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Abstract: Introduction and Objectives: Promoting professional values is an important factor in the development of nursing careers, so that any mischief in honoring professional commitment and ethics can overcome the best nursing care. The view of most nurses is that there are barriers to the ethical functioning of their work environment, which disrupts their ability to provide proper and appropriate care. In view of the above, and considering that such a study was not carried out in Bam, this study aimed to determine barriers to observance of professional ethics standards in clinical care at Pasteur Hospital in Bam. Methods: This descriptive-analytic study was conducted with the participation of nurses of Pasteur Bam Hospital in a census sampling. A tool for collecting information is a questionnaire that examines the barriers to observing professional ethics standards in three dimensions: managerial, environmental and individual-care. Data were analyzed by SPSS software version 23 using descriptive statistics (frequency distribution, mean, standard deviation) and inferential statistics (independent t-test, ANOVA). The results show the relationship between the ethical and demographic variables there Mnadaramary. The mean barriers standards of professional ethics in clinical care from the perspective of nurses 56/0±81/3 that according to the maximum (5), barriers to standards of professional ethics in clinical care, which has average barriers in various fields as follows: environmental barriers with an average of 66/0±10/4, administrative barriers with an average of 64/0±77/3 and personal barriers with an average of 65/0±75/3, respectively. Discussion: Given that environmental factors as the main obstacle in non-compliance with standards of professional ethics is, therefore, recommended that health centers-Treatment with careful planning and an emphasis on the principles and standards of care, including environmental factors, importance of professional ethics improvement in, the disadvantages of non-compliance with professional ethics, Providing favorable conditions for nurses such as improving the sector, creating an environment of physical and psychological comfort and safety and satisfy their needs such as rest and adequate income, develop shifts appropriate equipment standard, effective steps to comply with the best standards of professional ethics Take away.
Keywords: professional ethics, clinical care, nurses.
Resumen: Introducción y objetivos: Promover los valores profesionales es un factor importante en el desarrollo de las carreras de enfermería, por lo que cualquier travesura en el cumplimiento del compromiso y la ética profesional puede superar la mejor atención de enfermería. La opinión de la mayoría de las enfermeras es que existen barreras para el funcionamiento ético de su entorno de trabajo, lo que altera su capacidad para brindar una atención adecuada y apropiada. En vista de lo anterior, y considerando que dicho estudio no se llevó a cabo en Bam, este estudio tuvo como objetivo determinar las barreras para el cumplimiento de los estándares de ética profesional en la atención clínica en el Hospital Pasteur en Bam. Métodos: Este estudio descriptivo analítico se realizó con la participación de enfermeras del Hospital Pasteur Bam en una muestra del censo. Una herramienta para recopilar información es un cuestionario que examina las barreras para observar los estándares de ética profesional en tres dimensiones: gestión, medio ambiente y atención individual. Los datos se analizaron mediante el software SPSS versión 23 utilizando estadísticas descriptivas (distribución de frecuencia, media, desviación estándar) y estadísticas inferenciales (prueba t independiente, ANOVA). Los resultados muestran la relación entre las variables éticas y demográficas que existen en Mnadaramary. La media de las barreras estándares de ética profesional en la atención clínica desde la perspectiva de las enfermeras 56/0±81/3 que según el máximo (5), barreras a las normas de ética profesional en la atención clínica, que tiene barreras promedio en varios campos como sigue : barreras ambientales con un promedio de 66/0±10/4, barreras administrativas con un promedio de 64/0±77/3 y barreras personales con un promedio de 65/0±75/3, respectivamente. Discusión: dado que los factores ambientales como el principal obstáculo en el incumplimiento de los estándares de ética profesional es, por lo tanto, recomendado que los centros de salud: tratamiento con una planificación cuidadosa y un énfasis en los principios y estándares de atención, incluidos los factores ambientales, la importancia de los profesionales mejora de la ética, desventajas del incumplimiento de la ética profesional, proporcionar condiciones favorables para las enfermeras, como mejorar el sector, crear un entorno de confort y seguridad física y psicológica y satisfacer sus necesidades, como descanso e ingresos adecuados, desarrollar turnos en el equipo adecuado Pasos estándar, efectivos para cumplir con los mejores estándares de ética profesional.
Palabras clave: ética profesional, atención clínica, enfermeras.
