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Purpose: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. Methods: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. Results: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. Conclusion: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.

One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.

As future providers of health services, nursing students should learn about ethical concepts over the course of their education. These concepts are currently taught in nursing schools, yet the degree of moral sensitivity in nursing students before entering clinical settings is a topic of controversy. This was a cross-sectional study on the nursing students studying for a bachelor’s degree in Qazvin University of Medical Sciences selected through census sampling (n = 205). Data were collected by Lutzen's Moral Sensitivity Questionnaire and analyzed through statistical tests using SPSS 16. The level of significance was P < 0.05. In order to conduct the study, permission was obtained from the Ethics Committee of Shahid Beheshti University of Medical Sciences.The mean of moral sensitivity was found to be 66.1 + 8.1, which is a moderate level. Of all the dimensions of moral sensitivity, "expressing benevolence" had the highest (16.9 ± 4.04) and "structuring moral sense" had the lowest (5.2 ± 1.45) mean scores. Among demographic variables, age was found to have a significant positive correlation with the score of moral sensitivity (r = 0.2, P = 0.01).Nursing students are relatively familiar with the ethical concepts of patient care, but that does not seem to be sufficed, as moral sensitivity is an extremely crucial factor in care. It is therefore recommended that the necessary training be provided to develop moral sensitivity in nursing students both in educational and practical environments.

Introduction: Power is a complex and extensive concept in nursing, which has a decisive impact on the accomplishment of duties, satisfaction and achievement of professional goals. Explaining the concept of power in nursing from the perspective of nurses and accessing its various dimensions may result in a better understanding of this issue. Aim: This study was aimed to explore the concept of power in nursing, using the views and experiences of Iranian nurses. Materials and Methods: This study was a qualitative research which used a content analysis approach. Participants were selected from among nurses active in clinical, management, and educational practices using the purposive sampling method. Data were collected using a semi-structured individual interview. The results were obtained by analysing the data using an inductive approach and the constant comparison method. Results: The participants of this study regarded the power of nursing as a positive concept and the issue of power in nursing consisted of three classes, the genesis with the subclasses of “being purposeful”, “being under the shadow of the profession nature”, “being dependent on the source”, strengthening with the subclasses of “being emotional and introverted”, “being formed in the context of professional communication”, “fluidity and flowing”, and the evolution with the subclasses “based on human values”, and “being a tool for professional excellence”. Conclusion: The concept of power in nursing can be considered a purposeful issue based on the nurses’ viewpoint which flourishes in the context of human, moral and caring nature of the nursing profession. According to its dependence on the nature of profession and on the basis of professional communication, Power of nursing grows with a fluidlike flowing structure, linked with human values, reaches maturity and results in outcomes such as improving the quality of care and professional excellence.

The human dignity of patients with cardiovascular disease (CVD) is an important issue, because of patients’ dependence upon caregivers, and because it impacts all aspects of their quality of life (QOL). Therefore, understanding and improving the status of dignity among these patients is of great importance. This study aimed to determine the status of dignity in patients with CVD admitted to cardiac intensive care units (CICUs) in Iran. This cross-sectional descriptive study was performed in 2015 on 200 patients admitted to the CICUs of hospitals affiliated to Kerman University of Medical Sciences, Iran. The participants were selected using random sampling method. Patients’ understanding of dignity was assessed through the reliable and valid Persian version of the Patient Dignity Inventory (PDI). Patients who were able to read and write or speak Persian and were conscious were included in the study. Data were analyzed using descriptive statistics tests, independent t-test, and one-way ANOVA in SPSS software. The mean age of the study participants was 59.0 ± 17.0. The mean score of human dignity was 3.60 ± 1.39. The mean scores of the factors of loss of independence, emotional distress and uncertainty, changes in ability and mental image, and the loss of human dignity were 3.94 ± 1.06, 3.63 ± 1.37, 3.57 ± 1.20, and 3.30 ± 2.08, respectively. A significant statistical correlation was observed between human dignity and the demographic characteristics of gender and frequency of hospitalizations in a CICU and a significant difference between those who lived alone and those who lived with family was observed (P < 0.05). Patients hospitalized in CICUs experience numerous problems associated with human dignity in each of its four dimensions. It is recommended that a study be conducted to investigate the relationship between the human dignity of patients with CVD and their QOL, anxiety, and depression.

