The main purpose of this study was to validate a scale to examine the moral sensitivity of Korean nurses. A pre-existing scale, the Moral Sensitivity Questionnaire (MSQ), developed by Lützén, was used after deletion of three items. The reliability and validity of the scale were examined by using Cronbach’s alpha and factor analysis, respectively. According to the results, reliability of the scale was adequate but its construct validity was not fully supported. Through discussion on evidence of validity, five subconstructs emerged. (...) In particular, unlike the factor structure of the MSQ, two subconstructs, patient-oriented care and professional responsibility, were newly extracted. It was assumed that the other three MSQ subconstructs, conflict, meaning and benevolence (expressed as nurses being ethically good), would not be sensitive to cultural background. Given these findings, interpretations about the meaning of moral sensitivity of Korean nurses are discussed. (shrink)

Background In the globalizing world, nurses often meet humans from different cultures and values. This fact has led them to make ethical decisions, which do not comply with their own moral jurisdictions at care setting. Objectives The objective of the study was to investigate the relationships between moral development levels of the nurses and their scores of nursing principled thinking and practical consideration during decision making for ethical dilemmas. Methods This was a descriptive correlational study. Nursing Dilemma Test, Moral Development (...) Scale for Professionals and socio-demographic form were used. Study was conducted with 227 nurses. Ethical considerations: An institutional authorization, an ethics approval from non-interventional ethics committee of the respective university, permission from the authors of the scales used and informed consents from the nurses were obtained in order to conduct the study. Results In this study, nurses were found to be at post-conventional level according to Kohlberg’s moral development theory. Sociodemographic and working characteristics of the nurses have not affected their scores of moral development level and their scores of nursing principled thinking, practical consideration and familiarity. Nurses take attention for moral principles during decision making although not at a desirable level, and they are relatively affected by environmental factors Conclusion Although nurses are familiar with ethical problems at scenarios including ethical dilemmas, they cannot make decisions in accordance with their moral development levels during decision making for ethical dilemmas. Nurses should be instructed and supported for ethical decision making by recognizing factors that may be effective on their decision making. (shrink)

Training nurses on spiritual principles and values helps to stimulate moral imagery and a deep understanding of moral problems in them. However, spirituality issue was not included in ethical educa...

Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...) moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses’ moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care. (shrink)

This study describes the level of moral sensitivity among nursing students enrolled in a traditional baccalaureate nursing program and a master’s nursing program. Survey responses to the Modified Moral Sensitivity Questionnaire for Student Nurses from 250 junior, senior, and graduate students from one nursing school were analyzed. It was not possible to draw conclusions based on the tool. Moral category analysis showed students ranked the category structuring moral meaning highest and interpersonal orientation second. The moral issue ranking highest was honesty, (...) respect for the patient second, and third was responsibility to know the patient’s situation. Seniors agreed more often about the need to focus on patient safety. As students progress through the baccalaureate program and into the graduate program, their perspectives increasingly recognize the contextuality of moral issues. The results show a need to further develop a tool to measure moral sensitivity, using student understanding and perceptions of moral issues. (shrink)

Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts. Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies. Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses. Participants: The 69 participants attended a 1-year educational (...) programme for ambulance nurses at a Swedish university. Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study. Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care. Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability. (shrink)

Background:Moral distress is one of intensive care unit nurses’ major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses’ personal and professional practice, recognizing moral distress is very important.Research objective:The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses.Research design:This study is a descriptive-correlation research.Participants and research context:A total of (...) 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included “demographic questionnaire,” “ICU Nurses’ Moral Distress Scale,” “Copenhagen Burnout Inventory” and “Hinshaw and Atwood Turnover Scale.” Data analysis was done by using SPSS19.Ethical considerations:Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran.Findings:The findings showed intensive care unit nurses’ moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses’ age, their work experience and the fraction of nurses’ number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress.Discussion:Some of the findings of this research are consistent with other studies and some of them are inconsistent.Conclusion:Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses’ moral distress, burnout and their turnover intention are essential. (shrink)

The present study was conducted to determine the relation between nurses’ moral distress and the ethical climate in selected hospitals of the Iranian Social Security Organization (ISSO). This descriptive-analytical correlational study was conducted in 6 hospitals under the coverage of the Iranian Social Security Organization in 2016. Three hundred nurses were selected by convenience sampling method. Data were gathered using Corley’s Standard Moral Distress and Olson’s Hospital Ethical Climate Scales. Data were analyzed using SPSS software version 19. The mean score (...) of the nurses’ moral distress was 1.94 ± 0.66, which is considered moderate. The mean score of ethical climate was 88.97, indicating desirable ethical climate in these hospitals. The frequency score of moral distress had a unilateral reverse correlation with the total score of ethical climate as well as its dimensions, including colleagues, patients, hospitals and physicians. The score of the intensity of nurses’ moral distress also had a unilateral reverse correlation with the total score of ethical climate and the scores of the hospital and physicians dimensions. These results emphasized the importance of creating a positive ethical climate to decrease moral distress as well as the need for professional interventions to increase support in moral issues. (shrink)