University of Turku, Finland.
University of Turku, Finland; Turku University Hospital, Finland.
Nurs Ethics. 2020 May;27(3):714-725. doi: 10.1177/0969733019897780. Epub 2020 Jan 26.
Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients' safety or their good care. However, there is lack of research of moral courage.
This study describes nurses' experiences of care situations demanding moral courage and their actions in these situations.
A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation of the Nurses' Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis.
The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee.
Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action.
Care situations demanding moral courage focus on good and safe patient care and the patient's good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients' and their relatives' experiences of care situations demanding moral courage.
护士在日常护理中会遇到复杂的伦理困境。护士在这些威胁患者安全或护理质量的情况下，需要有道德勇气采取行动，这一点很重要。然而，目前对于道德勇气的研究还很缺乏。
本研究描述了护士在需要道德勇气的护理情境中的体验，以及他们在这些情境中的行为。
采用定性描述性研究设计。数据是通过问卷中的开放性问题收集的，该问卷用于验证护士道德勇气量表。样本由芬兰一所主要大学医院四个不同临床科室的 286 名护士组成，共提供了 611 份回答。使用归纳内容分析法对数据进行分析。
该研究遵循了公认的良好科学实践原则。数据的使用得到了工具开发者、数据收集者和参与医院的授权。该研究还获得了大学伦理委员会的批准。
护士在大多数情况下都表现出了道德勇气，但有时也未能如此。尽管需要道德勇气的情况各不相同，但它们可以归类为与同事、医生、患者、亲属、护士自己、管理者和组织有关的七个主要领域。护士以不同的方式在这些情况下采取行动。解决这些情况的主要行为是口头沟通或立即采取行动，例如中断行动。
需要道德勇气的护理情境主要关注良好和安全的患者护理，患者的利益是关注的中心。这些情况主要与其他医疗保健专业人员的活动有关。研究结果可应用于通过基础和继续护理教育来发展伦理护理。需要研究医生和管理者的道德勇气，以及患者及其亲属在需要道德勇气的护理情境中的体验。
