Nursing Ethics最新文献

{"title":"Family caregivers' role in dignity of people with schizophrenia: A qualitative study.","authors":"Elham Amiri, Hossein Ebrahimi, Hossein Habibzadeh, Rahim Baghaei","doi":"10.1177/09697330251319372","DOIUrl":"https://doi.org/10.1177/09697330251319372","url":null,"abstract":"<p><p><b>Background:</b> When patients with schizophrenia feel a lack of dignity, their sense of worth is weakened and they are more likely to feel like a burden to their family. In this regard, families play a vital role in supporting the patient, who can effectively contribute to preserving their dignity. The concept of understanding the role of families in the patients' dignity is influenced by various factors. Still, there is limited knowledge in this domain in the sociocultural context of Iran.<b>Aim:</b> This study was to elucidate the role of family caregivers in the patients' dignity with schizophrenia, based on the perspectives of patients, family caregivers, and healthcare personnel.<b>Design:</b> This qualitative study was conducted utilizing conventional content analysis. The data were accordingly collected through field notes, and semi-structured, in-depth face-to-face interviews with 16 patients with schizophrenia, 4 family caregivers, 2 nurses, and 3 psychologists. The data were analyzed according to Graneheim and Lundman (2004).<b>Ethical Considerations:</b> The study protocol was approved by the ethics committee and followed ethical principles closely.<b>Findings:</b> The analysis of the data led to the emergence of two subcategories as follows: \"Under the umbrella of family support\" and \"Being ignored by the family.\" The category of \"Under the umbrella of family support\" was characterized by subcategories including \"Being the center of attention,\" \"Understanding the patient's condition,\" \"Financial support,\" and \"Emotional support.\" Besides, the category of \"Being ignored by the family\" was characterized by subcategories including \"Rejection from the family,\" \"Not accepting the patient's condition,\" and \"Tangential life with patients.\"<b>Conclusion:</b> This study found that some family caregivers were trying to reach the stage of acceptance. Following the understanding of the patient's condition, the family caregivers were responsible for the patient and were considered a strong support for the patient, and in such a situation, the patients' dignity was respected. On the other hand, some family caregivers did not accept the patient's condition and were indifferent to the patients' needs, which in such a situation created grounds for violating the dignity of the patients. A deep understanding of the factors threatening the patients' dignity with schizophrenia from their families can help health policymakers take positive steps toward preserving the dignity of these patients by designing and implementing programs aimed at raising awareness and empowering families.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251319372"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617830","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":"Impact of interactive ethics education program on nurses' moral sensitivity.","authors":"Pınar Doğan, Merve Tarhan, Ahu Kürklü","doi":"10.1177/09697330251324319","DOIUrl":"https://doi.org/10.1177/09697330251324319","url":null,"abstract":"<p><p>BackgroundNurses working in a clinic must be morally sensitive to identify unethical circumstances and act morally. Educational strategies that can effectively gain this sensitivity are a matter of curiosity.ObjectiveThis study aimed to examine if an interactive ethics training program would benefit (a) moral sensitivity and (b) knowledge.Research DesignThe present study was quasi-experimental based on a control group pretest/posttest.Participants and Research ContextThe study involved 53 nurses from 10 hospitals in Istanbul, Türkiye. The intervention group received the 5-week Interactive Ethics Training Program. Data were collected through the Personal Characteristics Form, Moral Sensitivity Questionnaire, and Nursing Ethics Knowledge Test.Ethical ConsiderationsThe study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Non-Invasive Research Ethics Committee (No. 78/2022) from Istanbul Medipol University.ResultsThere was a statistically significant difference between the two groups in the posttest for moral sensitivity (MD: -10.247; <i>p</i> = .010) and knowledge level (MD: 4178; <i>p</i> = .009).ConclusionAn interactive ethics training program in nursing ethics education positively impacts nurses' moral sense and knowledge. Improving nurses' moral awareness can facilitate ethical decision-making. Therefore, it is advised that nurse educators design their curricula based on these results.