{"title":"Triage ethics in mass casualty incident simulation: A phenomenological exploration.","authors":"Adrianna Lorraine Watson, Jeanette Drake, Matthew Anderson, Sondra Heaston, Pyper Schmutz, Calvin Reed, Rylie Rasmussen","doi":"10.1177/09697330241299526","DOIUrl":"10.1177/09697330241299526","url":null,"abstract":"<p><p>BackgroundDisaster scenarios challenge both novice and experienced nurses to navigate complex ethical dilemmas in resource-limited environments. Traditional nursing education often leaves new nurses unprepared for the ethical demands of disaster nursing. Utilitarianism must often guide triage ethics and decision-making. There is a critical need to equip nursing students with these ethical competencies.Research question/AimThis study explores nursing students' lived experiences using introductory triage ethics in mass casualty incident simulation (MCIS).Research designA qualitative, interpretive phenomenological approach was employed, analyzing reflective journal responses from senior nursing students following MCIS participation.Participants and research contextParticipants were senior-year nursing students from a private university in the U.S., engaging in MCIS as part of their curriculum, which simulated resource-limited disaster scenarios requiring real-time ethical decisions.Ethical considerationsThe study received Institutional Review Board (IRB) approval, and participants provided informed consent. Data were anonymized and did not affect academic evaluation.FindingsTwo major themes emerged: 1. <b>Living in Ethical Dilemmas</b> (subthemes: <i>We Could Have Saved Them If…</i>, <i>Looking Past Obvious Suffering</i>, <i>How Can We Be Prepared?</i>, <i>We Can't Abandon Them</i>). 2. <b>Development of Ethical Competency</b> (subthemes: <i>Knowing You've Done Enough</i>, <i>Finding New Perspectives</i>, <i>There Is No Right Answer</i>). Students grew in moral reasoning and emotional resilience, transitioning from patient-centered care to utilitarian decision-making.ConclusionsParticipation in the mass casualty incident simulation allowed nursing students to confront and navigate complex ethical challenges in real time, fostering significant growth in moral reasoning and emotional resilience. Through immersion in simulated ethical dilemmas, students grappled with the tension between patient-centered care and the realities of utilitarian decision-making. This experience catalyzed a deeper understanding of ethical ambiguity and the development of moral clarity, equipping them with foundational skills for ethically navigating crises. Nursing curricula should recognize and incorporate opportunities that facilitate this ethical growth through experiential learning.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1313-1326"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630968","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-12-22DOI: 10.1177/09697330241305554
Yujia Liu, Yanjie Wang, Xueying Li, Li Ma, Xiaohan Li
{"title":"Dignity in nursing homes: A qualitative descriptive study of older adults' experiences.","authors":"Yujia Liu, Yanjie Wang, Xueying Li, Li Ma, Xiaohan Li","doi":"10.1177/09697330241305554","DOIUrl":"10.1177/09697330241305554","url":null,"abstract":"<p><p>BackgroundWith the deepening trend of global aging, the issue of dignity of older adults has received widespread attention. The research on the dignity of older adults in nursing homes in China has only just begun, and it is necessary to further explore the dignity experience of older adults in nursing homes.Research ObjectiveTo investigate the thematic features of dignity experiences of older adults residing in nursing homes in mainland China. Furthermore, it may serve as a starting point for further research that formulates intervention strategies.Research DesignThis is a qualitative descriptive study. Twenty older adults living in one of two private nursing homes between September and November 2022 were selected as participants. For each patient, we conducted semi-structured interviews, from which we extracted and assessed information using qualitative content analysis method. SRQR reporting guidelines were used.Ethical considerations'Ethical considerations' with information regarding ethical review, informed consent process and confidentiality.ResultsFive themes and eight subthemes emerged from the transcripts: (1) self-esteem (sense of self-worth and becoming a burden), (2) perceived value to society (being respected and belonging), (3) interpersonal relationships (relationships with others and respectful behavior toward others), (4) autonomy (control of daily life and participation in decision-making), and (5) acceptance and adaptation.ConclusionDignity in older adults can be preserved by realizing self-worth, relieving the burden of self-perceived, promoting belonging, strengthening social ties, enhancing autonomy, and engaging in activities.