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Holloway, Immy, e Stephanie Wheeler. "Ethical Issues in Qualitative Nursing Research". Nursing Ethics 2, n.º 3 (setembro de 1995): 223–32. http://dx.doi.org/10.1177/096973309500200305.
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This article is concerned with ethical issues that have to be considered when under taking qualitative research. Some of the issues - such as informed consent, the dignity and privacy of the research subjects, voluntary participation and protection from harm - are the same as in other types of research and have their basis in moral and ethical principles. Qualitative research, however, generates specific ethical problems because of the close relationship that researchers form with participants. Qualitative research with patients is especially difficult because of their vulnerability and lack of power in the clinical situation. Therefore the potential conflict between the dual role of the nurse - the professional and the research roles - has to be solved. Researchers also learn how to cope with the tension of subjective and objective elements of the research. Nurses who attempt qualitative research have to consider a variety of complex ethical issues, which are addressed in this paper.
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Oelhafen, Stephan, Settimio Monteverde e Eva Cignacco. "Exploring moral problems and moral competences in midwifery: A qualitative study". Nursing Ethics 26, n.º 5 (27 de março de 2018): 1373–86. http://dx.doi.org/10.1177/0969733018761174.
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Background: Most undergraduate midwifery curricula comprise ethics courses to strengthen the moral competences of future midwives. By contrast, surprisingly little is known about the specific moral competences considered to be relevant for midwifery practice. Describing these competences not only depends on generic assumptions about the moral nature of midwifery practice but also reflects which issues practitioners themselves classify as moral. Objective: The goal of this study was to gain insight into the ethical issues midwives encounter in their daily work, the key competences and resources they consider indispensable to understand and deal with them, and to assess phenomena linked to moral distress. Methods: We conducted individual semi-structured interviews with eight midwives and two other health professionals, varying in terms of years of experience and work setting. Interview transcripts were analyzed in an interdisciplinary research group, following thematic analysis. Ethical considerations: This study was not subject to approval according to the Swiss Law on Research with Humans. Participants were informed about the study goals and gave written informed consent prior to participation. Results: External constraints limiting the midwife’s and the patient’s autonomy and resulting interpersonal conflicts were found to be the most relevant ethical issues encountered in clinical practice and were most often associated with moral distress. These conflicts often arise in the context of medical interventions midwives consider as not appropriate and situations in which less experienced midwives in particular observe a lack of both interprofessional communication and trust in their professional competence. Ethical issues related to late abortions or prenatal diagnostics and selective abortions were also frequently addressed, but many midwives involved had learned to cope with them. Discussion: In the light of the ethical issues and factors contributing to phenomena of moral distress, an empirically grounded profile of moral competences is drafted. Curricular implications in the light of possible adaptations within undergraduate midwifery education are critically discussed.
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Heggestad, Anne Kari T., Per Nortvedt e Åshild Slettebø. "The importance of moral sensitivity when including persons with dementia in qualitative research". Nursing Ethics 20, n.º 1 (19 de novembro de 2012): 30–40. http://dx.doi.org/10.1177/0969733012455564.
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The aim of this article is to show the importance of moral sensitivity when including persons with dementia in research. The article presents and discusses ethical challenges encountered when a total of 15 persons with dementia from two nursing homes and seven proxies were included in a qualitative study. The examples show that the ethical challenges may be unpredictable. As researchers, you participate with the informants in their daily life and in the interviews, and it is not possible to plan all that may happen during the research. A procedural proposal to an ethical committee at the beginning of a research project based on traditional research ethical principles may serve as a guideline, but it cannot solve all the ethical problems one faces during the research process. Our main argument in this article is, therefore, that moral sensitivity is required in addition to the traditional research ethical principles throughout the whole process of observing and interviewing the respondents.
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Elmore, James, David Kenneth Wright e Maude Paradis. "Nurses’ moral experiences of assisted death: A meta-synthesis of qualitative research". Nursing Ethics 25, n.º 8 (28 de dezembro de 2016): 955–72. http://dx.doi.org/10.1177/0969733016679468.
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Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded.
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Fida, Roberta, Carlo Tramontano, Marinella Paciello, Mari Kangasniemi, Alessandro Sili, Andrea Bobbio e Claudio Barbaranelli. "Nurse moral disengagement". Nursing Ethics 23, n.º 5 (agosto de 2016): 547–64. http://dx.doi.org/10.1177/0969733015574924.
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Background: Ethics is a founding component of the nursing profession; however, nurses sometimes find it difficult to constantly adhere to the required ethical standards. There is limited knowledge about the factors that cause a committed nurse to violate standards; moral disengagement, originally developed by Bandura, is an essential variable to consider. Research objectives: This study aimed at developing and validating a nursing moral disengagement scale and investigated how moral disengagement is associated with counterproductive and citizenship behaviour at work. Research design: The research comprised a qualitative study and a quantitative study, combining a cross-validation approach and a structural equation model. Participants and research context: A total of 60 Italian nurses (63% female) involved in clinical work and enrolled as students in a postgraduate master’s programme took part in the qualitative study. In 2012, the researchers recruited 434 nurses (76% female) from different Italian hospitals using a convenience sampling method to take part in the quantitative study. Ethical considerations: All the organisations involved and the university gave ethical approval; all respondents participated on a voluntary basis and did not receive any form of compensation. Findings: The nursing moral disengagement scale comprised a total of 22 items. Results attested the mono-dimensionality of the scale and its good psychometric properties. In addition, results highlighted a significant association between moral disengagement and both counterproductive and citizenship behaviours. Discussion: Results showed that nurses sometimes resort to moral disengagement in their daily practice, bypassing moral and ethical codes that would normally prevent them from enacting behaviours that violate their norms and protocols. Conclusion: The nursing moral disengagement scale can complement personnel monitoring and assessment procedures already in place and provide additional information to nursing management for designing interventions aimed at increasing compliance with ethical codes by improving the quality of the nurses’ work environment.
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Dašić, Dejan, Gruja Kostadinović e Milan Stanković. "Ethical Aspects of Science and Technological Innovations". International Journal of Cognitive Research in Science, Engineering and Education (IJCRSEE) 11, n.º 2 (31 de agosto de 2023): 343–50. http://dx.doi.org/10.23947/2334-8496-2023-11-2-343-350.
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The progress of civilization depends on both science and ethics, on two different ideas. Unlike ethics, which deals with moral principles and ideals that guide human behavior, science is based on logical argumentation, empirical data, and methodical testing. However, as science develops, it often raises ethical questions that must be addressed. As a result, science and ethics are intertwined and both are essential for the moral and long-term advancement of science. This research examines the results of two interconnected processes: the quick development of science and technology and its moral ramifications, or the harm it does to people’s lives all around the world. The writers highlight the need for a qualitative shift in attitudes toward nature and society as a whole in order to address environmental challenges and remove the threat of a global ecological disaster by analyzing the substance and impact of these processes.
