Nursing Ethics最新文献

{"title":"An instrument to facilitate value-driven conversations on surveillance technology.","authors":"Daniëlle van Gaans-Riteco, Annerieke Stoop, Irene Muller-Schoof, Marieke van Vliet, Eveline Wouters","doi":"10.1177/09697330251376894","DOIUrl":"https://doi.org/10.1177/09697330251376894","url":null,"abstract":"<p><p>BackgroundThe application of care technology is complex, and has an impact on all stakeholders. A specific issue with surveillance technologies is the resulting ethical dilemmas. These dilemmas often touch on people's values, which arise from their perspectives and determine their attitudes and behaviour. One of the prerequisites for successful stakeholder involvement is knowing and acknowledging their values. Schwartz's theory of human values has been empirically tested and facilitates the prediction of attitudes and behaviours in different contexts.Research aimTo develop, test and validate a conversation instrument suitable for use in interviews to explore stakeholders' values regarding the application of surveillance technologies. The instrument was based on Schwartz's ten values model and adapted to fit the stakeholders' (professional) backgrounds, education and language levels.Research designWe integrated and adapted Schwartz's ten and nineteen values model, the Personal Value Dictionary, the Portrait Values Questionnaire and Schwartz's Value Survey to value cards tailored to the stakeholders' education and language levels. The adaption was an iterative process involving expert consultation. The value cards were validated in 34 interviews with stakeholders involved in the application of surveillance technologies for people with dementia in nursing homes.Ethical considerationsThis study was approved by the Ethical Research Board of Tilburg University (ID TSB_RP771).FindingsThe iterative process resulted in a concept version of the value cards, with expert feedback and 'member checks' guiding final revisions. The value cards helped participants articulate their values and were seen as useful tools for reflecting on key considerations related to surveillance technologies.Discussion and conclusionValue cards assisted stakeholders in sharing their most important principles regarding the application of surveillance technologies and may help explore their values related to complex technological innovations in the context of psychogeriatrics.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251376894"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prerequisites for ethical leadership in health and social care: Integrative review.","authors":"Anniina Seere, Riitta Suhonen, Johanna Wiisak","doi":"10.1177/09697330251366593","DOIUrl":"https://doi.org/10.1177/09697330251366593","url":null,"abstract":"<p><p>Health and social care organizations face structural reforms, workforce shortages, and increasing ethical demands. These pressures underscore the importance of ethical leadership, particularly from leaders managing complex services. While ethical leadership improves integrity, trust, and wellbeing, limited research has examined the prerequisites enabling its realization, especially from the perspectives of leaders in health and social care settings. Therefore, this integrative literature review aimed to identify and synthesize the prerequisites for ethical leadership in these contexts from a leadership perspective. The review was carried out following the PRISMA guidelines, with the protocol registered in PROSPERO and quality assessed using the Mixed Methods Appraisal Tool. A systematic search across six databases resulted in nine peer-reviewed studies (2010-2025). Inductive content analysis identified five categories of prerequisites for ethical leadership: (1) leader-centric prerequisites including ethical sensitivity and moral courage; (2) ethical organizational culture based on shared values; (3) leadership support such as mentoring and development; (4) ethical guidelines supporting consistent decision-making; and (5) resource sufficiency to enable ethical action. Ethical leadership emerged as both individual competencies and a dynamic process embedded in organizational structures. The ethical capacity of leaders was found to depend on personal capabilities and structural support. These findings inform leadership development and organizational strategies aimed at strengthening ethical practices in complex care environments.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251366593"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitors to compassionate care: A systematic review and qualitative meta-analysis.","authors":"Mostafa Ghasempour, Mansour Ghafourifard, Majid Purabdollah, Azad Rahmani","doi":"10.1177/09697330251374399","DOIUrl":"https://doi.org/10.1177/09697330251374399","url":null,"abstract":"<p><p>BackgroundThe importance of compassion and compassionate care, as an indicator for quality care, has been well acknowledged in recent years within health care. However, there are some international concerns about the state of compassion in the contemporary healthcare systems. There are many factors that facilitate or inhibit the provision of compassion in clinical settings.ObjectiveThis meta-synthesis of qualitative studies aimed to explore healthcare providers' perceived barriers and facilitators to compassion in healthcare settings.MethodsA systematic review and meta-synthesis of qualitative studies were used in this study. Five electronic databases including Scopus, Web of