The relationship between nurses' moral competency and missed nursing care: a descriptive-correlational study.

BACKGROUND: When any aspect of patient care is overlooked or delayed, it is known as Missed Nursing Care (MNC), leading to adverse events such as medication errors, infections, increased mortality rates, and poor prognosis. Moral competence is crucial for clinical nurses as it guarantees high-quality patient care in nursing practice. Thus, this study aimed to investigate the correlation between moral competencies and MNC among nurses. METHODS: This study was conducted with a descriptive-correlational design. The participants in the study were nurses who were currently enrolled at Shahid Beheshti University of Medical Sciences. In order to recruit nurses for the study, a convenience sampling method was implemented. The study tools were completed by a total of two hundred nurses. Research tools included a demographic questionnaire, the Moral Competence of Clinical Nurses Questionnaire, and the Kalisch and Williams Missed Nursing Care (MISSCARE) survey. ETHICAL CONSIDERATION: This study was approved by the Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences. RESULTS: The mean scores of moral competencies and MNC were 151.83 ± 12.60 and 42.71 ± 9.38, respectively. In other words, descriptive statistics showed that the moral competence score was more than 75%, and the MNC score was less than 50%. Also, there was a significant negative correlation between the total scores of moral competencies and MNC (r = -0.38, p < 0.001), indicating that more moral competence was correlated with lower levels of MNC. CONCLUSION: The study revealed a negative correlation between nurses' moral competence and MNC, suggesting that enhancing moral competence could reduce MNC. To reduce MNC occurrences, hospitals, and organizations should prioritize moral competency, according to our research.

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.

Ethical care in patients with Covid-19: A grounded theory.

BACKGROUND: Providing ethical care during the Covid-19 pandemic has become an inevitable challenge due to facing limitations such as fear of contracting the disease, lack of equipment and emergence of ethical conflicts; So that there is no clear picture of how to provide ethical care for patients with Covid-19. The study aimed to explain the ethical care process of patients with Covid-19. METHOD: This qualitative study was conducted in 2021-2023 using the grounded theory research method. Data were collected through conducting 21 semi-structured interviews with 19 participants (16 staff nurses, and 3 supervisor). Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin. RESULTS: The results indicated that starting the process with a problem means a challenge of how to do the right or correct thing for the patient. This process is driven by the feeling of duty and inner commitment to do the right thing. The sense of responsibility or commitment is directly related to the degree of faith in a person. The actions that a nurse takes to fulfill her sense of commitment is called the faith-based behavior process. The process of behavior based on faith is done through two steps. Attaining the satisfaction of God and as well as the satisfaction of one's conscience is the nurses' ultimate goal of doing the right work and being committed. CONCLUSION: The process of ethical care of patients with Covid-19 can be different according to the degree of faith and environmental conditions. A higher level of faith and more helpful environmental conditions, the greater the nurse's inner commitments in the first and second steps, as a result, the satisfaction of God and conscience will be greater.

Synthesis characterization of Zn-based MOF and their application in degradation of water contaminants.

Metal-organic frameworks (MOFs) are currently popular porous materials with research and application value in various fields such as medicine and engineering. Aiming at the application of MOFs in photocatalysis, this paper mainly reviews the main synthesis methods of ZnMOFs and the latest research progress of Zn MOF-based photocatalysts to degrade organic pollutants in water, such as organic dyes. This nanomaterial is being used to treat wastewater and has proven to be very efficient because of its exceptionally large surface area and porous nature. The results show that Zn-MOFs are capable of high degradation of the above pollutants and over 90% of degradation was observed in publications. In addition, the reusability percentage was examined and studies showed that the Zn-MOF nanostructure has very good stability and can continue to degrade a high percentage of pollutants after several cycles. This review focuses on Zn-MOFs and their composites. First, the methods of synthesis and characterization of these compounds are given. Finally, the application of these composites in the process of photocatalytic degradation of dye pollutants such as methylene blue, methyl orange, crystal violet, rhodamine B, etc. is explained.

Drug delivery and anticancer activity of biosynthesised mesoporous Fe2 O3 nanoparticles.