Introduction:
Approach the world today can be considered a return to rationality and ethics. After different periods of mankind is to have a rational approach and ethical needs. Therefore, we can focus ethics future global developments, he said. This approach can affect strings that are leading in serving human beings1. Although ethics all jobs are necessary but, in the nursing profession, this factor is more necessary because of the spiritual coupled with responsibility nurses play an important role in the recovery and return peace to them, so the nursing profession on ethics rests2. Ethics integral part of human life under a set of practical philosophy and the principles and values that the individual and collective behaviors as right and wrong under the rule of the3,4. Ethics in nursing, is very important and directly with clinical care, quality and competence of nurses5. So that any mischief in honoring professional commitment and ethics can overcome the best nursing care and, conversely, it can play an important role in the professionalization of nursing6
So far in the field of ethics, nurses largely a function of medical specialties which are due to nursing ethics as an independent subject, less attention has been paid7, but the role and responsibilities of the nurse every day definitions of a broader found and Nursing as a profession known independent legal and medical communities8. Ethics in Nursing will work ethic of the patient and the health care; and thereby the person committed that his career not do so the patient does not harm the care process to improve patient to have9.
In this context, many studies have been done in the world and Iran. Studies have shown that the mean score of moral reasoning for nurses abroad is 51.45 and in Iran 16.42, ethical principles are not favorable in clinical decision making and nurses are not able to apply ethical knowledge in the real environment10. The results Torabizadeh et al (2012) suggest that privacy and to the dignity of patients is not well respected, as well as medical and nursing staff little awareness of the importance of privacy and dignity of patients and their understanding of the different concepts11. The results also mohajjelaghdam et al (1392) suggest that the patients 8/41% of nurses are at high levels, 8/51% on average, and 4/6% in the weak code of ethics for professional nursing Iran has acted12. A study by Ghobadi Far and colleagues (2013) showed that although most health care providers highly assessed their performance in professional ethics, their performance score was moderate13. The findings of the study Sadeghi et al (2011) suggest that doctors and nurses to the patient's wishes and demands of neglect and do not provide enough information and just the patients14.
The argument and colleagues (2011) Nursing students' perceptions of barriers to professional ethics examined the data and found that the factors underlying the curriculum including the shortage of teachers fluent in ethics, failure curriculum, the use of improper methods in education ethical issues, evaluation problems and lack of objective means for evaluating the abilities of students in the field of professional ethics, the relationship between the individual and environmental constraints are effective clinical practice15. Study Nouhi et al (2013) to determine the ethical lapses of nurses by nurses in nursing ethics codes of ethics show is not suitable and planning in this regard is necessary administrative measures16.
The study of Gourchani et al. (2012) shows that nursing ethics is less than patients' viewpoints, while nurses report the average. 47% of nurses as well as their ethical performance levels were adequate, while 38% of patients considered the optimum performance. The higher average nurses 'ethical observance is from nurses' point of view to worrying patients because it suggests that nurses feel that their current performance is favorable, while not seen by the recipients of the service. As a result, we can say nursing ethics in the study were unfavorable17. The study of Mohammadi et al. (2018) shows that the level of knowledge of nursing and midwifery students and staff members has been reported from the principles of professional ethics in terms of communication, legal and ethical issues18.
The study of Khodayari et al. (2012) assessed the level of ethical values in hospitals at a moderate level close to the weak19, but in the study of Ghobadi Farr et al (2012), Mohajl Aghdam et al. (2012), the observance of ethical standards by Nurses are reported moderately (12 and 13). It seems appropriate to the diversity of beliefs and cultures, perceptions, and practices that apply to ethical values in clinical care. According to the results of the above studies and other studies, in this case, the majority of agree with each other and their views of the barriers to practice ethical in their work there, their ability to provide appropriate care and decent disrupted he does. In view of the above, and considering that such a study was not carried out in Bam, this study aimed to determine barriers to observance of professional ethics standards in clinical care at Pasteur Hospital in Bam.