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324319"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607117","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":"Health Professionals' perspectives on Human Rights and Mental Health Recovery.","authors":"Igor de Oliveira Reis, Emanuele Seicenti de Brito, Maria Luiza Dos Santos Barbosa, Maria Geraldo Dói, Ana Beatriz Zanardo Mion, Carla Aparecida Arena Ventura","doi":"10.1177/09697330251324323","DOIUrl":"https://doi.org/10.1177/09697330251324323","url":null,"abstract":"<p><p><b>Background:</b> The guarantee of human rights in the healthcare of individuals with mental disorders is a global challenge. Health practices frequently fail to integrate relational ethical principles in the promotion of holistic and inclusive care. It is therefore crucial to investigate how healthcare professionals perceive and conduct their practices in this context. <b>Objective:</b> To understand, in the light of Relational Ethics, the perceptions and conduct of healthcare professionals regarding the guarantee of human rights and the recovery process of individuals with mental disorders. <b>Research Design:</b> An exploratory study was conducted using ideas storming techniques and field notes for data recording, which were analyzed through Thematic Analysis and discussed in the light of the core elements of Relational Ethics. <b>Participants and Research Context:</b> The study involved 26 healthcare professionals (15 community health workers, 5 nurses, 3 nursing assistants, 2 doctors, and 1 pharmacy assistant) from a primary healthcare unit in a municipality in the state of São Paulo, Brazil, during the application of the module \"Recovery and Right to Health\" of the WHO QualityRights training. <b>Ethical Considerations:</b> The research project to which this study belongs was approved by the Research Ethics Committee of the School of Nursing at Ribeirão Preto, University of São Paulo (report number 6.257.303). <b>Findings:</b> Three themes were identified: (1) Feeling worthless when facing the lack of structure of mental health services: appearance, accessibility, and privacy; (2) dealing with barriers to the recovery of individuals with psychosocial, intellectual, or cognitive disabilities; and (3) an ethical duty: to understand the roles of families and other supporters in promoting recovery. These themes primarily explored resource scarcity, social stigma, and emotional support. <b>Conclusions:</b> The study reinforces the need for practices that integrate ethical care, respect for autonomy, and dialogue, which are fundamental to ensuring human rights and facilitating the recovery process.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324323"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607113","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":"Innovative care models: Expanding nurses' and optometrists' roles in ophthalmology.","authors":"Luke Yu Xuan Yeo, Collin Yip Ming Tan, Jemima W Allen, Charmaine Chai, Khadijah Binte Othman, Yih Chung Tham, Victor Teck Chang Koh, Julian Savulescu","doi":"10.1177/09697330251317670","DOIUrl":"10.1177/09697330251317670","url":null,"abstract":"<p><p>The expanding demands of healthcare necessitate novel methods of increasing the supply of trained professionals to enhance the delivery of care services. One means of doing so is to expand allied health professionals' scope of practice. This paper explores the ethics of two examples of such expansion in ophthalmology, comparing the widely accepted practice of nurses administering intravitreal injections and the relatively less prevalent optometrists functioning as physician extenders. We conducted a literature review of empirical research into both practices and conclude that nurses administering intravitreal injections are ethically justified. With adequate standardized training, optometrists can also function as primary eye care providers to improve accessibility to eye care. We provide an algorithm for the ethical introduction of innovative expanded allied healthcare.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251317670"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607121","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":"Ethical analysis of the change of values in healthcare.","authors":"David Hansen, Silviya Aleksandrova-Yankulovska, Florian Steger","doi":"10.1177/09697330251319374","DOIUrl":"https://doi.org/10.1177/09697330251319374","url":null,"abstract":"<p><p>What people value today can differ from what they have valued. But what does this value variability mean in the context of healthcare? We ethically analyze the current state of research on the change of embedded values in healthcare systems and the driving processes behind it. Starting with a systematic literature review and a content analysis, we subject the selected articles to an ethical analysis through three ethical theories: principlism, value ethics, and utilitarianism. The included papers demonstrated how moral dissonance between individual values and behavior leads to moral distress. The occurrence of moral distress was related to current healthcare practices. Beneficence and non-maleficence played a central role where principlism was considered, virtue ethics