Jiménez-Herrera María F, Llauradó-Serra Mireia, Acebedo-Urdiales Sagrario, Bazo-Hernández Leticia, Font-Jiménez Isabel, Axelsson Christer
Nursing Department, Universitat Rovira i Virgili (URV), Av/ Catalunya, 35 43002 Tarragona, Spain.
Faculty of Medicine and Health science, Nursing Department, University Internacional of Catalonia (UIC), Barcelona, Spain.
BMC Nurs. 2020 Jul 1;19:60. doi: 10.1186/s12912-020-00438-6. eCollection 2020.
Moral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals.
The study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants.
The emerging category "emotions and feelings in caring" has been analysed according to Haidt, considering that moral emotions include the subcategories of "Condemning emotions", "Self-conscious emotions", "Suffering emotions" and "Praising emotions". Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient's own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs.
Moral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.
道德情感是人类道德的关键要素。情感在护理过程中发挥着重要作用。紧急情况下的决策和评估十分复杂,经常会在医护人员中引发不同的情绪和感受。
本研究采用基于内容分析的定性演绎设计。对16名参与者进行了个人访谈和焦点小组访谈。
根据海特的理论,对新出现的“护理中的情感和感受”类别进行了分析,认为道德情感包括“谴责性情感”“自我意识情感”“痛苦情感”和“赞扬性情感”等子类别。在这些子类别中,我们发现护士在紧急情况下出现伦理冲突时所经历的感受与护理及其相关决策有关,即使他们曾经历过自认为本可以以不同方式帮助患者的情况,但当时的条件不允许,且他们感到临床实践中的伦理冲突造成了很大程度的焦虑和道德压力。护士们认为,从护理角度来看,护理具有一个超越患者自身康复的敏感维度,当这个维度与环境发生冲突时,会产生非人性化的影响。当护士感到护理达到了目标且对需求做出了适当回应时,就会产生积极的感受和满足感。
道德情感可以帮助护士识别那些能促使他们在极端情况下改善患者护理的情况。它们也可以成为个人和职业成长以及向以患者为中心的护理转变的起点。