Nursing Ethics最新文献

{"title":"Nursing lived experience: Critical care ethics and intellectual developmental disabilities.","authors":"Adrianna Watson, Jeanette Drake, Matthew Anderson, Gabby Sutton-Clark, Sara Prescott","doi":"10.1177/09697330251333394","DOIUrl":"https://doi.org/10.1177/09697330251333394","url":null,"abstract":"<p><p>BackgroundPatients with intellectual developmental disabilities (IDDs), as members of a vulnerable population, require specialized care that many ICU nurses feel inadequately prepared to provide. The complexity of caring for IDD patients often leads to feelings of moral distress, self-doubt, and a struggle to maintain resilience among ICU nurses.Research question/aim/objectivesThis study aims to explore ICU nurses' lived experiences caring for patients with IDD.Research designA descriptive, phenomenological qualitative approach was used along with inductive analysis to explore the meanings ICU nurses attribute to experiences caring for IDD patients.Participants and research contextICU nurses (<i>N</i> <i>=</i> 20) who met inclusion criteria were purposively sampled.Ethical considerationsThe study received ethical approval from an institutional review board. Informed consent was obtained from all participants.Findings/resultsThree main themes emerged from the analysis. First, in main theme 1, <i>If Only I Had Known More,</i> nurses reported insufficient training specific to IDD care, expressing shame about their knowledge gaps. Second, in main theme 2, <i>They Deserve Better,</i> nurses highlighted the lack of resources and institutional support, complicating efforts to deliver appropriate care. Finally, in main theme 3, <i>It Weighs on My Soul,</i> nurses reflected on the emotional toll of caring for IDD patients, discussing subthemes such as self-doubt, emotional detachment, coping efforts, witnessing isolation, and moral distress.DiscussionThese findings highlight personal, educational, and systemic gaps shaping ICU nurses' experiences with IDD patients. Limited training and insufficient resources intensified moral distress. There is an urgent need for IDD-oriented education, institutional support, and policies that promote compassionate, tailored care.ConclusionsFindings suggest there is a strong alignment with the ethics of care framework. Such a connection emphasizes the need for systemic changes to empower ICU nurses to deliver compassionate, individualized care to IDD patients and enhance professional resilience and patient outcomes.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333394"},"PeriodicalIF":2.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065133","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":"Support needed by nursing students to develop professional dignity.","authors":"Isabel Hlupheka Shilenge, Neltjie Christina van Wyk, Anna Elizabeth van der Wath","doi":"10.1177/09697330251328688","DOIUrl":"https://doi.org/10.1177/09697330251328688","url":null,"abstract":"<p><p>BackgroundNursing students' professional dignity development during work-integrated learning is dependent on support from professional nurses. If they are left unsupported, such development is jeopardised.AimThe aim of the study was to explore and describe the support that nursing students need from professional nurses, including their lecturers, during work-integrated learning to develop professional dignity.Research designA qualitative, exploratory-descriptive research design applied. Through volunteer sampling, participants were invited for face-to-face in-depth individual interviews to discuss the question: 'What support did you need from others during work-integrated learning to feel dignified as nursing students?' Saturation of data determined the number of participants. Recording of the interviews and the writing of field notes were carried out with the permission of the participants. Manual coding in a thematic analysis was done to analyse the intricate data content with intuition and insight.Participants and research contextThe study was undertaken in South Africa at a designated nursing education institution and the hospital where the students performed the bulk of work-integrated learning. Fourteen third-year students were interviewed. They had sufficient experience with work-integrated learning and could provide rich data concerning support needed to develop professional dignity.Ethical considerationsThe Faculty of Health Sciences Research Ethics Committee at the University of Pretoria approved the proposal (Reference number 73/2023) and the applicable authorities gave written permission for the research to be conducted. Since the participants were students, the researchers made sure that they did not feel obliged to participate.FindingsFour categories were identified, namely, (a) improving work-integrated learning experience, (b) value students' professional development, (c) cooperate to benefit students' professional growth and (d) manage resources optimally.ConclusionStudents needed to be respected and their input to quality nursing care acknowledged. Positive role models and learning conducive clinical environments contributed to their development.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328688"},"PeriodicalIF":2.