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.

Introduction: Quality of life is an important criterion in evaluation of medical treatment and status of health and well being, contributing to the prediction of mortality rate in hospitals. QOL may be affected by diseases and their related complications. This study aims to investigate the relationship between the quality of life (QOL) of hemodialysis patients and demographic variables. Materials and Methods: In this descriptive analytic study, SF36 questionnaire was used to examine the QOL of 60 hemodialysis patients in Kerman. Results: The mean score of the QOL in hemodialysis patients was 49.83 ± 17.56. The maximum of score was related to the physical activity domain (57.09) and minimum score was given to the vitality domain (43.85). The relationship between quality of life and age, job, literacy and marriage was significant. Conclusion: Our results revealed that the QOF in hemodialysis patients was less that in than normal people. It was shown that these patients need to live a happy life. Therefore, appropriate mental support and instruction on compatibility methods can increase their QOF.

Introduction: Most risk factors for cardio-vascular diseases are related to behavior and knowledge. Educational programs are essential for changing the patient's lifestyle. This study aimed to assess the effects of face-to-face training about risk factors based on health belief model on knowledge and attitude of myocardial infarction patients after discharge. Methods: This was a quasi-experimental study. Eighty patients were randomly assigned to either intervention or control group. Data were collected through a researcher-made questionnaire. Educational contents were designed in a health belief model frame based on the collected data and educational needs. Each patient in the intervention group received face-to-face training individually and the control group received the routine hospital method. Finally, data were analyzed using Chi-square, paired t –test, and independent T-test. Results: Study results showed that there were no significant differences between mean score of knowledge and attitudes in the two groups before the intervention (p> 0.05). However, after the intervention, knowledge and attitude scores in the intervention group (31.02±1.4,105.9±5.96) and the control group (51.86± 5.96, 16.92±1.4) showed a significant difference in every dimension of the model (p

Introduction: It is impossible to be successful in virtual training unless we consider individuals’ viewpoints toward it. Despite this fact, less attention has been paid to students’ attitudes at the end of a virtual course in the published studies. This study investigates the effect of a virtual training course on the students` attitudes toward virtual education and its relationship with learning styles. Methods: This was a quasi-experimental study based on pre- and post- tests. Study population included undergraduate nursing students of second semester entered to Razi Faculty of Nursing and Midwifery of Kerman University of Medical Sciences in year 2009 and were studying the course titled “fluid and electrolyte disorders”. Students were divided into two groups of traditional or virtual learning, randomly. Course content was presented to the virtual group via website while traditional group were taught in classroom. Students’ attitudes toward virtual education were collected via a researcher-made questionnaire. Their learning styles were assessed by Gaziano & Liesen questionnaire. Data was analyzed by descriptive statistics (mean, standard deviation, and frequency distribution) and analytical statistics (independent t-test and paired t). Results: Before training, the mean score (out of 5) of attitude toward virtual education was 3.19±0.48 in virtual group and 3.21±0.33 in traditional group the difference between mean scores was not significant. At the end of the semester, the score was 3.55±0.45 for virtual group and 3.21 ± 0.46 for traditional group which showed a statistically significant difference (p=0.03, t=2.15). The results of ANOVA revealed no significant relationship between learning style and attitude toward virtual training (p=0.07). Conclusion: This study showed that passing a virtual training course could improve students’ attitudes toward virtual education. There is no difference in attitude toward virtual education among people with different learning styles.

Background & Objectives: Coronary angiography is one of definitive diagnostic tests for coronary artery disease. Patients' education is one of the most interventions before coronary Angiography. The objective of this study is to compare two patients' education method (Video & Verbal) on patients' satisfaction and complications after coronary angiography. Materials & Methods: In a quasi-experimental, pretest-posttest design, 128 patients randomly assigned to either control or experimental group. Control group received verbal routine education by nurses and experimental group received an informative video about coronary angiography procedure as well as pre and post angiography interventions. Complications of patients were assessed by observation of researcher and satisfaction measured by a 4-state scale. The date analyzed by descriptive and analytic statistics. Results: Analysis of data showed that the satisfaction of patients in experimental group was higher than control group. This difference was statistically significant (P0.05). Conclusion: Results of this study confirmed the application of multi-media education in increasing patients' satisfaction. It is recommended that video education used as a substitute for verbal education before coronary angiography.