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Arnold, Tracey C. "Moral distress in emergency and critical care nurses: A metaethnography". Nursing Ethics 27, n.º 8 (23 de julho de 2020): 1681–93. http://dx.doi.org/10.1177/0969733020935952.
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Background: Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout. Objective: This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses. Method: This study used the Noblit and Hare’s approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis. Ethical considerations: Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases. Results: The synthesis of qualitative research on moral distress resulted in one central theme, “the battle within,” and five subthemes. Conclusions: The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses’ future patient care.
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Schipper, Karen, Elleke Landeweer e Tineke A. Abma. "Living with end-stage renal disease: Moral responsibilities of patients". Nursing Ethics 25, n.º 8 (18 de janeiro de 2017): 1017–29. http://dx.doi.org/10.1177/0969733016687154.
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Background: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. Objectives: To explore the moral challenges of living with a renal disease. Research design: A case study based on qualitative research. We used Walker’s ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues. Participants and research context: One case was chosen from 20 qualitative interviews with renal patients in the Netherlands. Ethical considerations: Several actions have been taken to ensure the informed consent, privacy, anonymity and confidentiality of the patient in this article. More details are offered in this article. The study has been conducted in line with the recommendations of the Medical Ethical Committee of the VU Medical Center. Findings: A renal disease can force people to change their identity, relationships, values and responsibilities. The case study illustrates the moral challenges confronting renal patients. Discussion and conclusion:: Moral issues can be raised by the changes to identities, relationships, values and responsibilities caused by renal disease. Support services for renal patients and their relatives should pay more attention to these issues in order to promote self-management.
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Ko, Hsun-Kuei, Hui-Chen Tseng, Chi-Chun Chin e Min-Tao Hsu. "Phronesis of nurses: A response to moral distress". Nursing Ethics 27, n.º 1 (11 de abril de 2019): 67–76. http://dx.doi.org/10.1177/0969733019833126.
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Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress.
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Rasoal, Dara, Annica Kihlgren, Inger James e Mia Svantesson. "What healthcare teams find ethically difficult". Nursing Ethics 23, n.º 8 (3 de agosto de 2016): 825–37. http://dx.doi.org/10.1177/0969733015583928.
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Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.
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Humphries, Anne, e Martin Woods. "A study of nurses’ ethical climate perceptions". Nursing Ethics 23, n.º 3 (6 de janeiro de 2015): 265–76. http://dx.doi.org/10.1177/0969733014564101.
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Background: Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand. Aim/objective: The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate. Research design/participants/context: This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research. Ethical considerations: Ethics approval for this study was granted by the New Zealand Ministry of Health’s Central Regional Health and Disability Ethics Committee on 14 June 2012. Findings: The themes identified in the data centred on three dominant elements that – together – shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff. Discussion: While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses’ ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere. Conclusion: Moral distress is inevitable in an ethical climate where the organisation’s main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care.
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Vryonides, Stavros, Evridiki Papastavrou, Andreas Charalambous, Panayiota Andreou e Anastasios Merkouris. "The ethical dimension of nursing care rationing". Nursing Ethics 22, n.º 8 (3 de novembro de 2014): 881–900. http://dx.doi.org/10.1177/0969733014551377.
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Background: In the face of scarcity, nurses may inevitably delay or omit some nursing interventions and give priority to others. This increases the risk of adverse patient outcomes and threatens safety, quality, and dignity in care. However, it is not clear if there is an ethical element in nursing care rationing and how nurses experience the phenomenon in its ethical perspective. Objectives: The purpose was to synthesize studies that relate care rationing with the ethical perspectives of nursing, and find the deeper, moral meaning of this phenomenon. Research design: A systematic review and thematic synthesis of qualitative studies was used. Searching was based on guidelines suggested by Joana Brigs Institute, while the synthesis has drawn from the methodology described. Primary studies were sought from nine electronic databases and manual searches. The explicitness of reporting was assed using consolidated criteria for reporting qualitative research. Nine studies involving 167 nurse participants were included. Synthesis resulted in 35 preliminary themes, 14 descriptive themes, and four analytical themes (professional challenges and moral dilemmas, dominating considerations, perception of a moral role, and experiences of the ethical effects of rationing). Discussion of relationships between themes revealed a new thematic framework. Ethical consideration: Every effort has been taken, for the thoroughness in searching and retrieving the primary studies of this synthesis, and in order for them to be treated accurately, fairly and honestly and without intentional misinterpretations of their findings. Discussion: Within limitations of scarcity, nurses face moral challenges and their decisions may jeopardize professional values, leading to role conflict, feelings of guilt, distress and difficulty in fulfilling a morally acceptable role. However, more research is needed to support certain relationships. Conclusions: Related literature is limited. The few studies found highlighted the essence of justice, equality in care and in values when prioritizing care—with little support to the ethical effects of rationing on nurses. Further research on ethical dimension of care rationing may illuminate other important aspects of this phenomenon.
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Rennó, Heloiza Maria Siqueira, Flávia Regina Souza Ramos e Maria José Menezes Brito. "Moral distress of nursing undergraduates: Myth or reality?" Nursing Ethics 25, n.º 3 (18 de maio de 2016): 304–12. http://dx.doi.org/10.1177/0969733016643862.
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Introduction: During their education process, nursing undergraduates experience ethical conflicts and dilemmas that can lead to moral distress. Moral distress can deprive the undergraduates of their working potential and may cause physical and mental health problems. Objective: We investigated the experiences of the undergraduates in order to identify the existence of moral distress caused by ethical conflict and dilemmas experienced during their nursing education. Ethical considerations: This study was designed according to the principles of research with human beings and was approved by the Human Research Ethics Committee. Method: A qualitative multiple-case study. Two federal higher education institutions were surveyed, from which 58 undergraduates in nursing participated in the study. The undergraduates were undergoing their professional training. The data were collected through focus groups and were submitted to thematic content analysis, with the resources of the ATLAS TI 7.0 software. Results: Moral distress in undergraduates is a reality and was identified in three axes of analysis: (1) moral distress is experienced by undergraduates in the reality of healthcare services, (2) the teacher as a source of moral distress, and (3) moral distress as a positive experience. Conclusion: The undergraduates in nursing manifest moral distress in different stages of their education, particularly during their professional training. The academic community should reflect and seek solutions for the reality of moral distress in undergraduates.
