Nursing Ethics最新文献

{"title":"COVID-19 guidelines and media influenced ethical care in nursing homes.","authors":"Caroline Wachtler, Monica Bergqvist, Pia Bastholm-Rahmner, Lars L Gustafsson, Katharina Schmidt-Mende","doi":"10.1177/09697330241268923","DOIUrl":"10.1177/09697330241268923","url":null,"abstract":"<p><p>BackgroundThe early phase of the COVID-19 pandemic affected nursing homes and their residents heavily. Guidelines on how to mitigate the virus's spread and ensuring safe healthcare delivery were continually evolving. Concurrently, nursing homes faced intense media scrutiny. This challenging environment severely impacted registered nurses and physicians employed within these facilities.AimTo understand the ethical challenges experienced by registered nurses and physicians working in nursing homes during the COVID-19 pandemic.Research designQualitative descriptive research using thematic analysis.Participants and research contextIndividual online interviews with four registered nurses and eight physicians clinically active at nursing homes in Sweden.Ethical considerationsThe study was approved by the Swedish Ethical Review Authority. All participants provided written consent.ResultsRegistered nurses and physicians working in nursing homes perceived ethical challenges stemming from early COVID-19 pandemic guidelines and media coverage. The main theme generated was 'Struggling to maintain professional and ethical standards under pressure' incorporating two subthemes: 'Guidelines developed without the profession put pressure on staff' and 'Media's biased reporting was perceived as unethical and undermined care'. Guidelines from the authorities were considered as developed without professional involvement. It made them difficult to adhere to without deviating from professional and ethical compasses. Media coverage adversely influenced relatives' perceptions, resulting in mistrust towards physicians' and registered nurses' in delivering optimal care for the residents.ConclusionsResilient care in nursing homes necessitates the collaborative development of guidelines involving registered nurses and physicians, particularly amidst crises. Moreover, it is vital to provide support to registered nurses navigating ethical dilemmas, especially during pandemics. Guidelines and principles for care during a crisis should be development with professional involvement, be transparent, and be available to the public, to promote neutral media coverage. Future research is crucial to enhance ethical standards and tackle challenges in this context.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"900-912"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral resilience and intention to leave: Mediating effect of moral distress.","authors":"Mustafa Sabri Kovanci, Azize Atli Özbaş","doi":"10.1177/09697330241272882","DOIUrl":"10.1177/09697330241272882","url":null,"abstract":"<p><p>AimsThis study aims to examine the mediating effect of moral distress on the relationship between moral resilience and the intention to leave.BackgroundMoral distress is a phenomenon that negatively impacts healthcare workers, healthcare institutions, and recipients. To eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience is important in protecting against the negative effects of moral distress, such as burnout and turnover intention. In this direction, it is necessary to increase the moral resilience of nurses to reduce negative situations such as turnover intention in nurses.MethodsIt is a descriptive-predictive study. Sociodemographic Information Form, Measure of Moral Distress - Healthcare Professionals, and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 220 clinical nurses were recruited.Ethical considerationsApproval was obtained from the university's non-interventional ethics committee, and informed consent was obtained from the participants.ResultsThe study found a total moral distress score of 6.39 ± 0.3.12 and moral resilience score of 2.69 ± 0.48. A moderate and weak negative correlation was found between moral distress and moral resilience. Moral distress has a moderating effect on the intention to leave nursing (β = -0.158, <i>p</i> = .010) and the intention to leave the current position (β = -0.174, <i>p</i> = .000). Individual's moral resilience directly affects the intention to leave. The presence of moral distress eliminates the direct effect of moral resilience and affects the intention to leave together with moral resilience.ConclusionsMoral resilience leads to decreased intention to leave, and moral distress mediates this situation. An increase in moral distress decreases moral resilience and increases intention to leave. It can be assumed that if moral distress is not controlled, increasing moral resilience will not affect the intention to leave the job.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"864-874"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917907","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 advocacy and moral distress among nurses in organ transplant units.","authors":"João Paulo Victorino, Emanuele Seicenti de Brito, Ursula Marcondes Westin, Mara Ambrosina de Oliveira Vargas, Karina Dal Sasso Mendes, Carla Aparecida Arena Ventura","doi":"10.1177/09697330241295368","DOIUrl":"10.1177/09697330241295368","url":null,"abstract":"<p><p>BackgroundHealth advocacy is crucial for both patients and healthcare professionals. However, nurses who recognize the importance of health advocacy may experience heightened moral distress, particularly in complex donation and transplantation cases where patient autonomy, respect, and advocacy are paramount.AimTo identify the factors contributing to moral distress among nurses working in solid organ transplant units at a university hospital in São Paulo, with a focus on health advocacy.Research DesignThis descriptive, cross-sectional study