Background and objectives: It is believed that any discrepancy between learning style of students and their field of study leads to their dissatisfaction and consequently dropping out of school The aim of this study was to compare the learning styles of Nursing students in Kerman Razi Nursing School in 2009 Methods : In this crosssectional study performed in 2009 all undergraduate and postgraduate Nursing students of Razi Nursing School (n=148) were asked to complete Kolb learning style inventory (KLSI) Version 31 Data were analyzed using descriptive and inferential statistics Results : From all students 878% were studying in undergraduate and 122% in master programs Among undergraduate students assimilator learning style (485%) and among master students convergent learning styles (444%) had the highest frequencies There was a statistically significant difference between learning styles of undergraduate and master students (P=0028) Conclusion: Since nursing is an occupation requiring interaction and communication with people attention of nursing teachers to the learning styles of their students is very essential for promotion of community health It is suggested that nursing teachers use a variety of teaching methods based on students educational level and preferred learning style

The high turnover of nurses has become a universal issue. The manner in which nurses view their organization’s ethical climate has direct bearing on their job satisfaction. There is little empirical evidence confirming a relationship between different sorts of ethical climate within organizations and job satisfaction in Iran.The aim of this study was to determine the correlation between nurses’ perception of ethical climate and job satisfaction in the Teaching Hospital of Kerman University of Medical Sciences.A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in 4 hospitals affiliated with the Kerman University of Medical Sciences. The instruments used in this study included a demo-graphic questionnaire, Ethical Climate Questionnaire (ECQ), and Job Satisfaction Scale (JS). Data analysis was carried out using Pearson’s correlation, one-way ANOVA, T-test and descriptive statistic through Statistical Package for Social Science (SPSS), version 16.Across the five dimensions of ECQ the highest mean score pertained to professionalism (mean = 13.45±3.68), followed by rules climate (mean = 13.41±4.01), caring climate (mean = 12.92±3.95), independence climate (mean = 11.35±3.88), and instrumental climate (mean = 8.93±2.95). The results showed a positive correlation among ethical climate type of: professionalism (p=0.001), rules (p=0.045), caring (p=0.000), independence (p=0.000) with job satisfaction, and no correlation was found between instrumental climate and job satisfaction.The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate and job satisfaction. Therefore managers of hospitals can promote nurses’ job satisfaction by providing ethics training programs that establish a working team and a culture that strengthens team spirit among nurses.

Background & Objectives: Coronary angiography is one of definitive diagnostic tests for coronary artery disease. Patients' education is one of the most interventions before coronary Angiography. The objective of this study is to compare two patients' education method (Video & Verbal) on patients' satisfaction and complications after coronary angiography. Materials & Methods: In a quasi-experimental, pretest-posttest design, 128 patients randomly assigned to either control or experimental group. Control group received verbal routine education by nurses and experimental group received an informative video about coronary angiography procedure as well as pre and post angiography interventions. Complications of patients were assessed by observation of researcher and satisfaction measured by a 4-state scale. The date analyzed by descriptive and analytic statistics. Results: Analysis of data showed that the satisfaction of patients in experimental group was higher than control group. This difference was statistically significant (P0.05). Conclusion: Results of this study confirmed the application of multi-media education in increasing patients' satisfaction. It is recommended that video education used as a substitute for verbal education before coronary angiography.

Background & Objective: Ethical competency in nursing means performing nursing cares based on bioethics This type of competency is an important factor in improving the quality of nursing cares Realizing the obstacles of acquiring ethical qualification by nursing students is one of the basic necessities towards nursing education development The development of ethical competency is one of the most important strategies which can help in improving nursing students capabilities and professional development This study aimed to identify the barriers to acquiring ethical qualification by nursing students through content analysis of their experiences Methods: A qualitative study was conducted using a content analysis approach Convenience sampling was employed to select 25 nursing students studying in nursing schools of Tehran public universities Tehran Iran Data were collected through semistructured interviews which were tape recorded and transcribed verbatim Data were analyzed using descriptive content analysis approach according to Graneheim and Lundman method Results: Eight themes emerged from data analyses including lack of motivation and interest of the students in their profession insufficient selfawareness the shortage of expert nursing instructors in ethics science inadequacy of curriculum inappropriate ethical teaching methods problems in evaluation of ethical characteristics poor interpersonal relationships and constraints in clinical setting Conclusion: It seems that in developing nursing students ethical competency both contexts and individuals have a role Therefore barriers of ethical competency should be sought in various aspects The present study provides special classification of obstacles that because of growing from a unique study context can be helpful in planning for the development of professional nursing ethics in education and clinical services Also the findings of this study can provide a base for further researches on this subject

