Background Nursing is regulated by a set of professional standards. Whilst many forms of ethics apply to nursing, the biomedical ethical framework is common, involving autonomy, beneficence, non-maleficence and justice. In healthcare, nurses often encounter ethical dilemmas that require them to navigate conflicting ethical principles. However, how nurses adhere to these principles in such situations is unclear. Research Aim To explore how registered nurses adhere to ethical principles when dealing with ethical dilemmas at work. Research Design A qualitative descriptive study (...) design. Participants and Research Context Between August and December 2023, 21 registered nurses were recruited from a teaching hospital through purposive sampling. Data were collected through semi-structured in-person interviews or online video conferencing. Braun and Clarke’s thematic analysis approach was employed to analyse the data. Ethical Considerations Interview participation was voluntary. Written consent was obtained before participation. Participants’ real identities were replaced with pseudonyms. This study was approved by the SingHealth Centralised Institutional Review Board. Findings The data analysis developed four major themes and 15 subthemes. The four major themes are “Addressing the dilemma,” “Contemplating the principles and consequences,” “Coordinating for well-informed, ethical decision,” and “Self-reflecting and finding consolation.” Conclusion This study explains how nurses navigate and uphold ethical principles when caring for patients to the best of their ability. Fully adhering to ethical principles can be challenging for caring for actively dying patients. Further research can expound on nurses’ experiences and adherence to ethical principles in complex clinical cases. (shrink)

Background and aimThe nature of pediatric settings may encounter nurses with more complicated ethical issues. A code of ethics guides nurses to act and decide ethically as a profession. Also, there is always a need to evaluate amount nurses adhere to this code of ethics, using valid and reliable instruments. This study aimed to develop a questionnaire and assess its psychometric properties to measure pediatric nurses' adherence to the code of ethics. MethodsIn this methodological research study, firstly, the questionnaire was (...) developed based on an extensive review of the related literature and the theoretical framework of nursing ethics. A panel of experts (n = 12) reviewed the preliminary questionnaire qualitatively and quantitatively (using CVI and CVR). A conveniently selected sample of 156 nurses working in pediatric wards in three hospitals filled out the questionnaire. The psychometric process included determining sample size and data adequacy using KMO and Bartlette's test of sphericity; exploratory factor analysis (principal component method with Promax rotation); item analysis; and Cronbach's alpha coefficient. Also, the Interclass Correlation Index (ICC) value was determined using a two-week interval test–retest method on 30 eligible nurses.ResultsThe CVI and CVR for the entire questionnaire were 0.85 and 0.78, respectively. The CVI and CVR of all items were reported higher than 0.59 and 0.8, respectively. Cronbach's alpha of the 28-items instrument was 0.92. Extracted six factors explained 65.31% of the total variance, and the values of the item correlations with the total questionnaire showed good internal consistency (0.52 to 0.90). The items of each factor were evaluated to determine the values they represent. Accordingly, the factors were named beneficence, nonmaleficence, human dignity, autonomy, informed consent, and honesty. The ICC value was 0.99.ConclusionsThe developed instrument is acceptable and has good reliability and validity. It can be used to assess the amount of pediatric nurses' adherence to the code of ethics by managers, teachers, and researchers. (shrink)

Background: The nature of children’s cancer comes with lots of ethical issues. Nurses are encouraged to adhere to ethical codes in their practice. Objectives: This study aimed to compare the perspectives of nurses and mothers of children with cancer regarding the adherence of nurses to ethical codes. Research design: In this descriptive-comparative study, a researcher-made questionnaire was used to assess the amount of adherence to Iranian nurses’ code of ethics in perspectives of pediatric oncology nurses and mothers. As a convention, (...) the total scores were categorized as optimal, average, and low adherence. Participants and context: A total of 200 mothers and 60 nurses in pediatric oncology wards of five major hospitals in Tehran, Iran, participated in 2016. Ethical considerations: Organizational approval by the university and informed consent were ensured before conducting the research. The principles of voluntariness, confidentiality, and anonymity were respected during the research process. Findings: Results showed the mean score of the adherence to ethical codes by nurses, as per the nurses is 86.71 (12.57) and as per the mothers is 78.67 (16.09). The highest frequency for “Low adherence” and “Optimal adherence” to code of ethics by nurses were “Respect for individual autonomy and decision-making” (mothers, 72% and nurses, 70%) and “Commitment to confidentiality” (mothers, 64% and nurses, 74%), respectively. This revealed a significant difference between the responses of the nurses and the mothers (p = 0.001). Discussion: The results support the other studies in Iran about the difference between the perspectives of patients and nurses about adherence of nurses to ethical codes. Conclusion: Integration of family-centered and conventional care in addition to more attention to the education of professional ethical principles could be helpful to improve the ethical performance of nurses in oncology pediatric wards. (shrink)

