Examination of ethical intelligence and cognitive flexibility of nurses and their role in predicting the level of patient privacy protection.

INTRODUCTION: Possessing ethical intelligence and cognitive flexibility can play a significant role in the acceptable performance of nurses. Furthermore, respecting the privacy of patients should always be a primary ethical principle that nurses focus on. This study aimed to investigate the ethical intelligence and cognitive flexibility of nurses and their role in predicting the level of patients' privacy observance. Also, determining the overall status of patient privacy protection and its two domains, namely human dignity domain and maintaining personal privacy, were specific objectives of this study. METHODS: This cross-sectional descriptive-analytical study was conducted in 2022. A sample of 340 nurses and 1067 patients from teaching hospitals affiliated with Shiraz University of Medical Sciences in southern Iran were selected. Standard questionnaires of ethical intelligence and cognitive flexibility were used for nurses, and a privacy observance questionnaire was used for patients. Data were analyzed using t-tests, ANOVA, Pearson correlation coefficient, and multiple linear regression with the SPSS23 software. RESULTS: The mean score of ethical intelligence and cognitive flexibility for nurses was 98.33 ± 18.06 (out of 200) and 74.56 ± 16.76 (out of 140), respectively. The mean score of patients' privacy observance was 79.74 ± 14.53 (out of 150). The results of multiple linear regression showed that the dimensions of perseverance and assertiveness towards rights (ß = 0.540, p < 0.001), action based on principles, values, and beliefs (ß = 0.454, p < 0.001), responsibility towards personal decisions (ß = 0.410, p < 0.001), accepting responsibility for serving others (ß = 0.393, p < 0.001), ability to forgive one's mistakes (ß = 0.301, p = 0.001), ability to forgive others' mistakes (ß = 0.287, p = 0.002), honesty (ß = 0.275, p = 0.004), acknowledgment of mistakes and failures (ß = 0.263, p = 0.005), commitment to promises (ß = 0.242, p = 0.005), and interest in others (ß = 0.237, p = 0.01) from the dimensions of ethical intelligence, as well as the dimensions of perceived control (ß = 0.580, p < 0.001), perception of multiple solutions (ß = 0.511, p < 0.001), and perception of justifications (ß = 0.373, p < 0.001) from the dimensions of cognitive flexibility had a positive and significant effect on the level of patients' privacy observance. CONCLUSION: Ethical intelligence and cognitive flexibility of nurses and the level of patient privacy protection were estimated to be at a moderate level. Also, the level of ethical intelligence and cognitive flexibility of nurses played a predictive role in the level of patients' privacy observance. It is suggested that hospital managers and policymakers enhance nurses' ethical intelligence and cognitive flexibility through educational, welfare, managerial, motivational, and job-related programs, thereby improving the status of patient privacy protection.

Are Doctors Equally Distributed Throughout the World?

Background: As the vital and scarce resource of the health system, physicians are responsible for treating patients and saving lives and the equitable distribution of physicians among the whole population is a prerequisite to achieving health for all. We aimed to investigate inequality in physician distribution in the world using the Gini coefficient. Methods: This descriptive-analytical study was conducted in 2021. The number of physicians and the population of countries were obtained from the WHO and United Nations (UN) databases. The Gini coefficient was calculated in three different modes and the distribution of physicians among countries in various Human Development Index (HDI) groups was determined using the physician ratio per 10,000 population. Results: There were generally more than 13 million doctors in the world. About 43% of the world's physicians were available to 20% of the world's population in very high HDI countries, and 12% of the population had access to about 1% of physicians in low HDI countries. An average of 19.5 physicians are distributed per 10,000 population worldwide. The Gini coefficient between the four groups of HDI countries was 0.55, and that of all countries in the world was 0.640. Conclusion: There was a shortage and inequality in the distribution of physicians worldwide. Governments should eliminate inequality in the distribution of the medical workforce, in particular physicians, by redoubling their efforts and accurate planning.