Background: Ischemic heart diseases are the most common cardiovascular diseases. This study aimed to assess the effects of video training about risk factors based on health belief model on knowledge and attitude of myocardial infarc-tion patients after discharge. Methods: This was a quasi-experimental study conducted in 2010. Eighty patients were randomly assigned to either intervention or control group. Data was collected by a researcher-made questionnaire. Results: Study results showed that the mean score of knowledge about disease, diet, physical activity and perceived benefit, severity, and susceptibility after video training was increased significantly. Conclusions: Using videos for educating myocardial infarction patients is a useful method for preventing recurrence of the disease.

Objective(s): To determine relationships between self-efficacy and health beliefs among type2 diabetic patients. Methods: A Health Belief Model (HBM). Results: Diabetic patient’s self-efficacy and health beliefs level are about average. There is significant relation between these tow variables. Among demographic variables it seems that education level has maximal effect on almost of models elements also with self-efficacy. Most elements are interrelated and this relation is significant. But cues to action have not significant regression with perceived benefits and perceived barriers. Conclusion: Significant relations between self-efficacy and health beliefs point out this fact that in order to patient self-care enhancement we need self-efficacy improvement via establishment of positive health beliefs. Health care professional due to continue communication with patients have specific position in positive health beliefs and self-efficacy. Results show that cues to action that indirectly related to health care personnel and Medias, have not adequate effects on enforcement of patients positive health beliefs. It is recommended more studies and measures in this field. |

Teaching ethics to nurses leads to their involvement in providing high quality care, enable them to duly encounter ethical issues. One of the key elements of educational systems is nursing instructors. Even though lots of studies show the role of instructors in students' learning, their role in promotion of professional ethics has been attended to less.The objective of this study is surveying the experience of nursing students with respect to the role of instructors in promotion of professional ethics.This qualitative study enrolled 15 undergraduate nursing students from three nursing schools in Teheran whom depth interview was performed. The interview was semi-structured with open ended questions. The analysis was accomplished by use of qualitative content-analysis method.Data analysis demonstrated 2 main themes and 7 subcategories in regard to the role of instructors in promotion of professional ethics in nursing students including: 1) the effective professional role model 2) facilitating creative learning. The effective professional role model encompasses individual characteristics and beliefs, clinical skills and professional commitment of role model. Creative learning facilitates by encouraging critical thinking and decision-making, Providing supportive learning conditions, providing proper space for sharing knowledge followed by evaluation and creative feedback.The findings of this study provides a background for strengthening the role of instructors in promotion of professional ethics with more emphasis on research which increase capability of instructors at nursing education centers.

Payesh2010; 9: 61-68Accepted for publication: 27 November 2008[EPub a head of print-7 March 2010] Objective(s): To evaluate the effect of a rehabilitation program on quality of life in breast cancer patients.Methods: Fifty-seven patients who underwent modified radical mastectomy, had finished chemotherapy and radiotherapy and received hormone therapy were selected and randomly assighned into case and control groups. Control group was under medical care and the case group in addition to medical care received a rehabilitation program (physiotherapy, education and individual counseling) for two months. Quality of life was measured by the EORTC QLQ C30 before one week and 3 months after rehabilitation in both groups. Results: Before intervention there were statistically significant differences in physical (P< 0.001) and emotional functioning (P= 0.02) in cases compared to control group, while no other significant differences were observed in other scale. One week after the program, differences among two groups in 6 scales were significant indicating a better condition in intervention group. Three months after the intervention the cases showed a statistical meaningful improvments in 11 scales.Conclusion: Rehabilitation programs might improve the quality of life after mastectomy in breast cancer patients.