Science, PubMed/Medline, CINAHL, and PsycINFO were searched to identify relevant studies. In this meta-synthesis, Thomas and Harden's thematic analysis approach was undertaken to synthesize the findings of the qualitative studies.ResultsA total of 20 papers were selected for meta-synthesis. The data analysis resulted in the development of three main themes for barriers to compassion: (a) organizational or systemic challenges, (b) personal and individual factors, and (c) patient and family-related factors. Moreover, three main themes for facilitators to compassion emerged from data analysis: (a) supportive organizational culture, (b) personal capacity for compassion, and (c) patient and family reactions.ConclusionThis meta-synthesis showed some barriers and facilitating factors for developing high-quality compassionate care. Understanding factors that influence compassionate care delivery may improve the cultivation of compassionate care. Moreover, identifying these challenges and facilitators provides a comprehensive framework through which healthcare providers, policy makers, and healthcare organizations can assess their own strategies to identify how compassion could be cultivated and developed in healthcare settings. It may inform practical strategies and interventions tailored to foster the delivery of compassionate care in each healthcare setting and improve the quality of care and health outcomes.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251374399"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' strategies for maintaining the privacy of children with cancer.","authors":"Leila Radrazm, Mohsen Soleimani, Ali Naderi, Nayyereh Raiesdana","doi":"10.1177/09697330251366592","DOIUrl":"https://doi.org/10.1177/09697330251366592","url":null,"abstract":"<p><p>BackgroundChildren with cancer represent one of the most vulnerable groups regarding privacy protection in hospitals. Preserving privacy is a fundamental principle of professional ethics, and neglecting it can lead to emotional distress and reduced trust in healthcare providers for both children and their families.ObjectiveThe aim of this study is to explore the strategies employed by nurses to maintain the privacy of hospitalized children with cancer.Research design and methodsThis qualitative study utilized an inductive content analysis approach, conducted between November 2022 and May 2024.Participants and research contextIndividual, in-depth semi-structured interviews were carried out with 11 nurses (mean age 36 years and average clinical experience 13.36 years) and 4 mothers (aged 31-42 years) whose children (aged 8-15 years) were hospitalized in the oncology wards of a hospital in Tehran, Iran. Purposive sampling was used. Data collection continued until data saturation was achieved and no new codes or categories emerging. All interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative data analysis software, following the Elo and Kyngäs (2008) content analysis method.Ethical considerationsThe research was approved by a research ethics committee from a University of Medical Sciences.FindingsThe analysis of the interviews led to the extraction of 4 main categories and 12 subcategories. The main categories included: ensuring psychological security, gentle entry into the child's personal space, involving the mother, and providing a sense of control to both the mother and child. These strategies were illustrated through direct participant quotes to enhance credibility and transparency.ConclusionNurses employed a thoughtful and empathetic approach to safeguard the privacy of children with cancer. They prioritized building psychological security, approached the child's private space gently, and engaged mothers as partners in care. By promoting a sense of control for both the child and mother, these strategies collectively supported privacy preservation.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251366592"},"PeriodicalIF":2.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on the 2025 Nursing Ethics Conference in Turku, Finland.","authors":"Ann Gallagher","doi":"10.1177/09697330251383298","DOIUrl":"https://doi.org/10.1177/09697330251383298","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251383298"},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does facilitation improve moral case deliberation quality?","authors":"Swanny Kremer, Marinus Spreen, Margreet Stolper, Bert Molewijk","doi":"10.1177/09697330251374396","DOIUrl":"https://doi.org/10.1177/09697330251374396","url":null,"abstract":"<p><p>BackgroundMoral Case Deliberation (MCD) is a standardized method to support healthcare professionals in reflecting upon and making morally challenging decisions guided by a trained facilitator.Research questionsThe study addresses the following research questions: (1) (How) does the addition of a trained MCD facilitator applying the stepwise plan of Bauduin and Kanne improve the quality of deliberation compared to regular case/team discussions/meetings? (2) (How) does the quality of the deliberation within the MCD intervention group improve differently over time compared to regular case/team discussions/meetings?Participants and research contextThree treatment teams of wards in a maximum secured forensic psychiatric hospital in the north of the Netherlands participated in this study.Research designA control group deliberated six times about moral decisions as usual. Two other teams deliberated two times \"as usual\" and four times led by a trained facilitator. All deliberation