Method:
This is a descriptive-cross-sectional study which aims to determine the barriers to observing professional ethics standards in nursing practice in 2018. The research environment of Pasteur Hospital affiliated to Bam University of Medical Sciences and the research community consisted of 205 nursing staff. Due to the small number of samples, sampling was done in this study by census method. Data were collected by questionnaire consists of two parts: the first part includes demographic information such as age, sex, marital status, level of education, experience, location of work, the status of employment nurses and the second part of the questionnaire barriers to compliance standards of professional ethics from the perspective of nurses in the study of peasant and colleagues20 in three aspects: management, environmental and personal care are made. The questionnaire contains 33 questions of professional ethical barriers (14 questions related to management, five questions related to the environment, 14 questions related to personal care) services. Five-point Likert scale items to be answered. Select the option strongly agree (score 5) or agree (score 4) indicates that the item is considered an obstacle to ethical professional. Choosing the Absolutely Opposed Option (Score 1) and Opposition (Score 2) indicates that the item does not impede the observance of professional ethics standards from the perspective of nurses. I do not have the choice to comment. The lack of knowledge of the effect of the variable in question is inadequate to professional ethics. In order to evaluate the content validity of the questionnaire to the 10 professors and PhD students of Nursing University of Medical Sciences were arranged and conducted on the basis of necessary reforms. In order to determine the reliability and internal consistency, Cronbach's alpha coefficient of the questionnaire completed by 20 nurses from α=0/89 is obtained20.
Researchers ethical considerations referred to the hospital in Bam and in research from the Department of Science and Technology of the University of Medical Sciences received Bam. After publishing the goals and benefits of this study, hospital authorities were allowed to consult. The questionnaire and consent form by the researcher and visitors at the right time again to be distributed.
The Results:
Study as a cross-sectional study, the information of barriers to professional ethical nursing practice is provided. In this study of 184 patients, 152% (6/82) of women and 32% (4/17) were men. Among these patients, 35 (19%) were single and 149 (81%) were married. Minimum age of 23 and a maximum of 55 years studied, the average age of 67/6±42/32 years. The minimum working experience of the studied samples is 1 year and maximum 25 years, with an average working experience of 8.34±5.88 years. Based on statistical results, 171 (92.9%) had undergraduate degrees and 13 (7.1%) had master's degrees. Among the subjects, 177 (96.2%) nurses, 3 (1.6%) nurses and 4 (2.2%) supervisors were nurses. The results of the study showed that there was a significant relationship between observing ethical criteria with age (P=0.57), gender (P=0.75), educational level (P=0.57), position (p=0.93) and marital status (P=0.38). There is no significant statistical relationship. Table 1 shows the relationship between service sector and professional ethics, which did not show a significant relationship between the service area and ethical standards (P=0.07). In the statistical results of Table 2, employment status was not correlated with ethical standards (P=0.42). The results of the study indicate that the average barriers to observance of professional ethics standards in clinical care from nurses' point of view was 3.81 ± 0.56, which, considering the maximum average5, has barriers to observing professional ethics standards in clinical care. The average of these barriers in different domains were: environmental barriers with a mean of 4.10 ± 0.66, management barriers with a mean of 3.77±0.64, and then individual barriers with an average of 3.75±0.65.
Comparison of ethical standards in the workplace
Comparison of ethical standards by type of employment
Discussion:
In this study, the barriers to observance of professional ethics standards in three areas of management, environment and individual care were examined from nurses' point of view, which in all dimensions had barriers to observance of professional ethics standards. Which is similar to the study by Dehghani et al. (2012), Ghamari et al. (2014), which could be of interest to managers and health planners9,20. The results of the present study indicate that the highest average of barriers to observing professional ethics standards was from nurses' perceptions regarding environmental domain (with a mean of 4.10±0.66), which was consistent with the results of peasant studies20, lunar9 and inspirational10. Factors associated with this area are: lack of facilities and equipment in the sector, biological and physical changes during night shifts, work on different shifts, crowded sectors, expect the unexpected patients and their nursing staff6,10,20. Therefore, it is suggested that by regulating more regular job shifts, which allow nurses the opportunity to adapt biological time to work, it will help nurses to better observe care standards, including: better observance of professional ethics standards in nursing care practices.
According to the results of environmental factors, management factors (mean 64/0±77/3) the main obstacle in standards of professional ethics in clinical care from the perspective of nurses. Factors related to the field of management include: organizing inappropriate nurses, nurse shortage, heavy workload of nurses, shifts inappropriate and compact, crowded wards, non-use of standard and advanced medical equipment, lack of patient awareness of the duties of nurse, lack of incentive programs by managers, directors inappropriate treatment6,9,20-23.
Improper management of nursing staff is one of the factors that significantly reduces the quality of nursing care and nursing care and nursing professionalism6. Despite the fact that there is a shortage of nursing personnel in Iran and the world, but in all countries, the departure of nurses from this profession is high, which will lead to an exacerbation of the shortage of nurses24,25. The shortage of nursing staff leads to an increase in factors associated with dissatisfaction and burnout, such as an increase in workload and unpleasant work shifts26; which, according to the results of the above studies, are barriers to observing professional and ethical standards in nurses.
