1
|
Pang F, Zhang Y, Liu H, Du A, Tian Y, Chen H, Xu Y. Factors associated with moral sensitivity among nurses in adult intensive care units: A cross-sectional study in China. Nurs Crit Care 2024. [PMID: 39291677 DOI: 10.1111/nicc.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Moral sensitivity may play a role in dealing with ethical issues in ICUs. However, the moral sensitivity of adult ICU nurses in China and its predictors have not been well investigated. AIMS To analyse the moral sensitivity of intensive care unit (ICU) nurses and its predictors. STUDY DESIGN A cross-sectional study through convenience sampling was conducted in the ICUs of five hospitals in China between November and December 2022. A total of 331 ICU nurses were recruited. Data were obtained using a self-developed socio-demographic characteristic questionnaire, the Moral Sensitivity Questionnaire, the Jefferson Scale of Empathy-Health Professionals and the Organizational Climate Scale for Nursing. The participating institutions received a link to the tools used for online data collection, which they then forwarded to nursing staff. RESULTS The valid response rate was 96.98% (n = 321). The total mean moral sensitivity score of nurses was 43.04 ± 5.95. The mean scores for empathic ability and organizational climate for nursing were 91.97 ± 17.88 and 101.28 ± 14.77, respectively. Regression analyses revealed that the primary factors associated with moral sensitivity among critical care nurses included work tenure (p < .05), empathic ability (p < .001) and organizational climate (p < .001). CONCLUSIONS High levels of moral sensitivity were found in critical care nurses in China. Work tenure, empathic ability and organizational climate were significant predictors of moral sensitivity in critical care nurses. RELEVANCE TO CLINICAL PRACTICE To enhance the ethical sensitivity of ICU nurses, we suggest to strengthen the training of novice nurses so that they can better face the moral dilemma in clinical practice. In addition, organizational managers should also take measures to create a positive and harmonious working atmosphere, promote the application of moral knowledge in nursing practice and enhance their moral sensitivity.
Collapse
Affiliation(s)
- Fang Pang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yaodan Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Huan Liu
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Aiping Du
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yongming Tian
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Heyu Chen
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yu Xu
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Zia T, Sabeghi H, Mahmoudirad G. Problem-based learning versus reflective practice on nursing students' moral sensitivity. BMC Nurs 2023; 22:215. [PMID: 37340373 DOI: 10.1186/s12912-023-01377-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 06/12/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Moral sensitivity is one of the prerequisites for nurses' professional competency and patient care. It is critical to teach professional ethics in a student-centered manner in order to increase students' moral sensibility. This study evaluated the effects of professional ethics education via problem-based learning and reflective practice on nursing students' moral sensitivity. METHODS This experimental study was performed on 74 nursing students who were randomly divided into three groups of problem-based learning, reflective practice and control. Principles of professional ethics were presented for the two intervention groups in four 2-hour sessions using ethical dilemmas scenarios. Participants completed the Moral Sensitivity Questionnaire before, immediately, and three months after the intervention. Data were analyzed using SPSS16. RESULTS Demographic characteristics of the three groups were similar (p > 0.05). The total moral sensitivity score significantly differed between the groups immediately and three months after the intervention (p < 0.001). The total mean score for moral sensitivity was significantly different between the two groups of problem-based learning and reflective practice, with the mean scores in the problem-based learning group being higher (p = 0.02). The mean score of moral sensitivity decreased statistically significantly in both experimental groups three months after the intervention as compared to immediately after the intervention (p < 0.001). CONCLUSION Nursing students' moral sensitivity can be increased through reflective practice and problem-based learning. While the results indicated that problem-based learning was more successful than reflective practice, additional research is recommended to confirm the influence of these two strategies on moral sensitivity.
Collapse
Affiliation(s)
- Toktam Zia
- Faculty Member, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Hakimeh Sabeghi
- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamhossein Mahmoudirad
- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran.
| |
Collapse
|
3
|
Momennasab M, Homayoon Z, Torabizadeh C. Critical Care Nurses' Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity. Crit Care Res Pract 2023; 2023:8248948. [PMID: 37197156 PMCID: PMC10185430 DOI: 10.1155/2023/8248948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 04/08/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023] Open
Abstract
Background Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses' adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS). Methods In this descriptive-correlational study, data were collected using the moral sensitivity questionnaire (MSQ) by Lützén et al., Paloutzian and Ellison's spiritual well-being scale (SWBS), and the adherence to ethical codes questionnaire. The study was conducted on 298 nurses working in critical care units of hospitals affiliated with Shiraz University of Medical Sciences in southern Iran in 2019. This study was examined and approved by the Ethics Committee of Shiraz University of Medical Sciences. Results The majority of the participants were female (76.2%) and single (60.1%), with a mean age of 30.69 ± 5.74 years. The mean scores of adherence to ethical codes, SWB, and MS were 64.06 (good), 91.94 (moderate), and 134.08 (moderate), respectively. Adherence to ethical codes had a positive correlation with the total score of SWB (P < 0.001, r = 0.25) and MS (P < 0.001, r = 0.27). A positive correlation was also observed between MS and SWB (P < 0.001, r = 0.41). Meanwhile, MS (β = 0.21) had a greater effect than SWB (β = 0.157) on adherence to ethical codes. Conclusion Critical care nurses showed a good adherence to ethical codes. MS and SWB also positively affected their adherence to ethical codes. Nursing managers can use these findings to devise plans for the promotion of MS and SWB in nurses and thus help improve their ethical performance.