Mesoporous magnetic nanoparticles of haematite were synthesised using plant extracts according to bioethics principles. The structural, physical and chemical properties of mesoporous Fe2 O3 nanoparticles synthesised with the green chemistry approach were evaluated by XRD, SEM, EDAX, BET, VSM and HRTEM analysis. Then, their toxicity against normal HUVECs and MCF7 cancer cells was evaluated by MTT assay for 48 h. These biogenic mesoporous magnetic nanoparticles have over 71% of doxorubicin loading efficiency, resulting in a 50% reduction of cancer cells at a 0.5 µg.ml-1 concentration. Therefore, it is suggested that mesoporous magnetic nanoparticles be used as a multifunctional agent in medicine (therapeutic-diagnostic). The produced mesoporous magnetic nanoparticles with its inherent structural properties such as polygonal structure (increasing surface area to particle volume) and porosity with large pore volume became a suitable substrate for loading the anti-cancer drug doxorubicin.

Cytotoxicity properties of plant-mediated synthesized K-doped ZnO nanostructures.

In this study, potassium-doped zinc oxide nanoparticles (K-doped ZnO NPs) were green-synthesized using pine pollen extracts based on bioethics principles. The synthesized NPs were analyzed using X-ray diffraction (XRD), inductively coupled plasma atomic emission spectroscopy (ICP-AES), scanning electron microscopy (SEM), energy-dispersive X-ray analysis (EDXA), and transmission electron microscopy (TEM). The cytotoxicity of these nanoparticles (NPs) on normal macrophage cells and cancer cell lines was evaluated. In the same concentrations of K-doped ZnO and pure ZnO NPs, K-doped ZnO NPs demonstrated higher toxicity. The results confirmed that the doped potassium could increase cytotoxicity. The IC50 of K-doped ZnO NPs, pure ZnO NPs, and the examined control drug were 497 ± 15, 769 ± 12, and 606 ± 19 µg/mL, respectively. Considering the obtained IC50 of K-doped ZnO NPs, they were more toxic to the cancer cell lines and had less cytotoxicity on normal macrophage cells.

Explaining the process of dealing with nursing errors in the emergency department: A grounded theory study.

BACKGROUND: Errors are among the factors threatening patient safety. It is essential to understand how to deal with nursing errors in the emergency department. Thus, the present study aimed to explain the process of dealing with nursing errors in the emergency department. METHOD: This qualitative study adopted Corbin and Strauss's (2008) grounded theory method. The data were collected by in-depth semi-structured interviews and field notes. Eighteen nurses, two doctors, and one patient companion participated in this study. The research setting was the emergency departments of five teaching hospitals in down tone of Tehran, Iran. The participants were selected by purposive sampling at first, and then by theoretical sampling. RESULTS: Following the data analysis, four main categories of "reality shock", "formulating a situational response", "reactive measure", and "progress or regress" were extracted. The data analysis showed that "formulating a situational response" is the core category of the process of dealing with errors among nurses in the study emergency departments. The first step in the process of dealing with errors in ED was the reality shock, then nurses entered the stage of formulating a situational response, after that they entered the stage of "reactive measure" and finally they entered the stage of progress or regress. DISCUSSION AND CONCLUSION: After an error occurs in the emergency department, nurses experience four stages during the process of dealing with nursing errors. When dealing with an error, nurses think about protecting the patients. However, some contextual factors direct the nurses towards protecting themselves rather than the patient. The decision-makers in the healthcare system can modify these contextual factors, provide in-service training, develop anonymous reporting systems, and establish a positive support environment, thus directing the nurses towards supporting the patients (in addition to trying to protect oneself).

Investigating the relationship between the ethical atmosphere of the hospital and the ethical behavior of Iranian nurses.

BACKGROUND: The ethical guidelines and ethical atmosphere of the hospital affect the quality of nursing care. Improving the health of patients in most cases depends on the observance of ethical points and ethical behaviors by nurses. The aim of this study was to determine the effect of hospital ethics and ethical training guidelines on improving the quality of nursing care and nurses' professional ethics. MATERIALS AND METHODS: This is a descriptive-analytical study. This study was performed by multi-stage relative cluster sampling on 260 qualified nurses in 2014. Data were collected using the Hospital Ethical Climate Questionnaire and the Judgments about Nursing Decisions Questionnaire and analyzed using SPSS software version 19. RESULTS: The results showed that nurses' perceptions of the ethical climate of hospitals were relatively positive. The ethical behavior of nurses was moderate and good. Nurses' perception of the ethical climate scores was not related to the ideal ethical behavior of nurses (r = 0.11, P = 0.86). The ethical climate perceptions of nurses were related to real workplace ethical behavior score (r = 0.188, P = 0.002). The results also showed that ethical guidelines can improve the quality of nursing care. CONCLUSION: Considering the results of this study, it seems that holding nursing ethics training programs can be a big step toward promoting the professional behavior of nurses and the observance of professional ethics by nurses.