The results peasant et al (2013) suggest that nurses am working towards nurses shifts, ethical performance better, while nurses with morning and evening (Dvshyft burst) compared to other shifts , less professional ethical standards were met. Therefore it is necessary to reduce the effects of fatigue caused by long working time, changes in nurses' shifts occur27,36.
Thus, according to the results of the above studies observed that a major challenge is the shortage of personnel joined by medical personnel as a barrier in professional ethics is clinically known. Seems to be a shortage of personnel in health centers with careful planning and controlled solve. Also, by educating nurses about the principles and standards of care, they can familiarize themselves with the importance of observing professional ethics in improving the quality of patient care and the disadvantages of not adhering to professional ethics. Direct supervision of clinical interventions can also help to remove barriers.
Based on the results of this study, the next important obstacle to observing professional ethics standards in clinical care from the viewpoint of nurses after the management factors is individual factors (with a mean of 3.75±0.65). Factors such as lack of time23,34, failure to meet basic needs such as income or adequate rest, and nurse inherent characteristics such as personality, values in this area are20,28. Considering that solving basic staffing needs, such as income or rest, is an important factor in facilitating the observance of nursing professional ethics standards from nurses' perspective. Therefore, increasing income and reducing workload can lead to promotion of ethical standards of nurses29,33. So be sure the proper planning in order to solve the problems nurses more effective action to be taken, because in this case, even if the nurse and wants, beacause expressed to abide by professional ethics, it can not be that it is appropriate standards Ensure professional ethics in care services.
The results of various studies indicate that there is no relationship between nursing ethics and age1,19,29,30,31, which is consistent with the results of this study; but some other studies indicate that the age of compliance with ethical codes in nurses has decreased16,32, which can be attributed to the severity of nursing work and physical fatigue resulting from the activity in the clinic. Therefore, it can be argued that several factors that are associated with age can explain the role of age in reducing or increasing. For example, if the number of night shifts and workload is planned for a person of higher age, the number of his errors is reduced or vice versa16.
There are no significant correlations between the degree of observance of professional ethics and sex1,7,19,30, which is consistent with the results of the present study, but the results of some other studies indicate that there is a significant relationship between gender and the application of ethics16,29,31. As women have better moral performance than men. But it seems that due to the women's personality framework on emotional and communication issues, this group of staff is more committed to ethical issues in providing care and treatment.
There are no other demographic variables such as marital status, work experience, education level, employment status and service area, with respect to professional and ethical values, which is similar to the results of studies conducted in this area16,19,30,31,35.
Conclusion:
Regarding environmental factors as the most important barrier to non-observance of professional ethics standards, it is suggested that health care centers with careful planning and emphasis on principles and standards of care, including environmental factors, the importance of observing professional ethics In improving patients' conditions, disadvantages of professional ethics. Providing favorable conditions for nurses such as improving the conditions of the sectors, creating a comfortable and safe physical and psychological environment and meeting their needs, such as rest and income, developing appropriate shifts, providing standard equipment, an effective step to better observe professional ethics standards.
Study Limitations:
One of the limitations of this study was the lack of time from the nursing staff to fill in the questionnaires. In this regard, the questionnaires were tried to be distributed mid-shift work. Other limitations can be mentioned in this study only in a teaching and medical center. It is suggested in future researches that studies be conducted with a wider statistical community for more reliable generalizations.
Agradecimientos
This article is the result of a research project approved by the Student Research Committee of Bam University of Medical Sciences (97/97), which was funded by the Deputy of Research and Technology of Bam University of Medical Sciences. In this way, the authors of this paper from the Assistant Director for Research and Technology for financing, the hospital officials due to cooperation, the working nurses who patiently completed the relevant questionnaires, and other collaborators who collaborated on the preparation and implementation of the project, thanked and commended.
References
1- Maarefi F, Eslami Akbar R, Ashk Torab T, Abbas Zadeh A, Alavi Majd H. Check the patient's perspective in relation to compliance with ethical codes of nurses’ professional commitment in Medical Sciences hospitals of Jahrom in 2013. Journal of Ethics and Culture in Nursing and Midwifery 2014 Jun 22; 1(2): 19-26. [In Persian]
2- Azodi, F., Azodi, P., Sedighi, Z., Jahanpour, F. Patient safety situation from the nurses viewpoints in an educational hospital. Journal of Pharmaceutical Sciences and Research. 2017: 9(9), pp. 1647-1650.