Collapse
Affiliation(s)
- Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Homayoon
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Camellia Torabizadeh
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
4
|
Bahrieni F, Azodi P, Hajivandi A, Seddighi Z, Jahanpour F. The effect of durability of knowledge transfer through reminiscence on the moral sensitivity of nurses. BMC Nurs 2022; 21:305. [PMID: 36352444 PMCID: PMC9644455 DOI: 10.1186/s12912-022-01060-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nursing is a moral attempt and endeavor. Moral sensitivity training is one of the most important ways to strengthen nursing moral decision making. Thus, the purpose of this study was to determine the effect of durability of knowledge transfer through reminiscence on nurses' moral sensitivity. METHODS The present study is a controlled randomized clinical trial conducted in pre- and post- interventional forms. The research population consisted of all nurses working at Bushehr Persian Gulf martyrs training hospital in 2017, 68 nurses participated as samples in the study selected by available sampling method and then randomly assigned to two groups of intervention and control groups. In this study, Morphological Sensitivity Questionnaire of Lautzen was used. Validity and reliability of the questionnaire have been confirmed. The pre-test was obtained from the control and intervention group. An 8-hour reminiscence training session was held for the intervention group. In order to study, the durability of training, posttest was obtained from both groups. Data were analyzed by SPSS software version 19 and using t-test, Chi-square, paired t-test. RESULTS The mean moral sensitivity score in nurses before intervention in both groups was not statistically different (P = 0.42). The comparison of the mean scores of nurses' moral sensitivity after intervention in the control and intervention groups, which in fact, indicates the durability of education, showed a significant difference. (P < 0.001). CONCLUSION The results of this study showed that the transfer of knowledge and education through reminiscence has a lasting effect on enhancing the moral sensitivity of nurses. Therefore, its inclusion in nursing educational programs as a training strategy can be considered as a step toward facilitating the training of nurses' moral sensitivity. TRIAL REGISTRATION This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT2016021612830N18 on May 17, 2017. This study adheres to the CONSORT 2010 statement guidelines.
Collapse
Affiliation(s)
- Farideh Bahrieni
- Nursing and Midwifery faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Parviz Azodi
- Paramedical Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Zahra Seddighi
- Persian Gulf martyrs hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Faezeh Jahanpour
- Nursing and Midwifery faculty, Bushehr University of Medical Sciences, Bushehr, Iran.
| |
Collapse
|
5
|
Arhiri L, Gherman MA, Holman AC. Ageism against older patients in nursing: conceptual differentiations and the role of moral sensitivity. J Elder Abuse Negl 2022; 34:198-221. [PMID: 35686299 DOI: 10.1080/08946566.2022.2086957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ageism in nursing is difficult to identify, prevent and combat. Using a mixed-method approach in two exploratory cross-sectional studies (N = 512), we brought support for a proposed conceptual difference between ageism toward older adults and ageism toward older patients which may facilitate the identification of ageism in healthcare settings. We also investigated whether nurses' moral sensitivity could buffer the negative effect of socio-cognitive factors on ageism against older patients. Our findings supported our assumption, suggesting that fostering nurses' moral sensitivity could be a promising new avenue to prevent and combat ageism in nurses, together with comprehensive gerontological education meant to decrease stereotyping and help nurses fulfill their roles of moral advocates against older patient discrimination.
Collapse
Affiliation(s)
- Laura Arhiri
- Faculty of Psychology and Education Sciences, "Alexandru Ioan Cuza" University of Iasi, Iasi, Romania
| | - Mihaela-Alexandra Gherman
- Faculty of Psychology and Education Sciences, "Alexandru Ioan Cuza" University of Iasi, Iasi, Romania
| | - Andrei Corneliu Holman
- Faculty of Psychology and Education Sciences, "Alexandru Ioan Cuza" University of Iasi, Iasi, Romania
| |
Collapse
|
6
|
Hajibabaee F, Salisu WJ, Akhlaghi E, Farahani MA, Dehi MMN, Haghani S. The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic. BMC Nurs 2022; 21:58. [PMID: 35277159 PMCID: PMC8913325 DOI: 10.1186/s12912-022-00834-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Caring for patients during a pandemic can be difficult for healthcare workers, the patients themselves, and healthcare systems. Nurses are expected to recognize ethical dilemmas and make sound judgments when confronted with them. Sensitizing nurses to ethical issues strengthen their ability to identify ethical dilemmas and make ethical choices. As a result, this study aimed to determine a relationship between moral sensitivity and caring behavior among nurses during the coronavirus (COVID-19) pandemic. Method The current study is a cross-sectional study of 406 nurses who worked in a single hospital during the COVID-19 epidemic. We used a demographic questionnaire and the caring behavior inventory (CBI) tool to collect data online. The data were analyzed using descriptive and correlational statistics. Findings Eighty-three point seven percent of participants in this study were female, and 71.9% were married. 47.5% reported caring for a COVID-19 patient for longer than a month; their average work experience was 13.1 years. Additionally, Moral Sensitivity correlated positively with caring behavior and its dimensions (r = 0.164, P = 0.001). However, a significant and inverse link existed between the dimension "following the rules" and the nurse's caring conduct (r = -0.117, P = 0.019). Conclusion During the pandemic, nurses' moral sensitivity was moderate and significantly connected with their caring behavior. Because nurses encounter numerous obstacles while caring for patients in critical conditions, they require ethical empowerment to perform correctly, as caring behavior improves with increased moral sensitivity.
