Iranian Journal of Medical Ethics and History of Medicine

Caring for dying patient is one of the painful events and a tough experience for nurses. Care of dying patient according to his/her cultural norms is one of the principles of nurse's professionalism. Therefore identifying and explaining the daily experiences of nurses in cultural care of dying patients would help in determining caring standards. Due to the lack of such studies, the aim of this study was to explain the nurses' experiences in the care of dying patients.
This study is a qualitative investigation with content analysis method. Eighteen nurses working in teaching hospitals of Tehran were selected by purposeful sampling method from 2010 to 2011. Data were collected through semi-structured face to face interviews. Content of the interviews were transcribed and analyzed by content analysis.  
The findings were classified into two themes of cultural exposure and cultural skills.  Understanding of family presence and family bereavement were two sub-themes of cultural exposure.  Cultural skills consist of 3 sub-themes i.e., preparation for telling bad news, facilitating facing death and solacing family members. 
Regarding our results, in order to meet patients and their families expectations in a respectful manner, nurses awareness of cultural norms of the dying patient and his/her family seems to be necessary. It would be an important step in reforming and improving nursing performance and professional development.

Nurses face numerous patients with different cultural backgrounds and needs on a daily basis. Cultural diversity can be an obstacle in the way of providing quality healthcare services. Cultural competency is the proper response to cultural and ethnic diversity in the society. This research was conducted to define the concept of cultural competency in nursing education.

In this study, Persian and English keywords related to cultural competency, nursing education and nursing curriculum were first searched separately and in combination on the internet and in existing literature. Consequently, papers that were more directly related to the topic were chosen and their concepts were extracted. Cultural competency refers to a set of knowledge, views and skills used simultaneously to enable the individual to work efficiently in different cultural conditions. In this study, first cultural competency was defined and then the process of its acquisition, the facilitating factors, barriers and consequences were described.

Considering that in Iran cultural variables are affected by many different factors, it seems necessary to investigate cultural competency in the existing cultural conditions. Moreover, there seems to be a need for comprehensive planning to provide solutions for professors and students in this respect.

The cultural competence, responsibility and ethical beliefs are influential factors in providing quality services by nurses and pay an important role in patient's right. The purpose of this research was to illustarte a predictive model of patient's right based on cultural competence, responsibility and ethical beliefs. The research method was correlational study conducted in 2016 among 300 nurses in west Azerbaijan in 2016, selected by multistage cluster sampling. For gathering the data, the Perng and Watson’s nurses’ cultural competence questionnaire, and the Mergler and Shield responsibility questionnaire as well as the Mahmoudi and et al questionnaire on ethical beliefs and Scale rights of patients were used. The data were analyzed by using Pearson correlational coefficient and bootstrap through SPSS software and amos-22. The results indicated that the model was fitted and has direct effect in cultural competence (0.11), responsibility (0.57) and ethical beliefs (0.24) on nurse’s attitude with the rights of patients were significant. The indirect effects of cultural competence (0.03) and responsibility (0/03) with mediating of forming the model of ethical beliefs were significant. In conclusion, %65 of the variance in nurses’ attitudes to the patients' rights was determined by the variables of this research model. Due to the direct and indirect effects of cultural competence, responsibility and ethical beliefs on the attitudes of nurses towards patients' rights, it is important to increase cultural competence relationship and responsibility with nurses’ attitudes towards   patient’s rights by focusing on ethical beliefs.

One of the most important patient rights is to respect the patients’ autonomy and their participation in the process of treatment decision-making. This is of particular importance for the patients in the emergency department, who require due care in differential diagnosis leading to illness and death. However, the problem arises when this right is negligently ignored and despite the fact that it seems a simple matter, it is difficult to manage and control. Accordingly, this study aimed to investigate this issue through the case report of a patient diagnosed with acute abdomen. Moreover, an attempt was made to briefly review how negligence occurs, its causes and consequences, as well as its management strategies. In this report, the results highlighted the importance of patient participation, obtaining informed consent from the patient in the entire treatment process (diagnosis, treatment, rehabilitation, and prevention), and maintaining privacy and confidentiality regarding all medical and non-medical information of patients that are provided to the treatment staff in verbal, written, partial, and even electronic forms, especially in sensitive and stigmatizing cases. It seems that there are certain strategies to manage such negligence including timely detection, investigation of the causes and consequences, compensation for the damage, enhancing the cultural competence of the treatment staff, developing relevant local guidelines and instructions, having an efficient system with the support of the organization for handling it, and strengthening communication skills and teamwork.