Carnevale F, Delogu B, Bagnasco A, Sasso L
McGill University, Montreal, Canada.
SSD Medicina Penitenziaria ASL 2 Savonese, Savona, Italy.
J Prev Med Hyg. 2018 Dec 15;59(4):E315-E322. doi: 10.15167/2421-4248/jpmh2018.59.4.928. eCollection 2018 Dec.
Correctional nursing can involve significant ethical difficulties. This study examined ethical challenges encountered by correctional nurses in the Italian region of Liguria. Empirical data were analyzed in relation to relevant ethical standards. The former involved a study of 75 nurses and managers in the Ligurian correctional system, while the latter involved an analysis of the Italian Code of Ethics for Nurses and related standards for correctional practice.
Quantitative and qualitative methods were used for the empirical study. Questionnaires were administered to collect data on participants' characteristics and care settings. The Measure of Job Satisfaction (MJS) was also administered. Five focus groups were conducted.
Quantitative Data: Respondents identified factors that mostly impacted on recruitment and retention. Unfavourable factors included: structural, organizational, and relational factors. Favourable factors included: nursing consultation, continuing education activities, and peer support. MJS results were equal to 'unsatisfied'. Qualitative Data: five themes were identified through thematic analysis of focus group data: Health needs of incarcerated persons; Negotiation of the boundaries between care and custody; Job satisfaction related to nursing in a correctional setting; Barriers to providing good care; and Security needs. Ten categories of norms were identified in the Code as areas of ethical standards relevant for the empirical data.
Our empirical findings demonstrate that these nursing standards can be systematically compromised in correctional settings. Nurses feel compelled to provide ethically-problematic nursing services, with situations of moral distress. This research informs the development of needed policy, educational, and practice changes for nurses in correctional settings.
惩教护理可能涉及重大的伦理困境。本研究调查了意大利利古里亚地区惩教护士所面临的伦理挑战。针对相关伦理标准对实证数据进行了分析。前者涉及对利古里亚惩教系统中的75名护士和管理人员的研究，而后者涉及对意大利护士伦理守则及惩教实践相关标准的分析。
实证研究采用了定量和定性方法。通过问卷调查收集参与者特征和护理环境的数据。还实施了工作满意度量表（MJS）。开展了五个焦点小组。
定量数据：受访者确定了对招聘和留用影响最大的因素。不利因素包括：结构、组织和关系因素。有利因素包括：护理咨询、继续教育活动和同伴支持。MJS结果为“不满意”。定性数据：通过对焦点小组数据的主题分析确定了五个主题：被监禁者的健康需求；护理与监管界限的协商；惩教环境中与护理相关的工作满意度；提供优质护理的障碍；以及安全需求。守则中确定了十类规范，作为与实证数据相关的伦理标准领域。
我们的实证研究结果表明，这些护理标准在惩教环境中可能会系统性地受到损害。护士感到不得不提供存在伦理问题的护理服务，面临道德困境。本研究为惩教环境中护士所需的政策、教育和实践变革的制定提供了参考。
