Parchami Faezeh, Jackson Alun C, Sharifi Farshad, Parsapoor Alireza, Bahramnezad Fatemeh
School of Nursing and Midwifery, 48439Tehran University of Medical Sciences, Tehran, Iran.
Australian Centre for Heart Health, Melbourne, VIC, Australia; Faculty of Health, Deakin University, Geelong, VIC, Australia; Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC, China.
Nurs Ethics. 2022 Nov-Dec;29(7-8):1739-1749. doi: 10.1177/09697330221109945. Epub 2022 Jul 8.
Moral sensitivity is the first step towards ethical decision-making. This sensitivity should form a basic attitude in healthcare team members, particularly nurses, toward providing effective and ethical care. This is highlighted in intensive care units (ICUs) where close attention should be paid to patient rights and moral or ethical decision-making. The present study aimed at determining and comparing the effect of written simulation and computer simulation of a virtual patient on the development of moral sensitivity of ICU nurses. Randomized controlled trial with one control arm and two experimental arms. This study involved 204 ICU nurses working in hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran, from 2019 to 2021 using a random allocation method. The participants were allocated to three groups comprising virtual patient computer simulation, written simulation, and the no simulation control group. After training based on a Patient Rights Charter, five scenarios, with themes reflecting the clauses of the Patient's Rights Charter, were written as a computer program and text for the computer simulation and written simulation groups, respectively. Finally, nurses' moral sensitivity was assessed using the Lützén moral sensitivity questionnaire as pre- and post-tests (immediately and 2 months after the intervention). Ethical permission was obtained for the study. All the participants signed the informed consent before the study onset. The study results showed a significant difference in moral sensitivity among the three groups before the intervention ( = 0.003). Immediately after the intervention compared to pre-intervention, the three groups showed no significant differences in this regard ( = 0.056), however a significant difference among the three groups was found 2 months post-intervention ( < 0.001).
道德敏感性是迈向道德决策的第一步。这种敏感性应成为医疗团队成员，尤其是护士，提供有效且符合道德护理的基本态度。这在重症监护病房（ICU）中尤为突出，在那里应密切关注患者权利以及道德或伦理决策。本研究旨在确定并比较虚拟患者的书面模拟和计算机模拟对ICU护士道德敏感性发展的影响。采用一个对照组和两个试验组的随机对照试验。本研究纳入了2019年至2021年在伊朗德黑兰医科大学附属医院工作的204名ICU护士，采用随机分配方法。参与者被分为三组，分别是虚拟患者计算机模拟组、书面模拟组和无模拟对照组。在基于《患者权利宪章》进行培训后，编写了五个场景，其主题分别反映了《患者权利宪章》的条款，分别作为计算机程序和文本用于计算机模拟组和书面模拟组。最后，使用吕岑道德敏感性问卷在干预前和干预后（干预后立即和2个月）对护士的道德敏感性进行评估。该研究获得了伦理许可。所有参与者在研究开始前签署了知情同意书。研究结果显示，干预前三组在道德敏感性方面存在显著差异（P = 0.003）。与干预前相比，干预后立即三组在这方面没有显著差异（P = 0.056），然而在干预后2个月发现三组之间存在显著差异（P < 0.001）。
