Moral reckoning among nurses: A directed qualitative content analysis.

BACKGROUND: When nurses face ethical challenges, they attempt to accept responsibility for their actions and start moral reckoning. Moral reckoning is the personal evaluation of one's behaviors or others' behaviors during ethically challenging situations. RESEARCH AIM: This study aimed at exploring the concept of moral reckoning and its stages among Iranian nurses using Nathaniel's moral reckoning Theory. RESEARCH DESIGN: This descriptive qualitative study was conducted in 2022 using directed content analysis. PARTICIPANTS AND RESEARCH CONTEXT: Eighteen nurses were purposively recruited from three teaching hospitals affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Data were collected via in-depth semi-structured interviews which lasted 50 minutes on average and were concurrently analyzed via the three-step directed content analysis method proposed by Elo and Kyngas. ETHICAL CONSIDERATIONS: This study earned the ethical approval of the Ethics Committee of Golestan University of Medical Sciences, Gorgan, Iran (code: IR.GOUMS.REC.1400.171). FINDINGS: During data analysis, 157 final codes were developed and categorized into 23 subcategories, 10 categories, and four themes. The themes of the study are ease (with the two categories of becoming and interacting), upset (with the two categories of mental upset and behavioral upset), resolution (with the two categories of making a stand and giving up), and reflection (with the four categories of remembering, telling the story, examining conflicts, and living with consequences). CONCLUSION: Ethically challenging situations alter the ease stage of moral reckoning among nurses, cause them mental and behavioral upset, and thereby, require them to make stand or give up. Then, they continuously examine events in their mind and finally, live with the positive and negative consequences of the events.

Evaluation of safety standards accomplishment in educational hospitals of Neyshabur University of Medical Sciences-Iran.

Patient's safety and staff in hospital is one issue that has always been considered as an important principle by experts in health systems. Therefore, for increase safety, standards and safety regulations must be considered. This study aims to evaluation of safety standards accomplishment in educational hospitals of Neyshabur University of medical Sciences. This cross-sectional descriptive study, safety standard status of all wards including 17 various wards from 22 Bahman hospital and 14 various wards from hakim Hospital in Neyshabur city (2016) was investigated. Data were collected using a questionnaire safety standard status hospitals (264 questions). Also data analyzed by SPSS16 software, using descriptive (Mean ± SD) and inferential statistics (T-Test). The results revealed that Safety standard status in 22bahman and hakim hospital were weak (2.42 ± 0.14) and moderate (3.04 ± 0.18) respectively. Also result showed in Hakim hospital, the highest and lowest safety standard status in Internal and Administrative-financial unit was (3.42 ± 0.19) (1.36 ± 0.58) respectively. In addition in hakim hospital, the highest and lowest safety standard status in operation room and administrative-financial unit (3.53 ± 0.28), 1.36 ± 0.58) respectively. According to the result, the safety condition in hospitals of Neyshabur city is moderate and poor status. However, imperfect implementation of safety protocols can endanger safety conditions in hospital. Therefore, it is necessary to take the required correcting measures to ensure full safety in hospitals. •Safety is defined by development of systems for preventing incidents, injuries, and other unpleasant events in organizations.•This article showed the safety status is not appropriate in most units of hospitals, which can lead to dangers for patients and personnel.•It is suggested for future studies to compare the safety status of different provinces.

Evaluation of Oral Ginger Efficacy against Postoperative Nausea and Vomiting: A Randomized, Double - Blinded Clinical Trial.

BACKGROUND: Postoperative nausea and vomiting is one of the most common side effects associated with surgical procedures. OBJECTIVES: The aim of this study was to determine the effect of ginger on intensity of nausea and vomiting after surgical procedures. PATIENTS AND METHODS: This study was a randomized, double blinded, clinical trial. 160 eligible patients were randomly assigned into experimental or placebo groups. The experimental group received 4 capsules containing 250 mg ginger and placebo group received 4 placebo capsules 1 hour before surgery. The severity of nausea and vomiting was measured at 2, 4, 6 hours post operation using visual analogue scale and a structured questionnaire. The data were analyzed by independent t - test, Mann-Whitney U test, chi -square and GEE using SPSS 16 and STATA version 11. RESULTS: Mean nausea score at 2 hours post operation was significantly lower in the experimental group (P= 0.04). Mean nausea score at 4 and 6 hours post operation was lower in the experimental group; however, there was no significant difference between the groups at any time post operation. The frequencies of nausea in the experimental group at 2 and 6 hours post operation were lower than that in the placebo group, however, at 2 hours post operation, it was borderline significant (P = 0.05) There was no significant differences between two group in the intensity of vomiting at any time. CONCLUSIONS: Use of ginger was effective at decreasing postoperative nausea. Ginger could be used as a safe antiemetic drug at post operation.

Effect of herbal therapy to intensity chemotherapy-induced nausea and vomiting in cancer patients.

BACKGROUND: Chemotherapy-induced nausea and vomiting are the most important complications for cancer patients as its prevalence has been reported to be about 54-96 percent. ginger has been used for medicinal purposes including nausea and vomiting in traditional Persian, Chinese and Indian pharmacopoeia. OBJECTIVES: The objective of this study was to evaluate the efficacy of complimentary ginger among cancer patients experiencing nausea and vomiting. MATERIAL AND METHODS: A randomized cross-over clinical trial was carried out on patients under chemotherapy treatment for at least 2 episodes of chemotherapy and at least 2 episodes of previous experience of nausea and vomiting. Subjects of this study received 2 different complementary regimes with 250mg ginger capsule in regime A and placebo capsule in regime B. subjects of the study were crossed over to receive the other regime during the two cycles of chemotherapy. RESULTS: Findings of the study indicated that subjects receiving ginger showed significant reduction in frequency and intensity of nausea and vomiting compared to placebo receiving subjects. CONCLUSIONS: According to finding of this study, in accordance to most of other researches, ginger is an effective agent to reduce chemotherapy-induced nausea and vomiting. However, there are some researches supporting ginger as a moderate antiemetic agent among cancerous patients under chemotherapy.

Effects of LI4 acupressure on labor pain in the first stage of labor.

INTRODUCTION: Complementary and alternative medicines have been used to decrease labor pain for many years. Despite reports that some of these methods reduce pain, increase maternal satisfaction, and improve other obstetric outcomes, they have received limited attention in the US medical literature. The purpose of this study was to evaluate the effects of LI4 acupressure on labor pain in the first stage of labor, on labor duration, and on patient satisfaction. METHODS: A single, blind, randomized clinical trial was performed with eligible women (N = 100) who were at the beginning of the active phase of labor (3-4 cm dilatation of cervix with regular uterine contractions). The women in the acupressure group (n = 50) received LI4 acupressure at the onset of the active phase for the duration of each uterine contraction over a period of 20 minutes, and the women in the control group (n = 50) received a touch on this point without massage. Labor pain was measured using a structured questionnaire of a subjective labor pain scale (visual analogue scale) before the intervention, immediately after the intervention, 20 and 60 minutes after the intervention, and then every hour. RESULTS: There were significant differences between the groups in subjective labor pain scores immediately and 20, 60, and 120 minutes after intervention (P ≤ .001). Active phase duration (3-4 cm dilatation to full dilatation) and second stage duration (full dilatation to birth) were shorter in the acupressure group. The women in the acupressure group reported greater satisfaction. DISCUSSION: LI4 acupressure was effective at decreasing pain and duration of labor. The participants were satisfied, and no adverse effects were noted.