Nursing Ethics最新文献

BackgroundEnsuring that mothers and newborns receive respectful care is crucial to providing high-quality care. Our research aimed to describe the care received by neonates and identify risk variables for Disrespect and Abuse (D&A) in neonates.MethodsWe carried out a comprehensive analysis of published, quantitative research on D&A on newborns. The databases of SCOPUS, Web of Science, PubMed, Embase, ProQuest, and Cochrane Library were thoroughly searched for articles. The quality of the research was assessed using the STROBE measures. Studies meeting certain requirements were eligible for inclusion: they had to evaluate the prevalence and risk factors associated with the mistreatment of newborns after childbirth; finally, 525 potentially relevant articles were carefully reviewed, and only 10 were ultimately selected.ResultSix prospective cohort studies, one retrospective cohort study, two cross-sectional studies, and one mixed-method research comprised the 10 papers that made up this review. In included studies infants had experienced at least one D&A episode. We have divided them into two categories: indicators of disrespect and factors affecting disrespect. Indicators of disrespect were the major contributing factor to D&A. According to this review, some maternal and newborn factors contributed to the D&A of newborns: preterm births, female deliveries assisted by an instrument, rural births, mothers living in rural areas, births with parity greater than 2, and unmarried birth mothers.ConclusionHealth systems must be confident that no neonate is denied medical care due to family socio-economic and cultural factors. This study can inform future research around interventions for improving policy and practice.

BackgroundMany patients in medical wards lack decision-making capacity and cannot provide valid consent. As a result, nurses and other healthcare professionals often face a dilemma: whether to neglect the medical needs of such patients, or provide healthcare interventions without obtaining valid consent. Previous studies have indicated that many interventions are provided without consent; however, there is insufficient knowledge about how staff in this context reason about the ethical dilemmas they encounter.AimTo explore the ethical reasons provided by nurses and other healthcare professionals in medical wards for and against providing healthcare interventions without patients' consent.Research designThe study employed a qualitative explorative design. Eight focus group interviews were held with 37 staff across five different professions, mainly nurses, at two Swedish hospitals. The material was subjected to qualitative analysis, following a Reflective Thematic Analysis framework.Ethical considerationsEthical approval for this study was obtained from the Swedish Ethical Review Authority. All participants were informed orally and in writing about the study's aims and its voluntary nature. No sensitive personal information was registered. Participants provided their oral consent to participate before the interviews took place.Findings/ResultsThematic analysis resulted in four main themes: Coercion is a bad word; Reasons to accept coercion; Coercion is part of ward culture, and Unacceptable coercion.ConclusionsParticipants overwhelmingly supported the current use of 'consentless measures' at the investigated wards. Most situations described either needed no justification, according to participants, or could be easily justified by reference to the benefit of the patient, the patient's poor decision-making capacity, or the benefit of others. A range of implicit, contextual, and institutional justifications were also given. Suboptimal ward culture was considered a prime driver of consentless measures and a force that compromises nurses' agency in the patient encounter.

BackgroundEthical competence in nursing is essential. However, a theoretical definition of ethical competence in nursing and the critical components of ethical competence appear to be absent, resulting in a lack of convergence on the core content to be taught on ethical competence in nursing education.Aim and research questionsThis study aimed to answer the following questions: What are the essential components of ethical competence in nursing? What is their definition in terms of nursing? What is the theoretical definition of ethical competence in nursing?MethodWalker and Avant's concept synthesis.ResultsEthical competence in nursing consists of 12 essential components, defined and grouped into three main themes: (1) Ethical knowledge and understanding; having knowledge and understanding of the main theories of theoretical and practical ethics and the principal codes of ethics in nursing; (2) Personal ethical qualities; having ethical awareness and ethical self-awareness, ethical sensitivity, ethical perception, and ethical judgement. (3) Ethical ability and courage to perform; capable of moral reasoning, ethical reflection, and ethical decision-making, having moral courage and demonstrating ethical action and behaviour. The theoretical definition is thus: Nurses considered ethically competent have knowledge and understanding of the main ethical principles in nursing and possess personal ethical qualities, that is, ethical self-awareness, ethical awareness, ethical sensitivity, ethical perception, and ethical judgment as well as having the ethical ability and the courage to perform ethically, that is, capable of moral reasoning, ethical reflection, ethical decision-making, having moral courage, they demonstrate ethical action, and ethically responsible conduct.ConclusionsThis study is essential to nursing as a discipline and profession. The findings provide a theoretical definition of ethical competence in nursing and the qualities characterising ethically competent nurses, which can be of great value in clinical practice, nursing education, leadership, and nursing research and theory development.