Collapse
|
7
|
Momennasab M, Ghanbari M, Rivaz M. Improving nurses' knowledge, attitude, and performance in relation to ethical codes through group reflection strategy. BMC Nurs 2021; 20:222. [PMID: 34742303 PMCID: PMC8572492 DOI: 10.1186/s12912-021-00749-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The most basic responsibility of nurses that even precedes their therapeutic role is respect for professional ethics in providing clinical care. The present study was conducted to determine the effect of group reflection on the knowledge, attitude and performance of nurses in relation to ethical codes. METHODS The present blinded, before-after, educational trial was conducted on 86 nurses working at a general hospital in the south of Iran who were randomly divided into a intervention (n = 44) and a control (n = 42) group. Data were collected before and after the intervention using three tools, including a knowledge test, an attitude rating scale and a performance questionnaire. In the intervention group, the intervention given consisted of four sessions of group reflection, and the control group received a single lecture on ethical codes. RESULTS The mean changes in the nurses' score of knowledge after the intervention compared to before differed significantly in both intervention and control groups (P < 0.001), but there was no significant difference between the two groups in terms of the mean changes in the score of knowledge (2.73 ± 3.45 in intervention group vs. 2.57 ± 3.36 in control group, P = 0.83). Although the mean score of attitude differed significantly between the intervention and control groups in the posttest (34.7 ± 8.44 in intervention group vs. 29.95 ± 9.09 in control group, P < 0.014), the two groups were not significantly different in terms of the mean changes in the score of attitude in relation to ethical codes before and after the intervention (P < 0.14). Moreover, the two groups were significantly different in terms of the mean changes in the scores of performance in the two stages (9.07 ± 16.84 in intervention group vs. 0.67 ± 20.01 in control group, P < 0.001). CONCLUSION Group reflection can improve the knowledge, attitude and performance of nurses in relation to ethical codes. Although lectures can help improve nurses' knowledge and attitude in this area, they have no significant effects on their performance. TRIAL REGISTRATION Iranian Registry of Clinical Trials (No: IRCT2016070317546N6, registration date: 10 October 2016), https://www.irct.ir/trial/16112.
Collapse
Affiliation(s)
- Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marjan Ghanbari
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Rivaz
- Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Namazee Sq, Shiraz, 7193613119 Iran
| |
Collapse
|
8
|
Jasemi M, Goli R, Zabihi RE, Khalkhali H. Educating ethics codes by lecture or role-play; which one improves nursing students' ethical sensitivity and ethical performance more? A quasi-experimental study. J Prof Nurs 2021; 40:122-129. [DOI: 10.1016/j.profnurs.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
|
9
|
Kim BS, Lee M, Jang SJ. Hospital nurses' empathy and moral sensitivity toward elderly care: A cross-sectional study. J Nurs Manag 2021; 30:2138-2146. [PMID: 34350659 DOI: 10.1111/jonm.13442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study is to explore factors that influence elderly caring attitudes, with a focus on empathy and moral sensitivity. BACKGROUND Medical and nursing needs of the elderly have escalated as a consequence of changes induced by aging and the associated diseases and disabilities. METHOD A cross-sectional study involving 229 nurses from four general hospitals in South Korea was conducted. Questionnaires assessing demographic and work experience information, empathy (Empathy Construct Rating Scale), moral sensitivity (Korean version of the Moral Sensitivity Questionnaire) and elderly caring (Elderly Caring Attitude Scale) were used. Data were analysed using multiple regression analysis. RESULTS The factors influencing the caring attitudes of nurses were empathy, moral sensitivity, preference for geriatric nursing and experience with continuing education in geriatric nursing. The explanatory power of this regression model was 59.4%. CONCLUSIONS Strategies to enhance empathy and moral sensitivity of nurses and education related to geriatric nursing might help improve elderly caring attitudes. IMPLICATIONS FOR NURSING MANAGEMENT Continued education in geriatric nursing should be provided for nurses caring for the elderly. In terms of nursing management and education, it is necessary to consider and develop strategies to improve the empathy and moral sensitivity of nurses toward elderly patients.
Collapse
Affiliation(s)
- Bo-Song Kim
- College of Nursing, Eulji University, Daejeon, South Korea
| | - Miyoung Lee
- College of Nursing, Eulji University, Daejeon, South Korea
| | - Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| |
Collapse
|
10
|
Abstract
BACKGROUND Professional ethical codes are an important part of healthcare. They are part of the professionalisation of an occupation, are used for regulation of the professions and are intended to guide ethical behaviour in healthcare. However, so far, little is known about the practical use of professional codes in healthcare, particularly in paramedicine. OBJECTIVE The aim of this scoping review was to determine what is known in the existing literature about health professionals' knowledge, awareness and use of their professional codes. METHOD A scoping review was performed based on a six-stage framework as described by Levac et al. Six databases were searched: OVID Medline, EMBASE, EMCARE, CINAHL, ProQuest and Scopus, in September 2020. Google Scholar, Trove and Google using .gov and .org websites were also searched for grey literature. Two reviewers independently assessed study eligibility. RESULTS The search yielded 1162 results after duplicate removal. Thirty-nine studies remained after title and abstract review. Twenty-five articles were included after full-text review. Sixteen examined nursing, eight examined medicine and one examined both nursing and medicine. No studies were identified that examined paramedicine. Twenty-one studies were of a cross-sectional design and four studies were of a qualitative design. CONCLUSION Most health professionals know the codes exist, but do not think they know the content. Despite valuing professional codes highly, healthcare professionals do not use them regularly in clinical practice. Further research is needed, and professional codes should be made useful for practice and consideration given to how codes can be written, communicated and implemented to increase their actualisation in healthcare. Research should also begin in paramedicine to identify clinician's knowledge and use of codes in this profession. REVIEW REGISTRATION Open Science Framework - doi:10.17605/OSF.IO/NKBY4. ETHICS STATEMENT This article does not contain any studies involving human participants performed by any of the authors. The review followed good scientific conduct.
