Nurses’ professional dignity in private health care: a descriptive phenomenological study

Dignity: the cornerstone of psychological health among victims of child labor, a qualitative study

BACKGROUND

Respecting the dignity of child labor is one of their most urgent needs. In many cases, the dignity of child labor is not maintained in countries with unfavorable economic conditions. The aim of the present study was understand adolescents' perceptions of their dignity in child labor.

METHODS

This study is a qualitative research with conventional content analysis approach. Twenty teenagers who having work experience as child labor were selected from one welfare center and three charity centers in using purposeful sampling method in 2022-2023. Data was generated through individual, deep, and semi-structured interviews. In order to analyze the data was used Granheim and Lundman's method.

RESULTS

Three main themes were presented in this study including, "preservation of privacy and security", "honoring individual identity to develop dignity" and "comprehensive support", and 9 categories.

CONCLUSION

understand adolescents' perceptions as child labor of their dignity, privacy and security of child labor victims and respect for their identity and all-round support are defined. And in this supportive environment, the dignity of working children is preserved and appropriate behavioral consequences are created. Therefore, it is suggested that a cultural and institutional background be provided in which all components of the child labor's dignity are emphasized.

Exploring a guide for codes of ethics for the development of ethical competence in Iranian nursing students: a systematic review and meta-synthesis

BACKGROUND

Improving the ethical competencies of nursing students, as an important dimension of professional competence, is a primary objective of nursing education. Thus, this study aimed to explore a guide for codes of ethics for the development of ethical competence among nursing students in the healthcare system of Iran.

METHODS

This is a systematic review and meta-synthesis of qualitative studies conducted in the healthcare system of Iran. The review included studies published between January 1, 2000 and March 2024. We conducted a comprehensive search in various international and national databases, including Web of Science, PubMed, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and SID. Initially, 86 qualitative studies were identified, and after a meticulous screening process, 39 studies were carefully reviewed. Finally, 10 qualitative studies were selected for analysis. The meta-synthesis employed an interpretive approach by thematic synthesis.

RESULTS

Based on our results, four main themes and 10 categories, along with summarized codes, were extracted as crucial elements of the codes of ethics for the professional competence of Iranian nursing students. The main themes identified were knowledge, standards, experiences, and attitudes (KSEA).

CONCLUSIONS

The concept of codes of ethics for developing professional competencies in Iranian nursing students was detected as a multidimensional concept with four major areas. By emphasizing the rights of clients and the standardization of nursing practice, this set of ethical codes can contribute to preventing clinical errors and legal issues at hospitals and educational settings. Furthermore, it fosters a positive environment that encourages professional behaviors among nursing students. Nursing students, as future nurses, should apply codes of ethics when facing emerging ethical challenges. Nurse educators have a crucial role in providing students with the necessary preparation and guidance during their professional socialization process in nursing schools.

Reflections of nursing students on the care of the person's dignity at the end of life: A qualitative study

BACKGROUND

The education of nursing students not only implies transmitting knowledge and clinical skills, but also values, attitudes, and behaviours. In healthcare, it is considered essential to respect and preserve the dignity of people. This is even more important in palliative care, where the fragility of people makes them potentially vulnerable. There is limited knowledge regarding the conceptualization and experience of nursing students and human dignity in palliative care.

AIM

To describe how 5th-year nursing students conceptualise and experience human dignity, while caring for people with terminal illness.

DESIGN

Qualitative descriptive design, with thematic content analysis as per Graneheim and Lundman.

SETTING

A palliative care centre for people on low incomes with terminal illnesses which no longer respond to curative treatments.

PARTICIPANTS

A total of 11 fifth-year nursing students who completed their professional practice in a palliative care unit.

METHODS

Data collection was conducted through guided online reflections via reflective journaling between April and November 2020. The study protocol was reviewed and approved by the Scientific Ethical Committee within the educational institution (CEC2021065).

RESULTS

Four thematic categories were identified (1) Concept of dignity; (2) Dignity: an essential element in the relationship with others, (3) Instances when the dignity of the person is not considered; (4) The value of reflection on dignity in clinical practice.

CONCLUSION

Dignity is one of the main values recognized in the person. Dignity should be promoted in the education of future nursing professionals, particularly with people who are in the final stage of life, where fragility and vulnerability it is more palpable.

Beyond mere respect: new perspectives on dignity for healthcare workplace learning

Introduction

Although dignity in workplace learning in healthcare is gathering interest, we know little about stakeholders' conceptualizations in this area across professional groups. Dignity breaches in workplace learning are common, often with serious and long-lasting consequences for the affected. Conceptualizations shape behaviours and experiences. To prevent dignity violations in students' learning, it is thus important to understand stakeholders' understandings of the topic. This study therefore explores the dignity conceptualizations around workplace learning that students, placement educators and university staff hold across seven allied health professional groups.

