Eren Nurhan
Istanbul University, Turkey.
Nurs Ethics. 2014 May;21(3):359-73. doi: 10.1177/0969733013500161. Epub 2013 Oct 3.
Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry.
The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered.
The study design was descriptive and cross-sectional. RESEARCH CONTEXT: Methods comprised of a questionnaire administered to psychiatric nurses (n=202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience.
PARTICIPANTS consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n=202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study.
The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence.
The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor.
In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a focus on case studies and criteria for evaluation of service, and competency and responsibility needs to be established in psychiatric nursing education and practice.
护理是一项与人打交道且依赖人际关系的职业。护理是这些关系的重要组成部分，涉及保护、忍耐、关注和担忧。
本研究旨在评估精神科护士的道德信念以及所遇到的道德问题。
本研究设计为描述性横断面研究。研究背景：方法包括向土耳其伊斯坦布尔五家精神病院的精神科护士（n = 202）发放问卷、开展精神科护理伦理教学、由护理焦点小组讨论所报告的道德问题，以及由有临床经验的院士对问卷和报告进行分析。
参与者由通过整群抽样法从五家精神病院自愿参与本研究的护士组成（n = 202）。伦理考量：在研究前获得了每位参与者的书面知情同意。
结果表明护士在精神科伦理方面需要更多教育。人员不足、工作量过大、工作条件、缺乏监督和在职培训被认为是导致不道德行为的原因。与道德规范或护理相关的问题包括：（a）疏忽，（b）粗鲁/粗心行为，（c）不尊重患者权利和人的尊严，（d）旁观者冷漠，（e）缺乏适当沟通，（f）污名化，（g）专制态度/恐吓，（h）约束期间的身体干预，（i）受反应性情绪影响而操纵，（j）未征得同意，（k）不尊重隐私，（l）不诚实或不清楚，（m）暴露于不健康的身体状况，以及（n）违反保密原则。
结果表明精神科住院病房的护理道德规范不充分，护理标准较差。
为了解决这些问题，需要在精神科护理领域开展大规模研究，重点关注案例研究和服务评估标准，并且需要在精神科护理教育和实践中确立能力和责任。
