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Future nurses could use these finding to reflect on their developed attributes throughout their studies and clinical placements and adjust their career preparation and learning to bridge any identified gaps. Organizational values and intervention for nursing staff could also be redesigned to align with the aspects of career success.

Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

Background Shared decision making (SDM) is recognized as the gold standard for patient-centered care. This study aimed to assess and compare the SDM among patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality. Methods This is a cross-sectional study that was performed on 300 dialysis patients (218 HD and 82 PD) referred to two Dialysis Centers. Data were collected using demographic information and a 9-item Shared Decision Making Questionnaire (SDM-Q-9). The data were analyzed using ANOVA and independent t-test by SPSS software. Results The mean SDM-Q-9 score in all samples (PD and HD) was 21.94 ± 15.08 (in a possible range of 0 to 45). Results of the independent t-test showed that the mean SDM-Q-9 score in PD patients (33.11 ± 10.08) was higher than HD patients (17.14 ± 74.24) (p < 0.001). The results showed a statistically significant difference in mean SDM-Q-9 score based on patients’ age, educational level, and income (p < 0.05). Conclusion Implementing shared decision making and providing information on RRT should be started in the early stage of CKD. The health care providers should involve patients with CKD and their families in dialysis-related decisions and it should be started in the early stage of CKD.

Reducing nurses' autonomy can impair their decision-making and ability for appropriate interventions. Lowered independence hinders ethical reasoning, which may lead to moral distress. This descriptive correlation study investigates the relationship between professional independence and moral distress in 173 nurses working in emergency departments in Tabriz, Iran. Data were collected using questionnaires designed to assess professional autonomy and moral distress and analysed using descriptive and inferential statistics via the SPSS 13 software. The level of professional autonomy among emergency nurses was low (83.2±16.9), and moral distress, moderate (7.43±3.52). A statistically significant negative relationship was reported between professional independence and the frequency of moral distress (p=0.018). Bivariate analysis related professional autonomy with the frequency and intensity of moral distress. Multiple regression analysis showed that age significantly predicted moral distress (frequency, intensity, and total scores). Lack of autonomy hinders nurses from functioning effectively and efficiently in practice and even can lead to moral distress. Increasing professional independence and the use of experienced nurses as mentors in emergency settings to support younger nurses can help with the reduction of moral distress.