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儿科护士在儿童床边护理中的伦理困境。

Pediatric nurses' ethical difficulties in the bedside care of children.

机构信息

Chung-Ang University, Republic of Korea.

Chonbuk National University, Republic of Korea.

出版信息

Nurs Ethics. 2019 Mar;26(2):541-552. doi: 10.1177/0969733017708330. Epub 2017 Jun 14.

Abstract

BACKGROUND

: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective.

OBJECTIVES

: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children.

METHODS

: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea.

ETHICAL CONSIDERATIONS

: Ethical review was obtained from an ethics committee. The participants were informed about the aim of the study, and voluntary participation, anonymous response, and confidentiality were explained to them.

FINDINGS

: Three themes emerged from the analysis: ethical numbness in a task-oriented context, negative feelings toward family caregivers, and difficulty in expressing oneself in an authoritative climate. Conclusion and implications: We need to develop strategies to manage ethical difficulties at an institutional level. Furthermore, it is important that pediatric nurses have the opportunity to communicate with fellow nurses and other medical staff regarding ethical difficulties. In addition, cultivation of pediatric nurses' moral, ethical, and philosophical thinking patterns requires the immediate provision of continuous education in nursing ethics at the site of clinical nursing, time to discuss ethical difficulties, and other supportive measures. Findings indicated that, to provide high-quality patient-centered care, we should enhance nurses' ethical sensitivity and autonomy and improve the ethical climate in hospitals.

摘要

背景

儿科护士在日常工作中会遇到伦理难题。已有多项研究旨在揭示儿科护士群体中的伦理问题,但我们认为,从他们自身的视角来看,其伦理困境尚未得到充分探讨。

目的

本研究旨在探讨儿科护士在为住院患儿提供床边护理时所面临的伦理困境。

方法

采用现象学方法,对韩国 14 名女性儿科护士进行访谈并收集资料,同时对访谈内容进行分析。

伦理考量

本研究已获得伦理委员会的审查。研究目的向参与者做了说明,同时向他们解释了自愿参与、匿名回复和保密性等问题。

结果

分析结果呈现出 3 个主题:以任务为导向的环境中的伦理麻木、对患儿家属的负面感受、在权威氛围中难以表达自我。结论和意义:我们需要在机构层面制定策略来管理伦理困境。此外,儿科护士有机会与其他护士和其他医务人员就伦理困境进行沟通也很重要。此外,培养儿科护士的道德、伦理和哲学思维模式需要在护理现场立即提供护理伦理学的持续教育、讨论伦理困境的时间以及其他支持措施。研究结果表明,为了提供高质量的以患者为中心的护理,我们应该增强护士的伦理敏感性和自主性,并改善医院的伦理氛围。

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