Collapse
|
11
|
Lim A, Kim S. Nurses' ethical decision-making during end of life care in South Korea: a cross-sectional descriptive survey. BMC Med Ethics 2021; 22:94. [PMID: 34271891 PMCID: PMC8285824 DOI: 10.1186/s12910-021-00665-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/09/2021] [Indexed: 11/11/2022] Open
Abstract
Background Although nurses are crucial to ensure patients’ peaceful death in hospitals, many nurses experience various ethical conflicts during end-of-life care. Therefore, research on nurses’ entire ethical decision-making process is required to improve nurses’ ethical decision-making in end-of-life care. This study aimed to identify Korean nurses’ ethical decision-making process based on their moral sensitivity to end-of-life patients. Methods In total, 171 nurses caring for terminal patients responded to the survey questionnaire. To measure the participants’ moral sensitivity and ethical decision-making process, we used the Korean version of the Moral Sensitivity Questionnaire and Nurses’ Ethical Decision-Making around End of Life Care Scale. Finally, multiple linear regression analysis was used to investigate the effect of moral sensitivity on nurses’ ethical decision-making. Results The mean of moral sensitivity was 4.8 ± 0.5 (out of 7), and that of ethical decision-making was 4.6 ± 0.5 (out of 6). Among the sub-dimensions of ethical decision-making, the highest score was in perceived professional accountability (5.2 ± 0.5), and the lowest in moral reasoning and moral agency (3.9 ± 0.6); the score of moral practice was 4.4 ± 0.7. In the multiple linear regression model, moral sensitivity (β = 0.852, p < .001), clinical department (β = − 7.018, p = .035), ethics education (β = 20.450, p < .001), job satisfaction (β = 5.273, p < .001), and ethical conflict (β = − 2.260, p = 0.031) were influential ethical decision-making factors. Conclusions This study revealed a gap between nurses’ thoughts and practices through the ethical decision-making process. They failed to lead their thought to moral practice. It also implies that moral sensitivity could positively affect nurses’ ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses’ ethical decision-making. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death.
Collapse
Affiliation(s)
- Arum Lim
- Department of Nursing, Graduate School, Yonsei University, Seoul, Korea
| | - Sanghee Kim
- College of Nursing and, Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
| |
Collapse
|
12
|
Alnajjar PhD HA, Abou Hashish PhD EA. Academic Ethical Awareness and Moral Sensitivity of Undergraduate Nursing Students: Assessment and Influencing Factors. SAGE Open Nurs 2021; 7:23779608211026715. [PMID: 34263030 PMCID: PMC8243134 DOI: 10.1177/23779608211026715] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/28/2021] [Indexed: 11/15/2022] Open
Abstract
Nursing students are exposed to ethically challenging conditions in their future workplaces; hence, they must be ethically knowledgeable and morally sensitive to provide patients with holistic care based on sound ethical decision-making skills. Objectives: This study aimed to assess nursing students' perception of their academic ethical awareness and moral sensitivity and determine the relationship between these variables. Methods: We conducted a descriptive correlational research study with a convenient sample of nursing students (N = 246) in a Saudi University nursing college. Data were collected using the Academic Ethical Awareness Questionnaire and Moral Sensitivity Questionnaire. We used descriptive statistics, ANOVA, and regression analyses. Results: Nursing students exhibited moderate academic ethical awareness and moral sensitivity. The regression analysis showed that academic ethical awareness can substantially predict 28.8% of the explained moral sensitivity variance (p < 0.001). Nursing students were aware that the violation of patients' respect or confidentiality and cheating in examinations were unethical behaviors. However, they showed low ethical awareness toward plagiarism behaviors. Furthermore, they reported higher moral sensitivity for patient-oriented care and professional responsibility and did not experience conflict. Academic level and integrated classroom and clinical learning experiences seemed to positively impact students' academic ethical awareness. Conclusion: The findings provide a basis for monitoring nursing students' professional misconduct so that they maintain integrity and adhere to academic ethics guidelines. Constant exertions for fostering nursing ethics courses with inspiring learning content and innovative instructional material are vital in improving nursing students' academic integrity and ethical care.
Collapse
Affiliation(s)
- Hend Abdu Alnajjar PhD
- College of Nursing - Jeddah, King Saud Bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ebtsam Aly Abou Hashish PhD
- College of Nursing - Jeddah, King Saud Bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia.,Faculty of Nursing, Alexandria University, Alexandria, Egypt
| |
Collapse
|
13
|
Afrasiabifar A, Mosavi A, Dehbanizadeh A, Khaki S. Nurses' caring behaviour and its correlation with moral sensitivity. J Res Nurs 2021; 26:252-261. [PMID: 35251248 PMCID: PMC8895006 DOI: 10.1177/1744987120980154] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Different and contradictory results have been reported for nurses' caring behaviour and moral sensitivity. AIMS The present study aimed to examine the correlation between nurses' caring behaviour and moral sensitivity. METHODS The research was a descriptive, correlational study. Data were collected using moral sensitivity (range: 0-100) and caring behaviour (range: 24-144) questionnaires. A total of 250 nurses who worked in the clinical wards of Yasuj teaching hospitals in 2018, were selected by systematic random sampling. The collected data were analysed using SPSS version 19 for descriptive statistics and Pearson correlation tests. RESULTS Seventy-four percent of nurses had moderate moral sensitivity (50-74). Nurses' moral sensitivity and caring behaviour mean scores were reported to be 59.5 ± 11.1 (range: 31-87) (Potential range 0--100) and 110.99 ± 17.99 (range: 69-94) (Potential range 22-144), respectively. The Pearson test showed a positive correlation between nurses' caring behaviour and moral sensitivity at a 99% level (p = 0.001). CONCLUSIONS Nurses' moral sensitivity and caring behaviour were found to be moderate and good, respectively. Furthermore, there was a positive correlation between moral sensitivity and caring behaviour in nurses, that is, nurses provided better caring behaviour as levels of moral sensitivity increased.