Background & Objective : Libraries are among main parts of universities as libraries of high quality lead to improvement in education and research within universities and the society Assessing quality of services in educational systems is important to improve quality of provided services This study was conducted to assess the quality of services provided by the central library of Kerman University of Medical Sciences from the faculty members and students point of view Methods : In this study 200 faculty members and students of Kerman University of Medical Sciences were chosen using stratified random sampling The data was collected using LibQUAL+TM standard questionnaire after its validity and reliability were confirmed Results : Our findings showed that the mean score of general satisfaction of the central librarys provided services was 613 out of 9 Among the three aspects of library service quality information control was the most satisfactory factor (598) which was followed by efficacy of services (596) and the librarys atmosphere (589) Faculty members were more satisfied with the central librarys provided services in all aspects compared to students although this difference was not significant The most frequent referral to the central library and using references was once a month Conclusion : Although the findings of this study were suggestive of faculty members and students relative satisfaction of provided services improving quality of services necessitates better and more organized planning Improvement of library service quality can lead to promoting faculty members and students scientific level in universities of medical sciences medical knowledge and medical education

Moral distress and professional stress are common problems that can have adverse effects on nurses, patients, and the healthcare system as a whole. Thus, this cross-sectional study aims to examine the relationship between moral distress, professional stress, and intent to stay in the nursing profession. Two hundred and twenty full-time nurses employed at teaching hospitals in the eastern regions of Iran were studied. A 52-item questionnaire based on Corley's Moral Distress Scale, Wolfgang's Health Professions Stress Inventory and Nedd Questionnaire on Intent to Stay in the Profession was used in the study. Additionally, demographic details of the study population were collected. No significant correlation was observed between the intensity and frequency of moral distress, professional stress, and intent to stay in the profession among nurses (P > 0.05). There was a significant correlation between moral distress, professional stress, and age, number of years in service and work setting (P < 0.05). Given the important effect of moral distress and professional stress on nurses, in addition to the educational programs for familiarization of nurses with these concepts, it is recommended that strategies be formulated by the healthcare system to increase nurses' ability to combat their adverse effects.

Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of Iranian nurses on breaking bad news to patients and their families. In this research, a qualitative approach was adopted. In-depth and semi-structured interviews were conducted with 19 nurses who had at least one year work experience in the ward, and content analysis was performed to analyze the data. Five major categories emerged from data analysis, including effective communication with patients and their families, preparing the ground for delivering bad news, minimizing the negativity associated with the disease, passing the duty to physicians, and helping patients and their families make logical treatment decisions. The results of this study show that according to the participants, it is the physicians' duty to give bad news, but nurses play an important role in delivering bad news to patients and their companions and should therefore be trained in clinical and communicative skills to be able to give bad news in an appropriate and effective manner.

Background & Aim: Researchers in the nursing science study complex constructs for which valid and reliable instruments are needed. When an instrument is created, psychometric testing is required, and the first-step is to study the content validity of the instrument. This article focuses on the process used to assess the content validity. Methods & Materials: This article examines the definition, importance, conceptual basis, and functional nature of content validity in instrument development. The conditional and dynamic nature of content validity is discussed, and multiple elements of content validity along with quantitative and qualitative methods of content validation are reviewed. Results: In content validity process, content representativeness or content relevance of the items of an instrument is determined by the application of a two-stage (development and judgment) process. In this review, we demonstrate how to conduct content validity process, to collect specific data for items generation and calculation of content validity ratio, content validity index, modified Kappa coefficient, and to guide for interpreting these indices. Face validity through suggestions of expert panel and item impact scores is also discussed in paper. Conclusion: Understanding content validity is important for nursing researchers because they should realize if the instruments they use for their studies are suitable for the construct, population under study, and sociocultural background in which the study is carried out, or there is a need for new or modified instruments.

