Education and Ethics In Nursing ISSN: 2322-5300

بررسی تأثیر برنامۀ آموزش اخلاق بر تعارض اخلاقی پرستاران شاغل در بخش‌های مراقبت ویژه

دوره 13، شماره 1
فروردین 1403
صفحه 33-41

نوع مقاله : مقاله پژوهشی اصیل

نویسندگان

1 کارشناسی ارشد داخلی جراحی، گروه پرستاری، دانشگاه علوم پزشکی جهرم، جهرم، ایران

2 استادیار، گروه پرستاری، دانشگاه علوم پزشکی جهرم، جهرم، ایران

3 استادیار، گروه پرستاری، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

4 کارشناسی ارشد داخلی جراحی، گروه پرستاری، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

چکیده
مقدمه: یکی از راه­های کاهش تعارض­های اخلاقی، آموزش اخلاق حرفه ­ای به پرستاران، می­باشد. این پژوهش، با هدف تعیین تأثیر برنامۀ آموزش اخلاق،  بر تعارض اخلاقی پرستاران بخش­های مراقبت ویژه، انجام شده است.
روش کار: این مطالعۀ نیمه تجربی تک گروهی، از نوع قبل و بعد بود که با مشارکت 21 نفر از پرستاران شاغل، در بخش­های مراقبت ویژۀ بیمارستان پیمانیه جهرم (1399)، انجام گردید. نمونه ­ها به شکل سرشماری، وارد مطالعه شدند که برنامۀ آموزش اخلاق، طی 4 جلسۀ 90 دقیقه ­ای و در طول یک ماه برای نمونه ­های پژوهش، برگزار کردند. ابزار جمع‌آوری اطلاعات، بر اساس دو پرسشنامۀ اطلاعات دموگرافیک و تعارض اخلاقی پرستاران بخش ویژه، بود که جهت سنجش میانگین تعارض اخلاقی پرستاران، در قبل و یک ماه پس از پایان آموزش، پرسشنامه­ ها توسط شرکت­ کنندگان تکمیل شدند؛ سپس داده­ های جمع ­آوری شده، با استفاده از آزمون تی زوجی در نرم افزار spss نسخۀ 20، مورد تجزیه و تحلیل قرار گرفتند که سطح معناداری آن کمتر از 05/، در نظر گرفته شد.
یافته‌ها: میانگین نمرۀ تعارض اخلاقی قبل از مداخله، برابر با  19/47±33/ 232 و میانگین نمرۀ تعارض اخلاقی پرستاران، پس از مداخله 22/63±174/76، تشکیل ­داد که این تفاوت از لحاظ آماری، معنادار بود(0/001>P).
نتیجه‌گیری: برنامۀ آموزش اخلاق، موجب کاهش تعارض اخلاقی پرستاران، در بخش­های مراقبت ویژه گردیده است؛ بنابراین پیشنهاد می­شود که جهت کاهش تعارض اخلاقی پرستاران، در بخش­های مراقبت ویژه، از برنامۀ آموزشی اخلاق، استفاده گردد.

کلیدواژه‌ها

عنوان مقاله English

Evaluation the effect of ethics education program on ethical conflict of nurses working in intensive care

نویسندگان English

zahra Foruozandeh 1
mohsen faseleh jahromi 2
, Rasoul Eslami Akbar 3
zahrasadat sabzevari 4
1 MSc, Department of Nursing, Jahrom University of Medical Scienes, Jahrom, Iran
2 Assistant Professors, Department of Nursing, Jahrom University of Medical Scienes, Jahrom, Iran
3 Assistant Professor, Department of Nursing, Jahrom University of Medical Scienes, Jahrom, Iran
4 MSc, Department of Nursing, Jahrom University of Medical Scienes, Jahrom, Iran
چکیده English

Introduction:
One of the ways to reduce ethical conflicts is to teach professional ethics to nurses. This study was conducted with the aim of determining the effect of the ethics training program on the moral conflict of special care nurses.
Materials and Methods:
This study was a semi-experimental research of a single group before and after, which was conducted with the participation of 21 nurses working in the special departments of Peymaniyeh Jahrom Hospital in 2019. The samples were included in the study by census. Ethics training program was held during 4 sessions of 90 minutes during one month for research samples. The data collection tool was Persian version of the moral conflict questionnaire of nurses in the special department. In order to measure the average moral conflict of nurses before and one month after the end of the training, questionnaires were completed by the participants. Then, the collected data were analyzed using the paired t-test in spss software version 20. A significance level of less than 0.5 was considered.
Results:
The average moral conflict score before the intervention was 232.33±19.47 and the average moral conflict score of the nurses after one month of intervention was 174.76±22.63, which was statistically significant (P <0.001).
Conclusions:
Ethics training program reduced the moral conflict of nurses in intensive care units. Therefore, it is suggested to use an ethics training program to reduce the moral conflict of nurses in intensive care units.