employs both quantitative and qualitative methods. For this, the quantitative phase of the study was conducted utilizing the Moral Distress Scale, while the qualitative phase was executed through focus group discussions.Participants and Research ContextThe quantitative phase involved 15 nurses using the Moral Distress Scale. The qualitative phase consisted of a focus group with 5 nurse managers/coordinators from the transplant units. Quantitative data were analyzed using R® software, while qualitative data were analyzed using Bardin's Content Analysis.Ethical ConsiderationsThe study was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing, University of São Paulo. Participation was voluntary and confidentiality was ensured.ResultsA significant correlation was found between moral distress and the factors of \"disregard for patient autonomy\" (<i>p</i> = .0100) and \"therapeutic obstinacy\" (<i>p</i> = .0492).ConclusionThe primary determinants associated with moral distress in the context of health advocacy were identified as \"disregard for patient autonomy\" and \"therapeutic obstinacy.\"</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"994-1003"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511704","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":"Truth-telling, and ethical considerations in terminal care: an Eastern perspective.","authors":"Qing Ma, Yi Wu, Ronghua Fang","doi":"10.1177/09697330241312376","DOIUrl":"10.1177/09697330241312376","url":null,"abstract":"<p><p>Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article aims to provide ethical strategies for clinical nurses in China regarding truth-telling decisions for terminally ill patients on the basis of their individual autonomy. This article first presents a common case scenario in China and then critically discusses ethical issues related to ethical principles and philosophical theories. The aim is to provide the much needed strategy for truth-telling for nurses who are terminally ill rather than to focus on attitudes toward disclosure. This article focuses on nursing morality, ethics, norms, and philosophy in health care and discusses countermeasures taken by nurses in truth-telling decision-making in combination with Chinese Confucian culture. The analysis identifies key ethical strategies tailored to Chinese nurses' practices, emphasizing individual autonomy, cultural sensitivity, and family dynamics in truth-telling decisions. The complexity of end-of-life illness requires Chinese nurses to strengthen the communication training needed to deliver bad news, as well as critical and autonomous thinking and good communication skills when implementing patient- and family-centered care, to achieve true delivery of bad news, thereby increasing patient autonomy and promoting more successful collaboration among patients, families, and providers. To improve the quality of care. Chinese nurses should integrate ethical principles with Confucian values to enhance patient-centered communication, respecting autonomy while adapting to cultural nuances in end-of-life care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"971-979"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957885","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 courage of nursing: Bibliometric analysis.","authors":"Mingtao Huang, Sihua Wei, Jiansen Xia","doi":"10.1177/09697330241277987","DOIUrl":"10.1177/09697330241277987","url":null,"abstract":"<p><p>BackgroundMoral courage is a recognized virtue. Researchers have focused on various aspects of nursing moral courage, such as its conceptualization and influencing factors. Within these studies, various literature reviews have been conducted, but to our knowledge, bibliometric mapping has not been utilized.AimThis article aims to analyze the production of literature within nursing moral courage research.Research DesignTo investigate publication patterns, we employed VOSviewer and CiteSpace software, focusing on publication dynamics, prolific research entities, and most cited articles. Additionally, we forecasted future research trends.Ethical considerationsIn our study, ethical review was not required.ResultsA total of 105 information sources were identified in the WoS database. Overall, there has been a significant increase in research volume after 2020. The most prolific countries are the United States, Finland, and China, while the most prolific source title is \"Nursing Ethics.\" Keywords are also related to moral dilemmas and ethics. However, there are further improvements needed in international cooperation.ConclusionsThe results proposed in this paper can serve as a starting point for comprehensive or systematic literature reviews and seek more detailed data, information, and knowledge in the field of nursing moral courage. It can enable outsiders to quickly understand research on nursing moral courage, whether for in-depth exploration or simply to facilitate more effective collaboration with nursing ethics experts.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"767-781"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331098","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":"Linking ethical leadership to nurses' internal whistleblowing through psychological safety.","authors":"Heba Emad El-Gazar, Nadiah A Baghdadi, Sally Mohammed Farghaly Abdelaliem, Mohamed Ali Zoromba","doi":"10.1177/09697330241268922","DOIUrl":"10.1177/09697330241268922","url":null,"abstract":"<p><p><b>Background:</b> Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored.<b>Aim:</b> This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety.<b>Research design:</b> A multicenter cross-sectional research design was used for this study.<b>Participants and research context:</b> This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses.<b>Ethical consideration:</b> Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study.