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Sasso, Loredana, Barbara Delogu, Roberto Carrozzino, Giuseppe Aleo e Annamaria Bagnasco. "Ethical issues of prison nursing: A qualitative study in Northern Italy". Nursing Ethics 25, n.º 3 (12 de abril de 2016): 393–409. http://dx.doi.org/10.1177/0969733016639760.
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Background: Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues. Research questions: ‘How do correctional nurses describe their working experience in prisons? What issues emerged?’ Methodology: This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses’ employer. Formal consent was obtained from all the nurses who volunteered to participate in this study. Findings: Five themes emerged from the focus groups: (1) prisoners’ healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. ‘Manipulation’ was a transversal theme that emerged from all the focus groups. Discussion: The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care. Conclusion: In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress.
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Zubariev, Oleksandr. "Сhildfree in the Focus of Qualitative Sociological Research". 47, n.º 47 (30 de dezembro de 2021): 26–32. http://dx.doi.org/10.26565/2227-6521-2021-47-03.
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The article deals with the problematics of childfree in sociological discourse. It is noted that the concept of "childfree" appears in the context of rethinking the prevailing public discourse about childlessness. If the concept of “childless” refers to people who are childless for reasons beyond their control, then the concept of “childfree” refers to people who are childless because they themselves made such a choice. Attention is focused on the insufficient development of this issue in modern Ukrainian sociology. A review of sociological studies of the childfree phenomenon, implemented using qualitative methods, is carried out. In particular, the work of the British sociologist Josephine Davies, devoted to the question of how women who choose not to be mothers experience the period from 45 to 55; the study by J. Veevers, who singles out "early articulators", "postponers", "aficionados" and "rejectors" among the childfree; E. Campbell, who shows that sometimes the nature of the relationship between a woman and her mother can influence a woman's choice to be a childfree in the future; R. Gillespie, who studies in detail the formation of the identity of chіldfree women; P. Bonnici, who studies the impact of voluntary childlessness on a woman's identity; K. Park, which reveals the strategies of stigma management that use childfree; A. Campbell, who studies the social perception of women who have chosen sterilization as a permanent form of contraception. The opinion is expressed that the phenomenon of childfree can be considered in the context of "aesthetics of existence" or "self-technique" (M. Foucault), because the question of whether or not to have children is not subject to strict moral prohibitions, but rather intense moral issues. If voluntary childlessness is a form of stylization of life, then, accordingly, it can be analyzed in such aspects as: determination of ethical substance, way of self-subordination, form of ethical work and teleology of the moral subject.
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Kleemola, Emmi, Helena Leino-Kilpi e Olivia Numminen. "Care situations demanding moral courage: Content analysis of nurses’ experiences". Nursing Ethics 27, n.º 3 (26 de janeiro de 2020): 714–25. http://dx.doi.org/10.1177/0969733019897780.
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Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage.
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Khoiri, Nailurrohmah, Assya Syahnaz e Febri Widiandari. "Perkembangan Moral Santri di Madrasah Tahfidz Putri Anak (MTPA)". Jurnal Intelektual: Jurnal Pendidikan dan Studi Keislaman 13, n.º 1 (4 de junho de 2023): 44–57. http://dx.doi.org/10.33367/ji.v13i1.3543.
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Santri Tahfidz is seen as people of good morals because they have the Al-Qur'an as a controller of their behavior. This study aims to analyze moral development, influencing factors, and Pesantren's efforts to develop the ethical aspects of santri tahfidz at Madrasah Tahfidz Putri Anak (MTPA). The research method used qualitative, data collection techniques through interviews and observations. The process of determining the informants used purposive sampling. This research found three research results. First, the stage of moral development of santri tahfidz at MTPA was the heteronomous stage. Second, the factors that affect the moral development of santri tahfidz were divided into 2, namely, internal factors in the form of nature or nature that has been brought from birth and external factors; the family, the pesantren environment and social relations between friends. Third, the pesantren's efforts in developing the morality aspects of the santri tahfidz were by implementing rules and consequences, as well as several religious and social programs or activities within the pesantren environment.
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Sasso, Loredana, Annamaria Bagnasco, Monica Bianchi, Valentina Bressan e Franco Carnevale. "Moral distress in undergraduate nursing students". Nursing Ethics 23, n.º 5 (agosto de 2016): 523–34. http://dx.doi.org/10.1177/0969733015574926.
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Background: Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. Objectives: The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. Research design: The research design was a systematic literature review. Method: The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. Ethical consideration: Since this was a systematic review, no ethical approval was required. Findings: From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. Conclusion: Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students.
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McAndrew, Natalie S., e Joshua B. Hardin. "Giving nurses a voice during ethical conflict in the Intensive Care Unit". Nursing Ethics 27, n.º 8 (14 de julho de 2020): 1631–44. http://dx.doi.org/10.1177/0969733020934148.
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Background: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. Research question/objectives/methods: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice. Participants and research context: Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States. Ethical considerations: This study was approved by the Institutional Review Board at the organization where the study took place. Findings: Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict. Discussion: Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict. Conclusion: These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.
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Storaker, Anne, Dagfinn Nåden e Berit Sæteren. "From painful busyness to emotional immunization: Nurses’ experiences of ethical challenges". Nursing Ethics 24, n.º 5 (24 de janeiro de 2016): 556–68. http://dx.doi.org/10.1177/0969733015620938.
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Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched.
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Huang, Fei Fei, Qing Yang, Jie Zhang, Kaveh Khoshnood e Jing Ping Zhang. "Chinese nurses’ perceived barriers and facilitators of ethical sensitivity". Nursing Ethics 23, n.º 5 (agosto de 2016): 507–22. http://dx.doi.org/10.1177/0969733015574925.
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Background: An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. Aim: The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. Research design: A convergent parallel mixed-methods research design was adopted. Participants and research context: In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire–revised version was used to assess the levels of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments ( n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses’ perceptions of the barriers and facilitators in nurturing ethical sensitivity ( n = 15). The data were collected from February to June 2014. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Results: Despite moderately high overall Chinese Moral Sensitivity Questionnaire–revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. Discussion: The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. Conclusion: This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses’ sensitivity to ethical issues.
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Janssens, Rien MJPA, Ezra van Zadelhoff, Ger van Loo, Guy AM Widdershoven e Bert AC Molewijk. "Evaluation and perceived results of moral case deliberation". Nursing Ethics 22, n.º 8 (25 de dezembro de 2014): 870–80. http://dx.doi.org/10.1177/0969733014557115.