Role of judgment in promoting nurses' decisions and ethical behavior.

BACKGROUND: Ethical decision-making and behavior of nurses are major factors, which can effect on the quality of nursing care. It seems that there is a correlation between demographic variables and ethical decision-making and moral behaviors of nurses. Promoting patients' health is one of the issues related to nurses' ethical behaviors. The aim of this study was to determine the role of judgment in promoting nurses' decisions and ethical behavior. MATERIALS AND METHODS: This was a descriptive, cross-sectional study in which 260 nurses were selected based on the inclusion criteria. Sampling method was available. The data collection tool was the Hospital Ethics Committee Survey Questionnaire. Data were analyzed by SPSS software version 20. RESULTS: In this study, judgments and ethical behaviors of nurses were evaluated at the moderate and good level. Gender, marriage status, education level, and nursing position were effective in judgments and ethical behavior of nurses. Age, job experience, and participation in the ethics workshop had no significant effect on ethical behavior and moral judgment. The mean score of moral belief of nurses participating in this study was 181.56 ± 17.60, and their mean moral practice in the real environment was 168.5 ± 17.77. CONCLUSION: The judgment competencies in ethical situation of nurses should be promoted to a higher level. It seems that more advanced educational methods are needed to achieve this goal. The findings from this study show the necessity of nurses' ability to improve their behavior and moral judgment. It also shows that nurses need more reinforcement based on the demographic variables.

Leishmanicidal activities of biosynthesized BaCO3 (witherite) nanoparticles and their biocompatibility with macrophages.

The aim of this study was cost-effective and greener synthesis of barium carbonate (BaCO3 or witherite) nanoparticles with economic importance, and to evaluate their therapeutic potentials and biocompatibility with immune cells. Barium carbonate nanoparticles were biosynthesized using black elderberry extract in one step with non-toxic precursors and simple laboratory conditions; their morphologies and specific structures were analyzed using field emission scanning electron microscopy with energy dispersive X-ray spectroscopy (FESEM-EDX). The therapeutic capabilities of these nanoparticles on the immune cells of murine macrophages J774 and promastigotes Leishmania tropica were evaluated. BaCO3 nanoparticles with IC50 = 46.6 µg/mL were more effective than negative control and glucantium (positive control) in reducing promastigotes (P < 0.01). Additionally, these nanoparticles with a high value of cytotoxicity concentration 50% (CC50) were less toxic to macrophage cells than glucantime; however, they were significantly different at high concentrations compared to the negative control.

Magnetic cobalt oxide nanosheets: green synthesis and in vitro cytotoxicity.

Cobalt oxide nanoparticles were prepared via green chemistry route and fully characterized by Field Emission Scanning Electron Microscope (FESEM), Energy-dispersive X-ray spectroscopy (EDAX), X-ray diffraction (XRD), High-resolution transmission electron microscopy (HRTEM) and Transmission electron microscopy (TEM) analyses; the CoO and Co3O4 nanoparticles, in sheet-shaped cobalt oxide form, ensued simultaneously in one step. The varying concentrations of NPs were analyzed via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test on the cancer cell line (U87) which revealed that with increasing concentration of cobalt oxide nanoparticles, the survival rate of U87 tumor cells decreases; IC50 of nanoparticles being ~ 55 µg/ml-1.

Spiritual care experiences by cancer patients, their family caregivers and healthcare team members in oncology practice settings: A qualitative study.

PURPOSE: Integrating spirituality into the patient care within a healthcare team, increases the ability to provide "holistic care" for cancer patients. The spiritual care experiences of different involved persons can be a guide for future planning. Therefore, this study aimed to explore the spiritual care experiences of hospitalized cancer patients, their family caregivers and healthcare team members in oncology settings. METHODS: This is a descriptive qualitative study which was conducted with 21 participants, who were selected by purposive sampling. Semi-structured interviews were used to collect the data. The data were analyzed with conventional content analysis method. RESULTS: Two themes of "systematic care" and "caring with paradoxical results" were extracted from the spiritual care experiences of our participants. CONCLUSIONS: Spiritual care as professional, comprehensive, collaborative and artistic care should be provided in a multidisciplinary healthcare team for cancer patients. Otherwise, patients may experience deprivation of spiritual services and consequently, spiritual distress.

Simplification of gold nanoparticle synthesis with low cytotoxicity using a greener approach: opening up new possibilities.

