila Afshar Associate Professor, Department of Medical Ethics, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2021 04 16 2021 07 12 Values ​​predispose people to make the right and especially ethical decisions, and are important for good performance in medical sciences. Students’ lived experiences and the value-rich exposures during their education are some effective means of achieving professional values that help them build their own value frameworks. In this phenomenology of practice study, we aimed to explore and describe the lived experiences of a sample of medical students in Shahid Beheshti University of Medical Sciences regarding their value-rich exposures. In-depth interviews, students’ written stories, recorded video interviews related to past trips and photographs were used to collect data. The data was analyzed based on Van Manen’s thematic analysis method. Five themes emerged from the data: “in the shadow of a supportive mentor”, “a well-orchestrated, value-rich program”, “human interactions in a value system”, “acquiring values in a real-life environment”, “and seeking values in oneself”. Our study identified different dimensions of value-rich exposure based on the lived experiences of medical students and pointed out some issues that medical education planners can consider to improve the quality of value-based education for medical students. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1014 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1014/370

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 11 03 950 950 Fariba Asghari Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Shahvari Assistant Professor, School of Nursing and Midwifery, Islamic Azad University of Ghachsaran, Ghachsaran, Iran. Abbas Ebadi Professor, Behavioral Sciences Research Center, Life style institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. Fateme Alipour Associate Professor, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Associate Professor, Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Maryam Bahreini Associate Professor, Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Homayoun Amini Professor, Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2021 01 20 2021 11 03 This study was conducted to develop and validate an instrument to measure the medical professionalism climate in clinical settings. The item pool was developed based on the Tehran University of Medical Sciences Guideline for Professional Conduct. The items were distributed between two questionnaires, one for health-care providers and the other for patients. To assess the construct validity of the questionnaires, 350 health-care providers and 88 patients were enrolled in the study. The reliability of the questionnaires was evaluated by calculating Cronbach’s alpha and ICC. At first a 74-item pool was generated. After assessing and confirming face and content validity, 41 items remained in the final version of the scale. Exploratory factor analysis revealed the three factors of “personal behavior”, “collegiality” and “respect for patient autonomy” in a 25-item questionnaire for service providers and a single factor of “professional behavior” in a 6-item questionnaire for patients. The three factors explained 51.775% of the variance for service providers’ questionnaire and the single factor explained 63.9% of the variance for patients’ questionnaire. The findings demonstrated that from the viewpoints of patients and service providers, this instrument could be applied to assess the medical professionalism climate in hospital clinical settings. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/950 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/950/373

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 11 03 953 953 EN Saleheh Tajalli Researcher, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Somayeh Rostamli Researcher, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Nazi Dezvaree Researcher, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Professor, Maternal and Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Maliheh Kadivar Professor, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2021 01 24 2021 11 03 Due to the unique nature of the neonatal intensive care unit (NICU) and its moral distress, this study aimed to investigate moral distress in the NICU. This cross-sectional study was conducted on 234 physicians and nurses working in the neonatal wards of eight hospitals. The Corley’s Moral Distress Scale was used to collect data. Findings showed that 25 of the participants were physicians and 209 were nurses. The intensity and frequency of distress among physicians and nurses were assessed as moderate. The mean intensity and frequency of moral distress among nurses and physicians were 48.3%, 41.5% and 46.46%, 15.62% respectively. The results showed that the mean intensity and frequency of distress were higher, however not significantly, among nurses. The intensity and frequency of moral distress had a statistically significant and direct correlation with the intention to leave and the number of staff in each working shift among the nurses. Moral distress in the NICU practitioners was moderate, so addressing this issue and trying to alleviate it was important. Identifying the causes behind moral distress can help adopt appropriate measures to prevent and reduce them. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/953 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/953/374

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 11 03 973 973 EN Kurosh Jodaki PhD Candidate of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Maryam Esmaeili Assistant Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Cheraghi Professor, Department of Critical Care and Nursing Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Health Sciences Phenomenology Association, Ministry of Health and Medical Education, Tehran, Iran. Shahzad Pashaeypoor Assistant Professor, Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Akram Sadat Sadat Hoseini Associated Professors, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. 2021 02 13 2021 11 03 Although conscience, as an ethical concept, has emerged widely in the field of nursing, its functional meaning and its effects on nurses' performance are not clear. Therefore, the present study aimed to analyze the concept of conscience in the context of Iranian nurses’ ethical performance.  This study used a hybrid model including theoretical, fieldwork, and final analytic stages. In the theoretical phase, English and Persian articles published up to 2020 and indexed by scientific databases were analyzed. In the fieldwork phase, semi-structured in-depth interviews were conducted on nurse participants. The last two stages were jointly considered to draw the study’s conclusions. In the theoretical phase, conscience was considered as a context-dependent concept, an inner voice, and a criterion for distinguishing right from wrong. The fieldwork phase’ results were categorized into three themes: “perception of conscience”, “commands of conscience”, and “obedience to conscience. The final definition was reached by merging the theoretical and field stages. This article aimed at investigating the relevance of conscience to ethical practice in the nursing field. Findings show that conscience is an inner feeling or voice that plays a vital role in providing ethical care by nurses.   https://jmehm.tums.ac.ir/index.php/jmehm/article/view/973 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/973/376

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 14 0 2021 09 01 931 931 Saba Hoobehfekr Resident of Psychiatry, Department of Psychiatry, 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. Azadeh Sayarifard Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.