Methods

Using a social constructionist perspective, we conducted individual and group narrative interviews (n = 51) with students, placement educators and university workplace learning staff from seven allied health professional groups. We used the 5-step Framework Analysis to explore and develop themes, identifying differences and similarities across stakeholder groups.

Results

We identified eight distinct, yet interrelated, dimensions of dignity from participants' narratives: dignity as respect, dignity as self-x (the various relationships we have with ourselves), dignity as feeling safe, dignity as understanding otherness, dignity as supporting others, dignity as equality, dignity as professionalism, and dignity as belonging. Dignity as respect was identified across all participants, although mutual respect and a culture of respect were only present in academic participants' talk. The remaining seven dimensions all present important factors extending our understanding of the construct of dignity.

Discussion

In line with existing research, our study identifies the absence of an unambiguous, positive conceptualization of dignity in workplace learning among stakeholders. It adds novelty in two ways: by identifying dignity dimensions that require informed action beyond respecting others, and by revealing a tension between dignity as professionalism and dignity as equality. We suggest revising existing dignity concepts in workplace learning to address this tension and to reinforce that active care, team integration and skilled support are all non-negotiable elements of dignified behaviour within workplace learning.

Development and psychometric evaluation of perceived clinical nurses' professional dignity scale: a sequential-exploratory mixed-method study

BACKGROUND

In recent years, one of the concepts that has received attention in the nursing profession is professional dignity. On the other hand, there was no proper scale to evaluate this concept. This study aimed to develop and evaluate the psychometric properties of perceived clinical nurses' professional dignity scale (PCNPDS).

METHODS

This exploratory sequential mixed method was developed and implemented in Iran. The study was conducted in two phases; (a) item generation by hybrid concept analysis and (b) item reduction by psychometric evaluation including validity and reliability of the developed scale. Also, the interpretability (ceiling and floor effect), stability (intraclass correlation coefficient), and absolute stability (standard error of measurement) were calculated.

RESULTS

68 items in the primary item pool were finally reduced to 22 items after evaluating the validity (face, content, and construct validity) and reliability. Exploratory factor analysis revealed three factors (organizational dignity, dignity-based competency, and dignity-based appreciation) and explained 47.55% of the total extracted variance. Confirmatory factor analysis showed that the model had a good fit. Finally, Cronbach's alpha coefficient, McDonald's omega, ICC, and SEM were calculated as 0.90, 0.89, 0.96, and 1.91, respectively.

CONCLUSION

The 22-item developed scale is valid and reliable for professional dignity measurement among Iranian clinical nurses.

Threats to professional dignity of Iranian clinical nurses: A qualitative study

AIM

Identifying threats to the nurses' professional dignity has an important role in maintaining and promoting their dignity. This study aimed to evaluate the perception of Iranian nurses' experiences of threats to their professional dignity in clinical settings.

DESIGN

A qualitative directed content analysis approach was used.

METHODS

The present qualitative study was conducted in Iran.Clinical nurses were selected using the purposive sampling method. Data were collected through in-depth semi-structured interviews with 15 clinical nurses from October 2020 to March 2021. The qualitative content analysis method was used to analyze the data.

RESULTS

Two main categories and 16 subcategories were extracted as follows: (1) professional factors (containing seven subcategories) and (2) organizational factors (containing nine subcategories).

CONCLUSIONS

To promote the professional dignity of nurses, it is recommended to identify the factors threatening their professional dignity and create healthy work environments for them.

Coping strategies that motivated frontline nurses while caring for the COVID-19 patients during the pandemic: A scoping review

BACKGROUND

The world faced a great health crisis during the COVID-19 pandemic. Consequently, the health care providers struggled and faced tremendous difficulties in treating high-load critical patients. This was particularly true in low- and middle-income countries where the work and patient loads are always higher and nurses at the forefront must deal with emergencies while being at high risk of exposure. However, little is known about the survival strategies of frontline nurses as dealt with the pandemic.

OBJECTIVES

This study catalogued the coping strategies of frontline nurses to deal with caring for the COVID-19 patients during the pandemic.

METHODS

The Arksey O'Malley framework was followed to conduct a scoping review. A systematic literature search was conducted using three databases: Google Scholar, Scopus and PubMed; and out of the 192 studies, 12 met the inclusion criteria set for this review study.

RESULTS

A total of 44 strategies were identified that motivated nurses to deal with the COVID-19 situation, and these strategies could be categorized into five main themes: nurses' self-strategies, nurses' strategies at the ethical level, employers' strategies, nursing leaders' strategies and supplementary strategies.