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1060-1072"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878005","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":"Educational needs of midwifery students in medical ethics: A qualitative study.","authors":"Roghieh Bayrami, Nazafarin Ghasemzadeh, Daniz Montakhabi Oskuii","doi":"10.1177/09697330241287836","DOIUrl":"10.1177/09697330241287836","url":null,"abstract":"<p><p><b>Background:</b> Ethics education is a basic part of midwifery education program. However, there is no evidence to show that ethics education has been able to meet the educational needs of midwifery students. <b>Purpose:</b> This study aimed to explore the educational needs of students for ethics in midwifery program with a focus on the course of history, ethics, and rules of midwifery. <b>Research design and participants:</b> The present study is qualitative descriptive content analysis research, exploring midwifery students' needs of ethics education in bachelor's degrees. We conducted in-depth semi-structured interviews with 11 undergraduate midwifery students, seven midwives working in hospitals and health centers, and seven midwifery faculty members in Urmia University of Medical Sciences. The participants were selected using a purposeful sampling method and invited to join the study from December 2021 to June 2022. The sampling continued until data saturation. <b>Findings:</b> Content analysis identified four categories and associated subcategories: 1. \"The client's rights\": respecting the dignity of clients, confidentiality, the client's right to choose and make decisions; 2. \"Legal and ethical requirements of fertility\": abortion, alternative treatment for infertility, domestic violence; 3. \"Communication skills\": communication with the client, communication with clients' caregivers and communication with colleagues; and 4. \"ethical principles in research\": compliance with ethical principles in the research process and ethical principles in publishing research findings. <b>Ethical considerations:</b> The study was approved by the Ethics Committee of Urmia University of Medical Sciences. Before filling the questionnaires, written informed consent was obtained from the participants. The participants were assured of the confidentiality of personal information. <b>Conclusion:</b> The educational needs of midwifery students can be met by providing theoretical and practical training on respecting the pregnant mother, communication skills, legal and ethical aspects of the reproductive period, and incorporating ethical principles in related courses.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1129-1142"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479127","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-11-15DOI: 10.1177/09697330241295377
Doris M Boutain, Marie-Anne Sanon Rosemberg, Eunjung Kim, Robin A Evans-Agnew
{"title":"Legal dissemination protections in community-based participatory health equity research.","authors":"Doris M Boutain, Marie-Anne Sanon Rosemberg, Eunjung Kim, Robin A Evans-Agnew","doi":"10.1177/09697330241295377","DOIUrl":"10.1177/09697330241295377","url":null,"abstract":"<p><p>BackgroundThere are legal protections for nurse researchers at public universities who employ community-based participatory research (CBPR) in research about social or health inequities. Dissemination of CBPR research data by researchers or participants may divulge unjust laws and create an imperative for university involvement.Research QuestionWhat are United States-based legal dissemination protections for CBPR health equity nurse researchers?Research DesignThree case examples employing CBPR are examined: 1) a mixed methods study with participants reporting illegal discrimination in a municipal initiative about capacity building in community-based organizations serving children; 2) a visual methods study exposing potential clean air law violations in environmental justice research; and 3) a study examining workload violations and illegal discrimination among hotel workers.Participants and Research ContextThe cases involved participants from protected social class backgrounds. The research is described with respect to: background, funding, research purpose, and research team; research participants' power and legal vulnerability; dissemination of relevant research information balancing vulnerability and power; research dissemination issues; potential legal issues involved; and laws researchers may use.Ethical ConsiderationsIRB approval was obtained for the studies. Using a social justice ethical framework, studies highlight actual or potential legal aspects of data dissemination in the context of gathering data about injustice.Findings Legal protections for research data dissemination, whistleblower protection, research advancement protection, anti-harassment protection, false claims, defamation, and visual data liabilities are described.ConclusionKnowledge of legal research data dissemination protections is an essential competency for nurse researchers invested in uplifting social justice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1268-1284"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644982","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2025-03-12DOI: 10.1177/09697330251324301