sessions were video recorded. These videos were assessed on four factors by 54 applied university students: variety of argumentation, critical engagement, moral focus, and structure of deliberation.Ethical considerationsWritten informed consent was obtained from all team members for the use of video recordings. In addition, a confidentiality statement was provided to all student assessors.ResultsThis study indicates that adding a trained MCD facilitator using a step-by-step plan improves the quality of deliberation within MCD compared to regular case/team discussions/meetings. A facilitator has shown a positive impact by enhancing the four factors of quality of deliberation within MCD. Also, the quality within both MCD intervention groups improved differently over time.ConclusionsThis first step on how to conceptualize and measure quality of moral deliberations via video analysis will be useful for future ethics support and ethics education studies.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251374396"},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional values of undergraduate nursing students: A cross-sectional study.","authors":"Simone Cosmai, Davide Allevi, Simone Nicoli, Jasmen Ali, Cristina Chiari, Diego Lopane, Alberto Gibellato, Stefano Mancin, Michela Piredda, Beatrice Mazzoleni","doi":"10.1177/09697330251366618","DOIUrl":"https://doi.org/10.1177/09697330251366618","url":null,"abstract":"<p><p><b>Background:</b> Professional values form the ethical foundation of nursing practice and are essential for developing moral reasoning and integrity in care delivery. The internalization of these values begins during undergraduate education through academic coursework, clinical experiences, and role models. Understanding how Italian nursing students perceive and prioritize professional values is crucial for curriculum development and preparing future nurses for ethically demanding clinical environments.<b>Objective:</b> To investigate the importance that undergraduate nursing students assign to professional values using the Italian version of the Nursing Professional Values Scale-3 (I-NPVS-3).<b>Methods:</b> A cross-sectional multicenter study was conducted between March and July 2024 among 463 nursing students enrolled in Bachelor programs across four Italian universities. The 28-item I-NPVS-3 scale assessed three domains: Caring, Activism, and Professionalism. Participants rated each item's perceived importance on a 5-point Likert scale. Data were collected using Microsoft Forms and analyzed using descriptive statistics, Welch's t-tests, and ANOVA.<b>Results:</b> Of 463 students, 358 completed surveys were analyzed (77% response rate). The sample comprised 45% first-year students, with 77% female participants and mean age of 23 years. Students assigned high average scores to professional values overall (mean 4.5, SD 0.74). The Caring domain received the highest mean score (4.67, SD 0.55), followed by Activism (4.32, SD 0.63) and Professionalism (4.21, SD 0.71). \"Respecting the inherent dignity, values, and human rights of all individuals\" was the most valued item (82% rating it as extremely important). Female students scored higher across all domains compared to males. Younger students emphasized Caring more, while older students showed greater interest in Activism and Professionalism, though differences were not statistically significant.<b>Conclusions:</b> Italian nursing students prioritize Caring values most highly, emphasizing dignity, respect, and patient-centered care. The findings suggest curriculum enhancements should focus on strengthening Activism and Professionalism domains, particularly research engagement and policy involvement, to better prepare future nurses for evolving healthcare challenges.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251366618"},"PeriodicalIF":2.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relational autonomy in pediatric healthcare: A scoping review.","authors":"Amarens Matthiesen, Nicole Drumm, Alison J Gerlach, Donna Koller, Tieghan Killackey","doi":"10.1177/09697330251366601","DOIUrl":"https://doi.org/10.1177/09697330251366601","url":null,"abstract":"<p><p>BackgroundThe concept of relational autonomy has gained popularity for accentuating the social embeddedness of autonomy. In pediatrics, relational autonomy provides a framework for conceptualizing the complexities of healthcare processes, such as shared decision-making and children's transitions to adult care systems. However, a lack of clarity exists regarding how to define and operationalize relational autonomy in pediatric healthcare. To our knowledge, no reviews of literature have been conducted to better understand this concept in pediatrics and guide further research.Research AimThe purpose of this scoping review was to describe literature focusing on relational approaches to autonomy in the context of pediatric healthcare.Research designA scoping review methodology proposed by Arksey and O'Malley and the Joanna Briggs Institute guided this review. Seven databases were searched for literature published between 2004 and 2024. Out of 2895 potentially relevant publications, a total of 28 articles were included for review.Ethical ConsiderationsThis study was conducted and reported in accordance with recognized scientific scoping review guidelines.FindingsVarious terms were used to describe relational approaches to autonomy in pediatrics. These terms shared a common goal of promoting a more holistic view of children and their decision-making processes in pediatric care. Most articles relied on adult perspectives (e.g., caregivers and healthcare providers) to shed light on shared decision-making processes. The perspectives of children and nurses were underrepresented in the literature, especially in the context of the Global South.ConclusionAdditional research is needed to capture the lived experiences of a wider range of individuals with developing and exercising autonomy using diverse research methods. As the perspectives of nurses and children remain excluded from literature, new knowledge on their experiences with autonomy can inform the delivery of care that is ethically and morally sound.