کلیدواژه‌ها English

  • Ethics
  • Education
  • Nurses
  • Conflict
  1. Fuladvandi M, Amiresmaili MR, Tofighi M, Fuladvandi GR, Ramezani M. The relationship between job satisfaction and organizational citizenship behavior: a study on nurses working in intensive care units and emergency departments of hospitals affiliated to Kerman University of Medical Sciences in 2012. Journal of Health and Development. 2015;3(4):341-50.[persian]
  2. Redman BK, Fry ST. Nurses’ ethical conflicts: what is really known about them? Nursing Ethics. 2000;7(4):360-6.doi: 10.1177/096973300000700409.
  3. Wlodarczyk D, Lazarewicz M. Frequency and burden with ethical conflicts and burnout in nurses. Nursing Ethics. 2011;18(6):847-61. doi:10.1177/0969733011408053.
  4. Joolaee S, Bakhshandeh B, Mohammad Ebrahim M. Nursing ethics codes in Iran: report of an action research study. Journal of Medical Ethics and History of Medicine. 2010;3(2):45-53.
  5. Jahandar F, Mohtashami J, Atashzadeh -Shorideh F, Pishgooie SAH. Effectiveness of the negotiating style on ICU nurses’ moral conflict in selected hospitals of Guilan University of Medical Sciences. Journal of Medical Ethics and History of Medicine. 2016;9(1):37-49. [persian]
  6. Pishgooie A-H, Barkhordari-Sharifabad M, Atashzadeh-Shoorideh F, Falco-Pegueroles A. Ethical conflict among nurses working in the intensive care units. Nursing ethics. 2019;26(7-8):2225-38. [persian]
  7. Cooper R, Frank G, Shogren C. Considerations in dealing with ethical conflict encountered in healthcare reform: perceptions of Nurse leaders. Open Journal of Nursing. 2014;4(10):695 -704.
  8. Johnstone M-J, Facn PBR. Bioethics: a nursing perspective: Elsevier; 2019.
  9. Azoulay E, Timsit J-F, Sprung CL, Soares M, Rusinova K, Lafabrie A, et al. Prevalence and factors of intensive care unit conflicts: the conflicus study. American journal of respiratory and critical care medicine. 2009;180(9):853-60. doi: 10.1164/rccm. 200810-1614OC.
  10. Hamric AB, Blackhall LJ. Nurse-physician perspectives on the care of dying patients in intensive care units: collaboration, moral distress, and ethical climate. Critical care medicine. 2007;35(2):422-9.doi: 10.1097/01.CCM.0000254722.50608.2D
  11. Mobley MJ, Rady MY, Verheijde JL, Patel B, Larson JS. The relationship between moral distress and perception of futile care in the critical care unit. Intensive and Critical care nursing. 2007;23(5):256-63. doi: 10.1016/j.iccn.2007.03.011
  12. Haghighinezhad G, Atashzadeh-Shoorideh F, Ashktorab T, Mohtashami J, Barkhordari-Sharifabad M. Relationship between perceived organizational justice and moral distress in intensive care unit nurses. Nursing ethics. 2019;26(2):460-70.

doi: 10.1177/0969733017712082

  1. Schaden E, Herczeg P, Hacker S, Schopper A, Krenn CG. The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians. BMC medical ethics. 2010;11(1):19.
  2. Park DW, Moon JY, Ku EY, Kim SJ, Koo Y-M, Kim O-J, et al. Ethical issues recognized by critical care nurses in the intensive care units of a tertiary hospital during two separate periods. Journal of Korean Medical Science 2015; 30(4): 495-501.