<b>Results:</b> Ethical leadership was positively linked to nurses' psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses' internal whistleblowing intentions.<b>Conclusion:</b> Our study suggests that nurse leaders can foster nurses' intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"837-850"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972191","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 injury and mental health outcomes in nurses: A systematic review.","authors":"Giuliano Anastasi, Francesco Gravante, Paola Barbato, Stefano Bambi, Alessandro Stievano, Roberto Latina","doi":"10.1177/09697330241281376","DOIUrl":"10.1177/09697330241281376","url":null,"abstract":"<p><p><b>Introduction:</b> Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. <b>Aim:</b> This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. <b>Methods:</b> The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was considered eligible. The risk of bias and the quality of evidence were assessed using the Joanna Briggs Institute checklist and the GRADE approach. <b>Results:</b> Out of 4730 articles identified, eight met the inclusion criteria. The analysis revealed significant positive associations between moral injury, anxiety, and depression, along with a significant negative association with quality of life. <b>Conclusion:</b> These findings highlight the need for healthcare systems to implement strategies that mitigate moral injury among nurses. Future research should prioritize longitudinal studies to explore causal relationships and develop targeted interventions. Additionally, standardizing the concept and measurements of moral injury is crucial for enhancing the comparability and understanding of this phenomenon.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"698-723"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331099","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 20th International Pan Arab Critical Care Medicine Society Conference: A nursing ethics perspective.","authors":"Ali Haddad, Ann Gallagher","doi":"10.1177/09697330251327853","DOIUrl":"10.1177/09697330251327853","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"693-695"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651656","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":"Compassionate nursing in challenging contexts: The importance of judgments.","authors":"Elizabeth Peter, Shan Mohammed, Caroline Variath","doi":"10.1177/09697330241272892","DOIUrl":"10.1177/09697330241272892","url":null,"abstract":"<p><p>BackgroundNurses' demonstration of compassion is an ethical and often regulatory expectation. While research has been conducted to examine the barriers and facilitators of compassion in nurses, little is known about how nurses develop and express compassion for patients who may be blamed for their health condition. Unvaccinated COVID-19 patients are an example of such patients.Research questionsHow do nurses provide compassionate care for unvaccinated adults infected with COVID-19? How did the context of COVID-19 vaccination in Canada shape nurses' relationships with unvaccinated patients?Research designA generic qualitative approach using interviews to gather data was used. Martha Nussbaum's conceptualization of compassion and its cognitive requirements was employed to add depth to the analysis.Participants and research contextSeventeen Registered Nurses, from a range of practice settings, who had cared for unvaccinated patients with COVID-19 participated.Ethical considerationsEthics approval was received, and signed informed consent was obtained. Participants who were the current students of the researchers were excluded.FindingsThree themes were identified:1) Encountering Extreme Workplace Impediments to Compassion.2) Managing Emotions to Provide \"Nonjudgmental Care.\"3) Practicing Narrative Imagination.DiscussionThe difficult working conditions during the pandemic impeded nurses' capacity to be compassionate. Yet, none judged their patients' suffering as trivial, and all provided necessary nursing care. Some initially blamed these patients for the severity of their illness and suppressed their emotions to provide what they called \"nonjudgmental care.\" Upon reflection, participants recognized that these patients' life circumstances may have been barriers to vaccination which, in the end, facilitated the development of compassion.ConclusionThis research has implications that go beyond that of caring for patients with COVID-19. The ideal of \"nonjudgmental care\" requires critical re-examination because judgments and emotions are required for compassion.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"738-751"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upholding ethical pillars in nursing academia.","authors":"William G Zic","doi":"10.1177/09697330241277990","DOIUrl":"10.1177/09697330241277990","url":null,"abstract":"<p><p>This manuscript explores the philosophical implications of ethical principles such as honesty, integrity, fairness, reliability, and objectivity and their impact on professional nursing. By examining these values within Western society, the discussion highlights the importance of integrating these virtues into contemporary nursing education. Through a detailed analysis of each precept, the document underscores their potential to enhance the quality of education, improve interactions among faculty and staff, and achieve positive student outcomes. Ultimately, this treatise advocates for a balanced pedagogical approach in nursing that leverages these elements to foster a more compassionate world, where ethical connections in academia underpin our collective existence.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"892-899"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308925","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}