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土耳其地震后的伦理问题:一项关于护士观点的定性研究。

Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.

作者信息

Ünsal Betül, Özbudak Arıca Esra, Höbek Akarsu Rukiye

机构信息

Department of Nursing, Health Sciences Faculty, Yozgat Bozok University, Yozgat, Turkey.

出版信息

Int Nurs Rev. 2025 Sep;72(3):e13048. doi: 10.1111/inr.13048. Epub 2024 Oct 26.

Abstract

BACKGROUND

After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges.

AIM

The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake.

METHODS

A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data.

RESULTS

The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included "humanitarian duties," "non-adherence to ethical principles," "respect for the injured," and "medical errors."

CONCLUSION

In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency.

IMPLICATIONS FOR NURSING POLICY

Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining the integrity of healthcare delivery, preserving public trust, and ensuring the well-being of both the injured and healthcare providers during times of crisis.

摘要

背景

自然灾害发生后,被困在废墟中的人们急需生存和救援行动,这导致对医疗服务的需求激增。护士在应对此类灾难的后果方面起着关键作用。在危急情况下工作的护士面临诸多挑战,包括安全问题和伦理困境。伦理考量主要围绕护士在灾难期间提供护理的限制、职责和规范的改变,带来了重大且复杂的挑战。

目的

本研究旨在阐明护士护理经历的本质和精髓,并深入描述在照顾地震受伤者时遇到的伦理困境。

方法

本研究采用描述性现象学设计。共有16名在2023年土耳其地震后在任何地震地区的野战医院工作至少7天的护士参与了研究。研究于2023年3月13日至3月20日进行。通过半结构化表格的面对面访谈方法收集数据。采用科莱齐现象学方法的步骤对定性数据进行分析。

结果

该研究涉及16名年龄在20至36岁之间的土耳其护士。通过数据分析,确定了四个主要主题、14个子主题和25个编码。访谈得出的主要主题包括“人道主义职责”“不遵守伦理原则”“尊重伤者”和“医疗差错”。

结论

在这个复杂的过程中,在管理、教育和心理社会援助等领域加强对护士的支持变得至关重要,从而培养他们的个人和专业敏锐度、奉献精神和伦理敏感性。完善包含护士在灾难场景中应遵循原则的指南和专业标准,同时提供医学和伦理能力的全面培训,是一条重要的前进途径。专注于危机管理的培训将使护士能够做出符合伦理的决策并提高他们的专业水平。

对护理政策的启示

包括地震在内的自然灾害给医疗专业人员,尤其是在这些紧急情况下提供护理中起关键作用的护士带来了重大的伦理挑战。资源分配和分诊、护理职责和确保护理连续性、知情同意和沟通、文化敏感性以及提供心理社会支持等问题是地震情况下护理政策的关键伦理考量。在与地震相关的护理政策中解决这些伦理问题对于维持医疗服务的完整性、维护公众信任以及确保危机期间伤者和医疗服务提供者的福祉至关重要。

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