BackgroundAn ethical foundation for caring involves doing good, alleviating suffering, and treating human beings with dignity and respect. While virtual reality (VR) has primarily been used to develop clinical skills, there is limited research on its use for educating healthcare personnel in ethical competence and the use of VR grounded by ethical concepts and theories. This gap has prompted us to develop a theoretical basis grounded in enhancing the ethical competence of health professionals using VR.AimThe study aimed to develop a caring-perception model for enhancing ethical competence in VR environments for educating healthcare personnel.Method and MaterialThe development of the caring-perception model was fundamentally anchored in theoretical frameworks established by the three caring theorists Eriksson, Martinsen, and Koskinen. Hermeneutic reading was used to interpret selected texts, extracting meaningful fragments to form interpretive patterns, leading to the creation of basic elements for a theoretical model. The caring-perception model was then interpreted in the context of developing ethical competence in a VR environment.ResultsThe caring-perception model consists of six fundamental elements: "I am here," "I see and listen," "I'm affected," "I realize," "I'm responsible," and a synthesis in "ethical bearing and acting." The theory model serves as a robust framework aimed at enhancing healthcare personnel's ethical competence within VR environments.DiscussionVR grounded on a theoretical basis and educational model has the potential to offer unique opportunities to enhance healthcare personnel's ethical competence and to practice ethical decision-making in simulated scenarios, fostering presence, attentiveness, and ethical reflection. Despite challenges such as technical barriers and the need for substantial investment, the potential benefits of using VR for ethical training can promise improved patient outcomes and a more ethically aware healthcare workforce.

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, p < .05). A moderate, positive, statistically significant relationship was found between compassion satisfaction and professional commitment (r: 0.403, p < .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.

BackgroundMedia narratives about healthcare scandals can profoundly influence public trust in medical institutions and professionals. In neonatal care, where trust in healthcare providers is crucial for parental decision-making, negative media portrayals may create ethical challenges by fostering fear and skepticism. The erosion of trust in neonatal nurses and healthcare institutions may seriously affect maternal decision-making and neonatal health outcomes.AimTo explore the ethical implications of media narratives on maternal trust in neonatal care. Specifically, it investigates how media portrayals of neonatal care scandals impact expectant mothers' perceptions of neonatal professionals, their emotional responses, and their healthcare choices.Research designA qualitative research design was employed using semi-structured interviews. Thematic analysis, following Braun and Clarke's framework, was used to analyze the data.Participants and research contextThe study included 22 expectant mothers in their third trimester who had been exposed to media coverage of neonatal care scandals in Turkey.Ethical considerationsEthical approval was obtained from the University Research Ethics Committee. Participants provided written informed consent, ensuring voluntary participation and anonymity.ResultsFour major themes emerged: (1) erosion of trust in neonatal nurses and institutions, leading to skepticism and emotional distress; (2) the emotional impact of media narratives, including fear, anxiety, and defensive decision-making regarding neonatal care choices; (3) perceived quality of care, highlighting concerns over the differences between public and private NICUs and resource allocation; and (4) the need for ethical reforms, including transparency, independent oversight, and media accountability to restore trust.ConclusionsMedia narratives significantly shape maternal perceptions of neonatal care, raising critical ethical concerns about trust and accountability. The findings highlight the need for systemic reforms to ensure ethical transparency, responsible media reporting, and enhanced communication between healthcare providers and the public. Addressing these ethical challenges is essential for fostering trust in neonatal nursing and ensuring equitable, high-quality care for newborns.