Collapse
Affiliation(s)
| | - Asadolah Mosavi
- Clinical Nurse, School of Nursing, Yasuj University of Medical Sciences, Iran
| | | | - Sahar Khaki
- Clinical Nurse, School of Nursing, Yasuj University of Medical Sciences, Iran
| |
Collapse
|
14
|
Cerit B, Çoşkun S, Çalışkan MA, Temelli G. The Relationship Between Nurses' Ethical Sensitivity Levels and Their Attitudes Toward Principles About Die with Dignity. JOURNAL OF RELIGION AND HEALTH 2021; 60:162-177. [PMID: 33128221 DOI: 10.1007/s10943-020-01102-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
This study was conducted to determine the relationship between nurses' ethical sensitivity levels and their attitudes toward principles about die with dignity. The study was descriptive and correlational in design. The data were obtained from 226 nurses. The results of the correlation analysis conducted to determine whether there is a relationship between the nurses' ethical sensitivity level and their attitudes toward principles about die with dignity are among the autonomy, meaning and relation showed a significant, negative and low-level relationship between. As a result of the research, it was found that there was a negatively, significant and low-level relationship between autonomy, meaning and relation and attitudes toward respectable principles of death.
Collapse
Affiliation(s)
- Birgül Cerit
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, 14030, Bolu, Turkey.
| | - Simge Çoşkun
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, 14030, Bolu, Turkey
| | - Mehmet Ali Çalışkan
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, 14030, Bolu, Turkey
| | - Gülnur Temelli
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, 14030, Bolu, Turkey
| |
Collapse
|
15
|
Opsahl A, Nelson T, Madeira J, Wonder AH. Evidence-Based, Ethical Decision-Making: Using Simulation to Teach the Application of Evidence and Ethics in Practice. Worldviews Evid Based Nurs 2020; 17:412-417. [PMID: 33001572 DOI: 10.1111/wvn.12465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence-based practice and ethics should not be taught as isolated concepts. Instead, it is imperative to prepare students with the knowledge needed to practice ethical, evidence-based decision-making in health care. PURPOSE The purpose of this project was to describe how a mock hospital ethics committee meeting impacted students' learning about the use of evidence to support ethical decision-making in health care. METHOD A mock hospital ethics committee was convened for 121 students from schools of nursing, social work, law, and medicine. RESULTS Thematic content analysis showed a positive impact on nursing students' learning of ethics, group dynamics, discipline-specific responsibilities, and EBP. LINKING EVIDENCE TO ACTION This interprofessional education experience showed students how evidence and ethics can be used to guide and support practice priorities, responsibilities, and decisions on resource utilization and treatment to enable optimal outcomes for patients and organizations.
Collapse
Affiliation(s)
- Angela Opsahl
- Indiana University School of Nursing, Bloomington, IN, USA
| | - Tammi Nelson
- Indiana University School of Social Work, Bloomington, IN, USA
| | - Jody Madeira
- Indiana University Maurer School of Law, Bloomington, IN, USA
| | | |
Collapse
|
16
|
De Panfilis L, Tanzi S, Perin M, Turola E, Artioli G. "Teach for ethics in palliative care": a mixed-method evaluation of a medical ethics training programme. BMC Palliat Care 2020; 19:149. [PMID: 32977796 PMCID: PMC7519533 DOI: 10.1186/s12904-020-00653-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Training in medical ethics aims to educate health care professionals in dealing with daily care ethical issues. To guarantee quality of life and spiritual and emotional support, palliative care professionals have to develop ethical and relational skills. We propose the implementation and evaluation of a specialized training programme in medical ethics dedicated to a hospital-based Palliative Care Unit. METHODS This study is a mixed-method before-after evaluation with data triangulation. RESULTS The results highlight that participants developed their ethical knowledge, and a deeper ethical awareness. They also felt more confident and motivated to widely apply ethical reflections and reasonings in their daily practice. CONCLUSION The participants appreciated the innovative structure of the training, especially regarding the integration of the theoretical-interactive and practical parts. However, they recommended increasing the number of concrete occasions for ethical supervision and practical application of what they learned during the programme. The training programme also has some potential practical implications: the development of advanced ethical skills within a hospital-based PC team may improve the quality of life of the patients and their families. In addition, health care professionals with advanced ethical competencies are able to educate patients and their families towards more active participation in the decision-making process.