Background: Nursing is a stressful profession and nursing students are exposed to high levels of stress in both theoretical and clinical components of their educational programme This fact not only affects their academic performance but also may lead to various physical and psychological disorders Objective: The purpose of this study was to investigate the level and sources of stress in nursing students of Kerman Zarand Bam and Jiroft nursing schools Methods: It was a descriptive study on 274 volunteer baccalaureatenursing students selected by randomized clustering method Data were collected by questionnaire and analyzed by using parametric statistics Results: Mean score of students stress level was 296 at the range of 15 The highest stress levels were related to copying with personal problems ( =340) feeling anxious ( =334) and experiencing anger in facing every problem ( =331) Among sources of stress lack of agreement between theoretical and clinical trainings ( =350) educational achievements and qualification for the job ( =340) and attitude and expectations of others toward nursing profession ( =330) have the most important roles There was a significant relationship between the stress level and having living mother and fathers educational level (P

Maintaining dignity and respect is among patients’ most fundamental rights. The importance of patient dignity, the status quo, patients’ needs, and a shortage of survey studies in this area were the underlying incentives for conducting this study. This was a cross-sectional descriptive study in which data were collected through Patient Dignity Inventory (PDI). The questionnaire was completed by 280 inpatients in 2012 to determine their perspectives on their personal state of human dignity. In this study, the mean score of patients’ dignity was 1.89 out of 5 (SD = 0.81). Results indicated a significant relationship between type of hospital and the distress caused by disease symptoms, peace of mind, and social support (P < 0.05). There were also relationship between type of ward and dependency (P < 0.05), type of disease and dependency (P < 0.05), gender and social support (P < 0.05), household size and peace of mind (P < 0.05). The person’s satisfaction with household income showed significant relationship with symptom distress, dependency and existential distress (P < 0.05). Results showed a significant inverse correlation between age and patient dignity (P = 0.005, r = - 0.166). However, the relationship between employment status, health insurance, education level and the above factors were insignificant. Studies indicate that there is a relationship between patients’ dignity and mental distress, and therefore policy makers and health services officials should establish and implement plans to maintain and enhance patients’ dignity in hospitals. Educating the health team, particularly the nurses can be very effective in maintaining patients’ dignity and respect.

School is the first social institution which affects adolescents' lives, and it determines their opportunities, life quality and behavior. Thus, the aim of this study was to determine the relationship between students' bonds with their school and multiple health risk behaviors amongst high school students in Kerman City, Iran.In this cross-sectional study, high school students of all levels participated during November and December 2001 in Kerman. The research sample included 1024 students (588 females and 436 males) aged 15 to 19 years. A CTC (Communities That Care Youth Survey) questionnaire was designed based ona standard questionnaire in order to collect a profile of students' risk behaviors. A multi-stage cluster sampling method was used to collect the data.In the final multivariate logistic regression, two variables including; age, (ORa=1.15, P=0.02) and male gender (ORa=2.14, P=0.001) had a significant positive association with multiple health risk behaviors (MHRB). School commitment (ORa=0.38, P=0.001) and school rewards for involvement (ORa=0.80, P=0.21), had a significant negative association with MHRB.Our results quantified the pivotal role of schools in shaping the risky behavior of students. It seems that school may minimize the risky behaviors by creating a strong link, and improving the effective communications with students.

The high turnover of nurses has become a universal issue. The manner in which nurses view their organization's ethical climate has direct bearing on their job satisfaction. There is little empirical evidence confirming a relationship between different sorts of ethical climate within organizations and job satisfaction in Iran. The aim of this study was to determine the correlation between nurses' perception of ethical climate and job satisfaction in the Teaching Hospital of Kerman University of Medical Sciences. A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in 4 hospitals affiliated with the Kerman University of Medical Sciences. The instruments used in this study included a demographic questionnaire, Ethical Climate Questionnaire (ECQ), and Job Satisfaction Scale (JS). Data analysis was carried out using Pearson's correlation, one-way ANOVA, T-test and descriptive statistic through Statistical Package for Social Science (SPSS), version 16. Across the five dimensions of ECQ the highest mean score pertained to professionalism (mean = 13.45±3.68), followed by rules climate (mean = 13.41±4.01), caring climate (mean = 12.92±3.95), independence climate (mean = 11.35±3.88), and instrumental climate (mean = 8.93±2.95). The results showed a positive correlation among ethical climate type of: professionalism (p=0.001), rules (p=0.045), caring (p=0.000), independence (p=0.000) with job satisfaction, and no correlation was found between instrumental climate and job satisfaction. The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate and job satisfaction. Therefore managers of hospitals can promote nurses' job satisfaction by providing ethics training programs that establish a working team and a culture that strengthens team spirit among nurses.