To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both self-cultivation (...) of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education. (shrink)

The aim of this study was to compare Swedish and Chinese nurses' experiences of ethical dilemmas and workplace distress in order to deepen understanding of the challenges neuroscience nurses encounter in different cultures. Qualitative interviews from two previously performed empirical studies in Sweden and China were the basis of this comparative study. Four common content areas were identified in both studies: ethical dilemmas, workplace distress, quality of nursing and managing distress. The themes formulated within each content area were compared and (...) synthesized into novel constellations by means of aggregated concept analysis. Despite wide differences in the two health care systems, the nurse participants had similar experiences with regard to work stress and a demanding work situation. They were struggling with similar ethical dilemmas, which concerned seriously ill patients and the possibilities of providing good care. This indicates the importance of providing nurses with the tools to influence their own work situation and thereby reducing their work-related stress. (shrink)

This article is part of a wider study entitled Value of Nursing, and contains the literature search from electronic databases. Key words for the search included `values of nursing', `values in nursing', `organisational values' and `professional identity'. Thirty-two primary reports published in English between 2000 and 2006 were identified. The findings highlight the importance of understanding values and their relevance in nursing and how values are constructed. The value of nursing is seen to be influenced by cultural change, globalization, and (...) advancement in technology and medicine. These factors are crucial in providing a more structured and measured view of what nursing is, which will result in greater job satisfaction among nurses, better nurse retention and enhanced patient care within a supportive and harmonious organization. The findings of this review have implications for policy makers in recruitment and retention in determining the global value of nursing. (shrink)

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland (n =427), Estonia (n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% (n = 322) in Finland, 54% (n =119) in Estonia and 86% (n = 160) in Lithuania. A modified version of a (...) scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs. (shrink)

Background: Developing professional values among nursing students is important because values are a significant predictor of the quality care that will be provided, the clients’ recognition, and consequently the nurses’ job satisfaction. The literature analysis showed that there is only one validated tool available in Turkish that examines both the personal and the professional values of nursing students. Objective: The aim of this study was to assess the reliability and validity of the Salford-Scott Nursing Values Questionnaire in Turkish. Design of (...) the study: This study was a Turkish linguistic and cultural adaptation of a research tool. Participants and research context: The sample of this study consisted of 627 undergraduate nursing students from different geographical areas of Turkey. Two questionnaires were used for data collection: a socio-demographic form and the Salford-Scott Nursing Values Questionnaire. For the Salford-Scott Nursing Values Questionnaire, construct validity was examined using factor analyses. Ethical considerations: The study was approved by the Cumhuriyet University Faculty of Medicine Research Ethics Board. Students were informed that participation in the study was entirely voluntary and anonymous. Results: Item content validity index ranged from 0.66 to 1.0, and the total content validity index was 0.94. The Kaiser–Meyer–Olkin measure of sampling was 0.870, and Bartlett’s test of sphericity was statistically significant (x2 = 3108.714, p < 0.001). Construct validity was examined using factor analyses and the six factors were identified. Cronbach’s alpha was used to assess the internal consistency reliability and the value of 0.834 was obtained. Conclusion: Our analyses showed that the Turkish version of Salford-Scott Nursing Values Questionnaire has high validity and reliability. (shrink)

Background Healthcare professionals, especially professional nurses, experience various types of moral suffering due to inevitable ethical conflicts. Moral resilience is recently proposed as a resource to address moral suffering. However, there is no tool to measure moral resilience in Chinese professional nurses. Aim This study aimed to translate the Rushton Moral Resilience Scale (RMRS) into Chinese and evaluate the psychometric properties of the Chinese version of RMRS (Chi-RMRS). Research design A methodological and descriptive research design. Participants and research context A (...) convenience sample of 411 Chinese professional nurses was recruited through an online survey platform between February and March 2023. Ethical considerations This study was approved by the Research Ethics Committees of the University and hospitals involved. Results The RMRS was translated and culturally adapted into a Chinese version. Neither floor nor ceiling effects were observed. The scale-level content validity index (CVI) was 0.922 with the item-level CVIs ranging from 0.833 to 1.000. The explanatory factor analysis (EFA) generated a three-factor structure for the Chi-RMRS, and the confirmatory factor analysis (CFA) demonstrated the three-factor structure with factor loadings for each item ranging from 0.42 to 0.80. The scale-level Cronbach’s α coefficient was 0.811 with each dimension ranging from 0.717 to 0.821, and composite reliability (CR) coefficient for the overall scale was 0.920, with each dimension varying from 0.739 to 0.824. The standard error of measurement (SEM) and smallest detectable change (SDC) were 3.522 and 9.763, respectively. Discussion The Chi-RMRS is able to measure moral resilience of Chinese professional nurses, and has good validity and reliability. It can be used in research and practice to determine the level of moral resilience, thus helping nursing managers to monitor the status of Chinese professional nurses, then develop interventions to maintain the well-being of professional nurses and to ensure quality of care. (shrink)

