Leaders should emphasize a clear expression of values, objectives, and mission of the organisation; and try to raise confidence in employees, respecting and caring for them, supporting their views and suggestions, and being optimistic about the future.

Background: Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it. Objectives: This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units. Research design: This was a descriptive cross-sectional research. Participants and research context: In total, 382 nurses working in the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version). Ethical considerations: This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed. Findings: The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to “using resources despite believing in its futility,” with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of “working with incompetent staff.” The most frequently observed type of conflict was moral dilemma. Conclusion: The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment.

Background:Burnout has its focus on exhaustion and it includes persistent response to long-lasting job-related stressful events. It has a special relevance in health care area in which staff is under constant psychological, emotional, and physical stress. The results of several studies on burnout prevalence among Iranian nurses indicate its high incidence. Therefore, more accurate researches are required for better preventive interventions, and to do so, a reliable validated scale is required. One of the suitable and new tools for the measurement of burnout is Copenhagen Burnout Inventory (CBI). This study aimed to translate and investigate psychometric properties of CBI in Iranian nurses.Materials and Methods:In this methodological study, after the translation process, face and content validities via qualitative and quantitative methods was done. Content validation ratio, scale-level content validated index, item-level content validity index were measured. Then, construct validity was determined through factor analysis. Furthermore, internal consistency reliability and stability were assessed. The questionnaire was sent to 450 nurses who were randomly selected via quota sampling.Results:Face and content validity were acceptable. After translation and cultural adaptation process, exploratory factor analysis suggested a new model based on four factors and fit indices validated this model via confirmatory factor analysis. Internal consistency and stability of CBI were affirmed for each subscale separately.Conclusions:The four-factor Persian version of the CBI proved to enjoy acceptable psychometric properties. It can be applied to evaluate burnout in Iranian nurses or other health care providers.

Background: Despite advances in postoperative pain control, it is still a big challenge with high-prevalence for practitioners. Inadequate control of postoperative acute pain is common which can lead to serious complications for patient. Objectives: This study aimed to compare massage therapy and music therapy in the control of postoperative pain and amount of received opioid drug after abdominal surgery. Methods: In this randomized 3-group trial, 102 patients in the surgical wards of 3 military hospitals, Ahvaz, Iran, were randomly allocated to music group, massage group, and usual-care group. Participants in the massage and music groups received 10-minutes sessions of slow-stroke back massage and without lyrics music, respectively, 1, 6, and 12 hours after surgery. The pain intensity was measured by numeric rating scale 10 minutes after each intervention session. Also, the mean of received opioid drug during 12 hours was measured in each group. Results: The results indicated a decreasing trend of pain intensity in all the groups. However, the trend of pain intensity had a significantly more decrease in the massage group compared to the both music group (P = 0.001) and usual-care group (P = 0.001).

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