was criticized for not addressing the structural problems in the healthcare system, and consequences of value change for healthcare professionals and the society were analyzed. Further, principlism cannot fully cover the value change in medical care with its top-down and bottom-up processes leading to consequences for the patients, healthcare professionals, and society as a whole. We found correlations between top-down value change processes in the healthcare system and the quality of care. Health professionals are forced to develop an attitude that does not adhere to traditional medical values any longer and eventually leads to low-value care. Accompanying phenomena like moral distress cause dropout of healthcare workers. These can be hardly slowed down from the bottom-up by the development of resilience and moral courage. More effectively, structural changes through value interventions have the potential to improve working conditions and the quality of care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251319374"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607110","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":"Moral comfort and its influencing factors from intensive care unit nurses' perspective.","authors":"Nessa Abbasivand-Jeyranha, Maasoumeh Barkhordari-Sharifabad","doi":"10.1177/09697330251324312","DOIUrl":"https://doi.org/10.1177/09697330251324312","url":null,"abstract":"<p><p>BackgroundIntensive Care Unit (ICU) nurses face ethical challenges during decision-making in terms of the sophisticated nature of in-patients. Moral comfort is known as a phenomenon with a positive effect on moral decision-making and moral actions of nurses.AimThis study investigated ICU nurses' level of moral comfort and factors affecting it.Research DesignThis study used a cross-sectional descriptive design.Participants and research contextA total of 350 ICU nurses were selected with the convenience sampling method. The data collection tool included the Demographic Characteristics Questionnaire and the Moral Comfort Questionnaire. The data were analyzed with SPSS19 using descriptive and inferential statistics.Ethical ConsiderationsUpon the Committee of Ethics in Human Research's acceptance of the research concept, approvals were secured, and informed written consent was acquired from all participants. They were assured of the information confidentiality of participation.FindingsThe mean moral comfort score was 112.75 ± 13.18. The mean score of personal factors related to ethics was higher than the external factors pertaining to the environment/organization. The mean scores of \"moral comfort in a specific situation\" and \"moral comfort in general\" were 50.52 ± 5.08 and 62.32 ± 9.31, respectively. The mean moral comfort score of nurses was significantly correlated with age, clinical work experience, ICU work experience, marital status, education, and employment status (<i>p</i> < .05). Regression analysis revealed that ICU work experience as the strongest predictor variable predicted 17.7% of moral comfort variance.ConclusionAlthough moral comfort score was at a favorable level, ICU nurses did not feel comfortable when making decisions in moral situations, and nursing managers did not support the decisions of nursing staff. Consequently, this issue warrants the attention of nursing managers and policy-makers. They need to enhance the quality of healthcare by offering more support and addressing the variables influencing the moral comfort of nurses.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324312"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607123","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":"A care ethical perspective on family caregiver burden and support.","authors":"Maaike Haan, Jelle van Gurp, Marianne Boenink, Gert Olthuis","doi":"10.1177/09697330251324294","DOIUrl":"https://doi.org/10.1177/09697330251324294","url":null,"abstract":"<p><p>Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. For many people, taking on a caring role is self-evident. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. Using a care ethical approach, this theoretical paper aims to provide nurses with an alternative perspective on caregiver burden and support. Drawing on the concepts of relationality and contextuality, we explain that family care often is not a well-demarcated or actively chosen task. Instead, it is a practice of responding to an all-encompassing \"call\" to care flowing from a relationship, within a social and cultural context where norms, motivations, and expectations shape people's (sometimes limitless) care. We consider relational interdependence at the root of persisting in care provision. The question is then whether self-sacrifice is a problem that nurses should immediately solve. In ideal circumstances, self-sacrifice is the result of a conscious balancing act between values, but family care in the context of serious illness barely provides room for reflection. Yet, instant attempts to alleviate burden may overlook family caregivers' values and the inherent moral ambiguities and/or ambivalent feelings within family care. Family care is complex and highly personal, as is finding an adequate balance in fulfilling one's sometimes conflicting values, motivations, and social expectations. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers <i>from</i> the situation but should support them <i>in</i> whatever overwhelms or drives them in standing-by their loved ones until the end.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324294"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558491","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":"Nursing ethics and the perspectivity of nursing: Response to '30 years of nursing ethics'.","authors":"Settimio Monteverde","doi":"10.1177/09697330251322268","DOIUrl":"https://doi.org/10.1177/09697330251322268","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251322268"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558492","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":"System-wide assessment using the Measure of Moral Distress - Healthcare professionals.","authors":"Adam T Booth, Kathryn L Robinson","doi":"10.1177/09697330251324296","DOIUrl":"https://doi.org/10.1177/09697330251324296","url":null,"abstract":"<p><p><b>Background:</b> Moral distress is the inability to do the right thing due to institutional constraints. The Measure of Moral Distress - Healthcare Professionals (MMD-HP) measures this phenomenon and has extensively explored moral distress among nurses. There are limited large-scale research studies using the MMD-HP to identify levels of moral distress across multiple healthcare professionals (HPs) and settings.<b>Research question:</b> What are the overall levels of moral distress among HPs?<b>Research design:</b> A quantitative, exploratory, cross-sectional study of HPs in a healthcare system using the MMD-HP. <b>Participants and research context:</b> Eligible participants included HPs (<i>N</i> = 8,206) working in all inpatient and outpatient units and centers in a multi-site healthcare system located in the Southeastern United States. <b>Ethical considerations:</b> The Institutional Review Board provided approval for this research. A survey preamble supplied information within the learning management system and consent was presumed with survey completion.<b>Findings:</b> A total of 3,561 HPs completed the MMD-HP. The top three morally distressing items included compromised patient care due to inadequate resources, caring for more patients than is safe, and low quality of patient care due to poor team communication. Intensive care unit (ICU) areas had significantly greater moral distress than all other areas (<i>p</i> < 0.001). Formal leaders had the greatest moral distress (<i>p</i> < 0.001). Mixed-acuity and medical-surgical HPs accounted for 22.8% of those who reported considering leaving their current position due to moral distress. Nurses represented 42.2% of those considering leaving their current position due to moral distress.<b>Conclusions:</b> This study uniquely identified that formal leaders and HP participants in the ICU setting had the greatest moral distress. Exploring moral distress is imperative for healthcare systems to decrease turnover, improve engagement, and the quality of patient care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251324296"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544069","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":"Implications of assisted dying for nursing practice.","authors":"Mark Wareing","doi":"10.1177/09697330251314096","DOIUrl":"10.1177/09697330251314096","url":null,"abstract":"<p><p>This conceptual paper considers the practice implications of assisted dying for contemporary nursing practice within the United Kingdom in response to the publication of a parliamentary report leading to a private members' bill that will form the basis of a debate and possible change in legislation. A recurring theme within the nursing research is how nurses should respond to patients expressing an interest or making a request for assisted dying. This paper explores contemporary evidence and argues that the procedure of assisted dying is a complex (manifold) and puzzling (paradoxical) practice. The UK nursing profession may replicate recent healthcare catastrophes if the response to a proposal for assisted dying is based on a technical-rational stance, or if nurses merely coalesce around a single determinant such as patient autonomy. The paper presents two nursing communicative interventions that seek to address how to respond to a patient request for an assisted death that foregrounds the preferences and personhood of the patient whilst providing opportunities for enquiry-based approaches to enhance nursing responses to intractable suffering.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"373-384"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015097","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}