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Background: Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. Research questions: How did participants evaluate moral case deliberation? What has moral case deliberation brought to them? What has moral case deliberation contributed to care practice? Should moral case deliberation be further implemented and, if so, how? Research design: Quantitative analysis of a questionnaire study among participants of moral case deliberation, both caregivers and team leaders. Qualitative analysis of written answers to open questions, interview study and focus group meetings among caregivers and team leaders. Participants and research context: Caregivers and team leaders in a large organization for aged care in the Netherlands. A total of 61 moral case deliberation sessions, carried out on 16 care locations belonging to the organization, were evaluated and perceived results were assessed. Ethical considerations: Participants gave informed consent and anonymity was guaranteed. In the Netherlands, the law does not prescribe independent ethical review by an Institutional Review Board for this kind of research among healthcare professionals. Findings: Moral case deliberation was evaluated positively by the participants. Content and atmosphere of moral case deliberation received high scores, while organizational issues regarding the moral case deliberation sessions scored lower and merit further attention. Respondents indicated that moral case deliberation has the potential to contribute to care practice as relationships among team members improve, more openness is experienced and more understanding for different perspectives is fostered. If moral case deliberation is to be successfully implemented, top-down approaches should go hand in hand with bottom-up approaches. Conclusion: The relevance of moral case deliberation for care practice received wide acknowledgement from the respondents. It can contribute to the team’s cohesion as mutual understanding for one another’s views is fostered. If implemented well, moral case deliberation has the potential to improve care, according to the respondents.
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Jansen, Trine-Lise, Marit Helene Hem, Lars Johan Dambolt e Ingrid Hanssen. "Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands". Nursing Ethics 27, n.º 5 (20 de outubro de 2019): 1315–26. http://dx.doi.org/10.1177/0969733019877526.
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Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.
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Solum, Eva Merethe, Veronica Mary Maluwa, Bodil Tveit e Elisabeth Severinsson. "Enhancing students’ moral competence in practice". Nursing Ethics 23, n.º 6 (3 de agosto de 2016): 685–97. http://dx.doi.org/10.1177/0969733015580811.
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Background: Nurses and student nurses in Malawi often encounter challenges in taking a moral course of action. Several studies have demonstrated a need for increased awareness of ethical issues in the nursing education. Objective: To explore the challenges experienced by nurse teachers in Malawi in their efforts to enhance students’ moral competence in clinical practice. Research design: A qualitative hermeneutic approach was employed to interpret the teachers’ experiences. Participants and research context: Individual interviews (N = 8) and a focus group interview with teachers (N = 9) from different nursing colleges were conducted. Ethical considerations: Ethical approval was granted and all participants signed their informed consent. Findings: Two overall themes emerged: (1) authoritarian learning climate, with three subthemes: (a) fear of making critical comments about clinical practice, (b) fear of disclosing mistakes and lack of knowledge and (c) lack of a culture of critical discussion and reflection that promotes moral competence; and (2) discrepancy between expectations on learning outcome from nursing college and the learning opportunities in practice comprising three subthemes: (a) gap between the theory taught in class and learning opportunities in clinical practice, (b) lack of good role models and (c) lack of resources. Discussion: Our findings indicated that showing respect was a central objective when the students were assessed in practice. A number of previous studies have enlightened the need for critical reflection in nursing education. Few studies have linked this to challenges experienced by teachers for development of moral competence in practice. This is one of the first such studies done in an African setting. Conclusion: There is a clear relationship between the two themes. A less authoritarian learning climate may enhance critical reflection and discussion between students, teachers and nurses. This can narrow the gap between the theory taught in college and what is demonstrated in clinical practice. Moral competence must be enhanced in order to ensure patients’ rights and safety.
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Mehdipour Rabori, Roghayeh, Mahlagha Dehghan e Monirosadat Nematollahi. "Nursing students’ ethical challenges in the clinical settings: A mixed-methods study". Nursing Ethics 26, n.º 7-8 (14 de novembro de 2018): 1983–91. http://dx.doi.org/10.1177/0969733018810766.
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Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. Objectives: This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran. Research design: This was a mixed-methods study with an exploratory sequential design. Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. Ethical considerations: The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study. Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale. Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges. Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences.
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Axelsson, Lena, Eva Benzein, Jenny Lindberg e Carina Persson. "Processes toward the end of life and dialysis withdrawal Physicians’ and nurses’ perspectives". Nursing Ethics 27, n.º 2 (11 de junho de 2019): 419–32. http://dx.doi.org/10.1177/0969733019848050.
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Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians’ and nurses’ perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient’s decision-making process, The challenge awaiting the family members’ processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient’s possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.
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Molloy, Jennifer, Marilyn Evans e Kevin Coughlin. "Moral distress in the resuscitation of extremely premature infants". Nursing Ethics 22, n.º 1 (8 de abril de 2014): 52–63. http://dx.doi.org/10.1177/0969733014523169.
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Objective: To increase our understanding of moral distress experienced by neonatal registered nurses when directly or indirectly involved in the decision-making process of resuscitating infants who are born extremely premature. Design: A secondary qualitative analysis was conducted on a portion of the data collected from an earlier study which explored the ethical decision-making process among health professionals and parents concerning resuscitation of extremely premature infants. Setting: A regional, tertiary academic referral hospital in Ontario offering a perinatal program. Participants: A total of 15 registered nurses were directly or indirectly involved in the resuscitation of extremely premature infants. Methods: Interview transcripts of nurses from the original study were purposefully selected from the original 42 transcripts of health professionals. Inductive content analysis was conducted to identify themes describing factors and situations contributing to moral distress experienced by nurses regarding resuscitation of extremely premature infants. Ethical considerations: Ethical approval was obtained from the research ethics review board for both the initial study and this secondary data analysis. Results: Five themes, uncertainty, questioning of informed consent, differing perspectives, perceptions of harm and suffering, and being with the family, contribute to the moral distress felt by nurses when exposed to neonatal resuscitation of extremely premature infants. An interesting finding was the nurses’ perceived lack of power and influence in the neonatal resuscitation decision-making process. Conclusion: Moral distress continues to be a significant issue for nursing practice, particularly among neonatal nurses. Strategies are needed to help mediate the moral distress experienced by nurses, such as debriefing sessions, effective communication, role clarification, and interprofessional education and collaboration.
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Escolar Chua, Rowena L., e Jaclyn Charmaine J. Magpantay. "Moral distress of undergraduate nursing students in community health nursing". Nursing Ethics 26, n.º 7-8 (28 de dezembro de 2018): 2340–50. http://dx.doi.org/10.1177/0969733018819130.
