Search

Background: Troubled conscience results from the lack of attention to the voice of conscience. Regarding the fact that ICU healthcare workers are constantly faced with stressful and challenging situations, they often experience a troubled conscience. Aim: This study aimed to explain the factors leading to troubled conscience and identify the consequences of troubled conscience among ICU nurses. Methods: Qualitative content analysis was used to answer the research question. A total of 18 ICU nurses were selected to participate in this study using purposive sampling. Data were collected using face-to-face, semi-structured interviews. Findings: Four categories of "carelessness", "contextual challenges", "non-supportive and unpredictable structure" and "whirlpool of troubled conscience" were shown to constitute the main causes of troubled conscience among ICU nurses. Conclusion: Troubled conscience negatively impacts nurses and is associated with psychological/behavioral changes among them. The identification and explanation of troubled conscience help healthcare providers to confront it and manage its causes. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID‐19 pandemic, there was a remarkable increase in public volunteering for the care of hospitalized patients. They faced challenges during their voluntary care provision. This study aimed at exploring public volunteers' experiences of the challenges of the voluntary care provision to hospitalized patients with COVID‐19. Methods: A descriptive qualitative study with an inductive content analysis method was conducted, 2022–2023. Eighteen public volunteers providing care to hospitalized patients with COVID‐19 were purposefully selected among 10 hospitals, specialized in COVID‐19 care in Tehran and Shiraz, Iran. Data were collected over 7 months through in‐depth semistructured interviews and concurrently analyzed using conventional content analysis methods. Findings: The challenges of voluntary care provision to hospitalized patients with COVID‐19 were illustrated in five main categories, each with two subcategories. The categories included structural challenges, interpersonal conflicts, financial constraints, covert participation and the deteriorating condition of care provision. The subcategories comprised lack of volunteer recruitment bases, ineffective organization of voluntary activities, pervasive distrust, heightened risk of clinical errors, conflicts between volunteer commitments and primary occupation, lack of financial support, lack of family support, isolation by friends, mental trauma and physical exhaustion. Conclusion: Public volunteers encounter diverse challenges while providing care to hospitalized patients with COVID‐19, which negatively impacts their motivation to serve. By addressing these challenges, we can create a more supportive environment for volunteers and enhance the quality of care provided to patients during public health emergencies. Identifying such challenges can assist healthcare managers and policymakers develop effective strategies to mitigate mounting difficulties and enhance volunteer services, thereby improving the overall quality of care provided to patients during public health crises. Patient Contributions: Participants were identified and recruited after the study objectives were explained in person to the managers. The participants were approached and interviewed by one author. Participation was voluntary and the participants did not receive any financial compensation for their time. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to explore the factors affecting nurses' intentions to leave or stay in their profession during the coronavirus pandemic in Iran. Introduction: Because the effectiveness of a healthcare response to a disaster depends on an available, skilled, and motivated healthcare workforce, it is essential to understand and address potential barriers to and reasons for the intentions of medical staff to leave or stay in their profession. Methods: A qualitative study with a conventional content analysis approach was conducted. The participants included nurses working in hospitals during the COVID‐19 pandemic, and nurses who had previously left their job or had been absent from work for a period of time. The participants were selected using a purposeful sampling strategy. Data were collected through 19 in‐depth, individual semi‐structured interviews with 16 nurses. The COnsolidated criteria for REporting Qualitative research checklist was used to report the study. Findings: Three categories; commitment and work conscience (with a subcategory of risk‐taking), fear (with two subcategories of fear of family infection and fear of protective equipment shortages), and organizational factors (with two subcategories of organizational atmosphere of the hospital and motivational factors), emerged from the analysis. Conclusion: The reasons for quitting a nursing job or to keep working as a nurse during the pandemic include both personal and organizational factors. Commitment and work conscience in pandemic conditions is one of the main factors for keeping nurses in their profession. Implication for nursing practice and policy: Gaining insight into nurses' understanding of the situation and perspectives is the key to being able to provide appropriate support and keep them in the workforce. Peer support can play an important role in supporting novice nurses in facing challenges posed by a pandemic and should be improved. Also, programs and strategies need to be planned to improve resilience among nurses and to help them to manage their stress and fear. [ABSTRACT FROM AUTHOR]