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251366601"},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dilemma of surrogate decision-making in the intensive care unit: A focused ethnographic study.","authors":"Leqian Wu","doi":"10.1177/09697330251374393","DOIUrl":"https://doi.org/10.1177/09697330251374393","url":null,"abstract":"<p><p>BackgroundShared decision-making (SDM) requires bidirectional communication between medical staff and patients (or their surrogates) to ensure treatment aligns with patients' values and preferences. In the intensive care unit (ICU), critically ill patients often lose decision-making capacity, placing surrogate decision-making responsibilities on family members. However, surrogates face significant challenges due to restricted information access, communication barriers, and decision-making delays. The impact of ICU spatial isolation, restricted visitation policies (RVP), and information flow on the decision-making process remain underexplored. This study examines how these factors shape surrogate decision-making and affect its effectiveness.MethodsA focused ethnographic study was conducted in the ICU of a tertiary hospital in China over 6 months. Data were collected through participant observation and semi-structured interviews with 9 ICU physicians, 6 nurses, and 10 family surrogates. Thematic content analysis was used to systematically code and synthesize data, identifying key challenges within the ICU decision-making ecosystem.ResultsICU spatial isolation and RVP placed surrogates at the periphery of the information network, where they receive only fragmented and unidirectional updates. Medical staff predominantly relied on one-way, ad-hoc communication, preventing surrogates from fully understanding patient conditions. Additionally, discussions often neglected patients' values, impeding substituted judgment. The resulting information deficit led surrogates to seek external sources, exacerbating trust issues with medical staff. This dual-layered isolation-spatial and informational-and distrust increased the influence of non-medical factors such as financial constraints, emotional distress, and sociocultural pressures, potentially leading to decisions misaligned with patient interests. The study proposes a staged visitation and structured communication model to address these challenges and enhance surrogate decision-making quality.ConclusionsFuture research should assess the effectiveness of this model and explore strategies to balance ICU staff workload with surrogate informational needs in high-stress environments.Ethical considerationsThe study was approved by the Institutional Review Board of Dalian Medical University (Approval No. BECDMU 2024-008). Written informed consent was obtained from all formal interview participants, while oral informed consent was secured for ethnographic observations. Confidentiality and anonymity were strictly maintained.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251374393"},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relational vulnerability and technological mediation: The ethics of intelligent eldercare.","authors":"Yingying Wang, Min Liu","doi":"10.1177/09697330251374394","DOIUrl":"https://doi.org/10.1177/09697330251374394","url":null,"abstract":"<p><p>In current China, the 9073 elderly care system is accelerating the process of intelligentization. The fundamental tension between conventional filial piety ethics and technological rationality is evident in the numerous ethical debates triggered by intelligent older people's care services, despite their convenience. This study proposes an analytical paradigm called relational vulnerability, which creatively combines the philosophy of technology with Confucian relational ethics. Through the use of intricate mechanisms, this framework seeks to shed light on how technological mediation alters intergenerational ethics. According to research, intelligent services that improve physical care for older people while weakening emotional ties have a paradoxical effect that creates new kinds of alienation, such as the measurement of filial duty and the breakdown of ritual-embodied behaviors. By incorporating cultural calibration into the development of human-machine symbiosis, this study addresses this issue by proposing the design concepts of \"differential regulation\" and \"embodiment retention.\" This counteracts the interpretive shortcomings of the Western autonomy-based ethical paradigm in the context of Chinese older people care, creating new avenues for the application of Confucian bioethics in the age of technology and offering fresh perspectives on moral dilemmas in intelligent older people care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251374394"},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}