Background and aim Difficult moral situations assume more critical importance in pediatric wards since children are more vulnerable than adults. Given that professional ethics is a substantial part of children treatment, the present study was conducted to determine the ethical performance of nurses from the perspective of mothers and nurses in the pediatric wards of Be'esat Hospital in Hamadan. Materials and methods The present descriptive-analytical study was conducted on 58 nurses and 263 mothers of children referred to the pediatric wards (...) of Be'esat Hospital in Hamadan in 2019. The study samples were randomly selected. Data collection tools included the demographic form and Ethical Performance Assessment Questionnaire developed by Beykmirza et al. The obtained data were analyzed in SPSS software version 23using descriptive and inferential statistics. Results As evidenced by the obtained results, the mean ethical performance of nurses from the perspective of nurses and mothers were reported as 86.72 ± 6.397 and 69.92 ± 18.09. From the mothers' viewpoint, 27%, 39.2%, and 33.8% of nurses had weak, moderate and good levels of performance, respectively. On the other hand, from the nurses' perspective, 24.6% and 75.4% of nurses had moderate and good levels of performance, respectively. The obtained results were indicative of a statistically significant difference between the performance score as reported by mothers and nurses (P < 0.001). Conclusion Considering that the majority of mothers rated the ethical performance of nurses as weak and moderate, it is suggested that professional ethical principles be implemented in the form of Retraining programs in an attempt to improve the ethical performance of nurses. (shrink)

Background Professional ethics is the regulation and discipline of nurses’ daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are few studies on nurses' adherence to professional ethics. Research Aim An analysis of nursing adherence to nursing ethics from the perspective of clinical nurses in the Chinese public health system. Research Design This study adopts the grounded theory approach proposed by Strauss and Corbin. Participants and research context Between July 2021 and January (...) 2022, Clinical nurses were recruited for online video interviews using purposive and theoretical sampling methods in seven hospitals in Beijing, Tianjin, Shanxi, Henan, Guangdong, and Fujian, China. Data analysis was conducted using Strauss and Corbin’s coding approach. Ethical considerations This study was approved by the Ethics Committee of Sanming First Hospital (MingYiLun 71/2021) Findings A total of 27 participants were included. A theoretical model of nursing staff adherence to professional ethics was constructed. The main core was adherence to professional ethics and the other cores were (1) causal conditions: professional ethics code, individual conscience; (2) intervening conditions: personal growth, social support system, matching career compensation, prediction of adverse consequences; (3) action strategies: sticking to professional values, self-regulation, flexible response, post-event improvement; and (4) outcomes: self-harmony, reduced medical disputes. Conclusions This study provides an interpretive understanding of why clinical nurses adhere to professional ethics in China and describes the challenges and issues posed by nurses’ use of strategies to cope with ethical adversity. The findings can be used to develop future complex studies. (shrink)

AimsThis study aimed to investigate barriers in the observation of professional ethics during clinical care from a nursing viewpoint. Also, it examined the association between these barriers and nurse demographic variables.MethodsA descriptive-analytic design was carried out on 207 nurses working in selected hospitals within an urban area of Iran in 2019. Data were collected using a standard questionnaire containing 33 questions that measured barriers to observation of professional ethics. The questionnaire measures three domains of management, environment and individual care.ResultsIn the (...) management dimension, the most important barrier preventing observation of professional ethics was the shortage of personnel. For the environmental dimension, biological changes due to working on the nightshift, and for the individual care dimension, a lack of time were the most important barriers preventing observation of clinical ethics. Findings additionally highlighted a significantly inverse association between barriers to observing professional ethics and the male gender, participating in the ethics workshop and high work-level experiences.ConclusionsIt is suggested that nursing managers in hospitals correct and remove obstacles with careful planning and emphasis on principles and standards of care including environmental and managerial factors and training professional ethics to nurses. (shrink)

Background Managerial ethical principles and behaviours guide the roles, duties, responsibilities, behaviours, and relationships of nurse managers in healthcare institutions. Research objectives The aim of this study was to establish the managerial ethical principles and behaviours for nurse managers. Research question What are the managerial ethical principles and behaviours for nurse managers? Research design The Delphi method, one of the qualitative research methods, was used in this study. The Delphi process consisted of two rounds. Data were collected by e-Delphi technique. (...) Participations 42 experts were included in the first Delphi round and 39 in the second Delphi round. These experts consisted of nurse managers, academicians studying in the field of ethics and nursing management. Ethical considerations Participation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee of the university at which the researcher worked (Approval date: 24.07.2020, Decision No: 2020/12-16). Findings At the end of the Delphi rounds, eight managerial ethical principles and 29 ethical behaviours of these principles were identified. The distribution of these behaviours and principles were: justice (six behaviours), equality (two behaviours), honesty (two behaviours), fairness (two behaviours), responsibility (eight behaviours), confidentiality (two behaviours), clarity (two behaviours), and humanity (five behaviours). Conclusion These managerial ethical principles and behaviours are intended to guide nurse managers when providing nursing services but should be updated accordingly in line with changing conditions and developments. (shrink)