Journal of Medical Ethics and History of Medicine最新文献

The present study aimed to compile and develop a professional guideline for health-care providers in Iran regarding cyberspace usage. This was a mixed-methods study, conducted in three phases. In the first phase, the principles of ethics in cyberspace were collected through a review of the literature and available documents, and were then subjected to content analysis. In the second phase, the views of experts on medical ethics, virtual education, information technology and medical education, as well as clinical sciences experts and representatives of medical students and graduates were evaluated using the focus group method. In the third phase, the draft was evaluated by various stakeholders. Finally, after receiving the comments, the necessary modifications were applied to the guideline. The professional guideline for the use of cyberspace by health-care professionals comprised 30 codes in 5 domains, including the general regulations domain, care and treatment, research, education, and personal development. This guideline presents the various ways professionalism can be maintained in cyberspace interactions. Adherence to the principles of professionalism in cyberspace is required to protect and preserve the public trust in health-care professionals.

Role modeling is one of the most influential components of teaching professional behaviors to nursing students. The Role Model Apperception Tool (RoMAT) was designed in the Netherlands to measure role modeling behaviors in clinical educators. The aim of this study was assess the psychometrics of the Persian version of this tool. In a methodological study, the Persian version of the RoMAT tool was developed using the forward-backward translation method. Face validity was confirmed through cognitive interviews, and content validity was done by a panel of 12 experts. Construct validity was assessed through exploratory factor analysis (n = 200), and confirmatory factor analysis (n = 142) was evaluated after the tool was completed online by undergraduate nursing students. Reliability was confirmed using internal consistency and test and retest methods. Furthermore, ceiling and floor effects were assessed. The two components of "professional competencies" and "leadership competencies" emerged with a cumulative variance of 62.01%, a reliability with Cronbach's alpha of 0.93 and 0.83, and an intraclass correlation of 0.9 and 0.78, respectively. It was concluded that the Persian version of the Role Model Apperception Tool is a valid and reliable tool and can be used to investigate the role modeling behaviors of clinical instructors of nursing students.

Professionalism has been recognized as an essential component of inter-professional collaboration (IPC), and hence this study aimed at exploring elements of inter-professional professionalism (IPP) affecting IPC among surgery teams.  This qualitative study had been conducted from 2019 to 2021. Fifteen participants in surgery teams including surgeons, anesthesia nursing, and surgical technology nursing at hospitals of Shahid Sadoughi University were contributed to this study. Data was collected through semi-structured interviews and analyzed through inductive content analysis, an approach introduced by Lundman and Graneheim. Data analysis process included the following: (i) Developing verbatim transcription of interview, (ii) Extracting semantic units and classifying them under the top compact unit, (iii) Summarizing and classifying the compact units and selecting appropriate labels for them, and (iv) Sorting subcategories according to their similarities and differences. Two hundreds and forty-two codes, five sub-categories, two categories, and a theme entitled "reciprocal accountability in IPP" were extracted. The barrier category was named "weakness in accountability to team-based values" and the facilitator category was called "responsibility of maintaining empathetic relationship within the IP team". Development of IPP and professional values (e.g., altruism, empathetic communication, and accountability to individual's and team's roles) can facilitate collaborative processes among different professions.

Emergency medical technicians (EMTs) are very likely to leave the profession due to their obligation to work in critical situations such as the COVID-19 pandemic. This study aimed to investigate the relationship between the ethical work climate and the intention to leave the service among EMTs. In this descriptive correlational study, 315 EMTs working in Zanjan province were surveyed using the census method in 2021. The research tools included the Ethical Work Climate and the Intention to Leave the Service questionnaires. Data were analyzed using SPSS software version 21. We found the mean (SD) score of the organization's ethical work climate to be 73.93 (±12.53), and the intention to leave the service 12.54 (±4.52), which are at a moderate level. A statistically significant positive correlation existed between these variables (r = 0.148, P = 0.017). Also, there was a statistically significant relationship between age and employment status among the demographic variables, and the ethical work climate and the intention to leave (P < 0.05). Our findings indicate that ethical work climate is one of the influential but less noticed factors that affect the performance of EMTs. Therefore, it is suggested that managers implement measures to develop a positive ethical work climate to reduce the tendency to leave the service among EMTs.

In intensive care units (ICUs), patient privacy is of particular importance due to the structure of the ward environment and the critical situation of the patients. The aim of this study was to identify the dimensions of patient privacy in ICUs. For this purpose, a descriptive-qualitative-exploratory study was performed. The data collection methods included observations and interviews, which were handwritten and analyzed using qualitative content analysis with a conventional approach. A total of 27 participants were selected based on purposeful sampling and with maximum diversity of health-care providers and recipients. The study environment was the ICUs of two selected hospitals affiliated to the medical sciences universities of Isfahan and Tehran, Iran. The data were analyzed into 4 classes and 12 subclasses. The classes included physical, informational, psychosocial, and spiritual-religious privacy. Findings of the present study identified hidden layers of patient privacy as a multidimensional concept that is influenced by various factors. In order to provide holistic care, preparing the grounds for patient privacy ‎and familiarizing the staff with its various dimensions seem necessary.

The quality of care crisis (QCC) is one of the most crucial crises the modern medicine is confronting, as the existential and psychological needs of patients have not been addressed and satisfied. Several attempts have been made to find solutions for QCC, e.g., the Marcum's recommendation to make physicians virtuous. Most of the existing formulations for the QCC have regarded technology as one of the causes of this crisis and not part of its solution. Although the authors agree with the role of technology in creating the crisis of care to some extent, in this article we try to present the crisis of care so that medical technology is an important part of its solution. For this purpose, we analyzed QCC from the philosophical perspectives of Husserl and Borgmann and put forward a novel proposal to take account of technology in QCC. In the first step, it is discussed that the role of technology in causing the crisis of care is due to the gap between the techno-scientific world and the life- world of the patients. This formulation shows that the crisis-causing role of technology is not inherent. In the second step, it is tried to find a way to integrate technology into the solution to the crisis. In the proposed reframing, designing and applying technologies based on focal things and practices make it possible to develop technologies that are caring and are able to mitigate QCC.

The controversial role of ethics in clinical education and its ability to draw the attention of a large audience is inevitable. The issues and challenges of the COVID-19 pandemic have transformed the clinical education environment. This study was conducted to explore the challenges and ethical requirements of medical sciences education during the COVID-19 pandemic in 2020. The study was qualitative research and the instrument was a semi-structured interview. The participants included faculty members of the basic and clinical Sciences at Iran University of Medical Sciences. After 16 rounds of interviews, theoretical saturation was achieved. Qualitative data were analysed using conventional content analysis, which resulted in 81 preliminary codes and 28 sub-categories. Finally, two themes of "ethical challenges" and "ethical requirements", and 10 categories were achieved. The categories were consisted of "being patient-centred", "social accountability of curriculums", "ethical challenges of the clinical environment", "the poor performance of the clinical faculty members and students", "being justice-centred", "raising awareness", "observing clinical research ethics", "preservation and promotion of mental health", "patient confidentiality", and "respect for individuals". We hope the ethical challenges in medical education that were created due to the emergence of Covid-19 can be reduced and eliminated by defining a framework for ethical requirements.