Oh Younjae, Gastmans Chris
Hallym University.
KU Leuven.
Nurs Ethics. 2024 Jun;31(4):521-540. doi: 10.1177/09697330231200564. Epub 2023 Oct 4.
Frontline nurses who care for patients with COVID-19 work in stressful environments, and many inevitably struggle with unanticipated ethical issues. Little is known about the unique, ethically sensitive issues that nurses faced when caring for patients with COVID-19.
To better understand how frontline nurses who care for patients with COVID-19 experience ethical issues towards others and themselves.
Systematic review of qualitative evidence carried out according to the Preferred Reporting Items for Systematic reviews and Meta-analyses on ethical literature (PRISMA-Ethics). The electronic databases PubMed, Embase, Cinahl, Web of Science, Philosopher's Index, and Scopus were queried to identify candidate articles. Articles appearing from March 1, 2020 to December 31, 2022 were considered if they met the following inclusion criteria: (1) Published qualitative and mixed method studies and (2) ethical issues experienced by nurses caring for patients with COVID-19. We appraised the quality of included studies, and data analysis was guided by QUAGOL principles.
Twenty-six studies meeting our inclusion criteria for how nurses experience ethical issues were characterised by two key themes: (1) the moral character of nurses as a willingness to respond to the vulnerability of human beings and (2) ethical issues nurses acted as barriers sometimes, impeding them from responding to requests of vulnerable human beings for dignified care.
Our review provides a deeper understanding of nurses' experiences of ethically sensitive issues, while also highlighting the critical need for adjustments to be made at organisational and societal levels. Ethical issues that emerged in situations where organisational and situational constraints impeded nurses' ethical responses to patients' appeals suggests that early practical support should be made available to resolve ethical issues recognised by nurses. Such support contributes to protecting and promoting not only the dignity of patients with COVID-19 but also of fellow humans in need during crisis.
照顾新冠肺炎患者的一线护士工作环境压力大，许多人不可避免地要应对意想不到的伦理问题。对于护士在照顾新冠肺炎患者时所面临的独特的、具有伦理敏感性的问题，我们知之甚少。
更好地了解照顾新冠肺炎患者的一线护士如何体验对他人和自身的伦理问题。
根据系统评价和Meta分析的首选报告项目对伦理文献（PRISMA-Ethics）进行定性证据的系统评价。查询电子数据库PubMed、Embase、Cinahl、科学网、《哲学家索引》和Scopus以识别候选文章。如果符合以下纳入标准，则考虑2020年3月1日至2022年12月31日期间发表的文章：（1）发表的定性和混合方法研究，以及（2）护士在照顾新冠肺炎患者时遇到的伦理问题。我们评估了纳入研究的质量，数据分析以QUAGOL原则为指导。
26项符合我们关于护士如何体验伦理问题纳入标准的研究呈现出两个关键主题：（1）护士的道德品质表现为愿意回应人类的脆弱性；（2）伦理问题有时成为护士的障碍，阻碍他们回应脆弱人群对尊严护理的请求。
我们的综述更深入地了解了护士对伦理敏感问题的体验，同时也强调了在组织和社会层面进行调整的迫切需要。在组织和情境限制阻碍护士对患者诉求做出伦理回应的情况下出现的伦理问题表明，应尽早提供实际支持以解决护士认识到的伦理问题。这种支持不仅有助于保护和促进新冠肺炎患者的尊严，也有助于保护和促进危机期间有需要的其他人的尊严。