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044559","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 moral dilemma of obstetric violence: A meta-synthesis.","authors":"Wei Li, Rui-Qiu Wang, Attiq-Ur-Rehman, Xi-Yuan Peng, Meng-Wei Ge, Lu-Ting Shen, Fei-Hong Hu, Yi-Jie Jia, Xiao-Lei Tang, Hong-Lin Chen","doi":"10.1177/09697330251333403","DOIUrl":"https://doi.org/10.1177/09697330251333403","url":null,"abstract":"<p><p>Although the global healthcare system is paying increasing attention to obstetric violence, this form of gender-based violence during childbirth remains a serious issue. The primary objective of this comprehensive study is to explore the experiences and needs of women subjected to obstetric violence on a global scale. A systematic search was conducted in December 2024 across the Web of Science, Embase, PubMed, and CINAHL databases to identify eligible studies. Data synthesis was performed using the three-stage thematic and content analysis method. A total of 39 eligible qualitative studies were included in this review. Thematic synthesis identified 6 themes and 17 sub-themes: (1) Obstetric Violence Types; (2) Gaslighting Effect: The Authoritative Position of Healthcare Providers; (3) Stigmatization and Discrimination Experienced by Women; (4) Who is Normalizing Obstetric Violence? (5) Substandard Medical Institutions; (6) Trauma Induced by Obstetric Violence. Obstetric violence continues to persist in various countries and regions. Women have endured various forms of obstetric violence, with their autonomy and rights to informed consent being severely compromised. They have experienced neglect and abandonment by healthcare providers, and face discrimination and differential treatment due to factors such as race, socioeconomic status, age, and culture. The primary cause of obstetric violence is the unequal power dynamics between healthcare providers and women, with the authoritative position of healthcare providers leading to a lack of communication and recognition between both parties.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333403"},"PeriodicalIF":2.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054387","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":"Big Five personality traits and ethical decision-making among nurses.","authors":"Xiaoyun Wang, Honglian Gao, Yuxiu Jia","doi":"10.1177/09697330251333371","DOIUrl":"https://doi.org/10.1177/09697330251333371","url":null,"abstract":"<p><p>BackgroundEthical decision-making plays a crucial role in addressing ethical challenges, and the importance of psychological factors in nursing has gained attention. However, research addressing the correlation between these traits and ethical decision-making capacity remains scarce, and the interactions between these factors remain unclear.AimTo explore the relationship between the personality traits and ethical decision-making abilities of nursing staff.Research designThis is a descriptive and correlational study.Participants and research contextThe sample comprised 1956 nurses from seven Class III Grade A general hospitals in Shandong Province, China. Data was collected using a general information questionnaire, the Neuroticism Extraversion Openness Five-Factor Inventory, and the Judgement About Nursing Decision, and was analyzed using the Pearson correlation test and multiple hierarchical analysis.Ethical considerationsThe proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. Participation in this study was voluntary. Consent was obtained and confidentiality kept.ResultsA significant positive correlation between the Big Five personality traits and ethical decision-making between nurses was revealed (r = 0.365, <i>p</i> < 0.001). The personality traits accounted for 16.4% of the overall variation in ethical decision-making. In addition, the participants' ethical decision-making scores were at a moderate level. The average score for the Big Five personality traits was 192.29 (SD = 12.05).ConclusionThe results showed a significant correlation between nurses' Big Five personality traits and their ethical decision-making abilities. Therefore, hospital administrators could consider incorporating personality assessments into their staffing decisions to place nurses in roles that best align with their strengths. Furthermore, it is beneficial for nursing educators to recognize the importance of understanding how personality traits influence ethical decision-making, as well as the need for enhancing ethical awareness among nurses. Utilizing Big Five personality traits to predict ethical decision-making capabilities can facilitate effective nursing staff placement, ultimately enhancing the quality of nursing care delivery.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333371"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990315","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":"Maternity providers' moral experiences addressing maternal drug use.","authors":"Caroline K Darlington, Peggy Compton, Rebecca Clark, Connie M Ulrich","doi":"10.1177/09697330251333368","DOIUrl":"https://doi.org/10.1177/09697330251333368","url":null,"abstract":"<p><p>BackgroundAddressing drug use among pregnant and postpartum women is complicated by the social, ethical, and legal interplay between maternal and child needs. The moral experiences of providers as they care for this population are poorly understood. The purpose of this review is to synthesize the qualitative literature on the moral experiences of prescribing maternity providers managing the care of pregnant and postpartum women who use drugs (PPWUD), specifically focused on drug testing and child welfare reporting decisions.MethodsThe Hunt and Carnevale (2011) bioethics framework was used to define moral experience as \"a person's sense that values that he or she deem important are being realized or thwarted in everyday life.