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Background: Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care., Objective: To explore nurses' experiences of ethical and legal issues in post-resuscitation care., Research Design: This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis., Participants and Research Context: In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional content analysis., Ethical Considerations: The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected., Findings: Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care., Conclusion: There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges.

Objective: Cancer is the third leading cause of death in Iran. Todays, caregiving to patients with cancer is shifting towards home based care, and home care needs from a caregiver's perspective can help improve the patient care. This qualitative study aimed to examine the home care needs of cancer patients from the perspective of home care nurses., Methods: This is a qualitative descriptive study carried out at home care centers in the northwest of Iran. A total of 15 participants were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through Conventional content analysis method in MAXQDA software.  Measures of trustworthiness were established throughout the study using Lincoln and Guba's (1985) criteria (dependability, credibility, transferability, and confirmability)., Results: Data analysis resulted in the extraction of four main categories including physical needs (pain relief, gastrointestinal problems including nausea and anorexia and nutritional problems, lethargy, wound care), psychological support (need for hope and emotional support), educational needs (need for information and self-care) and financial support (service insurance coverage, charity support). To promote these patients home care, insurance coverage of nursing home care services was emphasized by the participants., Conclusion: Various aspects of cancer patients home care needs were identified. Interdisciplinary home-based palliative care collaboration is needed to address their physical, psychological, and moral needs.

Introduction: This study investigated the relationship between compassion fatigue and compassion satisfaction among Iranian nurses working in critical care units. Method: A cross-sectional, descriptive survey using the Professional Quality of Life instrument was administered to 400 nurses working in the intensive care units of Iranian hospitals. Results: High risk levels of burnout and secondary traumatic stress existed among 42% and 96% of participants, respectively. Significant positive relationships were detected between burnout and secondary traumatic stress. An inverse relationship was detected between measures of compassion fatigue and compassion satisfaction. Discussion: To ensure culturally congruent care, it is important to evaluate professional quality of life within the context of specific cultures and societies. Iranian critical care nurses are at risk for burnout and secondary traumatic stress. Personal self-care and organizational wellness approaches that consider cultural norms should be designed to boost compassion satisfaction and reduce negative effects of stressful work environments.

Aim: The present study aims to assess the perception of nurses, patients and their relatives regarding the nature of workplace violence against nurses., Background: Workplace violence adversely affects the health, well-being and safety of nurses and the quality of nursing care., Methods: In the present descriptive comparative study, the nature of violence was assessed using a modified and validated International Labor Office, the International Council of Nurses, World Health Organization, and Public Services International Questionnaire., Results: Nurses, patients and relatives reported verbal abuse as the most common and sexual violence as the least common type of violence against nurses. Nurses mostly blamed factors associated with patients and their relatives as the cause of violence, whereas patients and their relatives blamed social factors., Conclusions: This study shows that violence is significantly prevalent in clinical settings, but its nature is differently perceived by nurses, patients and their relatives. This phenomenon requires further studies because knowledge of the causes of this difference could help to reduce and control violence., Implications for Nursing Management: It is necessary that nursing managers inform nurses about protocols for reporting all such cases in order to collect information, and based on a clear procedure, actively pursue reported cases and take the necessary measures to prevent violence against nurses., (© 2018 John Wiley & Sons Ltd.)

The nursing profession is focused on serving others and has high expectations that each member behaves professionally and ethically, as articulated in nursing codes of practice and conduct. Where these are not upheld, inappropriate and unprofessional workplace behaviors follow. Regrettably, unprofessional behavior is neither new nor constrained to the nursing profession, but is known to negatively impact staff and workplace relationships, and importantly, patient safety and care. The aim of this qualitative study was to explore Iranian nurses' experiences of professional communication between colleagues in the emergency department. Fifteen individual interviews were conducted. The overarching theme to emerge from the data was workplace communication, supported by two subthemes: unprofessional behavior and stressors in the workplace. Individually and collectively, these subthemes demonstrated staff attitudes and behaviors that are inconsistent with expectations of professional behavior and practice. Management proactively addressing unprofessional workplace behaviors is fundamental to establishing and maintaining positive workplace environments and supporting safe, quality patient care., (© 2017 John Wiley & Sons Australia, Ltd.)

