Gandossi Chiara, De Brasi Elvira Luana, Rosa Debora, Maffioli Sara, Zappa Sara, Villa Giulia, Manara Duilio Fiorenzo
San Raffaele Institute (IRCCS), 20132 Milan, Italy.
Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy.
Nurs Rep. 2023 Mar 20;13(1):539-548. doi: 10.3390/nursrep13010049.
Research shows that the longer nurses care for terminally ill patients, the greater they experience moral distress. The same applies to nursing students. This study aims to analyze episodes of moral distress experienced by nursing students during end-of-life care of onco-hematologic patients in hospital settings.
This study was conducted in the interpretative paradigm using a hermeneutic phenomenological approach and data were analyzed following the principles of the Interpretative Phenomenological Analysis.
Seventeen participants were included in the study. The research team identified eight themes: causes of moral distress; factors that worsen or influence the experience of moral distress; feelings and emotions in morally distressing events; morally distressing events and consultation; strategies to cope with moral distress; recovering from morally distressing events; end-of-life accompaniment; internship clinical training, and nursing curriculum.
Moral distress is often related to poor communication or lack of communication between health care professionals and patients or relatives and to the inability to satisfy patients' last needs and wants. Further studies are necessary to examine the quantitative dimension of moral distress in nursing students. Students frequently experience moral distress in the onco-hematological setting.
研究表明，护士照顾绝症患者的时间越长，他们所经历的道德困扰就越大。护理专业学生也是如此。本研究旨在分析护理专业学生在医院环境中对肿瘤血液科患者进行临终护理期间所经历的道德困扰事件。
本研究采用解释性范式，运用诠释现象学方法，并按照诠释现象学分析的原则对数据进行分析。
该研究纳入了17名参与者。研究团队确定了八个主题：道德困扰的原因；加剧或影响道德困扰体验的因素；道德困扰事件中的感受和情绪；道德困扰事件与咨询；应对道德困扰的策略；从道德困扰事件中恢复；临终陪伴；实习临床培训以及护理课程。
道德困扰通常与医护人员和患者或亲属之间沟通不畅或缺乏沟通，以及无法满足患者最后的需求和愿望有关。有必要进一步研究护理专业学生道德困扰的量化维度。学生在肿瘤血液科环境中经常经历道德困扰。
