Navigating Informed Consent Requirements and Expectations in Cluster Randomized Trials: Research Ethics Board Members' and Researchers' Views.

Informed consent is a cornerstone of ethical human research. However, as cluster randomized trials (CRTs) are increasingly popular to evaluate health service interventions, especially as health systems aspire toward the learning health system, questions abound how research teams and research ethics boards (REBs) should navigate intertwining consent and data-use considerations. Methodological and ethical questions include who constitute the participants, whose and what types of consent are necessary, and how data from people who have not consented to participation should be managed to optimize the balance of trust in the research enterprise, respect for persons, the promotion of data integrity, and the pursuit of the public good in the research arena.

Palliative care providers' roles in medical assistance in dying decision-making triads with patients and families: A qualitative analysis.

Objectives: Research on medical assistance in dying (MAiD) decision-making indicates that family members and close friends are often involved in making decisions with patients and their care providers. This decision-making model comprising patients, family members, and palliative care providers (PCPs) has been described as a triad. The objective of this study is to understand PCPs' experiences engaging in MAiD-related decision-making triads with patients and their families in Canada.

Women's autonomy for managing labour pain in a relational context: An interpretive description study.

Aim: To describe how women perceived relational autonomy for decision-making during childbirth pain and illuminate influencing factors.

Background: Most women report challenging pain during birth. Circumstances can affect their ability to engage in pain management decisions.

Intensive care unit professionals' responses to a new moral conflict assessment tool: A qualitative study.

Background: Moral distress is a serious problem for health care personnel. Surveys, individual interviews, and focus groups may not capture all of the effects of, and responses to, moral distress. Therefore, we used a new participatory action research approach-moral conflict assessment (MCA)-to characterize moral distress and to facilitate the development of interventions for this problem.

Causes of futile care from the perspective of intensive care unit nurses (I.C.U): qualitative content analysis.

Background: Medical care that has therapeutic effects without significant benefits for the patient is called futile care. Intensive Care Units are the most important units in which nurses provide futile care. This study aimed to explain the causes of futile care from the perspective of nurses working in Intensive Care Units are.

Assessing Safety Status of Pediatric Intensive Care Units of Tehran, Iran according to the World Health Organization's Safety Standards.

Given that children in pediatric intensive care units (PICUs) are more vulnerable to safety risks, health care officials are required to identify the weaknesses and strengths of care and ensure the safety of these children. In this study, the safety status in PICUs of selected educational children's hospitals in Tehran, Iran, was examined and compared with standards proposed by the World Health Organization (WHO). In this descriptive study, the performance of nurses with a bachelor's degree or higher and minimum work experience of six months in the PICU was examined.

How does Medical Assistance in Dying affect end-of-life care planning discussions? Experiences of Canadian multidisciplinary palliative care providers.

Background: More than a dozen countries have now legalized some form of assisted dying, and additional jurisdictions are considering similar legislations or expanding eligibility criteria. Despite the persistent controversies about the relationship between medicine, palliative care, and assisted dying, many people are interested in assisted dying. Understanding how end-of-life care discussions between patients and specialist palliative care providers may be affected by such legislation can inform end-of-life care delivery in the evolving socio-cultural and legal environment.

Medical assistance in dying legislation: Hospice palliative care providers' perspectives.

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society.

Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying.

Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers.

The challenges of using physical restraint in intensive care units in Iran: A qualitative study.

Background: Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide.

Aim: This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units.

White lies in pediatric care: a qualitative study from nurses' perspective.

Communication and sharing information with ill children are challenging. To protect a child from the bitter reality, sometimes use of well-intended untruths, or white lies is necessary. This research aimed at studying the experiences of nurses about the use of white lies in in pediatric clinical setting.

Designing a truth-based communication model in patient ethical care process.

Introduction: Providing information based on truth is very important in patients' treatment-related decisions and reduces emotional and physical sufferings as well as patient costs. The aim of this study was to design a model that is based on the culture and health-care context of Iran in order to establish a truth-based communication and provide accurate information to patient.

Materials And Methods: This qualitative study was conducted in 2019.

Moral neutralization: Nurses' evolution in unethical climate workplaces.

Introduction: Good quality of care is dependent on nurses' strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice.

Understanding childbirth pain in Brazilian women: A qualitative descriptive study.

Background: The pain associated with childbirth is a cause of severe pain, and the literature suggests that it can be influenced by psychosocial influences, the environment, and cognitive processes, creating the overall experience of childbirth. Therefore, the investigation of women's childbirth pain experience is essential.