\" A systematic search of PubMed, PsycINFO, and CINAHL resulted in 31 eligible articles. Study quality was assessed using the Critical Appraisal Checklist for Qualitative Research from the Joanna Briggs Institute (2015). Thematic narrative analysis was used to synthesize results and identify themes.FindingsOverall, maternity providers' experiences were characterized by ethical conflicts influenced by provider-level and policy-level factors. Even when endorsing patient autonomy and parental rights, no maternity providers endorsed continued maternal substance use that placed the fetus or child at significant risk. Structural constraints within healthcare systems and punitive laws were cited as significant barriers to providing optimal care to PPWUD. Biased drug testing protocols and some child welfare reporting policies created ethical conflict by placing maternity providers' relationship with their patients in opposition to their legal and ethical responsibility to report child maltreatment.ImplicationsMore rigorous characterization of these moral experiences is needed to support the development of provider-level interventions and policy-level changes as maternity providers care for both mothers and children impacted by drug use.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251333368"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003461","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 human right to assisted dying? Autonomy, dignity, and exceptions to the right to life.","authors":"Jon Wittrock","doi":"10.1177/09697330251328655","DOIUrl":"https://doi.org/10.1177/09697330251328655","url":null,"abstract":"<p><p>Debates on assisted dying remain controversial and call out for conceptual clarification. What is the moral basis for assessing competing arguments, and what is the best way to frame these arguments in terms of actual and potential human rights? This article aims to investigate whether autonomy alone suffices as a moral source for human rights and whether, on this basis, there should be a positive human right to assisted dying, and a negative human right to assist others in dying. Drawing upon discussions in political theory, medical ethics, and human rights scholarship, the article develops an account of autonomy as multidimensional and subject to trade-offs. Autonomy is divided into the dimensions of liberty, opportunity, capacity, and authenticity. Furthermore, there is a common intuition that human beings ought to be endowed with a domain of core autonomy that must never be compromised in any trade-off. This analytical framework is used to map conflicts and trade-offs concerning assisted dying. By way of conclusion, it is argued that autonomy suffices to describe what human rights protect, but not why they do so. Furthermore, it is argued that the terminology of rights used in debates on assisted dying risks misrepresenting what the debate is actually about, and that the debate should be framed in terms of the right to health and exceptions to the right to life, rather than general rights related to assisted dying. Thus, assisted dying should be seen as an extreme option, where death is not the end, but the means, and ought to be considered alongside other means, as a last resort, already in the legislative process.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328655"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812844","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 relationship between compassion competence, satisfaction, and professional commitment levels.","authors":"Ayşe Eminoğlu, Sebahat Kuşlu, Hatice Serap Koçak","doi":"10.1177/09697330251326236","DOIUrl":"https://doi.org/10.1177/09697330251326236","url":null,"abstract":"<p><p>BackgroundThe compassionate presentation of caregiving skills, which constitute the building block of nursing care, directly affects the quality of health services. It is extremely important for the future of the nursing profession to develop compassion competence and satisfaction in students who are candidates for the nursing profession and to reveal their level of commitment to the profession.Research aimThis study examined the correlation between compassion competence, compassion satisfaction, and professional commitment levels of nursing students.Research designThe study was conducted as a descriptive-correlational research.Participants and research contextThe study was conducted between 01.05.2023 and 01.10.2024 with nursing students continuing their education in the Nursing Department of state universities in Gaziantep. The research sample consisted of 280 nursing students. A convenience sampling method was used in this study. Nursing students who met the inclusion criteria and voluntarily agreed to participate were included in the sample. Personal Information Form, Compassion Competence Scale, Compassion Satisfaction Scale, and Nursing Professional Commitment Scale were used as data collection tools. SPSS package program, t-test, ANOVA, and Pearson correlation analyses were used to analyze the data.Ethical considerationsEthical approval for the study was received from the Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.ResultsNursing students' total score on the Compassion Competence Scale was 3.86 ± 0.04. The mean total score of the Compassion Satisfaction Scale was 50.37 ± 0.58. It was determined that the mean total score of the Nursing Professional Commitment Scale was 72.98 ± 0.77. A weak, positive, statistically significant relationship was found between compassion competence and professional commitment (r: 0.288, <i>p</i> < .05). A moderate, positive, statistically significant relationship was found between compassion satisfaction and professional commitment (r: 0.403, <i>p</i> < .05).ConclusionA positive correlation was found between compassion competence, compassion satisfaction, and professional commitment among nursing students. It is recommended to increase studies on developing empathy, compassion, and emotional resilience skills in nursing education programs. In addition, these findings emphasize that a compassion-oriented approach should be adopted to improve quality in the nursing profession.