Santos Sara Soares Dos, Godoy Simone de, Araújo Agostinho Ac, Montandon Diego Santiago, Silva Ítalo Rodolfo, Gastmans Chris, Mendes Isabel Amélia Costa
University of São Paulo.
Federal University of Rio de Janeiro.
Nurs Ethics. 2025 Aug;32(5):1418-1433. doi: 10.1177/09697330241287856. Epub 2024 Oct 14.
The ethical challenges faced by undergraduate nursing students and nurses may lead to moral distress, negatively affecting learning capacity and self-confidence and potentially influencing the quality of patient care. To examine the state of knowledge regarding the moral distress among undergraduate nursing students during clinical practice. This scoping review followed JBI guidelines. First, the LILACS, Web of Science, Scopus, CINAHL, PubMed/MEDLINE, PsycINFO, Embase, and ProQuest databases were consulted. Next, the reference lists of the studies included in the sample were checked. Studies exploring moral distress among undergraduate nursing students during clinical practice were included regardless of language or date of publication. Two independent reviewers simultaneously selected the studies. The sample included 12 articles with different research designs. Three conditions that trigger moral distress among undergraduate nursing students emerged: Interpersonal relationships between students and preceptors/supervisors and multidisciplinary teams; interpersonal relationships between students and patients; and the relationship between students and health services. This review identified the various circumstances that lead to moral distress among undergraduate nursing students. Therefore, these results highlight the importance of preventing moral distress in this group through teaching, especially before students begin their clinical practices.
本科护理专业学生和护士所面临的伦理挑战可能会导致道德困扰，对学习能力和自信心产生负面影响，并可能影响患者护理质量。为了调查本科护理专业学生在临床实习期间有关道德困扰的知识状况。本范围综述遵循循证卫生保健国际协作网（JBI）指南。首先，检索了拉丁美洲和加勒比地区卫生科学数据库（LILACS）、科学网、Scopus、护理学与健康领域数据库（CINAHL）、医学期刊数据库（PubMed/MEDLINE）、心理学文摘数据库（PsycINFO）、荷兰医学文摘数据库（Embase）和ProQuest数据库。其次，检查了样本中纳入研究的参考文献列表。纳入了探索本科护理专业学生在临床实习期间道德困扰情况的研究，无论其语言或出版日期如何。两名独立评审员同时进行研究筛选。样本包括12篇具有不同研究设计的文章。本科护理专业学生出现道德困扰的三种情况：学生与带教老师/上级以及多学科团队之间的人际关系；学生与患者之间的人际关系；以及学生与卫生服务机构之间的关系。本综述确定了导致本科护理专业学生道德困扰的各种情况。因此，这些结果凸显了通过教学预防该群体道德困扰的重要性，尤其是在学生开始临床实习之前。
