Background Hospital ethical climate has important implications for clinical nurses’ service behavior; however, the relationships are complicated by the fact that five types of ethical climate (caring, law and code, rules, instrumental, and independence) can be combined differently according to their level and shape differences. Recent developments in person-centered methods (e.g., latent profile analysis (LPA)) have helped to address these complexities. Aim From a person-centered perspective, this study explored the distinct profiles of hospital ethical climate and then examined the relationships (...) of the profiles with clinical nurses’ service behavior (both in-role and extra-role service behavior). Research design A quantitative study was conducted using cluster random sampling. Latent profile analysis and binary coded hexadecimal (BCH) analysis were conducted using Mplus 8.2. Participants and research context A total of 871 clinical nurses in China were surveyed using the Ethical Climate Scale and Nurses’ Service Behavior Questionnaire. Ethical considerations Ethical approval was obtained from the IRB of the First Affiliated Hospital of Jinan University (No. KY-2020-090). Results A four-profile hospital ethical climate model provided the best fit for the data. The four different profiles not only varied in level, but also in shape: high normative and low egoism (45.8%), high ethical climate (19.9%), low ethical climate (3.6%), and moderate ethical climate (30.8%). These profiles differentially predicted clinical nurses’ overall, in-role, and extra-role service behaviors. Conclusions The results reveal new insights into the nature of hospital ethical climate and how different clinical nurses in these profiles can be best managed to accomplish different forms of service behavior. (shrink)

Background: The three-dimensional model of nurses’ moral sensitivity has typically been studied using a variable-centered rather than a person-centered approach, preventing a more complete understanding of how these forms of moral sensitivity are expressed as a whole. Latent profile analysis is a person-centered approach that classifies individuals from a heterogeneous population into homogeneous subgroups, helping identify how different subpopulations of nurses use distinct combinations of different moral sensitivities to affect their service behaviors. Objective: Latent profile analysis was used to identify (...) three distinct profiles of nurses’ moral sensitivity. Associations of the profiles with service behaviors were then examined. Methods: Five hundred twenty-five nurses from three tertiary hospitals in China were investigated with Moral Sensitivity Questionnaire and Nurses’ Service Behavior Scale. Latent profile analysis was used to analyze the data. Ethical considerations: Approval was obtained from the Ethics committee for biomedical research of Medical College, the Hebei University of Engineering. Results: A three-profile moral sensitivity model provided the best fit to the data. The resulting profiles were low moral sensitivity, moderate moral sensitivity, and high moral sensitivity. There were significant differences in service behaviors among different profiles of moral sensitivity. Conclusion: The results provide a new and expanded view of nurses’ moral sensitivity, which may be used to monitor nurses’ service behaviors comprehensively and to evaluate nursing ethics management strategies. (shrink)

Background Nurses frequently experience ethical issues in their area of practice. In the challenging reality of today’s healthcare environment, nursing students need to be prepared to deal with ethical issues in their future roles. Nevertheless, Chinese nursing students’ ethical sensitivity status and the factors influencing it have not been described. Objective This study aims to explore the level of ethical sensitivity and its influencing factors among Chinese nursing students. Research design This was a cross-sectional study. We firstly cross-culturally adapted the (...) Japanese version of the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) into a Chinese version. Then, we administered the Chinese version of ESQ-NS, the Caring Ability Inventory (CAI), and general information questionnaire to nursing undergraduates. Participants and research context The invitations were sent to 600 nursing undergraduates from four universities in Hunan, China. Ethical considerations The study was supported by the Institutional Review Board (IRB) of the lead university. The Approval No. was E202092. Results A total of 489 undergraduate nursing students participated in the study. The mean score for ethical sensitivity of the samples was 36.34 ± 4.90, and 187.99 ± 22.64 for their humanistic care ability. Pearson’s correlation coefficient test indicated a meaningful and positive relationship between the ethical sensitivity and humanistic care ability (r = 0.576 and p <.01). And regression analysis showed that age, school year, experience in studying nursing ethics, how much you like nursing major, and humanistic care ability were of relevance to nursing students' ethical sensitivity. Discussion Our findings suggest that the mean ethical sensitivity score of Chinese nursing students is 36.34 (13–52). The humanistic caring ability of Chinese nursing students is still at a low level. Conclusion Future interventions for improving the ethical sensitivity of the nursing students should consider general information of participants and their humanistic care ability. (shrink)

BackgroundMoral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience.AimThe aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil.Research designThe research design is the qualitative study with discursive textual analysis.Participants and research context: 44 nurse managers (...) and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions.Ethical considerationsThe Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity.FindingsPersonal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation.ConclusionFrom the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience. (shrink)

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: We recruited 500 nurses (...) from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40%. The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity. Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Background With an increasing older population, the pressure on home care resources is growing, which makes it important to ensure the maintenance of quality care. It is known that compassion and ethical sensitivity can improve the quality of care, but little is known about care leaders’ perceptions on ethical sensitivity and compassion in home care and how it is associated with staff competence and thus quality of care. Aim The aim of the study was to explore home care leaders’ perceptions (...) of ethical sensitivity and compassion associated with care quality in home care. Research design, participants, and research context A hermeneutical approach with a qualitative explorative design was used. The data consists of texts from 10 in-depth interviews with home care leaders. Content analysis was used as a method. Ethical considerations The study was conducted following the ethical guidelines of the Declaration of Helsinki and the Finnish Advisory Board of Research Ethics. Research ethics permission was applied for from a Research Ethics Board. Findings One overall theme and four subthemes were found. The overall theme was: “Compassion provides deeper meaning and ethical sensitivity provides means for knowing how to act”. Discussion If nurses fail to be sensitive and compassionate with patients, good and high qualitative home care cannot be achieved. Ethical sensitivity and compassion can be seen as resources in home care but the organization and the care leaders need to provide the support for these to develop. Conclusion This study provides an understanding of the meaning of ethical sensitivity and compassion as sources of strength and their link to quality of care in a home care context. Further studies could focus on how to build compassion and ethical sensitivity into home-based care and how to ensure adequate support for healthcare professionals’ compassion and ethical sensitivity. (shrink)

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse Description Form” (...) developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit. Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested. (shrink)