CONCLUSIONS

The findings of this study will provide guidance for health care workers, employers, policymakers, regulators and other stakeholders to adopt and promote different strategies in managing difficult emergency situations in future.

IMPLICATIONS FOR NURSING MANAGEMENT

This study emphasizes the importance of learning how to deal with adversity by health care workers and organizations in an emergency.

Guaranteeing dignity and decent work for migrant nurses and health care workers beyond the COVID-19 pandemic

AIM(S)

The main aim of this article is to outline the devastating aftereffects of COVID-19 in terms of ethical recruitment and the respect of dignity of nurses and health care professionals.

BACKGROUND

Nations experience the ominous impacts of the COVID-19 pandemic in terms of an exacerbated shortage of nurses worldwide. In this situation, migration flows of nurses are skyrocketing and the respect of the migrant nurses' dignity as human beings should be guaranteed.

EVALUATION

Data from reports elaborated by the International Centre on Nurse Migration (ICNM) were examined and outlined the central role of the respect of dignity of every nurse to prevent unethical exploitation of them.

KEY ISSUE(S)

The respect of human dignity is a complex concept. Human dignity denotes the inner nature of human beings but also their rights at work.

CONCLUSION(S)

In a post-COVID-19 world with increased flows of nurse migration, it is crucial to guarantee dignity at work for migrant nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse leaders should prioritize the ethical recruitment of health care workers and give a prominent role to the WHO 'Code of Practice on the International Recruitment of Health Personnel' which recognizes the ethical bedrocks of employment.

Public health nurses' professional dignity: An interview study in Finland

BACKGROUND

Dignity is a central human value supported by nurses' professional ethics. In previous studies, nurses in clinical practice have experienced that dignity increased their work well-being and pride of work. Dignity is also strictly interweaved to professional identity in the different nursing' roles, but little is known about dignity among public health nurses and primary care settings.

PURPOSE

This study aimed to describe the perceptions of nursing's professional dignity of public health nurses in primary care in Finland.

RESEARCH DESIGN

An inductive qualitative descriptive approach with semi-structured focus group interviews was utilised.

PARTICIPANTS AND RESEARCH CONTEXT

Twenty-seven Finnish public health nurses were interviewed via eight semi-structured focus group interviews in primary health care settings.

ETHICAL CONSIDERATIONS

Before data collection, research permissions were obtained from participating health care centres. This type of research in Finland, with competent adult participants, does not require ethical pre-assessment but written and oral informed consent obtained before the interviews.

FINDINGS

Based on our findings, public health nurses perceived that professional dignity was (1) part of their self-respect, an observed daily value based on their acknowledged competence. Besides, they perceived that (2) service users' trust in public health nurses was a strong expression of professional dignity, and it could be uncovered when recipients of care utilised their services. In addition, public health nurses experienced that (3) professional dignity was an expression of different intertwined interprofessional and social factors.

DISCUSSION AND CONCLUSION

Professional dignity is simultaneously an essential prerequisite and an outcome of public health nurses' work. In future, more information would be needed to implement strategies in primary health care to foster nurses' professional dignity also in international public health arenas.

Dignity of Nursing Students in Clinical Learning Environments

As an important professional value, dignity has always been an ethical concern in nursing education and practice. However, the dignity of nursing students in clinical environments has remained a little-discussed topic. This study aims to explore and describe nursing students' dignity in clinical learning environments. This study is a qualitative descriptive work in which data were collected via semi-structured, in-depth, individual interviews and subsequently analyzed according to conventional content analysis. Based on the inclusion criteria of the study, nursing students were selected from different departments of university hospitals in the south of Iran from October 2019 to December 2020 (n = 21). Sampling continued to the point of data saturation. This study has been approved by the institutional review board of the university. Two themes emerged from the data collected in the interviews: trust-based relationships and formation of professional identity. The findings of the study show that nursing students need to be supported by their instructors and perceive that the personnel and patients believe in their ability. In an effectively supportive, trust-based atmosphere, these factors can contribute to maintaining nursing students dignity. Also, showing respect for their personal identity, projecting a positive image of nursing, and giving them authority to perform executive and clinical tasks in hospital departments play a major role in the formation of nursing students' professional identity and development of their dignity. Accordingly, it is recommended that in cultural contexts and clinical learning environments, more attention should be given to nursing students' dignity.

Discovering dignity through experience: How nursing students discover the expression of dignity

Introduction:

Dignity is a core value in nursing. Nursing education shall prepare students for ethical professional practice and facilitate insight into the phenomenon of dignity and its significance. There is limited knowledge about how nursing students discover dignity in their education.

Research aim:

The aim of the study is to develop an understanding of how nursing students discover and acquire dignity.

