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护理中的职业道德挑战及建议策略:一项定性研究

Professional ethical challenges and suggested strategies in nursing: a qualitative study.

作者信息

Ghavi Arezoo, Valizadeh Leila, Powers Kelly, Zamanzadeh Vahid

机构信息

Assistant Professor, Department of Nursing, Ferdows Branch, Islamic Azad University, Ferdows, Iran .

Professor, Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran .

出版信息

J Med Ethics Hist Med. 2024 Nov 23;17:10. doi: 10.18502/jmehm.v17i10.17109. eCollection 2024.

Abstract

Professional ethics are essential for supporting nurses in making ethical decisions and responding to current challenges. This study aimed to explore professional ethical challenges and the strategies nurses use to address them in Iran. An exploratory descriptive qualitative approach was employed, with data collected through two focus groups involving 16 nurses and semi-structured individual interviews with six nursing faculty members. Data were analyzed using thematic analysis following Braun and Clarke's method. Participants shared their experiences and perceptions of professional ethical challenges and proposed strategies to address them. Nine categories and 51 subcategories were identified, including: 1) Deficiencies in patient-centered care; 2) Communicating bad news to patients and families; 3) Decisions on withholding or withdrawing life-sustaining treatments; 4) Lack of cultural consideration in nursing care; 5) Challenges of incorporating new technology; 6) Ethical concerns in managing and using large patient datasets; 7) Upholding ethical principles in disaster or crisis nursing; 8) Gaps in providing palliative care; and 9) Fear of causing moral distress. The findings underscore the ethical challenges faced by nurses in clinical practice and suggest strategies for addressing each challenge in Iran.

摘要

职业道德对于帮助护士做出道德决策并应对当前挑战至关重要。本研究旨在探讨伊朗护士面临的职业道德挑战以及他们用以应对这些挑战的策略。采用探索性描述性定性研究方法,通过两个焦点小组(涉及16名护士)和对六名护理教员的半结构化个人访谈收集数据。按照布劳恩和克拉克的方法,使用主题分析法对数据进行分析。参与者分享了他们对职业道德挑战的经历和看法,并提出了应对策略。确定了九个类别和51个子类别,包括:1)以患者为中心的护理存在缺陷;2)向患者及其家属传达坏消息;3)关于停止或撤销维持生命治疗的决策;4)护理中缺乏文化考量;5)引入新技术的挑战;6)管理和使用大型患者数据集时的伦理问题;7)在灾难或危机护理中坚持伦理原则;8)姑息治疗提供方面的差距;9)对引起道德困扰的担忧。研究结果凸显了护士在临床实践中面临的伦理挑战,并提出了在伊朗应对每项挑战的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65af/12091083/f57cf913f30a/JMEHM-17-10-g001.jpg

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