3- Beheshtifar M, Esmaeli Z, Moghadam MN. Effect of moral intelligence on leadership. European Journal of Economics, Finance and Administrative Science 2011; 43(1): 6-11.
4- Gholamhosseini L, Hanafiye Moghadas M, Vandaee O. Value and Status of Professional Morality in the Providing Nursing Services. PSMH 2014; 10(1): 55-62. (In Persian)
5- Jahanpour, F., Paimard, A., Pouladi, S.H., Molavi Vardenjani, M. Comparing the durability of professional ethics’ learning in two methods of group discussion and multimedia software.2016: Research Journal of Medical Sciences. 2016: 10(3), pp. 120-123.
6- Ravani pour M, Vanaki Z, Afshar L, Azemian A. Thestandards of professionalism in nursing: the nursing instructors’ experiences. Journal of Evidence Based Care. 2014; 4(1): 27 – 40. [In Persian]
7- Davodi, M., Pouladi, S.,Vardanjani, M.M., Jahanpoor, F. Comparative study on the effect of professional ethics education using two methods, group discussion and multi-media software on the knowledge of nursing students. Research Journal of Pharmaceutical, Biological and Chemical Sciences.2016:7(4), pp. 2776-2781.
8- Azizi M, Hashemipor B, Barati H, Barati M, Vakili M. The Assessment of Observing Patients’ Right and Its Necessity from View of Nurses in Educational hospitals of Yazd, 2014. Nurse and Physician Within War. 2016; 4(10): 36-43. [In Persian]
9- Ghamari Zare Z, Alizadeh Barmi Z, Sadat Sadegholvaad H, Esmaeili M, Romouzi M. Study of barriers professional ethics in the practice of nurse care from nurse managers’ viewpoints in year 2013. J Educ Ethics Nurs. 2014; 3 (1) :57-63. [In Persian]
10- Elhami S, Saberi K, Ban M, Mousaviasl S, Moadab NH, Ghassemi M. The Challenges of Implementation of Professional Ethics Standards in Clinical Care from the viewpoint of Nursing Students and Nurses. Middle East Journal of Family Medicine. 2017; 7(10): 149.
11- Torabizadeh C, Ebrahimi H, Mohammadi E. Related to patient privacy and dignity: Literature review. Medical Ethics. 2012; 6(19): 119-132. [in Persian]
12- Mohajjel Aghdam A, Hassankhani H, Zamanzadeh V, Khameneh S, Moghaddam S. Nurses' performance on iranian nursing code of ethics from patients' perspective. Iran Journal of Nursing. 2013;26(84):1-11. [in Persian]
13- Ghobadifar MA, Mosalanejad L. Evaluation of staff adherence to professionalism in Jahrom University of medical sciences. Journal of Education and Ethics in Nursing. 2013; 2(2): 1-7. [In Persian].
14- Sadeghi R, Ashktorab T. Ethical Problems Observed by Nursing Students: Qualification Approach. Medical Ethics Journal. 2011; 5(15): 43-62. [In Persian]
15- Borhani F, Alhani F, Mohammadi I, Abbaszadeh A. Nursing students’ perceptions of barriers of acquiring professional ethics: a qualitative study. Strides in Development of Medical Education. 2011; 8(1): 67-80. [In Persian]
16- Nouhi E, Dehbanizadeh A, Zoladl M, Abidi H,Poranfard J. Evaluation of ethical lapses among nurses in Yasouj Shahid Beheshti hospital in 2014. J Educ Ethics Nurs. 2016; 5 (2):16-23. [In Persian]
17- Barati Marnani A, Ghoorchiani F, Ghorgi HA, Khatami Firouzabadi AM, Haghani H, Gholdust Marandi F. Observance of nursing ethics from the perspective of nurse and patient in a teaching hospital in Tehran University of Medical Sciences: 1391. Medical Ethics Journal. 2013; 7(23):63-79. [In Persian]
18- Mohamadi N, Gholami N, Rezaei S, Zangeneh M, Shahnavazi M, Roshanaei G et al. Evaluating staff and students’ knowledge about professional ethics in the Field of Communication, Law and Ethics. Research in medical education. 2018; 9(4): 1-9. [In Persian]
19- Khodayari Zarnagh R, Abbasi M, Arablou J, Mobbaseri K, Tourani S, Esmaeili A. Study the status of moral values; A survey in Tehran teaching-therapeutic hospitals in 1392. Bioethics Journal. 2013; 3(10): 93-115. [In Persian]
