Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
J Clin Nurs. 2019 Mar;28(5-6):733-744. doi: 10.1111/jocn.14702. Epub 2018 Nov 15.
Integrity is one of the core values in nursing that needs to be maintained by nurses in practice. However, the complexity in the nursing milieu can pose threats to integrity. An understanding of the common threats and coping strategies might assist nurses in preserving integrity in everyday practice.
To review and synthesis the concept of integrity in nursing and identify common threats and coping strategies.
Whittemore and Knafl's integrative review method was implemented. A search was performed in Scopus, Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Proquest Health and Medical electronic databases published in English between 2000-2017. Two reviewers independently assessed eligibility for inclusion. Methodological appropriateness for the included studies was assessed using the critical appraisal skills programme. The constant comparative method of grounded theory was used to analyse and synthesise data from seven peer-reviewed articles.
Two major conceptions of integrity were identified. These included the sense of wholeness with regard to personal-professional concerns and ethical-moral conducts. Five entities, self, patients, teamwork and work culture, the nature of work, and organisation, were identified as interweaving elements that may induce threats to integrity. When integrity is threatened, nurses use two key strategies to survive: adjusting and compensating. An emergent framework to facilitate understanding of nurses' threats to integrity is discussed.
A threat to nurses' integrity takes form when there is an unmitigated gap between a nurse's expectation and reality. While the expectation comes from within the nurse, the reality materialises out of the complex interplays that occur in the healthcare workforce. Maintaining integrity demands a continual strive to balance personal expectations, professional concerns and nursing realities.
诚信是护理的核心价值观之一，护士在实践中必须保持诚信。然而，护理环境的复杂性可能会对诚信构成威胁。了解常见的威胁和应对策略可能有助于护士在日常实践中保持诚信。
回顾和综合护理诚信的概念，确定常见的威胁和应对策略。
采用 Whittemore 和 Knafl 的综合评价方法。在 2000-2017 年期间，以英文在 Scopus、Medline、Embase、PsycINFO、Cumulative Index to Nursing and Allied Health Literature 和 Proquest Health and Medical 电子数据库中进行了搜索。两名评审员独立评估纳入标准。使用批判性评价技能计划评估纳入研究的方法学适宜性。使用扎根理论的恒定性比较方法分析和综合来自七篇同行评审文章的数据。
确定了诚信的两个主要概念。这些概念包括个人-专业关注和伦理-道德行为方面的整体感。自我、患者、团队合作和工作文化、工作性质和组织被确定为可能引发诚信威胁的交织元素。当诚信受到威胁时，护士使用两种关键策略来生存：调整和补偿。讨论了一个有助于理解护士诚信威胁的新兴框架。
当护士的期望与现实之间存在无法缓解的差距时，就会对护士的诚信构成威胁。虽然期望来自护士内部，但现实是在医疗保健劳动力中发生的复杂相互作用中产生的。保持诚信需要不断努力平衡个人期望、专业关注和护理现实。
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