BackgroundDisclosure of information that identifies deceased organ donors and/or organ transplant recipients is prohibited in many countries, including Australia. Anecdotal evidence suggests that some donor family members and transplant recipients desire and independently establish contact using strategies such as social media.ObjectiveTo describe and synthesise the views of Australian donor family members, transplant recipients, and healthcare professionals regarding the disclosure of identifying information between donor family members and transplant recipients.Research designAn exploratory descriptive qualitative study design was used.Participants and research contextSemi-structured interviews were conducted with 23 donor family members, 25 transplant recipients, and 16 healthcare professionals. Interviews were audio recorded and transcribed verbatim. Data were extracted and synthesised using thematic analysis.Ethical considerationsThis study was approved by the Human Research Ethics Committee of Griffith University, Queensland. Participation was voluntary, and informed consent was obtained from all participants.FindingsThree themes were revealed: (i) a desire for choice, (ii) perceptions of benefits, and (iii) perceptions of risks and risk mitigation. Some donor family members and transplant recipients would like the choice to pursue identifiable contact, and for this to be facilitated by donation agencies and transplant units. Many healthcare professionals also support the notion of choice.ConclusionCurrent Australian laws prohibit the disclosure of information identifying deceased organ donors and transplant recipients to each other. Any desire to amend existing laws would necessitate a thorough consultation process and the establishment of suitable systems and processes to support identity disclosure. Further research is needed to ascertain options for identifiable contact and to identify strategies to maximise benefit and minimise harm for donor family members and recipients.

BackgroundAlthough the Internet has become an important part of clinical nurses' professional and personal lives, there are currently no defined indicators to assess the level of cyber ethics literacy of clinical nurses.Research aimThis study aims to develop an evaluation index system for evaluating the cyber ethics literacy of clinical nurses.Research designA Delphi study.Participant and research contextTwo rounds of Delphi consultation were conducted from March 2024 to May 2024, with 20 experts participating in the first round and 18 experts in the second round.Ethical considerationsParticipation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee (No. 2022-0018).ResultsThe degree of expert positivity was 100% and 90%, the coefficients of expert authority were 0.863 and 0.883, and Kendall's W coefficient were 0.143 and 0.151, respectively (p < .001). The final developed evaluation index system of clinical nurses' cyber-ethical literacy contains 3 primary indicators, 10 secondary indicators, and 34 tertiary indicators.ConclusionThe evaluation index system constructed in this study is comprehensive, closely combines the characteristics of the nursing profession with cyber ethics, and is scientific and practical.

BackgroundThe growing incorporation of telenursing into the conventional healthcare system has raised urgent ethical and legal questions concerning the scope and standards of nursing practice. As nursing expands beyond traditional in-person care into digitally mediated environments, the lack of a legal framework in South Korea presents challenges to protecting patient rights and ensuring professional accountability.AimThis study aims to support the development of a regulatory framework for telecare nursing by identifying and prioritizing key legislative challenges affecting professional autonomy and ethical care delivery.Research designA two-round Delphi technique was employed.Participants and research contextA panel of twelve experts in nursing, health law, and digital health, each with over ten years of professional experience, participated. An initial set of 16 legislative items was developed through content analysis of legal documents and guidelines and reviewed by two subject-matter experts. Through iterative expert consultation, the item pool was refined and expanded to 24 statements for use in the Delphi process.Ethical considerationsThe study was approved by the institutional review board. Informed consent was obtained, and confidentiality was maintained throughout.ResultsEight items met all consensus criteria (necessity and feasibility ≥4.0; ≥80% agreement), including data security, documentation standards, identity verification, nurse certification, and informed consent. Seven ethically significant items such as scope of practice, liability, and reimbursement lacked feasibility consensus, suggesting major implementation barriers. Nine items were considered lower priority. The panel also highlighted three preparatory tasks: building public consensus, forming a multistakeholder steering committee, and legally recognizing nursing roles in telecare.ConclusionsLegislative priorities for ethical telecare were identified, though feasibility gaps indicate challenges to implementation. Legal frameworks should uphold ethical principles while supporting information governance, patient-centeredness, and professional empowerment. These findings offer timely guidance for integrating telecare into nursing practice and enhancing patient trust.