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Background: Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students. Aim: To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing. Research design: A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students that led them to have moral distress. Participants and research context: The study included 14 senior nursing students who had their course in Community Health Nursing in their sophomore year and stayed in the partner communities in their junior year for 6 and 3 weeks during their senior year. Ethical considerations: Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants. Findings: Nursing students are vulnerable and likely to experience moral distress when faced with ethical dilemmas. They encounter numerous situations which make them question their own values and ideals and those of that around them. Findings of the study surfaced three central themes which included moral distress emanating from the unprofessional behavior of some healthcare workers, the resulting sense of powerlessness, and the differing values and mindsets of the people they serve in the community. Conclusion: This study provides educators a glimpse of the morally distressing situations that often occurs in the community setting. It suggests the importance of raising awareness and understanding of these situations to assist nursing students to prepare themselves to the “real world,” where the ideals they have will be constantly challenged and tested.
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Ramvi, Ellen, e Venke Irene Ueland. "Between the patient and the next of kin in end-of-life care: A critical study based on feminist theory". Nursing Ethics 26, n.º 1 (24 de janeiro de 2017): 201–11. http://dx.doi.org/10.1177/0969733016688939.
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Background: For the experience of end-of-life care to be ‘good’ many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse–next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient. Research problem: From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care? Research design: A critical qualitative approach was used, based on four focus group interviews. Participants: A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated. Ethical considerations: The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began. Findings and discussion: Two descriptive themes emerged from the inductive analysis: ‘A feeling of mistrust, control and rejection’ and ‘Being between hope and denial of next of kin and the desire of the patient to die when the time is up’. Deductive reinterpretation of data (in the light of moral distress from a Feminist ethics perspective) has made visible the constraints that certain relations with next of kin in end-of-life care lay upon the nurses’ moral identity, the relationship and their responsibility. We discuss how these constraints have political and societal dimensions, as well as personal and relational ones. Conclusion: There is complex moral distress related to the nurse–next of kin relationship which calls for ethical reflections regarding these relationships within end-of-life care.
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Jakobsen, Rita, e Venke Sørlie. "Ethical challenges". Nursing Ethics 23, n.º 6 (3 de agosto de 2016): 636–45. http://dx.doi.org/10.1177/0969733015580810.
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Introduction: To meet and take care of people with dementia implicate professional and moral challenges for caregivers. Using force happens daily. However, staff also encounter challenges with the management in the units. Managing the caretaking function is also significant in how caretakers experience working in dementia care. Purpose: The purpose of this study is to explore the caregiver’s experiences with ethical challenges in dementia care settings and the significance of professional leadership in this context. Method: The design is qualitative, and data appear through narrative interviews. A total of 23 caretakers participated in the study. The transcribed interviews were subjected to a phenomenological-hermeneutical interpretation. Ethical considerations: The respondents signed an informed consent for participation prior to the interviews. They were assured anonymity and confidentiality in the publication of the data. Ricoeur’s method for interpretation ensures anonymity as the researcher relates to the data as one collective text. The study is part of a larger research project in ethics, in its entirety approved in line with the Helsinki Convention. Results: The findings show that the caretakers experienced inadequacy. Some of them described a negative work atmosphere where they experienced that their leaders did not take them seriously. Because of this, informal negative sub-groups functioned as an exclusive debriefing arena. Some of the informants described the opposite experience where the leaders actively supported them. Discussion: The analyses of the findings are discussed in light of the concepts of trust and mistrust in leadership. Conclusion: There is a correlation between the leadership and the caregivers’ experience of being in difficult situations.
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Syafira, Dinda, Suhairi Suhairi, Juwita Putri Wulandari, Putri Iswanti e Said Ihsan Fauzi. "Analisis Etika Komunikasi Bisnis Dalam Strategi Pemasaran Produk Di Sosial Media". Jurnal Ekonomika Dan Bisnis (JEBS) 3, n.º 2 (25 de julho de 2023): 379–84. http://dx.doi.org/10.47233/jebs.v3i2.1036.
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The purpose of this study is to analyze corporate communication ethics in product marketing strategies on social media. This study examines the literature on the principles of business ethics and marketing communications. The method used is descriptive research, collecting information from primary and secondary sources. The analysis was carried out using a qualitative approach to identify the ethical aspects of product marketing in social networks. The aftereffects of this study demonstrate that there are several moral perspectives that need consideration in web-based entertainment business correspondence, such as genuineness, receptiveness, decency and social obligation. This study assists with understanding the decision and utilization of business correspondence morals in item advertising techniques via virtual entertainment. These discoveries can be the reason for building more moral business correspondence rehearses in the computerized period
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Bagherian, Samaneh, Farkhondeh Sharif, Ladan Zarshenas, Camellia Torabizadeh, Abbas Abbaszadeh e Payam Izadpanahi. "Cancer patients’ perspectives on dignity in care". Nursing Ethics 27, n.º 1 (16 de maio de 2019): 127–40. http://dx.doi.org/10.1177/0969733019845126.
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Background: Since “dignity” is one of the fundamental rights of every patient, consideration for patients’ dignity is essential. Unfortunately, in many cases, especially in cancer patients, dignity is not fully respected. Dignity is an abstract concept, and there are only a few comprehensive studies on the dignity of cancer patients in Iran. Research objective: This study aimed to evaluate the perception of Iranian cancer patients on human dignity. Research design: A qualitative research approach was used as the study design. The data were collected through individual semi-structured interviews and analyzed using the qualitative content analysis method. Participants and research context: This study was conducted on cancer patients in internal medicine wards in Iran. The data were gathered through semi-structured interviews from May 2017 to February 2018. Ethical considerations: The study protocol was approved by the Research Ethics Committee of medical universities located in Southwest of Iran. The ethical principles were carefully followed throughout the study. Findings: Based on the results of the interviews, 3 main themes and 11 categories were determined. The main themes were identified as the “personal space and privacy,” “respect for human values,” and “moral support.” Discussion: The results of the present study showed the necessity of care for cancer patients in a respectful manner. The key elements in such care were the preservation of their personal space and privacy, respect for their values, and the provision of adequate moral support. These measures will have a positive effect on the perception of such patients on human dignity. Conclusion: Considering the special care required by cancer patients, the Iranian healthcare and hygiene managers should design and implement a care plan that includes the ethical principles related to human dignity.
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Torabi, Mohammad, Fariba Borhani, Abbas Abbaszadeh e Foroozan Atashzadeh-Shoorideh. "Barriers to ethical decision-making for pre-hospital care professionals". Nursing Ethics 27, n.º 2 (11 de junho de 2019): 407–18. http://dx.doi.org/10.1177/0969733019848044.
