Nursing Ethics最新文献

{"title":"Moral sensitivity and attitudes towards patient safety among critical care nurses.","authors":"Ali Afshari, Mohammad Torabi, Mahsa Dehghani, Mona Farhadi","doi":"10.1177/09697330251313788","DOIUrl":"https://doi.org/10.1177/09697330251313788","url":null,"abstract":"<p><strong>Introduction: </strong>Patient safety is essential for healthcare quality and a global concern. The rapid advancement of medical technology presents ethical challenges for critical care nurses, who navigate complex decision-making processes. Given their close relationships with patients, nurses are uniquely positioned to address patient safety issues. Thus, enhancing nurses' moral sensitivity and ethical values is increasingly important.</p><p><strong>Objective: </strong>This study aims to explore the relationship between moral sensitivity and attitude towards patient safety in critical care nurses.</p><p><strong>Methods: </strong>This cross-sectional, descriptive-correlational study was conducted from June to September 2022 in three hospitals affiliated with Hamadan University of Medical Sciences in Iran. Participants were nurses in intensive care units (ICUs), selected via convenience sampling. A total of 382 nurses completed questionnaires assessing demographic information, moral sensitivity, and patient safety attitudes. Data analysis was performed using descriptive statistics, t-tests, ANOVA, Pearson's correlation, and multiple regression in SPSS 26.<b>Ethical considerations:</b> This research received ethical approval from the Ethics Committee of Hamadan University of Medical Sciences. Participants provided informed consent regarding the study's objectives, and their confidentiality was strictly upheld throughout the research.</p><p><strong>Results: </strong>The nurses' average age and work experience were 38.6 years and 12.4 years, respectively. Mean scores for moral sensitivity and patient safety attitude were 81.65 ± 2.69 and 51.47 ± 2.21, indicating high levels and a significant positive correlation. Factors such as increasing age, work experience, fewer working hours, and completion of ethics training were linked to more positive attitudes towards patient safety (<i>p</i> < .05). Regression analysis showed that 42.8% of the variability in attitudes towards patient safety could be explained by moral sensitivity and demographic characteristics.</p><p><strong>Conclusion: </strong>This study highlights the relationship between moral sensitivity and patient safety attitudes among critical care nurses, emphasizing the importance of education, experience, and training in shaping ethical values. Enhancing moral sensitivity is vital for reducing risky behaviors and improving patient safety outcomes in critical care settings.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251313788"},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081885","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 fear of compassion effect nurses' caring behaviours? a cross-sectional study.","authors":"Şenay Takmak, Yeliz Karaçar","doi":"10.1177/09697330241259151","DOIUrl":"10.1177/09697330241259151","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study is to determine the levels of nurses' fear of compassion for others, fear of compassion from others, and fear of self-compassion and to examine the effect of fear of compassion on caring behaviors.</p><p><strong>Design: </strong>A cross-sectional, quantitative design was used.</p><p><strong>Participants and research context: </strong>The study was conducted between October 2022 and April 2023 with 304 nurses working in two public hospitals. Data collection tools were the \"Fears of Compassion Scales\" and the \"Caring Behaviors Inventory.\" Data were analyzed using a <i>t</i> test, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression model.</p><p><strong>Ethical considerations: </strong>Ethics committee approval of the research was obtained from the non-invasive ethics committee of Kütahya Health Sciences University (Reference No: 25.05.2022/2022/06-19). The principles of the Declaration of Helsinki were followed in the study. The purpose of the research was explained to all participants, and their verbal/written informed consent was obtained.</p><p><strong>Results: </strong>The mean scores of nurses on fear of compassion for others and from others were at a moderate level, and their scores on fear of self-compassion were close to a moderate level. It was found that the level of nurses' fear of compassion was related to their sociodemographic and professional variables. Fear of self-compassion, fear of compassion for others, and fear of compassion from others explained 33.5% of the total variance in caring behaviors.</p><p><strong>Conclusions: </strong>Nurses' caring behaviors were shown to be more associated with fear of self-compassion than fear of compassion for others. Fear of compassion may be one of the barriers to compassionate care. Interventions that will reduce nurses' fear of compassion may be one way to provide compassionate care. It is recommended to conduct awareness studies on self-compassion and accepting compassion from others in nurses.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"336-351"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421641","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":"Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.","authors":"Arzu Bulut, Halil Sengül, Çeçenya İrem Mumcu, Berkan Mumcu","doi":"10.1177/09697330241252971","DOIUrl":"10.1177/09697330241252971","url":null,"abstract":"<p><strong>Background: </strong>Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated.</p><p><strong>Objectives: </strong>In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy.</p><p><strong>Design: </strong>The present study utilized a cross-sectional survey design following quantitative methods.</p><p><strong>Methods: </strong>This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59 years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in.</p><p><strong>Ethical consideration: </strong>Research ethics approval was obtained from the researcher's university.</p><p><strong>Results: </strong>Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]).</p><p><strong>Discussion: </strong>Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses.</p><p><strong>Conclusion: </strong>Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"253-271"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072095","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":"Effect of digital storytelling-case studies patient privacy: A randomized controlled study.","authors":"Gulcan Eyuboglu, Zehra Gocmen Baykara","doi":"10.1177/09697330241238335","DOIUrl":"10.1177/09697330241238335","url":null,"abstract":"<p><strong>Background: </strong>It is essential to develop future nurses' privacy consciousness and attitudes toward patient privacy to recognise threats to patient privacy and take the necessary precautions.</p><p><strong>Objectives: </strong>To determine the effect of digital storytelling and case studies teaching methods on nursing students' privacy consciousness and attitudes toward patient privacy.</p><p><strong>Research design: </strong>Pretest-posttest, factorial group randomised controlled study.</p><p><strong>Participants and research context: </strong>Eligible 113 nursing students were randomised to the intervention I (<i>n</i> = 38), intervention II (<i>n</i> = 38), and control group (<i>n</i> = 37) by stratified block randomisation method. The education program consisted of two theoretical sessions and three practical sessions. Data were collected using questionnaires pre-, post-, 4 weeks, and 16 weeks after the intervention between November 2020 and May 2021 in Türkiye.</p><p><strong>Ethical considerations: </strong>Written approval was obtained from the university's Ethics Board. Informed written and verbal consent were obtained from the participants.</p><p><strong>Findings: </strong>The results showed a significant time effect on nursing students' privacy consciousness and attitudes toward patient privacy (<i>p</i> < .05), no significant difference between the groups (<i>p</i> > .05), and a significant, positive, and strong relationship between the privacy consciousness and the attitudes toward patient privacy. Students stated that digital storytelling was beneficial in focusing on the subject, memorability, interest, curiosity, and attention.</p><p><strong>Conclusions: </strong>Besides the ethics course, the privacy education program with digital storytelling and case studies develops nursing students' privacy consciousness and attitudes toward patient privacy. It is recommended to integrate privacy education into ethics courses and popularise digital storytelling and ethical case studies in ethics education.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"170-185"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327307","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":"Who is vulnerable and why? Uncovering mechanisms of vulnerabilization in healthcare.","authors":"Settimio Monteverde","doi":"10.1177/09697330241312537","DOIUrl":"10.1177/09697330241312537","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"3-4"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933387","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 perception of dignity in the hospitalized patient: Findings from a meta-synthesis.","authors":"Amarilda Mema, Valentina Bressan, Simone Stevanin, Lucia Cadorin","doi":"10.1177/09697330241238339","DOIUrl":"10.1177/09697330241238339","url":null,"abstract":"<p><p>Dignity is a value inherent to all human beings, guaranteed to every individual from birth, and influenced by culture and society. It is protected by various laws and declarations, and represents one of the fundamental human rights. Preserving human dignity is an essential aspect of nursing practice and a central element of care. Dignity is a highly subjective and personal concept; there may be variations in the way that patients perceive it and in the ways that nurses can guarantee it. A systematic review of the qualitative literature was conducted to obtain a comprehensive understanding of adult patients' perceptions of dignity in a hospital setting. This review adhered to the PRISMA Statement for reporting systematic reviews, and the results were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Major databases (PubMed, CINAHL, Scopus, and PsycINFO) were consulted and resulted in the inclusion of 21 studies. Methodological quality was assessed using the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Six main themes emerged from the data analysis: (1) The concept of dignity and its various dimensions; (2) The significance of maintaining one's own privacy and confidentiality; (3) The hospital environment's influence on patients' dignity; (4) Healthcare professionals' characteristics and behaviours that affect dignity; (5) The role of communication and the relationship with healthcare providers; and (6) The patient's ability to make choices and be involved actively in their care. These findings underscore the importance of understanding caregivers' perspectives on dignity to ensure that they provide respectful and dignified care and treatment that prioritizes the patient's mental and physical needs.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"19-41"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177405","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":"Development of the ethical decision-making competence scale.","authors":"Hsiang-Chu Pai, Lien-Jen Hwu","doi":"10.1177/09697330241235300","DOIUrl":"10.1177/09697330241235300","url":null,"abstract":"<p><strong>Background: </strong>Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students' competence in ethical decision-making.</p><p><strong>Aim: </strong>This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students.</p><p><strong>Participants and research context: </strong>Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale's reliability and validity were assessed. The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 (<i>n</i> = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model's fitness based on data from group 2 (<i>n</i> = 248). This study was conducted between August 2022 and July 2023.</p><p><strong>Ethical considerations: </strong>The Institutional Review Board of Chung Shan Medical University Hospital approved this study's design and procedure.</p><p><strong>Results: </strong>From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed 'ethical decision-making competence' with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, <i>p</i> < .001), which indicated good convergent validity. Cronbach's alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales.</p><p><strong>Discussion and conclusion: </strong>The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students' ethical decision-making abilities and to develop education strategies to improve their ethical care competence.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"88-98"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998100","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 reckoning among nurses: A directed qualitative content analysis.","authors":"Akram Sadat Montazeri, Homeira Khoddam, Fariba Borhani, Shohreh Kolagari","doi":"10.1177/09697330241255937","DOIUrl":"10.1177/09697330241255937","url":null,"abstract":"<p><strong>Background: </strong>When nurses face ethical challenges, they attempt to accept responsibility for their actions and start moral reckoning. Moral reckoning is the personal evaluation of one's behaviors or others' behaviors during ethically challenging situations.</p><p><strong>Research aim: </strong>This study aimed at exploring the concept of moral reckoning and its stages among Iranian nurses using Nathaniel's moral reckoning Theory.</p><p><strong>Research design: </strong>This descriptive qualitative study was conducted in 2022 using directed content analysis.</p><p><strong>Participants and research context: </strong>Eighteen nurses were purposively recruited from three teaching hospitals affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Data were collected via in-depth semi-structured interviews which lasted 50 minutes on average and were concurrently analyzed via the three-step directed content analysis method proposed by Elo and Kyngas.</p><p><strong>Ethical considerations: </strong>This study earned the ethical approval of the Ethics Committee of Golestan University of Medical Sciences, Gorgan, Iran (code: IR.GOUMS.REC.1400.171).</p><p><strong>Findings: </strong>During data analysis, 157 final codes were developed and categorized into 23 subcategories, 10 categories, and four themes. The themes of the study are ease (with the two categories of becoming and interacting), upset (with the two categories of mental upset and behavioral upset), resolution (with the two categories of making a stand and giving up), and reflection (with the four categories of remembering, telling the story, examining conflicts, and living with consequences).</p><p><strong>Conclusion: </strong>Ethically challenging situations alter the ease stage of moral reckoning among nurses, cause them mental and behavioral upset, and thereby, require them to make stand or give up. Then, they continuously examine events in their mind and finally, live with the positive and negative consequences of the events.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"321-335"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421642","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":"Clinical empathy in a medium and high-risk Brazilian unit.","authors":"Cristina Ortiz Sobrinho Valete, Aline Albuquerque, Esther Angelica Luiz Ferreira","doi":"10.1177/09697330241238334","DOIUrl":"10.1177/09697330241238334","url":null,"abstract":"<p><strong>Background: </strong>Clinical empathy is an essential part of healthcare, and patient-centered care models require clinical empathy to be established. Despite this, little is known about its measurement in the neonatal scenario.</p><p><strong>Research aim: </strong>To measure clinical empathy in health professionals who work with medium and high-risk neonates and build a construct of this empathy.</p><p><strong>Research design: </strong>Single-center survey study.</p><p><strong>Participants and research context: </strong>The Jefferson Scale of Empathy for Health Professionals questionnaire was applied to health professionals who work in an intensive care unit and a medium-risk unit, in Brazil. Analysis was done using descriptive statistics and a factor analysis model, to build the construct of empathy. Overall empathy was calculated, and the domains' punctuations were analyzed and compared to the maximum punctuation possible. The study followed the STROBE checklist.</p><p><strong>Ethical considerations: </strong>This study was approved by the Research Ethics Committee of the institution. All participants signed the informed consent form. Participants' confidentiality and anonymity were protected.</p><p><strong>Findings: </strong>Median empathy was 117 (IQR 113-124). The domain of Walking in the Patient's Shoes had lower scores and represented 77.6% of the maximum punctuation possible. The factor analysis included three factors named Understanding, Experiences, and Treatment, and Emotional Relationships, explaining 64.3% of the overall variance. The domain Walking in the Patient's Shoes was not included in the model.</p><p><strong>Conclusions: </strong>In this scenario, clinical empathy should improve. There is a need to improve the domain of Walking in the Patient's Shoes, in this case, the neonate, and provide more empathic care to them.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"212-221"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877818","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":"Developing an evidence-and ethics-informed intervention for moral distress.","authors":"Sadie Deschenes, Diane Kunyk, Shannon D Scott","doi":"10.1177/09697330241241772","DOIUrl":"10.1177/09697330241241772","url":null,"abstract":"<p><p>The global pandemic has intensified the risk of moral distress due to increased demands on already limited human resources and uncertainty of the pandemic's trajectory. Nurses commonly experience moral distress: a conflict between the morally correct action and what they are required or capable of doing. Effective moral distress interventions are rare. For this reason, our team conducted a multi-phase research study to develop a moral distress intervention for pediatric critical care nurses. In this article, we discuss our multi-phase approach to develop a moral distress intervention-proactive, interdisciplinary meeting. Our proposed intervention is a sequential compilation of empirical work couched within a relational ethics lens thus should point to enhanced potential for intervention effectiveness.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"156-169"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190336","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}