Collapse
Affiliation(s)
| | - Silvia Tanzi
- Palliative Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marta Perin
- Unit of Bioethics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Turola
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanna Artioli
- Palliative Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| |
Collapse
|
17
|
|
18
|
The relationship between moral sensitivity and medical errors attitude in nursing students. J Forensic Leg Med 2020; 73:101981. [DOI: 10.1016/j.jflm.2020.101981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/20/2020] [Accepted: 05/09/2020] [Indexed: 11/17/2022]
|
19
|
Vatandost S, Oshvandi K, Ahmadi F, Cheraghi F. The challenges of male nurses in the care of female patients in Iran. Int Nurs Rev 2020; 67:199-207. [PMID: 32314370 DOI: 10.1111/inr.12582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/04/2020] [Accepted: 02/26/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nurses professional duty mean that nurses must care for patients without gender discrimination. Meanwhile, the intrinsic differences between men and women and the need for personal contact with the patients during care procedures can create challenges for male nurses in the process of caring for a female patient. AIMS The present study aims to understand the challenges of male nurses in the care of female patients in Iran. METHODS A descriptive qualitative study was conducted with 20 male nurses selected by purposive sampling. Data were collected through unstructured and semi-structured interviews as well as observations and were analysed using conventional content analysis, based on the Graneheim and Lundman model. FINDINGS The findings revealed two main themes, including 'religious-cultural restrictions' and 'inappropriate organizational context'. DISCUSSION/CONCLUSION Male nurses are faced with a combination of religious-cultural and organizational challenges in providing patient care without discrimination in clinical settings. In addition to negatively affecting the quality of nursing care and satisfaction for female patients, these problems also create a stressful work environment for male nurses. IMPLICATIONS FOR HEALTH PRACTICE AND POLICY These problems can be alleviated in clinical settings by trying to ensure same-gender nurses and patients, especially when performing personal care. In addition to the efforts made by nurses to present a positive and real image of themselves in caring for female patients, health policy-makers should also attempt to improve society's attitude towards male nurses caring for female patients through the media.
Collapse
Affiliation(s)
- S Vatandost
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - K Oshvandi
- Child & Maternity Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - F Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - F Cheraghi
- Chronic diseases (home care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
20
|
Nora CRD, Zoboli E, Vieira MM. Validação por peritos: importância na tradução e adaptação de instrumentos. Rev Gaucha Enferm 2018. [DOI: 10.1590/1983-1447.2017.03.64851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Apresentar a validação de conteúdo por peritos, como etapa essencial da validação, tradução e adaptação cultural de instrumentos de psicometria, tendo como exemplo o processo de adaptação realizado com o questionário de sensibilidade moral para Portugal e Brasil. Método Trata-se de estudo metodológico, com um comitê de doze peritos, sete do Brasil e cinco de Portugal. A coleta e análise dos dados ocorreu em 2015, entre os meses de setembro e outubro, em Portugal e novembro e dezembro, no Brasil. Resultados Dos 30 itens apresentados aos peritos, 20 tiveram sugestão de adaptação. Algumas adaptações foram necessárias para que os itens ficassem claros e de fácil compreensão. A versão final permaneceu com 28 itens. Conclusão A validação de conteúdo dos instrumentos de psicometria por um comitê de peritos é essencial para pesquisadores e enfermeiros, cada vez mais preocupados em utilizar medidas confiáveis e apropriadas para pesquisas e avaliação da assistência.
Collapse
|
21
|
Dalla Nora CR, Zoboli EL, Vieira MM. Validation of a Brazilian version of the moral sensitivity questionnaire. Nurs Ethics 2017; 26:823-832. [PMID: 28814139 DOI: 10.1177/0969733017720849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Moral sensitivity has been identified as a foundational component of ethical action. Diminished or absent moral sensitivity can result in deficient care. In this context, assessing moral sensitivity is imperative for designing interventions to facilitate ethical practice and ensure that nurses make appropriate decisions. OBJECTIVE The main purpose of this study was to validate a scale for examining the moral sensitivity of Brazilian nurses. RESEARCH DESIGN A pre-existing scale, the Moral Sensitivity Questionnaire, which was developed by Lützén, was used after the deletion of three items. The reliability and validity of the scale were examined using Cronbach's alpha and factor analysis, respectively. PARTICIPANTS AND RESEARCH CONTEXT Overall, 316 nurses from Rio Grande do Sul, Brazil, participated in the study. ETHICAL CONSIDERATIONS This study was approved by the Ethics Committee of Research of the Nursing School of the University of São Paulo. FINDINGS The Moral Sensitivity Questionnaire contained 27 items that were distributed across four dimensions: interpersonal orientation, professional knowledge, moral conflict and moral meaning. The questionnaire accounted for 55.8% of the total variance, with Cronbach's alpha of 0.82. The mean score for moral sensitivity was 4.45 (out of 7). DISCUSSION AND CONCLUSION The results of this study were compared with studies from other countries to examine the structure and implications of the moral sensitivity of nurses in Brazil. The Moral Sensitivity Questionnaire is an appropriate tool for examining the moral sensitivity of Brazilian nurses.
Collapse
|
22
|
Abstract
BACKGROUND Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity. AIM This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction. RESEARCH DESIGN This research employed a descriptive and cross-sectional design. PARTICIPANTS AND RESEARCH CONTEXT This study was conducted with a sample of 236 nurses, all of whom worked in emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale. ETHICAL CONSIDERATIONS This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University. FINDINGS There was a weak and negative correlation (r = -0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = -0.335, p < 0.001) between the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale scores. DISCUSSION AND CONCLUSION Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized.