Ilse Cornu, Wim Vandewiele, Chris Gastmans
{"title":"The ethics of intimacy and sexuality of older adults living in nursing homes: A systematic review of argument-based literature.","authors":"Ilse Cornu, Wim Vandewiele, Chris Gastmans","doi":"10.1177/09697330251324301","DOIUrl":"10.1177/09697330251324301","url":null,"abstract":"<p><p>Admission to a nursing home does not automatically blunt the desire or reduce the need for intimacy and sexuality in older residents. This ageist and ableist stereotype that older people are asexual or post-sexual negatively affects nurses and other healthcare professionals, as they are regularly faced with residents' sexual expressions. How are nurses to view and respond appropriately if a clear understanding of current ethical concepts and argumentations about intimacy and sexuality in older adults is lacking? This study aimed to document and better understand current ethical concepts and arguments about intimacy and sexuality in institutionalised older adults. We used PRISMA and Reporting of Systematic Reviews in Ethics guidelines in a systematic review of current ethical literature (2010 to 2023). Six databases were searched: PubMed, Embase, Web of Science, CINAHL, Atla, and Philosopher's Index. Inclusion criteria were (1) publication was argument-based; (2) contained ethical concepts and arguments concerning intimacy and/or sexuality in institutionalised older adults; and (3) written in English, French, German, or Dutch. Our search returned 4371 publications; of those, 29 publications met our inclusion criteria. Since all included articles appeared in peer-reviewed journals, article quality was assumed to be sufficiently good. Our use of a modified version of the Qualitative Analysis Guide of Leuven showed that two main approaches characterised discussions of intimacy and sexuality in institutionalised older adults: (1) individual-cognitive-oriented approach and (2) relational-embodied-oriented approach. The first emphasises respect for autonomy and consent, fundamental to protecting rights and dignity. The second focusses on intentional bodily capacities and the interdependent nature of being human, both crucial for the emotional well-being of the residents, even when cognitive abilities decline. We conclude that the ethical landscape on sexuality in ageing has shifted, implying that changes are warranted on how ethicists, society, and healthcare professionals view sexual expressions of older adults.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1013-1034"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605563","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-11-17DOI: 10.1177/09697330241296874
Oonjee Oh, George Demiris, Connie M Ulrich
{"title":"The ethical dimensions of utilizing Artificial Intelligence in palliative care.","authors":"Oonjee Oh, George Demiris, Connie M Ulrich","doi":"10.1177/09697330241296874","DOIUrl":"10.1177/09697330241296874","url":null,"abstract":"<p><p>Palliative care aims to improve the quality of life for seriously ill individuals and their caregivers by addressing their holistic care needs through a person- and family-centered approach. While there have been growing efforts to integrate Artificial Intelligence (AI) into palliative care practice and research, it remains unclear whether the use of AI can facilitate the goals of palliative care. In this paper, we present three hypothetical case examples of using AI in the palliative care context, covering machine learning algorithms that predict patient mortality, natural language processing models that detect psychological symptoms, and AI chatbots addressing caregivers' unmet needs. Using these cases, we examine the ethical dimensions of utilizing AI in palliative care by applying five widely accepted moral principles that guide ethical deliberations in AI: beneficence, nonmaleficence, autonomy, justice, and explicability. We address key ethical questions arising from these five core moral principles and analyze the potential impact the use of AI can have on palliative care stakeholders. Applying a critical lens, we assess whether AI can facilitate the primary aim of palliative care to support seriously ill individuals and their families. We conclude by discussing the gaps that need to be further addressed in order to promote ethical and responsible AI usage in palliative care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1285-1296"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649520","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-10-22DOI: 10.1177/09697330241295376