The study aimed to explore the conditions that accompany conflict of conscience experienced by nurses in intensive care units. A qualitative approach guided the study, which was undertaken between April 2020 and April 2021. A total of 15 registered nurses working in intensive care units were recruited through purposive sampling. Individual semistructured interviews were conducted. The data were analyzed using a qualitative content analysis. The analysis revealed two themes: "conflict of conscience in relation to the structure" and "conflict of conscience based on context." Conflict of conscience in relation to the structure consisted of two categories: conflict of interest and conflict of conscience and law. Conflict of conscience based on context consisted of two categories: care dilemmas and arbitrary behaviors with end‐stage patients. A variety of factors were accompanied by a conflict of conscience for nurses in intensive care units. Given that conflict of conscience has negative consequences for the health and quality of nursing care, health care managers need to tailor strategies to reduce the negative consequences considering the findings of the study. [ABSTRACT FROM AUTHOR]

Introduction: A feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision‐making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses. Aim: To illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian‐speaking people with dementia who have emigrated from Iran. Method: The study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one year's experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation. Results: The meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to one's values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver. Conclusions: The enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context. [ABSTRACT FROM AUTHOR]

Background: Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts. Research objective: The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia. Research design: A phenomenological hermeneutical method guided the study. Participants and research context: A total of 10 enrolled nurses with Iranian background, aged 33–46 years, participated in the study. All worked full time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden. Ethical considerations: The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential. Findings: Three themes were constructed including perception of conscience, clear conscience grounded in relations and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day. Conclusion: Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe people's experiences of living with dementia in Iran. Background A knowledge gap exists regarding the experiences of living with dementia in nonWestern contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context-related experiences of dementia is a prerequisite for nurses' ability to provide adequate and meaningful care. Design Qualitative, cross-sectional design. Methods Qualitative content analysis of semi-structured interviews with people living with dementia in urban Iran (six women and nine men; 60-87 years old). Results The participants experienced their condition as a state of forgetfulness that was accompanied by losses and dependency on others. They wanted to feel good about themselves and feel important, but they continually struggled with matters such as a loss of accountability, feelings of futility and the frustration of others. Economic dependency and a lack of economic resources were sources of feelings of futility. Conclusion Experiences of living with dementia in Iran included a substantial struggle to stay connected to the social world and to deal with dramatic life changes, aspects of living with dementia that seem to be universal. However, the feelings of financial burden and the experience of being nagged for their shortfalls by family members have seldom been described in other studies and seem to represent a cultural aspect of their experience. Relevance to clinical practice The results of the study call for further nursing efforts in supporting people living with dementia in their struggle with their altered lives and in retaining their connections to everyday life. Furthermore, their family members might benefit from specific nursing interventions including information about dementia and advice on how to help the family members with dementia to interact with others while exercising their individual strengths. [ABSTRACT FROM AUTHOR]

The article presents a study on the validity and reliability of the Persian version of The Spirituality and Spiritual Care Rating Scale (SSCRS). The researchers stress that despite being committed to the concept of holistic nursing, the nursing practice does not always address the spiritual needs of patients. The nurses at the Razi Psychiatric Center in Tehran, Iran participated in the study. It is said that the study has provided information on how psychiatric nurses in Iran perceive spiritual care.

Introduction: This study compares self-reported Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) status among elderly survivors of the 2003 Bam Earthquake before, two months after, and five years after the event, and explores related determinants., Methods: A two-stage cluster survey was conducted on 210 elderly survivors in the earthquake-stricken area five years after the event., Results: Both ADL and IADL scores decreased two months after earthquake compared to prior status (p <0.001). No differences were observed between two months and five years after the event (p >0.05). Access to medical services were not related to level of ADL or IADL (p = 0.52 and p = 0.74, respectively). Elderly survivors with lower functional capability in terms of ADL experienced more problems in access to relief items (p = 0.04), but no similar association was found for IADL (p = 0.26)., Conclusion: The Bam earthquake adversely affected functional capacity of the elderly. Disaster responders must take into account functional capacity of elders when planning for medical and relief operations.