Collapse
|
23
|
Nora CRD, Zoboli ELCP, Vieira MM. Moral sensitivity in Primary Health Care nurses. Rev Bras Enferm 2017; 70:308-316. [DOI: 10.1590/0034-7167-2016-0453] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 10/02/2016] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to characterize the profile and describe the moral sensitivity of primary health care nurses. Method: this is a quantitative, transversal, exploratory, descriptive study. The data were collected through the Moral Sensitivity Questionnaire translated and adapted to Brazil. 100 primary health care nurses participated, from Rio Grande do Sul, Brazil. The data collection took place during the months of March and July 2016, in an online form. The analysis of the data occurred through descriptive statistical analysis. Results: the nurses had an average moral sensitivity of 4.5 (out of 7). The dimensions with the greatest moral sensitivity were: interpersonal orientation, professional knowledge, moral conflict and moral meaning. Conclusion: the nurses of Rio Grande do Sul have a moderate moral sensitivity, which may contribute to a lower quality in Primary Health Care.
Collapse
|
24
|
Huang FF, Yang Q, Zhang J, Zhang QH, Khoshnood K, Zhang JP. Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version. Nurs Ethics 2016; 23:784-793. [DOI: 10.1177/0969733015583183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Ethical issues pose challenges for nurses who are increasingly caring for patients in complicated situations. Ethical sensitivity is a prerequisite for nurses to make decisions in the best interest of their patients in daily practice. Currently, there is no tool for assessing ethical sensitivity in Chinese language, and no empirical studies of ethical sensitivity among Chinese nurses. Research objectives: The study was conducted to translate the Moral Sensitivity Questionnaire–Revised Version (MSQ-R) into Chinese and establish the psychometric properties of the Moral Sensitivity Questionnaire–Revised Version into Chinese (MSQ-R-CV). Research design: This research was a methodological and descriptive study. Participants and research context: MSQ-R was translated into Chinese using Brislin’s model, and the Translation Validity Index was evaluated. MSQ-R-CV was then distributed along with a demographic questionnaire to 360 nurses working at tertiary and municipal hospitals in Changsha, China. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Findings: MSQ-R-CV achieved Cronbach’s alpha 0.82, Spearman-Brown coefficient 0.75, significant item discrimination (p < 0.001), and item-total correlation values ranging from 0.524 to 0.717. A two-factor structure was illustrated by exploratory factor analysis, and further confirmed by confirmatory factor analysis. Chinese nurses had a mean total score of 40.22 ± 7.08 on the MSQ-R-CV, and sub-scores of 23.85 ± 4.4 for moral responsibility and strength and 16.37 ± 3.75 for sense of moral burden. Discussion: The findings of this study were compared with studies from other countries to examine the structure and meaningful implications of ethical sensitivity in Chinese nurses. Conclusion: The two-factor MSQ-R-CV (moral responsibility and strength, and sense of moral burden) is a linguistically and culturally appropriate instrument for assessing ethical sensitivity among Chinese nurses.
Collapse
|
25
|
Abstract
Background: Ethical sensitivity has been identified as a foundational component of ethical action. Diminished or absent ethical sensitivity can result in ethically incongruent care, which is inconsistent with the professional obligations of nursing. As such, assessing ethical sensitivity is imperative in order to design interventions to facilitate ethical practice and to ensure nurses recognize the nature and extent of professional ethical obligations. Aim: To review and critique the state of the science of nurse ethical sensitivity and to synthesize findings across studies. Research design: Whittemore and Knafl’s revised framework for integrative reviews guided the analysis. Research context and data sources: A comprehensive, computer-assisted search of literature published in Cumulative Index of Nursing and Allied Health Literature and PubMed was performed. A systematic approach was used to extract, reduce, and synthesize the data. Findings: Four major conceptualizations of ethical sensitivity emerged from the literature. A sample of 25 reports met inclusion criteria, including 17 empirical reports and 8 theoretical reports. Discussion: Despite the existence of a concept analysis and a validated tool, ethical sensitivity remains a highly theoretical concept with multiple, and at times competing, conceptualizations. Ethical sensitivity has been assessed extensively in the context of ethical dilemmas; however, little attention has been paid to the way the concept operates in day-to-day practice. Conclusion: Future research should focus on better ways to operationalize and assess the concept, with particular attention to nurse awareness of the ethical content of everyday practice.
Collapse
|
26
|
Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses’ moral sensitivity. Nurs Ethics 2016; 24:732-743. [DOI: 10.1177/0969733015623095] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy. Objectives: To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, three strategies were developed for determining the programme components and corresponding learning styles. Research design: This was a quasi-experimental study. Participants: A total of 234 junior-college student nurses participated in this study. All participants were aged 18–19 years. Ethical considerations: The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score. Results: The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies ( p = .042). Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning. Conclusion: This strategy was consistent with the student nurses’ preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge.
Collapse
Affiliation(s)
- Hsiao Lu Lee
- School of Nursing, National Yang-Ming University; Yuhing Junior College of Health Care and Management, Taiwan
| | | | | |
Collapse
|
27
|
Nora CRD, Deodato S, Vieira MMDS, Zoboli ELCP. ELEMENTS AND STRATEGIES FOR ETHICAL DECISION-MAKING IN NURSING. TEXTO & CONTEXTO ENFERMAGEM 2016. [DOI: 10.1590/0104-07072016004500014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This study aimed to identify the elements and strategies that facilitate the ethical decision-making of nurses faced with ethical problems, from publications on the theme. An integrative literature review was carried out. Data collection was performed between the months of April and May 2014, in the databases: SciELO, CINAHL, LILACS and MEDLINE. Original, theoretical and case study articles, with a health team that included nurses, published in Portuguese, English and Spanish were included. A total of 19 studies were selected, the analysis of which resulted in three categories: external factors of ethical decision-making in nursing, individual factors of ethical decision-making in nursing and facilitating strategies of ethical decision-making in nursing. It was concluded that nurses need to use strategies that develop sensitivity, ability and ethical competence, in order to make prudent ethical decisions, contributing to the quality of health care.
