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护士在照顾 COVID-19 患者时对伦理冲突的看法。

Nurses' Perceptions of Ethical Conflicts When Caring for Patients with COVID-19.

机构信息

Health Service of Castilla-La Mancha, Integrated Care Management of Talavera de la Reina (Toledo), 45600 Talavera de la Reina, Spain.

Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Avd/Real Fábrica de Sedas s/n, 45660 Talavera de la Reina, Spain.

出版信息

Int J Environ Res Public Health. 2023 Mar 8;20(6):4763. doi: 10.3390/ijerph20064763.

Abstract

The COVID-19 pandemic has caused ethical challenges and dilemmas in care decisions colliding with nurses' ethical values. This study sought to understand the perceptions and ethical conflicts faced by nurses working on the frontline during the first and second waves of the COVID-19 pandemic and the main coping strategies. A qualitative phenomenological study was carried out following Giorgi's descriptive phenomenological approach. Data were collected through semi-structured interviews until data saturation. The theoretical sample included 14 nurses from inpatient and intensive care units during the first and second waves of the pandemic. An interview script was used to guide the interviews. Data were analyzed following Giorgi's phenomenological method using Atlas-Ti software. Two themes were identified: (1) ethical conflicts on a personal and professional level; and (2) coping strategies (active and autonomous learning, peer support and teamwork, catharsis, focusing on care, accepting the pandemic as just another work situation, forgetting the bad situations, valuing the positive reinforcement, and humanizing the situation). The strong professional commitment, teamwork, humanization of care, and continuous education have helped nurses to deal with ethical conflicts. It is necessary to address ethical conflicts and provide psychological and emotional support for nurses who have experienced personal and professional ethical conflicts during COVID-19.

摘要

新型冠状病毒肺炎大流行给护理决策带来了伦理挑战和困境,这些决策与护士的伦理价值观发生了冲突。本研究旨在了解在新型冠状病毒肺炎第一波和第二波期间处于前线的护士的看法和所面临的伦理冲突,以及主要的应对策略。这是一项采用 Giorgi 描述性现象学方法进行的定性现象学研究。通过半结构化访谈收集数据,直到数据饱和。理论样本包括来自第一波和第二波大流行期间住院和重症监护病房的 14 名护士。使用访谈脚本指导访谈。使用 Atlas-Ti 软件按照 Giorgi 的现象学方法分析数据。确定了两个主题:(1)个人和专业层面的伦理冲突;(2)应对策略(主动和自主学习、同伴支持和团队合作、宣泄、关注护理、将大流行视为另一种工作情况、忘记糟糕的情况、重视积极的强化以及人性化情况)。强烈的专业承诺、团队合作、关怀的人性化以及持续的教育,帮助护士应对了伦理冲突。有必要解决伦理冲突,并为在新型冠状病毒肺炎期间经历过个人和职业伦理冲突的护士提供心理和情感支持。

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