Background: Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity. Aim: This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction. Research design: This research employed a descriptive and cross-sectional design. Participants and research context: This study was conducted with a sample of 236 nurses, all of whom worked in (...) emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale. Ethical considerations: This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University. Findings: There was a weak and negative correlation (r = –0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = –0.335, p < 0.001) between the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale scores. Discussion and conclusion: Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized. (shrink)

Background: People in both Taiwan and China originally descended from the Han Chinese, but the societies have been separated for approximately 38 years. Due to different political systems, variations exist in healthcare and nursing education systems in Taiwan and China. Objective: The purpose of this study was to examine the professional values of nursing students in Taiwan and China. Design: A cross-sectional design was applied in this study. The Nursing Professional Value Scale–Revised was used to measure the professional values of (...) the students. The questionnaire was distributed to eligible undergraduate students in a classroom setting. Ethical considerations: This study was approved by the Institutional Review Board at the first investigator’s university. Participants were informed that completion and return of the questionnaire was voluntary, and confidentiality was ensured by keeping the responses anonymous. Participants: A convenience sample included 292 Taiwanese students and 654 Chinese students. Findings: A total of 11 individual Nursing Professional Value Scale–Revised items showed significant differences between the two groups. These results reflect the differences in the perceived importance of these items between the groups. There was no significant difference between the two groups in the mean overall scores for the Nursing Professional Value Scale–Revised (p =.766) and three subscales (all p >.05). Conclusion: There are some differences in professional values between nursing students in Taiwan and China. Given the increasingly frequent and close interactions between Taiwan and China and the globalization of nursing, understanding these differences may help nursing educators identify students’ perceptions of their professional values and support the development of strategies to improve weaknesses in professional values. (shrink)

Objective: The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them.Methods: A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students.Results: A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing ethical disagreement in (...) the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators’ individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents’ individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students’ sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators’ sense of the purpose of bioethics education.Conclusions: This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students. (shrink)

BackgroundHealthcare professionals use the ethics of justice and care to construct moral reasoning. These ethics are conflicting in nature; different value systems and orders of justice and care are applied to the cause of actual moral conflict. We aim to clarify the structure and factors of healthcare professionals’ moral conflicts through the lens of justice and care to obtain suggestions for conflict resolutions.MethodSemi-structured interviews about experiences of moral conflict were conducted with Japanese nurses recruited using the snowball sampling method. Interviews (...) were conducted based on the real-life moral conflict and choice interview. Interviews were recorded and transcribed verbatim, then analyzed based on the interpretive method of data analysis. Verbatim transcripts were read four times, first to get an overall sense of the conflict, then to understand the person’s thoughts and actions that explain the conflict, and third and fourth to identify perspectives of justice and care, respectively. Each moral perspective was classified into categories according to Chally’s taxonomy.ResultsAmong 31 responses, 2 that did not mention moral conflict were excluded, leaving 29 responses that were analyzed. These responses were classified into six cases with conflict between both justice and care perspectives or within one perspective, and into two cases without conflict between perspectives. The “rules” category of justice and the “welfare of others” category of care were included in many cases of conflict between two perspectives, and they frequently occurred in each perspective.ConclusionsThe nurses in this study suggest that they make moral judgments based on moral values that are intertwined with justice and care perspectives complex manner.Organizational, professional, and patient-related factors influenced conflicts between justice and care. Additionally, multiple overlapping loyalties created conflicts within justice perspectives, and multifaceted aspects of care-provider’s responsibility and patient need created conflicts within care. Decision-making biased towards one perspective can be distorted. It is important to consider ethical issues from both perspectives to resolve conflicts, especially the effective use of the ethics of care is recommended. (shrink)

Background: An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. Aim: The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. Research design: A convergent parallel mixed-methods research design was adopted. Participants and research context: In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire–revised version was used to assess the levels (...) of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments ( n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses’ perceptions of the barriers and facilitators in nurturing ethical sensitivity ( n = 15). The data were collected from February to June 2014. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Results: Despite moderately high overall Chinese Moral Sensitivity Questionnaire–revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. Discussion: The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. Conclusion: This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses’ sensitivity to ethical issues. (shrink)

Globalization is a part of modern life. Sharing a common set of professional nursing values is critical in this global environment. The purpose of this research was to examine the professional values of nursing students from two distinct cultural perspectives. Nurse educators in Taiwan partnered with nurse educators in the United States to compare professional values of their respective graduating nursing students. The American Nurses Association Code of Ethics served as the philosophical framework for this examination. The convenience sample comprised (...) 94 Taiwanese students and 168 US students. Both groups reported high scores on an overall measure of values. They did differ substantially on the relative importance of individual items related to advocacy, competence, education, self-evaluation, professional advancement, and professional associations. Global implications for the collaborative practice of nurses from different cultures working together can be improved by first recognizing and then attending to these differences in value priorities. (shrink)