Gold nanoparticles (AuNPs) have diverse applications in the diagnosis and treatment of ailments. This study describes an extremely simplified synthesis of AuNPs using antioxidant-rich pollen extract as a local natural source. Ultraviolet-visible (UV-vis) spectroscopy, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM) were used to characterize the synthesized AuNPs; strong UV-vis absorption at 534 nm confirmed their formation, the XRD pattern showed the presence of a crystalline structure, and TEM images showed them to be spherical nanoparticles with an average size of 9.3 ± 2.9 nm. As synthesized AuNPs remained stable for up to two months under laboratory conditions without any sedimentation or change in the absorption value, presumably due to the protection afforded by the capping agents from pollen. AuNPs revealed low toxicity effects on MCF-7 and HUVECs cell lines (with an IC50 value of ∼400 µg mL-1 for both the cell lines). The proposed method did not use any hazardous materials or high-energy consuming devices; thus this efficient protocol may be adapted for large-scale production using local resources.

CeO2 foam-like nanostructure: biosynthesis and their efficient removal of hazardous dye.

In this study, CeO2 (cerium oxide) nanoparticles were synthesized using Pinus halepensis pollen and were characterized by field emission scanning electron microscopy (FESEM), powder X-ray diffraction (PXRD) and Raman spectroscopy. The results showed that the ensuing CeO2 nanostructures, ranging in size from 5 to 25 nm, had high porosity. Synthesized CeO2 showed the effective catalytic activity towards the photocatalytic removal of dyes. In this work, the photocatalytic activity to removal dye (methyl violet 2B), in the absence of UV radiation, using cerium dioxide nanoparticles (CeO2-NP) was determined. In this research, four main factors such as effect on color, concentration and pH were examined and maximum %R was obtained about was 97% in 75 min in presence of 50 mg of hydrogen peroxide.

Is there a relationship between moral competencies and the formation of professional identity among nursing students?

BACKGROUND: Moral competencies are essential for nursing work. Professional identity is a set of values and beliefs that a person has about her/his job, which includes moral values as well. The development of moral competencies and formation of professional identity in nursing students occurs mainly during their college years. The aim of this study was to investigate the relationship between moral competencies and the formation of professional identity among nursing students. METHODS: This study was designed as a descriptive-correlational study. The study population was consisted of nursing students who were enrolled in nursing schools at the time of the study. Two hundred and twenty-one nursing students completed the study tools. The research tools were a demographic questionnaire, Moral Development Scale for Professionals (MDSP), and Professional Identity Scale for Nursing Students (PISNS). RESULTS: The mean (SD) of MDSP and PISNS scores was 45.69 ± 5.90 and 55.61 ± 12.75, respectively. There was a significant statistical relationship between MSDP and PISNS scores (p < 0.05). A significant equation was found (f (2, 218) = 16.68, p < 0.001) with an R2 of 0.113. The MSDP scores increased 0.136 for each score of PISNS, and married students had 2.452 scores higher than single students. CONCLUSIONS: The positive correlation between the formation of professional identity and development of morality in nursing students indicates that by strengthening students' professional values, their moral competencies may develop positively.

Recommendations for spiritual care in cancer patients: a clinical practice guideline for oncology nurses in Iran.

BACKGROUND: In spite of the necessity of implementing spiritual care practices for cancer patients, there is no clear process in this regard in palliative care programs of the health system of countries. The present study was designed with the aim of developing a clinical practice guideline of spiritual care in cancer patients for oncology nurses in the current context. METHODS: This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of four focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the guideline in three rounds of the Delphi study), as well as revision and publication stages. RESULTS: The clinical guideline of spiritual care with 84 evidence-based recommendations was developed in three main areas, including the human resources, care settings, and the process of spiritual care. CONCLUSIONS: We are hoping by applying this clinical guideline in oncology settings to move towards an integrated spiritual care plan for cancer patients in the context of our health system. Healthcare organizations should support to form spiritual care teams under supervision of the oncology nurses with qualified healthcare providers and a trained clergy. Through holistic care, they can constantly examine the spiritual needs of cancer patients alongside their other needs by focusing on the phases of the nursing process.

A review: Recent advances in ultrasensitive and highly specific recognition aptasensors with various detection strategies.