20- Dehghani A, Dastpak M, Gharib A. Barriers to Respect Professional Ethics Standards in Clinical Care Viewpoints of Nurses. Iranian Journal of Medical Education 2013; 13(5): 421-30. [In Persian]
21- Hashmatifar N, Mohsenpour M, Rakhshani M. Barriers to moral sensitivity: viewpoints of the nurses of educational hospitals of Sabzevar. Iranian Journal of Medical Ethics and History of Medicine. 2014; 7(1):34-42. [In Persian]
22- Faramarzpour M, Najafi K, Ardeshiri R, Zafar Nia N, Askari Zadeh Mahani M. The causes of Common Errors in Nurses. Journal of Jiroft University of Medical Sciences. 2017; 3(3): 173-82. [In Persian]
23- Mohammadi MM, Parandin S, Bahrehmand P. Barriers to apply the principles of professional ethics in the practice from Viewpoints of Nurses and Nursing Instructors of Medical Sciences at Kermanshah University. Journal of ethics and culture in nursing and midwifery. 2014;1(2):1-8. [In Persian]
24- Hoseini-Esfidarjani SS, Negarandeh R. A new view towards resolving the nursing shortage challenge. Journal of School of Nursing and Midwifery, Tehran University of Medical Sciences (Hayat). 2017; 23(3): 196-200. [In Persian]
25- bazi A, sharafi S. Evaluation time Nurses for non-nursing tasks and text services in nursing shifts: a cross-sectional study. Navid No. 2016; 19(62): 24-32. [In Persian]
26- Borhani F, Atashzadeh Shoorideh F, Pour Hossein Gholi MA, Maani M. The Correlation between Ethical Climate and Job Satisfaction of the Nurses in Shahid Beheshti University of Medical Sciences. Medical Ethics Journal. 2017; 10(38): 51-8. [In Persian]
27- Dehghani A, Mohammad Khan Kermanshahi S. Evaluating of compliance with professional ethical standards in nursing practice from Nursing Staff's View points in Tehran University of Medical Sciences. Modern care j. 2013; 9 (3):208-216. [In Persian]
28- Pourbandbani M, Sadeghi R, Salsali M, Borhani F. Effective factors on active participitation on clinical nurses to solution of ethical issues: master nursing students perspective. Urmia J Nurs Midwifery 2013; 10(1):42-50. [In Persian]
29- Taheri L, Dehghani A, Eslami Akbar R. Factors related to facilitate complying nursing professional ethics: a descriptive study. J Educ Ethics Nurs. 2015;4(1):51-7. [In Persian]
30- Shareinia H, Khodadadi E, Nedaei H, Hosseini M. Professional and Ethical Values in Providing Nursing Care from Nurses’ Perspective. IJN. 2018;31(112):44-55. [In Persian]
31- Bijani M, Ghodsbin F, Javanmardi Fard S, Shirazi F, Sharif F, Tehranineshat B. An evaluation of adherence to ethical codes among nurses and nursing students. Journal of Medical Ethics and History of Medicine. 2017;10(6): 1-8.
32- Dehghani A, Radbeh F, Parviniannasab AM, Khaki S, Shamsizadeh M, Beyramijam M. Enactment of Professional Ethics Standards Compliance in Patients and Nurses Prospective. Journal of Holistic Nursing and Midwifery. 2015; 25(4): 64-72. [In Persian]
33- Yazdekhasti, A., Erfan, N., & Nazari, N. (2015). Investigating the Relationship between Spiritual Intelligence and Social Adaptation among Girl High School Students in Shahreza City. UCT Journal of Social Sciences and Humanities Research, 3(1),20-23.
34- mirzamasoumzadeh, b., & Mollasadeghi, v. (2013). Effects of osmotic stress on chlorophyll and proline different wheat cultivars, UCT Journal of Research in Science, Engineering and Technology, 1(1):12-13.
35- Akar E, Batçık KE, Acar C, Ton Ö, Canaz H, Baydın S, et al. A Comparative Analysis of the Effects of Melatonin and Nimodipine on Vasospasm. J Clin Exp Invest. 2018;9(3):113-8.
36- Aghajari, Z., Loghmani, L., Ilkhani, M., Talebi, A., Ashktorab, T., Ahmadi, M., & Borhani, F. (2018). The relationship between quality of learning experiences and academic burnout among nursing students of Shahid Beheshti University of Medical Sciences in 2015. Electronic Journal of General Medicine, 15(6).
Author notes
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