A comprehensive definition of the concept of spiritual care ensued. The findings can facilitate further development of nursing knowledge and practice in spiritual care and facilitate correction of common misconceptions about the provision of spiritual care.

Introduction:Professional values are standards of behavior for performance that provide a framework for appraising beliefs and attitudes that influence behavior. Development of professional values has been a continuous and long process and it is influenced by different factors. The aim of this study is “assessing different factors influencing development of professional values among nursing students and instructors”.Method:In this systematic review, a broad research was performed to find articles from Persian and English databases: pub Med, Pro quest, Elsevier, SID, Google scholar, Ovid and Iran Doc; nursing student, instructors, ethics, professional value, ethical value and educators were used as the key words. Among 3205 achieved articles, by eliminating repeated ones, 22 articles were assessed during the period 1995–2013. Data achieved from the articles were summarized, categorized and analyzed based on the research question.Results:In this study “education and achieving professional experiences”, “Students and instructors’ perspectives on professional values”, “the role of culture in considering and developing professional special values” and “the effect of learners’ individual characteristics” were extracted as the four main themes.Conclusion:Considering the effect of educational, cultural and individual factors in developing nurses’ professional values; it is recommended to the educational and health centers to consider value-based cares in clinical environments for the patients in addition to considering the content of educational programs based on ethical values in the students’ curriculum.

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The findings indicate that almost no patient is satisfied with the quality of services with respect to maintenance of their dignity. Regardless of their hospital location and state of health, most participants had common complaints. These findings agree with the literature and confirm that grounds should be provided for conserving dignity in the healthcare system. To reach this goal, healthcare professionals should be aware of the factors that violate or preserve dignity from the patient's perspective.

Background and ObjectivePatient delay makes a critical contribution to late diagnosis and poor survival in cases of breast cancer. Identifying the factors that influence patient delay could provide information for adopting strategies that shorten this delay. The aim of this meta-ethnography was to synthesize existing qualitative evidence in order to gain a new understanding of help seeking behavior in women with self-discovered breast cancer symptoms and to determine the factors that influence patient delay. MethodsThe design was a meta-ethnography approach. A systematic search of the articles was performed in different databases including Elsevier, PubMed, ProQuest and SCOPUS. Qualitative studies with a focus on help seeking behaviors in women with self-discovered breast cancer symptoms and patient delay, published in the English language between 1990 and 2013 were included. The quality appraisal of the articles was carried out using the Critical Appraisal Skills Programme qualitative research checklist and 13 articles met the inclusion criteria. The synthesis was conducted according to Noblit and Hare’s meta-ethnographic approach (1988), through reciprocal translational analysis and lines-of-argument.FindingsThe synthesis led to identification of eight repeated key concepts including: symptom detection, initial symptom interpretation, symptom monitoring, social interaction, emotional reaction, priority of medical help, appraisal of health services and personal-environmental factors. Symptom interpretation is identified as the important step of the help seeking process and which changed across the process through active monitoring of their symptoms, social interactions and emotional reactions. The perceived seriousness of the situation, priority to receive medical attention, perceived inaccessibility and unacceptability of the health care system influenced women’s decision-making about utilizing health services.ConclusionHelp seeking processes are influenced by multiple factors. Educational programs aimed at correcting misunderstandings, erroneous social beliefs and improving self-awareness could provide key strategies to improve health policy which would reduce patient delay.