Collapse
|
28
|
Abstract
Much attention has been paid to the role of the nurse in recognizing and addressing ethical dilemmas. There has been less emphasis, however, on the issue of whether or not nurses understand the ethical nature of everyday practice. Awareness of the inherently ethical nature of practice is a component of nurse ethical sensitivity, which has been identified as a component of ethical decision-making. Ethical sensitivity is generally accepted as a necessary precursor to moral agency, in that recognition of the ethical content of practice is necessary before consistent action on behalf of patient interests can take place. This awareness is also compulsory in ensuring patient good by recognizing the unique interests and wishes of individuals, in line with an ethic of care. Scholarly and research literature are used to argue that bolstering ethical awareness and ensuring that nurses understand the ethical nature of the role are an obligation of the profession. Based on this line of reasoning, recommendations for education and practice, along with directions for future research, are suggested.
Collapse
|
29
|
Huang FF, Yang Q, Zhang J, Khoshnood K, Zhang JP. Chinese nurses' perceived barriers and facilitators of ethical sensitivity. Nurs Ethics 2015; 23:507-22. [PMID: 25825415 DOI: 10.1177/0969733015574925] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. AIM The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. RESEARCH DESIGN A convergent parallel mixed-methods research design was adopted. PARTICIPANTS AND RESEARCH CONTEXT In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire-revised version was used to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments (n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses' perceptions of the barriers and facilitators in nurturing ethical sensitivity (n = 15). The data were collected from February to June 2014. ETHICAL CONSIDERATIONS This study was approved by the Institutional Review Boards of Yale University and Central South University. RESULTS Despite moderately high overall Chinese Moral Sensitivity Questionnaire-revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. DISCUSSION The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. CONCLUSION This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses' sensitivity to ethical issues.
Collapse
|
30
|
Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nurs Ethics 2014; 22:661-75. [PMID: 25096245 DOI: 10.1177/0969733014542673] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Moral sensitivity is a life-long cognitive ability. It is expected that nurses who work in a professional purpose at "curing human beings" should have a highly developed moral sensitivity. The general opinion is that ethics education plays a significant role in this sense to enhance the moral sensitivity in terms of nurses' professional behaviors and distinguish ethical violations. AIM This study was conducted as intervention research for the purpose of determining the effect of the ethics training on fourth-year students of the nursing department recognizing ethical violations experienced in the hospital and developing ethical sensitivity. METHODS The study was conducted with 50 students, with 25 students each in the experiment and control groups. Students in the experiment group were provided ethics training and consultancy services. The data were collected through the data collection form, which consists of questions on the socio-demographic characteristics and ethical sensitivity of the students, Moral Sensitivity Questionnaire, and the observation form on ethical principle violations/protection in the clinic environment. The data were digitized on the computer with the SPSS for Windows 13.0 program. The data were evaluated utilizing number, percentile calculation, paired samples t-test, Wilcoxon test, and the McNemar test. RESULTS The total Moral Sensitivity Questionnaire pre-test score averages of students in the experiment group were determined to be 93.88 ± 13.57, and their total post-test score averages were determined to be 89.24 ± 15.90. The total pre-test score averages of students in the control group were determined to be 91.48 ± 17.59, and their total post-test score averages were determined to be 97.72 ± 19.91. In the study, it was determined that the post-training ethical sensitivity of students in the experiment group increased; however, this was statistically not significant. Furthermore, it was determined that the number of ethical principle protection/violation observations and correct examples provided by students in the experiment group were higher than the control group and the difference was statistically significant. ETHICAL CONSIDERATIONS Written permission and ethical approval were obtained from the university where the study was conducted. Written consent was received from students accepting to participate in the study. CONCLUSION As a result, ethics education given to students enables them to distinguish ethical violations in a hospital and make a proper observation in this issue.
Collapse
|
31
|
Ramos FRS, Brehmer LCDF, Vargas MA, Trombetta AP, Silveira LR, Drago L. Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil. Nurs Ethics 2014; 22:428-39. [PMID: 25096246 DOI: 10.1177/0969733014538890] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students' personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. OBJECTIVES Nursing students' experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. METHODS The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. ETHICAL CONSIDERATIONS The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. RESULTS Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students' decision-making processes - realisation, reflection and intervention. CONCLUSION The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems.
Collapse
Affiliation(s)
| | | | | | | | | | - Laila Drago
- Federal University of Santa Catarina, Brazil
| |
Collapse
|
32
|
Abstract
BACKGROUND Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether. RESEARCH QUESTION Do significant gender differences exist in the moral distress scores of critical care nurses? RESEARCH DESIGN This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine whether gender differences exist in their mean moral distress scores. PARTICIPANTS AND RESEARCH CONTEXT Participants (n = 31) were critical care nurses from an American Internet nursing community who completed the Moral Distress Scale-Revised online over a 5-day period in July 2013. ETHICAL CONSIDERATIONS Institutional review board review approved the study, and accessing and completing the survey implied informed consent. FINDINGS The results revealed a statistically significant gender difference in the mean moral distress scores of participants. Females reported statistically significantly higher moral distress scores than did males. Overall, the moral distress scores for both groups were relatively low. DISCUSSION The findings of a gender difference have not previously been reported in the literature. However, other findings are consistent with previous studies on moral distress. CONCLUSION Although the results of this study are not generalizable, they do suggest the need for continuing research on moral distress in underrepresented groups in nursing, including cultural and ethnic groups.
Collapse
|