University of Turku, Finland; Turku University Hospital, Finland.
University of Turku, Finland.
Nurs Ethics. 2018 Mar;25(2):133-152. doi: 10.1177/0969733017700237. Epub 2017 Apr 10.
The ethics and value bases in healthcare are widely acknowledged. There is a need to improve and raise awareness of ethics in complex systems and in line with competing needs, different stakeholders and patients' rights. Evidence-based strategies and interventions for the development of procedures and practice have been used to improve care and services. However, it is not known whether and to what extent ethics can be developed using interventions.
To examine ethics interventions conducted on healthcare professionals and healthcare students to achieve ethics-related outcomes.
A systematic review.
Five electronic databases were searched: CINAHL, the Cochrane Library, Philosopher's Index, PubMed and PsycINFO. We searched for published articles written in English without a time limit using the keywords: ethic* OR moral* AND intervention OR program OR pre-post OR quasi-experimental OR rct OR experimental AND nurse OR nursing OR health care. In the four-phased retrieval process, 23 full texts out of 4675 citations were included in the review. Data were analysed using conventional content analysis. Ethical consideration: This systematic review was conducted following good scientific practice in every phase.
It is possible to affect the ethics of healthcare practices through professionals and students. All the interventions were educational in type. Many of the interventions were related to the ethical or moral sensitivity of the professionals, such as moral courage and empowerment. A few of the interventions focused on identifying ethical problems or research ethics.
Patient-related outcomes followed by organisational outcomes can be improved by ethics interventions targeting professionals. Such outcomes are promising in developing ethical safety for healthcare patients and professionals.
医疗保健中的伦理和价值基础是被广泛认可的。需要提高和增强对复杂系统中的伦理认识,并使其与竞争需求、不同利益相关者和患者权利保持一致。已经使用循证策略和干预措施来制定程序和实践,以改善护理和服务。但是,尚不清楚是否可以以及在何种程度上可以通过干预措施来发展伦理学。
考察针对医疗保健专业人员和医学生实施的伦理学干预措施,以实现与伦理学相关的结果。
系统评价。
在五个电子数据库中进行了搜索:CINAHL、Cochrane 图书馆、Philosopher's Index、PubMed 和 PsycINFO。我们使用关键词搜索了发表在英文期刊上、无时间限制的文章:ethic或moral以及intervention或program或pre-post或quasi-experimental或rct或experimental和nurse或nursing或health care。在四阶段检索过程中,从 4675 条引文中筛选出 23 篇全文纳入本综述。使用常规内容分析法对数据进行分析。伦理考虑:本系统评价在每个阶段都遵循了良好的科学实践。
可以通过专业人员和学生来影响医疗保健实践的伦理学。所有干预措施均为教育类型。许多干预措施与专业人员的道德或道德敏感性有关,例如道德勇气和赋权。少数干预措施侧重于识别道德问题或研究伦理。
针对专业人员的伦理学干预措施可以改善与患者相关的结果,其次是组织相关的结果。这些结果有望为医疗保健患者和专业人员的伦理学安全发展提供帮助。