Background: Many cancer patients still experience pain worldwide. There are many barriers for effective control of cancer pain and many of these are related to health care providers. There is a need for further investigation of these barriers. The aim of this study was to investigate nurse-related barriers to control of cancer pain among Iranian nurses., Materials and Methods: In this descriptive study 49 nurses from two hospitals affiliated to Tabriz and Ardebil Universities of Medical Sciences participated using a census sampling method. A demographic and profession related checklist and Barriers Questionnaire II (BQ-II) were used for data collection., Results: The results showed negative attitudes of participants regarding control of cancer pain. Participants believed that cancer pain medications do not manage cancer pain at acceptable levels; patients may become addicted by using these drugs; cancer pain medications have many uncontrollable effects; and controlling cancer pain may distract the physicians from treating disease., Conclusions: Iranian nurses have negative attitudes toward pain control in cancer patients especially about effectiveness of pain medication and their side effects. Educational intervention to reduce these misconceptions is needed.

Background: Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care., Objectives: The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care., Materials and Methods: In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests., Results: The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team., Conclusions: Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.

Byline: Zoleikha. Avestan, Vahid. Pakpour, Azad. Rahmani, Robab. Mohammadian, Amin. Soheili Context: Nurse-patient communication is one of the important factors affects the promotion and maintenance of the dignity of cancer [...]

Background: Chronic and cancer diseases are expected to rise with the growing population of the elderly in the world. Home palliative care might be a possible solution for improving these patients' quality of life; therefore, the present study sets out to investigate home care nurses' attitude towards and knowledge of home palliative care. Materials and Methods: This is a descriptive cross-sectional study (2018-19), in which 168 home care nurses and nursing assistants in East Azerbaijan Province (Iran) were included (2018). The questionnaire used was specifically designed by Shimizu et al. in 2016 for determining the nurses' attitude towards and knowledge of home care. Data analysis was carried out using descriptive and inferential statistics (T-test and ANOVA). Results: In this study, 95 (56.60%) and 113 (67.90%) of the participants were found to have negative attitudes and limited knowledge, respectively. The other participants seemed to have neutral attitudes towards and average knowledge of home palliative care. The Mean (SD) attitude score on terminal home care was estimated 2.33 (0.83), and the knowledge score on dying care was calculated 41.76%, which were the lowest in comparison with the scores of other dimensions. Conclusions: The home care nurses' attitude towards and knowledge of home palliative care were found to be negative and limited, respectively, which underscores the need to endeavor to improve the attitude towards home care and the knowledge of dying care. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills. [ABSTRACT FROM AUTHOR]

Nurses’ perceptions of resuscitated patients may affect their care, and this has not been investigated in previous literature. The aim of this study was to explore nurses’ perceptions towards resuscitated patients. In this descriptive-qualitative study seventeen clinical nurses participated using purposive sampling. In-depth, semi-structured interviews were conducted and data were analyzed by conventional content analysis. Four main categories emerged: Injured, undervalued, problematic, and destroyer of resources. Participants considered resuscitated patients to have multiple physical injuries, which are an important source of legal problems and workplace violence, and they believed that these patients will eventually die. Resuscitated patients are considered forgotten and educational cases. Iranian nurses have a strong negative perception towards resuscitated patients. Improving the quality of cardiopulmonary resuscitation, improving the knowledge and skills of personnel in performing resuscitation, and supporting managers and doctors to nurses in the post-resuscitation period can change the attitude of nurses and improve post-resuscitation care. [ABSTRACT FROM AUTHOR]

