Poikkeus Tarja, Numminen Olivia, Suhonen Riitta, Leino-Kilpi Helena
Department of Nursing Science, University of Turku, Finland.
J Adv Nurs. 2014 Feb;70(2):256-71. doi: 10.1111/jan.12213. Epub 2013 Jul 19.
The aim was to appraise and synthesize evidence of empirical studies of how nurses' ethical competence can be supported.
Ethical competence is an essential element of nursing practice. Nurses increasingly need support in competence when carrying out their responsibilities towards their patients.
A mixed-method systematic review of quantitative and qualitative studies was undertaken according to the University of York's Centre for Reviews and Dissemination guidelines.
Searches of MEDLINE, Nursing Database and British Nursing Index databases were conducted, yielding 512 citations between 1985-2012.
After a two-stage application of inclusion and exclusion criteria, 34 articles were included. The quality of the studies was assessed using STROBE or COREQ criteria. Data were analysed by content analysis.
Nurses' ethical competence has been studied from different viewpoints: ethical decision-making, ethical sensitivity, ethical knowledge and ethical reflection. There was little empirical evidence of provided support, but studies offered recommendations on how to support ethical competence. The most common strategies to support ethical competence were ethics education, ethics rounds, ethics committee and consultation. Nurse leaders and colleagues have a key role in providing opportunities for nurses to gain ethical competence.
There is a need to develop evidence-based support at the organizational and individual level to support nurses' ethical competence. Barriers for multiprofessional cooperation in ethical issues should be recognized and addressed as part of the development of organizational ethical practices. Research should pay more attention to the conceptual, theoretical and practical perspectives of ethical competence.
旨在评估和综合有关如何支持护士伦理能力的实证研究证据。
伦理能力是护理实践的重要组成部分。护士在履行对患者的职责时，越来越需要在能力方面获得支持。
根据约克大学综述与传播中心的指南，对定量和定性研究进行了混合方法的系统综述。
对MEDLINE、护理数据库和英国护理索引数据库进行了检索，在1985年至2012年期间获得了512条引用文献。
在分两阶段应用纳入和排除标准后，纳入了34篇文章。使用STROBE或COREQ标准评估研究质量。通过内容分析对数据进行分析。
从不同视角对护士的伦理能力进行了研究：伦理决策、伦理敏感性、伦理知识和伦理反思。关于所提供支持的实证证据很少，但研究就如何支持伦理能力提出了建议。支持伦理能力最常见的策略是伦理教育、伦理查房、伦理委员会和咨询。护士领导者和同事在为护士提供获得伦理能力的机会方面发挥着关键作用。
需要在组织和个人层面开展基于证据的支持措施，以支持护士的伦理能力。在伦理问题上多专业合作的障碍应作为组织伦理实践发展的一部分加以认识和解决。研究应更加关注伦理能力的概念、理论和实践视角。