Feliciano Villar, Daniela Martínez
{"title":"Ethical aspects of staff responses when older people with dementia express false beliefs.","authors":"Feliciano Villar, Daniela Martínez","doi":"10.1177/09697330241295376","DOIUrl":"10.1177/09697330241295376","url":null,"abstract":"<p><p>BackgroundChallenging false beliefs are common situations among people living with dementia. They frequently imply time-shifts, that is, situations in which the person re-lives past experiences. Since they have emotional implications and important ethical implications, they are difficult to manage by caregivers, who are faced with the decision of telling or not telling the truth.AimsThe study aimed to explore professional staff's perceptions of common and best practices to manage a situation in which a person living with dementia is having a false belief, specifically a time-shift. The study compares technical staff's and assistant carers' responses.Participants and research contextForty-two staff members working in four Spanish long-term care facilities were interviewed. 21 were assistant carers and 21 were technical staff.Research designThis study involved a qualitative design, content-analyzing participant's responses to semi-structured interviews. Participants read a vignette about a person living with dementia having a time-shift and were asked (1) how a situation like that is commonly managed and (2) how it should be managed.Ethical considerationsThe principles of informed consent, confidentiality, and assessment of consequences for participants were observed throughout the entire study, which was approved by the University of Barcelona Ethics Committee (IRB 00003099). Written participant's consent was obtained prior to interviews.FindingsAll the participants mentioned having experienced a situation similar to that described in the vignette. In the case of common practices, lying was the most frequently mentioned strategy. As for best practices, lying and telling the truth were mentioned as well as responses that lie in-between, such as distracting or relaxing. However, most assistant carers reported that they do not know how a challenging false belief should be managed.ConclusionOur findings stress the importance of organizational guidelines and staff development in the management of challenging false beliefs (and specifically time-shifts) in PLWD.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1047-1059"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511703","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-11-28DOI: 10.1177/09697330241299524
Odessa Petit Dit Dariel, Paula Cristofalo
{"title":"Time to care: How a homecare model harnesses nurses' professional ethic and cultivates caring.","authors":"Odessa Petit Dit Dariel, Paula Cristofalo","doi":"10.1177/09697330241299524","DOIUrl":"10.1177/09697330241299524","url":null,"abstract":"<p><p>BackgroundA persistent devaluation of care-work, difficult working conditions, and low salaries have led to challenges with staff recruitment and retention in the homecare sector in France. A new homecare organization adopting an innovative organizational model recently experimented an hourly payment method yielding positive outcomes.ObjectivesUsing Tronto's caring framework, this paper analyzes the strategies used by the founders as they developed their innovative model and the nursing activities performed during home visits.DesignA longitudinal qualitative study was conducted between 2017 and 2023. Homecare nursing teams were shadowed for 1-2 days per year yielding detailed field notes on caregiving activities, both before and after the new payment method. Secondary data included reports, videos, articles, and unpublished documents found online.Ethical considerationsWhile there is no requirement in France to obtain ethical approval in non-interventional research, verbal consent was obtained by all participants prior to their involvement in the study; confidentiality and anonymity were strictly maintained; and pseudonyms were assigned to protect identities.Findings63 interviews and 185 h of shadowing and observations were conducted. Results revealed a virtuous cycle of caring facilitated and encouraged by new incentives that resonated with nurses' professional ethics. The favorable working environment and the hourly payment method enabled nurses to provide caregiving in accordance with their values.ConclusionsAs the new hourly payment experiment is scaled-up nationally, it is imperative that it is not isolated from the organizational model. Without the underpinning values and principles, the hourly payment method alone is unlikely to shift the value attributed to caring.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1073-1089"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751952","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2024-09-25DOI: 10.1177/09697330241284096