One of the most studied topics in analytical chemistry and physics is to develop bio-sensors. Aptamers are small single-stranded RNA or DNA oligonucleotides (5-25 kDa), which have advantages in comparison to their antibodies such as physicochemical stability and high binding specificity. They are able to integrate with proteins or small molecules, including intact viral particles, plant lectins, gene-regulation factor, growth factors, antibodies and enzymes. The aptamers have reportedly shown some unique characteristics, including long shelf-life, simple modification to provide covalent bonds to material surfaces, minor batch variation, cost-effectiveness and slight denaturation susceptibility. These features led important efforts toward the development of aptamer-based sensors, known as apta-sensors classified into optical, electrical and mass-sensitive based on the signal transduction mode. This review provided a number of current advancements in selecting, development criteria, and aptamers application with the focus on the effect of apta-sensors, specifically for disease-associated analyses. The review concentrated on the current reports of apta-sensors that are used for evaluating different food and environmental pollutants.

Metallic SPIONP/AgNP synthesis using a novel natural source and their antifungal activities.

The green synthesis of nanoparticles (NPs) is important because of the favorable potential of plant biomolecules involved in the synthesis of NPs. This study aimed to provide a fast, easy, cheap, and environmentally friendly method for the synthesis of superparamagnetic iron oxide NPs (SPIONP) and silver nanoparticles (AgNPs) using Stachys lavandulifolia and an evaluation of their use as antifungal agents against Aspergillus niger and Fusarium solani. The physicochemical properties of AgNPs and SPIONPs were studied using FESEM, HRTEM, XRD, VSM, UV-Vis, and EDX spectroscopy. The sizes and morphologies of the AgNPs and SPIONPs, measured via electron microscopy, were 12.57 nm and 10.70 nm, respectively. Nanoparticles have previously been shown to have antifungal activities, and SPIONPs and AgNPs can show antifungal resistance. These NPs can be used as a substitute for widely used toxic fungicides to promote food safety and public health.

The synthesis, characterization, DNA/BSA/HSA interactions, molecular modeling, antibacterial properties, and in vitro cytotoxic activities of novel parent and niosome nano-encapsulated Ho(iii) complexes.

Based on the importance of metal-centered complexes that can interact with DNA, this research focused on the synthesis of a new Ho(iii) complex. This complex was isolated and characterized via elemental analysis, and FT-IR, fluorescence, and UV-vis spectroscopy. Additional confirmation of the Ho(iii) complex structure was obtained via single-crystal X-ray diffraction. DNA interaction studies were carried out via circular dichroism (CD) spectroscopy, UV-vis absorption spectroscopy, viscosity measurements and emission spectroscopy; it was proposed that the metal complex acts as an effective DNA binder based on studies in the presence of fish DNA (FS-DNA), showing high binding affinity to DNA in the presence of hydrophobic and electron donating substituents. Also, the interactions of this complex with human (HSA) and bovine serum albumin (BSA) proteins were studied via fluorescence spectroscopy techniques and the obtained results reveal an excellent propensity for binding in both cases. Furthermore, the interactions of the Ho(iii) complex with DNA, BSA and HSA were confirmed via molecular docking analysis. The antimicrobial activities of the Ho(iii) complex were tested against Gram-negative bacteria and Gram-positive bacteria. In addition, a niosome nano-encapsulated Ho(iii) complex was synthesized, and the parent and encapsulated complexes were evaluated as potential antitumor candidates. The main structure of the Ho(iii) complex is maintained after encapsulation using niosome nanoparticles. The MTT method was used to assess the anticancer properties of the Ho(iii) complex and its encapsulated form toward human lung carcinoma and breast cancer cell lines. The anticancer activity in the encapsulated form was more than that of the parent Ho(iii) complex. In conclusion, these compounds could be considered as new antitumor candidates.

Calcium carbonate nanowires: greener biosynthesis and their leishmanicidal activity.

The synthesis of inorganic rod shape nanostructures is important in chromatography, dentistry, and medical applications such as bone implants, and drug and gene delivery systems. Herein, calcium carbonate (CaCO3) nanowires were synthesized using a plant extract and the ensuing nanoparticles were characterized by XRD, FESEM, and HR-TEM. Then, the leishmanicidal effects of biogenic calcium carbonate nanowires were investigated against Leishmania major including the toxicity of varying concentrations of nanoparticles, and the percentage of viable and apoptotic cells based on flow cytometry analysis. Based on the results, the IC50 of these polymorphs were calculated to be 800 µg mL-1. An ecofriendly, inexpensive, and novel biogenic method for the production of a new advanced inorganic nanostructure, CaCO3 nanowires, is described without using hazardous chemicals; calcium carbonate nanowires maybe used as a smart drug carrier.