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Background: Emergency care providers are frequently faces with situations in which they have to make decisions quickly in stressful situations. They face barriers to ethical decision-making and recognizing and finding solutions to these barriers helps them to make ethical decision. Objectives: The purpose of this study was to identify barriers of ethical decision-making in Iranian Emergency Medical Service personnel. Methods: In this qualitative research, the participants (n = 15) were selected using the purposive sampling method, and the data were collected by deep and semi-structured interviews. Finally, the data are analyzed using the content analysis approach. Ethical considerations: Permission to conduct the study was obtained from the Ethics Committee of the Shahid Beheshti University of Medical Sciences. The objectives of the study were explained to the participants and written consent was received from them. Also, participants were assured that necessary measures were taken to protect their anonymity and confidentiality. Findings: The results of the analysis are classified in five main categories. It encompasses the following areas: perception of situation, patient-related factors, input and output imbalance, uncoordinated health system, and paradoxes. Conclusion: Emergency Medical Service personnel make ethical decisions every day. It is important that prehospital personnel know how to manage those decisions properly so that clients’ moral rights are respected. Hence, by identifying the dimensions and obstacles of ethical decision-making in Emergency Medical Service personnel, it is possible to enhance the moral judgment and ethical accountability of the personnel and develop the strategies necessary for ethical decision-making in them.
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Botes, Annatjie, e Marianne Otto. "Ethical Dilemmas Related to the HIV-Positive Person in the Workplace". Nursing Ethics 10, n.º 3 (maio de 2003): 281–94. http://dx.doi.org/10.1191/0969733003ne606oa.
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This study’s objectives were: (1) to describe and explore the ethical dilemmas surrounding the HIV-positive person in the workplace in South Africa; and (2) to describe the Rational Interaction for Moral Sensitivity (RIMS) approach as a possible mechanism for solving these ethical dilemmas. A qualitative, exploratory and descriptive research design was used. The target populations were HIV-positive employees and occupational health nurses working for a South African company. Data collected through individual HIV-positive employee interviews and occupational health nurse workgroups were analysed. The ethical dilemmas were conceptualized and described within the theoretical framework of the principles of ethics, namely, autonomy, beneficence, justice and confidentiality. To elicit a solution to the dilemmas, the data were recontextualized using the RIMS approach, a group decision-making strategy designed for the business environment.
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Fernandes, Maria ID, e Isabel MPB Moreira. "Ethical issues experienced by intensive care unit nurses in everyday practice". Nursing Ethics 20, n.º 1 (22 de agosto de 2012): 72–82. http://dx.doi.org/10.1177/0969733012452683.
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This research aims to identify the ethical issues perceived by intensive care nurses in their everyday practice. It also aims to understand why these situations were considered an ethical issue and what interventions/strategies have been or are expected to be developed so as to minimize them. Data were collected using a semi-structured interview with 15 nurses working at polyvalent intensive care units in 4 Portuguese hospitals, who were selected by the homogenization of multiple samples. The qualitative content analysis identified end-of-life decisions, privacy, interaction, team work, and health-care access as emerging ethical issues. Personal, team, and institutional aspects emerge as reasons behind the experience of these issues. Personal and team resources are used in and for solving these issues. Moral development and training are the most significant strategies.
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McAndrew, Natalie Susan, Jane Leske e Kathryn Schroeter. "Moral distress in critical care nursing: The state of the science". Nursing Ethics 25, n.º 5 (22 de setembro de 2016): 552–70. http://dx.doi.org/10.1177/0969733016664975.
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Background: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. Objectives: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. Review Methods: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies. Results: Synthesis of the scientific literature revealed inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems with the professional practice environment, difficulties with communication during end-of-life decisions, compromised nursing care as a consequence of moral distress, and few effective interventions. Conclusion: Providing compassionate care is a professional nursing value and an inability to meet this goal due to moral distress may have devastating effects on care quality. Further study of patient and family outcomes related to nurse moral distress is recommended.
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Fredwall, Terje Emil, e Inger Beate Larsen. "Textbook descriptions of people with psychosis – some ethical aspects". Nursing Ethics 26, n.º 5 (29 de abril de 2018): 1554–65. http://dx.doi.org/10.1177/0969733017753742.
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Background: Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field. Objectives: This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis. Research design: We used qualitative content analysis. Ethical considerations: The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required. Findings: The analysis shows that all 12 textbooks describe and present people who are considered as psychotic from a ‘perspective from above’. In this perspective, the readers are learning about psychosis in the professional’s language and from the author’s viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a ‘perspective from within’. Here, the readers are learning about psychosis from the patients’ own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person. Discussion and conclusion: Drawing partly on Rita Charon’s writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients’ own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness.
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Jasemi, Madineh, Sanaz Aazami, Masumeh Hemmati maslak pak, Hosein Habibzadeh e Roghayeh Esmaeili Zabihi. "Factors affecting conscience-based nursing practices: A qualitative study". Nursing Ethics 26, n.º 5 (26 de abril de 2018): 1350–60. http://dx.doi.org/10.1177/0969733018761173.
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Background: Conscience is a guiding factor in nursing practice for delivering the ultimate care. In order to expand the concept of conscience-based care, factors affecting conscience in nursing practice need to be identified. Objectives: The current study assessed nurses’ experiences to explore factors affecting conscience in nursing practice. Research design: This qualitative content analysis study employed purposive sampling to reach 14 nurses working at educational hospitals in Tabriz and Urmia, Iran. Data were analyzed using inductive and conventional analysis. Ethical considerations: This research was approved by the Ethics Committee of Urmia University of Medical Science. Voluntary participation, anonymity, and confidentiality were considered. Finding: Two themes emerged from our analysis for enhancing conscience in nursing practices, including environment of professional performance and personal factors. Discussion: The two important factors for enhancing conscience in nursing practice are environment and personal factors. Conclusion: It is necessary to emphasize on religious beliefs, professional commitment, and communication skills in educational training structure. Also, establishing appropriate management systems will help nurses to provide moral care.
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James, Trudi, e Hazel Platzer. "Ethical Considerations in Qualitative Research with Vulnerable Groups: Exploring Lesbians' and Gay Men's Experiences of Health Care – A Personal Perspective". Nursing Ethics 6, n.º 1 (janeiro de 1999): 73–81. http://dx.doi.org/10.1177/096973309900600108.
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It is rare to find honest accounts of the difficulties and dilemmas encountered when conducting sensitive research with vulnerable research populations. This account explores some of the ethical issues raised by a qualitative interview study with lesbians and gay men about their experiences of nursing care. There is tension between the moral duty to conduct research with vulnerable and stigmatized groups in order to improve care, and the inevitable lack of resources that go with such a venture. This increases the risk of harm during the process of research. The risk of harm to both the researchers and the researched is explored and the need for a support structure for both groups is raised. There is a pressing need to develop further understanding about the ways in which the dissemination of research can potentially harm already vulnerable research populations.