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251326236"},"PeriodicalIF":2.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755544","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":"Gaslighting of Inpatients-A threat to nursing care and a violation of relational autonomy.","authors":"Gabay Gillie, Yaarit Bokek-Cohen","doi":"10.1177/09697330251331194","DOIUrl":"https://doi.org/10.1177/09697330251331194","url":null,"abstract":"<p><p>Background Medical gaslighting refers to the mistreatment that patients experience following interactions with clinicians when their medical complaints and suffering are discounted, doubted, questioned, second-guessed, or denied, resulting in self-doubts of patients and psychological ramifications. This research focuses on the ethical aspects of medical gaslighting among hospitalized patients by nurses.Research QuestionWhat are the nursing care and nursing ethics perspectives concerning medical gaslighting? Research DesignA narrative review.Research MethodInterpretation of two narrative interviews with each participant through the lenses of nursing ethics.Participants14 hospitalized patients, males and females, ages 30-81, from the majority group in the population.ContextLengthy hospitalizations.Ethical considerationsEthical approval was granted; all participants signed an informed consent form for participation and publication.FindingsPatient experiences demonstrate medical gaslighting by nurses, violating relational autonomy and resulting in delayed care.DiscussionMedical gaslighting contradicts ethics of care, the professional values of nursing, and patient-centered care constituting obstacles to respectful patient-nurse relationships and to relational autonomy.ConclusionsMedical gaslighting is a profoundly concerning ethical phenomenon that adversely affects patient well-being and trust in nursing as a significant profession in a just society.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251331194"},"PeriodicalIF":2.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744335","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 community-based dementia screening for unhoused older adults.","authors":"Alisa Squires, Diana M Bowman, Heather M Ross","doi":"10.1177/09697330251328672","DOIUrl":"https://doi.org/10.1177/09697330251328672","url":null,"abstract":"<p><p>Screening for dementia and mild cognitive impairment (MCI) in community-based settings helps connect vulnerable older adults to medical and social support services promoting well-being. Referencing a universal screening program for unhoused older adults seeking emergency shelter services as a case example, this paper calls attention to alignment of programmatic features with the four principles of biomedical ethics, beneficence, nonmaleficence, autonomy, and justice. Regarding beneficence, homeless services workers gain insight into clients' needs and can facilitate engagement with resources to aid in their successful exiting of homelessness. Using assessment findings to promote safety in shelter environments incorporates nonmaleficence. Concerning autonomy, by choosing to share screening results with healthcare providers and other human service stakeholders such as public safety officials and social service professionals, older adults are empowered to take charge of their care. Justice is embodied by the ability to influence policy changes related to homelessness prevention and equitable distribution of health resources.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328672"},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674854","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 implicit ethical values in nurse educator stories.","authors":"Destiny R Brady, Susan Hunter Revell","doi":"10.1177/09697330251328638","DOIUrl":"https://doi.org/10.1177/09697330251328638","url":null,"abstract":"<p><p>BackgroundStorytelling is a frequent practice within nursing education. Stories are thought to be helpful for student learning, engagement, professional role development, and transmission of ethical values. Despite its common use, little is known about the stories told by nurse educators and the implicit ethical values within those stories.AimsTo describe the reasons nurse educators tell stories to undergraduate students and examine implicit ethical values within these stories.Research designA qualitative descriptive study with Rubin and Rubin's responsive interviewing method. Interview transcripts and written stories were analyzed thematically with constant comparison.Participants and research contextParticipants included 15 nurse educators, primarily from the northeastern United States.Ethical considerationsInstitutional Review Board (IRB) approval for protection of human subjects was received prior to conducting the study. Informed consent was obtained from all participants.FindingsNurse educators use storytelling to help students understand what it means to be a nurse, to improve student learning, because we are all human, and because the art and science of nursing requires storytelling. Ethical values from these stories were organized into the following themes: <i>advocacy</i>, <i>nurse attributes</i>, <i>importance of the nurse-patient relationship</i>, and <i>reflection</i>.ConclusionsFindings suggest that that storytelling in nursing education is used for role development and communicating ethical values. Additional studies are needed to determine the effectiveness of storytelling and how it can be used to improve nursing practice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330251328638"},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664870","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}