doi: 10.3346/jkms.2015.30.4.495

  1. Park M, Jeon SH, Hong H-J, Cho S-H. A comparison of ethical issues in nursing practice across nursing units. Nursing ethics. 2014;21(5):594-607. doi: 10.1177/0969733013513212.
  2. Rushton CH, Penticuff JH. A framework for analysis of ethical dilemmas in critical care nursing. AACN Advanced Critical Care. 2007;18(3):323-9.doi:10.4037/15597768-2007-3012.
  3. Cavaliere TA, Daly B, Dowling D, Montgomery K. Moral distress in neonatal intensive care unit RNs. Advances in Neonatal Care. 2010;10(3):145-56 .doi: 10.1097/ANC.0b013e3181dd6c48.
  4. Pauly B, Varcoe C, Storch J, Newton L. Registered nurses’ perceptions of moral distress and ethical climate. Nursing ethics. 2009;16(5):561-73. doi: 10.1177/0969733009106649.
  5. Falco-Pegueroles A, Lluch-Canut MT, Martínez-Estalella G, Zabalegui-Yarnoz A, Delgado-Hito P, Via-Clavero G, et al. Levels of exposure to ethical conflict in the ICU: Correlation between sociodemographic variables and the clinical environment. Intensive and Critical Care Nursing. 2016;33:12-20. doi: 10.1016/j.iccn.2015.10.004 .
  6. Falco-Pegueroles A, Lluch-Canut T, Roldan-Merino J, Goberna-Tricas J, Guardia-Olmos J. Ethical conflict in critical care nursing: Correlation between exposure and types. Nursing ethics. 2015;22(5):594-607. doi: 10.1177/0969733014549883
  7. Hassanpoor M, Hosseini M, Fallahi Khoshknab M, Abbaszadeh A. Evaluation of the impact of teaching nursing ethics on nurses' decision making in Kerman social welfare hospitals in 1389. Journal of Medical Ethics and History of Medicine. 2011;4(5):58-64. [persian]
  8. Gangineia H, Heidari M, Shoghli A, Mohajer M. Evaluation of Attitude and Performance of Nurses Attending In-service Training courses Regarding the Use of Professional Ethics in Educational Healthcare Centers of Zanjan, Iran. Journal of Medical Education Development. 2018;11(31):97-104.doi: 10.29252/edcj.11.31.97 .

 

  1. Azizi A, Sepahvani M, Mohamadi J. The effect of nursing ethics education on the moral judgment of nurses. Journal of Nursing Education. 2016;4(4):1-8. [persian]
  2. Grace PJ, Robinson EM, Jurchak M, Zollfrank AA, Lee SM. Clinical ethics residency for nurses: an education model to decrease moral distress and strengthen nurse retention in acute care. JONA: The Journal of Nursing Administration. 2014;44(12):640-6.
  3. Nikbakht-Nasrabadi A, Bozorgzad P, Yekani-Nejad M, Jafarloo A, Rahmati M. Effect of nursing ethics workshop on the rights of patients in the Emergency department. Cardiovascular Nursing Journal. 2015;4(3):6-15. [persian]
  4. Motaharifar F, Atashzadeh-Shoorideh F, Pishgooie AH, Falcó-Pegueroles A. Translation and psychometric properties of the “ethical conflict in nursing questionnaire: critical care version” in Iran. Electronic physician. 2017;9(2): 3776–3785. doi: 10.19082/3776. [persian]
  5. 27. Falco-Pegueroles A, Lluch-Canut T, Guàrdia-Olmos J. Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version. BMC medical ethics. 2013;14(22):1-8. doi: 1186/1472-6939-14-22.
  6. Saberi Z, Shahriari M, Yazdannik AR. The relationship between ethical conflict and nurses' personal and organisational characteristics. Nurs Ethics. 2019;26(7-8):2427-37.doi: 10.1177/0969733018791350 . [persian]
  7. Imanifar N, Seyedin AV, Afshar L, Sharifzadeh G. Comparison effect of teaching ethical principles using narrative ethics and lecture on the morl sensitivity of nurses. Medical Ethics Journal. 2015;9(31):95-125. [persian]
  8. Lluch-Canut T, Sequeira C, Falcó-Pegueroles A, Pinho JA, Rodrigues-Ferreira A, Olmos JG, et al. Ethical conflicts and their characteristics among critical care nurses. Nursing ethics. 2020;27(2):537-553. doi: 10.1177/0969733019857785.

31. Corley MC, Minick P, Elswick R, Jacobs M. Nurse moral distress and ethical work environment. Nursing ethics. 2005;12(4):381-90. doi: 10.1191/0969733005ne809oa.