Introduction: Despite being aware of the importance of nurses' role in providing clinical training to nursing students, studies show that sufficient research has not yet been conducted on the experience of clinical nurses who are engaged in training nursing students outside their normal working hours. The present study aim to describe the experience of these nurses who are training outside their routine working hours. Methods: This study was conducted using descriptive-phenomenology method. Twelve nurses was participated in this research. Data were collected using purposive sampling method and face to face interviews based on nurses' real life experience of students' learning in clinical settings through answering open-ended questions. Spiegel burg analysis method was used to analyze the data. Results: The result of data analysis was the derivation of four themes and eight sub-themes. Themes included "nurses as teaching sources", "changes in the balance of doing routine tasks", "professional enthusiasm", and "nurses as students' professional socialization source of inspiration". Sub-themes included "efficient education", "poor education", "support", "interference in the role," "self-efficacy development", "inner satisfaction", "positive imaging" and "being a model". Conclusion: It is necessary that academic centers plan for teaching nurses working on a contractual basis in the field of the evaluation method and various methods of teaching. The findings also suggested the development of individual self-efficacy in clinical nurses who train students. [ABSTRACT FROM AUTHOR]

Background: Compassion is an important ethical foundation of all healthcare professionals especially for nursing. However, there is little understanding of factors which could help and motivate nurses to deliver compassionate care in modern healthcare practices today. Moreover, a cultural context may affect the way compassionate care is delivered by healthcare professionals. Aims and objectives: This study aimed to explore what facilitates compassionate care in daily practice from the unique perspective of Iranian nurses. Research methods: This qualitative exploratory study was conducted in four hospitals. In this study, 16 nurses were selected from various wards. Data were collected by in‐depth, face‐to‐face interviews. For data analysis, a conventional content analysis approach was used. Results: As the most important theme, the theme ‘deepening individual's capacity for compassionate care’ emerged, which consisted of three categories: the personal system of values and beliefs, patient experience and positive role models of compassion. Conclusions: Addressing and developing nurses’ capacity for compassion is possible by providing organisational support and professional education, next to recruiting nurses with a high motivation to relieve patient suffering. These recommendations would help to provide high‐quality compassionate care in healthcare practices. Moreover, nurses could improve their individual capacity for compassion by following their value and belief system and by considering their colleagues as a role model of compassionate practice. [ABSTRACT FROM AUTHOR]

Purpose To illuminate the meaning of the lived experiences of resuscitation team members with the presence of the patient's family during resuscitation in the cultural context of Iran. Design An interpretative phenomenology was used to discover the lived experiences of the nurses and physicians of Tabriz hospitals, Iran, with family presence during resuscitation (FPDR). A total of 12 nurses and 9 physicians were interviewed over a 6-month period. Methods The interviews were audio recorded and semistructured, and were transcribed verbatim. Van Manen's technique was used for data analysis. Findings Two major themes and 10 subthemes emerged, including destructive presence (cessation of resuscitation, interference in resuscitation, disruption to the resuscitation team's focus, argument with the resuscitation team, and adverse mental image in the family) and supportive presence (trust in the resuscitation team, collaboration with the resuscitation team, alleviating the family's concern and settling their nerves, increasing the family's satisfaction, and reducing conflict with resuscitation team members). Conclusions Participants stated that FPDR may work as a double-edged sword for the family and resuscitation team, hurting or preserving quality. It is thus recommended that guidelines be created to protect patients' and families' rights, while considering the positive aspects of the phenomenon for hospitals. Clinical Relevance A liaison support person would act to decrease family anxiety levels and would be able to de-escalate any potentially aggressive or confrontational events during resuscitation. Well-trained and expert cardiopulmonary resuscitation team members do not have any stress in the presence of family during resuscitation. Resuscitation events tend to be prolonged when family members are allowed to be present. [ABSTRACT FROM AUTHOR]