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Montreuil, Marjorie, e Franco A. Carnevale. "Participatory Hermeneutic Ethnography: A Methodological Framework for Health Ethics Research With Children". Qualitative Health Research 28, n.º 7 (15 de março de 2018): 1135–44. http://dx.doi.org/10.1177/1049732318757489.
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When conducting ethics research with children in health care settings, studying children’s experiences is essential, but so is the context in which these experiences happen and their meaning. Using Charles Taylor’s hermeneutic philosophy, we developed a methodological framework for health ethics research with children that bridges key aspects of ethnography, participatory research, and hermeneutics. This qualitative framework has the potential to offer rich data and discussions related to children as well as family members and health care workers’ moral experiences in specific health care settings, while examining the institutional norms, structures, and practices and how they interrelate with experiences. Through a participatory hermeneutic ethnographic study, important ethical issues can be highlighted and examined in light of social/local imaginaries and horizons of significance, to address some of the ethical concerns that can be present in a specific health care setting.
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Enderle, Cleci de Fátima, Rosemary Silva da Silveira, Graziele de Lima Dalmolin, Valéria Lerch Lunardi, Liziane Iturriet Avila e Carmen Carballo Dominguez. "Teaching strategies: promoting the development of moral competence in undergraduate students". Revista Brasileira de Enfermagem 71, suppl 4 (2018): 1650–56. http://dx.doi.org/10.1590/0034-7167-2017-0704.
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ABSTRACT Objective: To identify strategies and spaces used by professors to promote the development of the moral competence of nursing undergraduate students. Method: Qualitative research, developed with 20 nursing professors, through a semi-structured interview, from July to October 2016. Data were submitted to discursive textual analysis. Results: Three categories were constructed: Active methodologies as strategies for the development of moral competence; Knowledge and development of clinical reasoning as motivating spaces of moral competence; Attitude of professors as a strategy for dialogue, empathy, recovery of moral values and development of caring skills. Final considerations: The use of strategies and spaces to develop pedagogical actions favors the search for knowledge, clinical reasoning and the approach of ethical and moral aspects that collaborate for the development of the moral competence of nursing undergraduate students.
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Muhammad, Giantomi, Dedih Surana, Iwan Sanusi e Andewi Suhartini. "Islamic Education As An Effort To Strengthen Morals In The Era Of Globalization". AL-WIJDÃN Journal of Islamic Education Studies 9, n.º 1 (15 de janeiro de 2024): 108–25. http://dx.doi.org/10.58788/alwijdn.v9i1.3602.
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Islamic education at this time is very much needed to develop knowledge based on faith and piety. This results in a pattern of physical and spiritual behavior that produces a form of self-concept, namely, being a person with character. The weakening of moral attitudes in the personality of a Muslim is not a small problem and needs to be taken seriously. Islamic education has an impact on increasing faith and piety to form a person who has character, especially with the increase in the current era of globalization, which changes all aspects of life, including mindset. The purpose of this study is to find out the process of Islamic education as the actualization of Islamic teachings so that it can be an effort to strengthen the morals that occur in this era of globalization in the personality of Muslims. This research is qualitative research with the type of library research (Library Research). The results of this study show that the strengthening of morals by Islamic education in the current era of globalization in addressing present moral and ethical deviations includes the need for revitalization as moral strengthening that needs to be carried out by Muslims today in facing the era of globalization, including 1) applying a holistic learning model and based on morality, 2) revitalizing moral education, 3) revitalizing social education, and 4) revitalizing the role of technology. Keywords: Islamic Education, Morals, Globalization Era, Morals, Ethics.
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Akhmal Choirul Amar, Garnes Puji Astuti e Iqbal Fathoni. "Pengangguran dalam Perspektif Ekonomi Islam dan Kovensional: Pengertian, Sebab, dan Solusi". Akuntansi dan Ekonomi Pajak: Perspektif Global 1, n.º 3 (6 de junho de 2024): 14–22. http://dx.doi.org/10.61132/aeppg.v1i3.175.
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This article discusses one of the employment problems in Indonesia, namely unemployment. This relates to employment management, including conventional and sharia (Islamic) components. The economic and social aspects of people's lives are greatly influenced by where they work. In a sharia (Islamic) perspective, employment and unemployment are aspects of employment issues with certain ethical and moral guidelines. This article discusses and investigates conventional and sharia perspectives on the problem of unemployment, including its definition, causes, solutions and implications for the Indonesian labor market. Researchers used qualitative techniques and library research data to write this article.
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Blomberg, Karin, e Birgitta Bisholt. "Clinical group supervision for integrating ethical reasoning". Nursing Ethics 23, n.º 7 (3 de agosto de 2016): 761–69. http://dx.doi.org/10.1177/0969733015583184.
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Background: Clinical group supervision has existed for over 20 years in nursing. However, there is a lack of studies about the role of supervision in nursing students’ education and especially the focus on ethical reasoning. Aim: The aim of this study was to explore and describe nursing students’ ethical reasoning and their supervisors’ experiences related to participation in clinical group supervision. Research design: The study is a qualitative interview study with interpretative description as an analysis approach. Participants and research context: A total of 17 interviews were conducted with nursing students (n = 12) who had participated in clinical group supervision in their first year of nursing education, and with their supervisors (n = 5). Ethical considerations: The study was based on the ethical principles outlined in the Declaration of Helsinki, and permission was obtained from the Regional Ethical Review Board in Sweden. Findings: The analysis revealed that both the form and content of clinical group supervision stimulated reflection and discussion of handling of situations with ethical aspects. Unethical situations were identified, and the process uncovered underlying caring actions. Discussion and conclusion: Clinical group supervision is a model that can be used in nursing education to train ethical reflection and to develop an ethical competence among nursing students. Outcomes from the model could also improve nursing education itself, as well as healthcare organizations, in terms of reducing moral blindness and unethical nursing practice.
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Ramos, Flávia Regina Souza, Laura Cavalcanti de Farias Brehmer, Mara Ambrosina Vargas, Ana Paula Trombetta, Luciana Ramos Silveira e Laila Drago. "Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil". Nursing Ethics 22, n.º 4 (4 de agosto de 2014): 428–39. http://dx.doi.org/10.1177/0969733014538890.
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Background: Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students’ personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Objectives: Nursing students’ experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. Methods: The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. Ethical considerations: The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Results: Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students’ decision-making processes – realisation, reflection and intervention. Conclusion: The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems.
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Rogowski, Robert. "Ethical problems at work in the opinion of employees of selected banks". Annales. Etyka w Życiu Gospodarczym 21, n.º 8 (14 de maio de 2018): 57–70. http://dx.doi.org/10.18778/1899-2226.21.8.05.