Aim: The purpose of this study is to understand women's childbirth pain and determine which influences can contribute to building different experiences.

The Seismic Shift in End-of-Life Care: Palliative Care Challenges in the Era of Medical Assistance in Dying.

Concerns regarding personal, professional, administrative, and institutional implications of medical assistance in dying (MAiD) are of particular interest to palliative and hospice care providers (PHCPs), who may encounter additional moral distress and professional challenges in providing end-of-life (EOL) care in the new legislative and cultural era. To explore PHCPs' encountered challenges and resource recommendations for caring for patients considering MAiD. Qualitative thematic analysis of audio-recorded semistructured interviews with PHCPs.

Factors behind ethical dilemmas regarding physical restraint for critical care nurses.

Background: Physical restraint is among the commonly used methods for ensuring patient safety in intensive care units. However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety.

Aim: The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients.

An Evolutionary Route for the Moral Development of Nursing Students: A Constructivist Grounded Theory.

Background: Developing moral competency is a main aim of educational systems, especially in healthcare-related disciplines.

Purpose: The aim of this study was to explore the moral development process in nursing students.

Methods: This study used a constructivist grounded theory.

Hospital/clinical ethics committees' notion: an overview.

Hospital ethics committees (HECs) help clinicians deal with the ethical challenges which have been raised during clinical practice. A comprehensive literature review was conducted to provide a historical background of the development of HECs internationally and describe their functions and practical challenges of their day to day work. This is the first part of a comprehensive literature review conducted between February 2014 and August 2016 by searching through scientific databases.

New visiting policy: A step toward nursing ethics.

Background:: Patients' rights arise from their expectations of the healthcare system, which are rooted in their needs. Visitation is seen as a necessary need for patients and families in intensive care units.

Objectives:: The authors attempted to design, implement, and evaluate a new visiting policy in the intensive care units.

Patients' and Families' Satisfaction With Visiting Policies in Cardiac Intensive Care Units.

Background: Families play a vital role in the recovery of patients admitted to intensive care units. They can help patients to adapt themselves to the crisis and feel more satisfied.

Objective: In this study, we examined the patients' and families' satisfaction with the current visiting policies in cardiac intensive care units in the largest Cardiovascular Medical and Research Center of Iran.

Development and Psychometric Evaluation of the Patient Safety Violation Scale in Medical Oncology Units in Iran.

Background: Patient safety is one of the key components of nursing care for cancer cases. Valid and reliable context-based instruments are necessary for accurate evaluation of patient safety in oncology units. The aim of the present study was to develop and evaluate the psychometric properties of the Patient Safety Violation Scale in medical oncology units in Iran.

Support in Clinical Settings as Perceived by Nursing Students in Iran: A Qualitative Study.

Background: Although support is one of the most substantial needs of nursing students during clinical education, it is not clearly defined in the literature.

Objectives: The current study aimed to explore the concept of support in clinical settings as perceived by nursing students.

Materials And Methods: A qualitative content analysis was used to explore the meaning of student support in clinical settings.

Iran's health policymakers' views on barriers and facilitators of nurse prescribing in their context: A qualitative study.

Background: In most countries, one of the main reasons for developing more advanced roles for nurses is to improve access to care in the context of limited number of doctors. It is considered that the introduction of major policy initiatives, such as nurse prescribing, requires high-level discussion and policy development to ensure successful implementation. This study aimed to identify the barriers and facilitators of nurse prescribing based on policymakers' views in Iran.

Factors affecting ethical behavior in pediatric occupational therapy: A qualitative study.

Background: It is the responsibility of each occupational therapist to always act ethically and professionally in a clinical setting. However, there is little information available concerning the factors influencing ethical behavior of occupational therapists at work. Since no study has been conducted in Iran on this topic, this qualitative study aimed to identify the factors influencing ethical behavior of pediatric occupational therapists.

A Review of Visiting Policies in Intensive Care Units.

Admission to intensive care units is potentially stressful and usually goes together with disruption in physiological and emotional function of the patient. The role of the families in improving ill patients' conditions is important. So this study investigates the strategies, potential challenges and also the different dimensions of visiting hours' policies with a narrative review.

Becoming a nurse as a moral journey: A constructivist grounded theory.

Background: Nursing students, during their study, experience significant changes on their journey to become nurses. A major change that they experience is the development of their moral competency.

Objective: The purpose of this study is to explore the process of moral development in Iranian nursing students.