Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Research Center for Life & Health Sciences & Biotechnology of the Police, Direction of Health, Rescue & Treatment , Police Headquarter, Tehran, Iran.
BMC Med Ethics. 2024 Jun 18;25(1):70. doi: 10.1186/s12910-024-01070-8.
The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care.
This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived.
The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care.
Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.
护理行业认为良心是临床实践的基础和基石,它对专业决策有重大影响,并提高了患者护理水平。然而,护理领域中良心的确切定义却缺乏,这使得衡量良心变得具有挑战性。为了解决这个问题,本研究采用 Schwartz Barcott 和 Kim 的混合方法分析基于良心的护理关怀的概念。
该方法涉及三个阶段的过程;理论、实地工作和分析。在第一阶段,通过电子数据库进行系统文献综述,以找到相关论文。使用主题分析提取符合纳入标准的 42 篇文章的内容,以确定意识护理关怀的属性、前因和后果。基于该阶段的工作定义,设计了实地工作阶段的计划。在该阶段,通过对负责医院患者护理的护士进行访谈收集数据。在该阶段,通过目的抽样选择了 5 名参与者进行深入访谈。使用定向内容分析进行数据分析。整合理论和实地工作阶段的结果,得出最终定义。
理论和实地工作阶段的整合,确定了基于良心的护理关怀的四个关键特征。首先,它涉及以认真负责的态度提供专业护理。其次,伦理道德是良心护理的核心。第三,外部精神在塑造这种背景下的良心方面起着重要作用。最后,基于良心的护理关怀既是内源性的,也是外源性的,专业承诺是关怀的核心。
基于良心的护理关怀是道德关怀的重要组成部分,它将临床实践提升到专业护理水平。它需要整合个人和社会价值观,受个人信仰和文化背景的影响,并得到专业能力、资源和医疗保健领域有利的组织氛围的支持。这种方法导致提供响应式护理、道德诚信和个人卓越,最终导致护理专业的发展。