Background: Many articles have studied workplace incivility and its influence on outcomes, but very few have been conducted to assess how to prevent this issue. In this study, we aimed to determine how to prevent workplace incivility from the nurses' perspective. Materials and Methods: This was a qualitative study which was based on a conventional content analysis approach. Thirty four nurses (25 to 52 years old) from seven training hospitals in Tabriz, Iran were selected through purposive sampling. Thirty six semi-structured interviews and eight field notes were analyzed. Results: The data analysis revealed 417 codes, ten categories, three subthemes and one theme, that is, A Need for a Comprehensive Attempt. Attempt of organization, nurses, and public as subthemes are needed to prevent workplace incivility. Conclusions: The findings of the study indicated that a comprehensive and systematic attempt was needed to prevent incivility. Nurses should try to improve their skills; officials should try to show the real image and position of nurses and hospitals to the community. [ABSTRACT FROM AUTHOR]

Background: Mobile applications are among effective learning tools and have a significant role in transferring information and knowledge to nurses. Objective: The current study was carried to identify the factors affecting nurses' use of practical health related mobile applications in education and patient interaction based on the combined Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI). Material and Methods: The study is a descriptive-analytical study with a cross-sectional method. The research population includes nurses working at Tabriz University of Medical Sciences hospitals, 150 of which were selected as the research sample using simple and available sampling. The data collection instrument was a questionnaire, the validity and reliability of which were confirmed (α=0.9). Data analysis was carried out using a correlation test and regression analysis by applying SPSSv16 software. Results: The findings show that perceived usefulness and perceived ease of use have a direct and significant effect on the rate of using mobile applications by nurses (P-value≤0.01), ((β=0.52), (β=0.40)). Other findings indicate that relative advantage, compatibility, trialability and observability, have a direct and significant effect on nurses' use of mobile applications, while complicatedness does not have a significant effect. Conclusion: The current study identifies the effective factors in nurses' use of health-related mobile applications based on an integrated model of TAM and DOI. Designers of mobile applications should consider these factors in designing and developing programs so that mobile applications can successfully fulfill their purpose in healthcare. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Caring is the essence of nursing. Caring to be meaningful needs to be based on mutual agreement between nurses and patients as to what constitutes nurse caring behaviors. As a result, healthcare professional can enhance patients' satisfaction of care by providing appropriate caring behavior. However, previous research that combined multiple types of patients, nurses and institutions demonstrated disagreement in prioritizing important behaviors. This paper reports a study that aimed at determining the caring behaviors which oncology patients and oncology nurses perceive to be the most important. Methods: This study is a comparative descriptive design that was conducted in an Iranian oncology centre. Convenience sampling was used to recruit 200 patients and 40 nurses to take part in the study. Data were collected over a period of 4 months in 2009 using the Caring Assessment Questionnaire, developed by Larson. Caring behaviors (n = 57) were ranked on a 5-point Likert-type scale and ordered in six subscales: "Being accessible", "Explains and facilitates", "Comforts", "Anticipates", "Trusting relationship", "Monitors and follows through". The data were analyzed using SPSS software version 13.0. The overall mean was calculated for each subscale to determine the rank distribution of the subscales. The nonparametric Mann-Whitney U test analysis of variables was used to compare patients' and nurses' scores on subscales. Results: The results demonstrate that both groups considered the same order of importance of caring, the high ranking of "Monitors and Follows through and "Being Accessible" and the low ranking of "Comforts" and "Trusting Relationships". Also, Patients only ranked "Being accessible" (p = 0.04) and "Explains and facilitates" (p = 0.03) higher than nurses. Conclusions: The oncology patients and nurses perceived highly physical aspects of caring and the results provide for nurses to be aware of the need, during their interactions with patients, to validate the effect their intended caring has upon patients. By so doing and with further refinement of the concept of caring for nursing in studies such as this, the practical aim of making patients feel cared for can be achieved. [ABSTRACT FROM AUTHOR]