Rezaei Zeinab, Nematollahi Monirsadat, Asadi Neda
Department of Pediatric and Neonatal Intensive Care Nursing, Kerman University of Medical Sciences, Kerman, Iran.
Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.
BMC Nurs. 2023 Sep 5;22(1):303. doi: 10.1186/s12912-023-01459-7.
Nurses working in neonatal intensive care units play a crucial role in providing care to critically ill or premature neonates. However, is not without its challenges, particularly when it comes to making difficult ethical decisions about end-of-life care. In some cases, neonates do not survive despite the best efforts of medical professionals. The present study aimed to investigate the relationship between moral distress, ethical climate, and attitudes towards end-of-life care among nurses working in neonatal intensive care units.
This is a descriptive-analytical cross-sectional study (May 21, 2021).The research population included 126 nurses working in neonatal intensive care units in Kerman province (Kerman, Jiroft, Bam, and Rafsanjan). Data collection tools included four questionnaires: demographic information, the Frommelt Attitudes towards Care of the Dying (FATCOD), the Hospital Ethical Climate Survey, and the Moral Distress Scale. SPSS22 was used to analyze the data.
The results revealed that the mean frequency and intensity of moral distress were 44.42 ± 17.67 and 49.45 ± 17.11, respectively. The mean ethical climate was 92.21 ± 17.52 and the FATCOD was 89.75 ± 9.08, indicating NICU nurses' positive perceptions of ethical climate and their favorable attitudes towards EOL care, respectively. The results showed a direct and significant relationship between ethical climate and the FATCOD (P = 0.003, r = 0.26).
We suggest policymakers and managers design strategies for better ethical climate in hospitals and reduction of moral distress among nurses.
在新生儿重症监护病房工作的护士在为危重症或早产新生儿提供护理方面发挥着至关重要的作用。然而，这项工作并非没有挑战，尤其是在做出关于临终护理的艰难伦理决策时。在某些情况下，尽管医疗专业人员尽了最大努力，新生儿仍未能存活。本研究旨在调查新生儿重症监护病房护士的道德困扰、伦理氛围与对临终护理态度之间的关系。
这是一项描述性分析横断面研究（2021年5月21日）。研究人群包括克尔曼省（克尔曼、吉罗夫特、巴姆和拉夫桑詹）新生儿重症监护病房的126名护士。数据收集工具包括四份问卷：人口统计学信息、弗罗梅尔特临终关怀态度量表（FATCOD）、医院伦理氛围调查问卷和道德困扰量表。使用SPSS22对数据进行分析。
结果显示，道德困扰的平均频率和强度分别为44.42±17.67和49.45±17.11。平均伦理氛围得分为92.21±17.52，FATCOD得分为89.75±9.08，分别表明新生儿重症监护病房护士对伦理氛围的积极认知及其对临终护理的积极态度。结果显示伦理氛围与FATCOD之间存在直接且显著的关系（P = 0.003，r = 0.26）。
我们建议政策制定者和管理人员制定策略，以改善医院的伦理氛围并减少护士的道德困扰。