Elisabeth Irene Karlsen Dogan, Laura Terragni, Anne Raustøl
{"title":"Human rights education for nursing students: A scoping review.","authors":"Elisabeth Irene Karlsen Dogan, Laura Terragni, Anne Raustøl","doi":"10.1177/09697330241284096","DOIUrl":"10.1177/09697330241284096","url":null,"abstract":"<p><p><b>Background:</b> Human rights are an important part of nursing care, and nurses deal with human rights matter daily. Despite their relevance and acknowledgement of their importance, human rights issues remain limited in nursing education. <b>Aim:</b> The study's aim was to describe how human rights education has been addressed in nursing education. <b>Method:</b> A scoping review was conducted according to the Preferred Reporting Items for Scoping reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) recommendations. The search was conducted in March 2023, with an updated search in February 2024. We searched in the following databases provided by EBSCO: Academic Search Elite, CINAHL, Education Source, ERIC, ScienceDirect and MEDLINE. Additionally, we also searched in Embase via Ovia and Scopus. The papers were screened for eligibility by title, abstract and full text independently by at least two reviewers, and the whole research team was involved in this process. <b>Ethical considerations:</b> The scoping review was guided by ethical conduct and scientific guidelines. <b>Findings:</b> Nine papers matched the inclusion criteria. Three thematic groups were identified: (a) focus of human rights education, (b) the learning design of the coursework and (c) learning outcomes in human rights education. <b>Conclusion:</b> Human rights education can benefit from being tailored to the students' experiences and including voices from the rights-holders. Bringing in the students' experiences and rights-holders' voices can enable self-reflection and discussion regarding human rights concerns. Hence, if the intention is to support nursing students to develop an awareness and act upon human rights concerns, the curriculum ought to include opportunities for reflection and discussion around human rights concerns and experiences in the students' own context.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1177-1196"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331096","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}
Nursing EthicsPub Date : 2025-06-01Epub Date: 2025-02-06DOI: 10.1177/09697330251317673
Kirsikka Selander, Eveliina Korkiakangas, Risto Nikunlaakso, Tiina Koivisto, Jaana Laitinen
{"title":"Ethically challenging situations in eldercare: A cross-sectional study.","authors":"Kirsikka Selander, Eveliina Korkiakangas, Risto Nikunlaakso, Tiina Koivisto, Jaana Laitinen","doi":"10.1177/09697330251317673","DOIUrl":"10.1177/09697330251317673","url":null,"abstract":"<p><p>BackgroundEthically challenging situations are one of the many stressors that strain eldercare employees.AimThe study aimed to examine (1) the mean levels of ethically challenging situations among eldercare employees in different Finnish eldercare service types and (2) the associations between organizational constraints and poor work-unit collaboration with ethically challenging situations.Research designCross-sectional survey in 2020 including 4,347 Finnish eldercare employees (response rate 67%). These employees provide care and support to older adults, such as assist with daily activities and manage medical needs. Employees were classified into four categories based on the eldercare service type: home care (<i>n</i> = 1,683), service housing (<i>n</i> = 1,649), outpatient and ward care (<i>n</i> = 650), and guidance and activity services (<i>n</i> = 365). The data was analyzed with variance analysis, t-tests, and linear regression analysis.Ethical considerationsThe study was approved by the ethical board of the Finnish Institute of Occupational Health. Respondents' provided informed consent for participation.FindingsAnalyses showed that the level of ethically challenging situations was highest in service housing, among nurses, and among practical nurses. Organizational constraints-job strain and organizational injustice-had the strongest positive association with ethically challenging situations. Poor work-unit collaboration, instead, had a minor positive association with ethically challenging situations.ConclusionsOrganizational constraints, especially job strain and organizational injustice, are important to identify to alleviate ethically challenging situations among eldercare workers.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1035-1046"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257150","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}