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The paper presents ethical problems faced by the employees of selected banks in Poland. The theoretical section of the paper describes the codes of ethics in banking, especially those concerning the moral aspects of working in banking. The empirical part of the paper presents the results of research on the ethos of bank workers. Quantitative and qualitative analyses were carried out using a special Internet forum devoted to the banking sector. The study includes a content analysis of comments posted by the bank employees on the Internet forum.
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Mohammadi, Fateme, Hadise sadate Tabatabaei, Farzaneh Mozafari e Mark Gillespie. "Caregivers’ perception of women’s dignity in the delivery room: A qualitative study". Nursing Ethics 27, n.º 1 (2 de maio de 2019): 116–26. http://dx.doi.org/10.1177/0969733019834975.
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Introduction: Dignified care is one of the moral responsibilities of professional caregivers. However, in many cases the dignity of hospitalized patients, especially women in the delivery room, is not maintained. Dignity is an abstract concept and there has been no previous research exploring the dignity of pregnant women in the delivery room in Iran. Objectives: The objective of this study is to define and explain the concept of dignity for pregnant women in the delivery room from the perspectives of professional caregivers. Research design: This is qualitative research. The data were collected through in-depth semi-structured individual interviews. The conventional content analysis method was used to analyze the data. In qualitative content analysis, participant narrative is examined in-depth and sorted into categories and themes. Participants and research context: Potential participants who met the entrance criteria for this study were approached between July 2016 and February 2017. In all, 20 professional caregivers working in the delivery room setting within Iranian general hospitals were invited to participate in the study. The sampling was done through targeted sampling until saturation was achieved. Ethical considerations: The research ethics committee of the Shiraz University of Medical Sciences has approved the study’s protocol and all commonly recognized ethical principles were followed throughout the study. Findings: The findings of this study were presented in three main themes, including “privacy,” “respecting patients’ preferences,” and “comprehensive attention” and eight categories. Discussions and conclusion: Women in the delivery room need to be taken care of in an environment where healthcare staff promote the preservation of dignity through maintaining privacy, by providing attentive care and through ensuring that patient preferences regarding care and treatment are respected. In such an environment, the dignity of these women would be maintained and desirable outcomes achieved.
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Mainuddin, Mainuddin, Tobroni Tobroni e Moh Nurhakim. "Pemikiran Pendidikan Karakter Al-Ghazali, Lawrence Kolberg dan Thomas Lickona". Attadrib: Jurnal Pendidikan Guru Madrasah Ibtidaiyah 6, n.º 2 (16 de agosto de 2023): 283–90. http://dx.doi.org/10.54069/attadrib.v6i2.563.
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This paper aims to find out how Al-Ghazali, Lawrence Kolberg, and Thomas Lichona think about character education in contemporary Islam. The benefits for the government and educators make the educational ideas of Al-Ghazali, Lawrence Kolberg, and Thomas Lichona an inspiration in upholding quality Indonesian education. This research method is qualitative with descriptive analysis techniques using library research (library research). Through this literature review, researchers try to describe existing phenomena, which are currently taking place or in the past, and are sourced from various sources that have theoretical depth from experts. This study examines the perspective of character education according to Al-Ghazali, Thomas Lickona, and Lawrence Kolberg by examining the theories put forward. The results of this paper are that according to Al-Ghazali educational thinking is religious-ethical in nature, al-Ghazali's educational goals cover three aspects, namely cognitive aspects, affective aspects, and psychomotor aspects. Al-Ghazali mentioned four scientific classification categories, namely; classification of science syar'iyah (religion) and 'aqliyah (reason); theoretical and practical sciences; knowledge is presented (hudhûri) and acquired (hushûli); The knowledge of fardhu 'ain and fardhu kifayah. Meanwhile, Thomas Lickona stated that the notion of character education is a deliberate effort to help someone understand, pay attention to, and carry out core ethical values. And more broadly, he stated that character education is a deliberate (conscious) effort to realize virtue, namely objectively good human traits, not only good for individuals but also good for society as a whole. According to Lawrence Kolberg, Kohlberg offers fictional moral issues, so that for the context of the Indonesian nation, it is necessary to prioritize contemporary moral issues that actually occur in everyday life. In this case, what needs to be emphasized is that children have diverse experiences in social problems. Children must also be confronted with moral problems from a different perspective. Thus the diversity of moral problems and various perspectives in solving moral problems will encourage children's moral development to a higher stage.
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Peter, Elizabeth, Shan Mohammed e Anne Simmonds. "Sustaining hope as a moral competency in the context of aggressive care". Nursing Ethics 22, n.º 7 (14 de outubro de 2014): 743–53. http://dx.doi.org/10.1177/0969733014549884.
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Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture how competencies may reflect an adaptation to a less than ideal work environment. Research design: A critical qualitative approach was used. Participants: Fifteen graduate nursing students from various practice areas participated. Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings.
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Skirbekk, Helge, Marit Helene Hem e Per Nortvedt. "Prioritising patient care: The different views of clinicians and managers". Nursing Ethics 25, n.º 6 (29 de janeiro de 2017): 746–59. http://dx.doi.org/10.1177/0969733016664977.
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Background: There is little research comparing clinicians’ and managers’ views on priority settings in the healthcare services. During research on two different qualitative research projects on healthcare prioritisations, we found a striking difference on how hospital executive managers and clinical healthcare professionals talked about and understood prioritisations. Aim: The purpose of this study is to explore how healthcare professionals in mental healthcare and somatic medicine prioritise their care, to compare different ways of setting priorities among managers and clinicians and to explore how moral dilemmas are balanced and reconciled. Research design and participants: We conducted qualitative observations, interviews and focus groups with medical doctors, nurses and other clinical members of the interdisciplinary team in both somatic medical and mental health wards in hospitals in Norway. The interviews were recorded and transcribed verbatim. Ethical considerations: Basic ethical principles for research ethics were followed. The respondents signed an informed consent for participation. They were assured anonymity and confidentiality. The studies were approved by relevant ethics committees in line with the Helsinki Convention. Findings: Our findings showed a widening gap between the views of clinicians on one hand and managers on the other. Clinicians experienced a threat to their autonomy, to their professional ideals and to their desire to perform their job in a professional way. Prioritisations were a cause of constant concern and problematic decisions. Even though several managers understood and empathised with the clinicians, the ideals of patient flow and keeping budgets balanced were perceived as more important. Discussion: We discuss our findings in light of the moral challenges of patient-centred individual healthcare versus demands of distributive justice from healthcare management. Conclusion: The clinicians’ ideals of autonomy and good medical and nursing care for the individual patients were perceived as endangered.