Research design:

The study has a hermeneutic approach where qualitative interviews of nursing students were employed. The process of interpretation was inspired by text of Fleming, Gaidys and Robbs.

Participants and research context:

Nineteen nursing students agreed to be included in the study, representing six different campuses at three different educational institutions. All were in the final year of their study. The interviews took place at the educational institutions.

Ethical considerations:

The educational institutions facilitated recruitment of the students who signed voluntarily for participation and continuous informed consent. The study was approved by The Norwegian Center of Reporting Data (NSD). The research recommendations of the Declaration of Helsinki were followed.

Findings:

The nursing students discovered the expression and significance of dignity through experiences, gained through introspection and in interaction with others during the education.

Discussion:

The findings are discussed using Gadamer’s concept of experience and how experiences can create new insight. In particular, the students’ experiences with the inner ethical and external aesthetic dimension of dignity are discussed.

Conclusion:

The study shows that students discovered the inner ethical dignity through experiencing vulnerability, pride and shame. They discovered the external aesthetic dignity through incidents, where they experienced both to be confirmed and not to be confirmed, and through observation of good or bad role models. Crucial negative and positive experiences are important for discovering the expression and significance of dignity.

Preserving nurses' professional dignity: Six evidence-based strategies

AIM

This study aimed to develop and refine strategies for preserving nurses' professional dignity.

BACKGROUND

Professional dignity is a non-negotiable nursing professional value. It should at all times be respected because of the worthiness of nurses as professional human beings. They are at the centre of healthcare societies. Their worth and contributions to the health of others should be acknowledged and preserved.

METHODS

Descriptive qualitative research was conducted during the development of the strategies while applying the principles of strategic navigation. The process was guided by the findings of the initial phase of the study and contextualised literature. Focus group discussions were held with healthcare professionals for the refinement of the strategies in two private hospitals in South Africa.

FINDINGS

The strategies unfolded multiple possibilities to value nurses' professional dignity. These were pathways for respecting, appreciating and supporting nurses; honouring nurses' desire to hold the well-being of patients in the highest regard; supporting nurses in fulfilling their professional roles; enabling nurses to take pride in themselves and the nursing profession; supporting nurses in demanding and complex circumstances and supporting nurses in coping with humiliating workplace experiences.

CONCLUSION

Strategies to ensure successful outcomes in preserving nurses' professional dignity were developed and refined. The professional dignity experiences that mattered most were presented.

IMPLICATIONS FOR NURSING/HEALTH POLICY

Valuing nurses' professional dignity promotes respect and support for nurses and their desire to prioritise patient-centred care, contributing to improved nursing practice and nurses' confidence to assert their professional dignity. Preserving nurses' professional dignity is a necessity in healthcare. It should be affirmed in equal standing in nursing codes of conduct, nursing curriculums and healthcare policies.

Sense of coherence and strategies for coping with stress among nurses

BACKGROUND

The nursing profession is associated with constant presence of difficult situations and stress, which arise from responsibility for the highest values - human life and health. With demographic changes in the society, the demand for nursing care increases. Looking after the health of nursing staff becomes a non-material investment in employees. One of the most important health potentials described in literature is the sense of coherence. It can significantly contribute to maintaining good health, modify one's functioning in a stressful working environment and influence the choice of strategies for coping with stress.

AIM

The aim of the study was to describe the specific relationship between the sense of coherence and strategies for coping with stress in a group of professionally active nurses.

METHODOLOGY AND METHODS

The study involved 91 nurses in central Poland, aged 22-52. The group was diversified in terms of: education, work system, marital status and place of residence. The study was conducted with the use of: Sense of Coherence Questionnaire SOC-29 and Inventory to Measure Coping Strategies with Stress - Mini-COPE. The study was conducted in accordance with the principles of scientific research set out in the Helsinki Declaration.

RESULTS

The sense of coherence value in the test group was M = 134.24 (SD = 19.55). In stressful situations nurses most often used active strategies to cope with stress: Planning M = 2.10 (SD = 0.54), Seeking Emotional Social Support M = 1.95 (SD = 0.68) and Seeking Instrumental Social Support M = 1.95 (SD = 0.69), and the least frequently: Alcohol/Drug Use M = 0.28 (SD = 0.48). The level of the sense of coherence and its components differentiated the strategies of coping with stress used in the examined group of nurses.

CONCLUSIONS

The research confirmed that the sense of coherence serves as a health potential in a stressful working environment - a high sense of coherence translate into better mental health, correct functioning in the working environment, and using adaptive strategies of coping with stress. Nurses with a stronger sense of coherence used more adaptive strategies to deal with stress than those with average or low levels.