目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用...目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用CiteSpace可视化分析软件对检索到的文献进行国家合作、发文机构、关键词共现、文献共被引等分析。结果共筛选出630篇文献,1995—2022年,有关护理领域道德困扰的发文量总体呈上升的趋势,其中美国、加拿大等发达国家及其机构在护理领域道德困扰方面的研究成果较多。工作满意度、伦理氛围、生命维持治疗、重症监护护士等12个方向是该领域的研究热点,新生儿学、沟通、伦理决策、量表研制等11个方向是该领域的研究前沿。结论美国、加拿大等发达国家在护理领域道德困扰方面的研究成果较多,我国目前仍处于探索与发展的初始阶段,研究成果相对较少,今后应结合我国文化与医疗背景,加强国际间的交流与合作,促进我国有关护理领域道德困扰研究的发展。展开更多
目的了解和分析神经外科重症监护病房(intensive care unit,ICU)护士经历的道德困扰,为制定适宜的干预措施提供依据。方法采用质性研究中的现象学方法,对浙江省绍兴市中心医院11名神经外科ICU护士进行半结构式访谈,运用Colaizzi的7步分...目的了解和分析神经外科重症监护病房(intensive care unit,ICU)护士经历的道德困扰,为制定适宜的干预措施提供依据。方法采用质性研究中的现象学方法,对浙江省绍兴市中心医院11名神经外科ICU护士进行半结构式访谈,运用Colaizzi的7步分析法进行分析,提炼主题。结果神经外科ICU护士承受着无效护理、医护沟通障碍、人力短缺等多方面因素的道德困扰,不仅影响护士的身心健康,还影响护士的职业认同感,并导致护士的职业倦怠。ICU护士因为性格、价值观、沟通能力等不同其应对道德困扰的方式各异。结论神经外科ICU护士道德困扰体验呈现多维度,管理者应当优化管理模式,减少道德困扰来源,加强护士道德韧性,降低护士职业倦怠,加强支持系统提高护士心理防御能力,多管齐下减轻护士道德困扰的发生。展开更多
Objective:This integrative review aimed to identify the common characteristics of moral distress in nursing and distinguish it from other types of distress by examining nurses’perspectives in the literature.These ins...Objective:This integrative review aimed to identify the common characteristics of moral distress in nursing and distinguish it from other types of distress by examining nurses’perspectives in the literature.These insights will help update existing tools and create new ones to capture moral distress better,guiding the development and implementation of strategies to support nurses in addressing this challenge.Methods:Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in three databases(EBSCO Medline,CINAHL,and PubMed).Additionally,two journals,Bioethics and Nursing Ethics,were manually searched to reduce search bias.The included studies were primary resources published in English between 2018 and 2023,utilizing quantitative,qualitative,or mixed methods to examine moral distress’s characteristics,components,and definitions.All of identified studies were screened,extracted,and analyzed independently by two researchers.Results:Nineteen studies were included.The results were grouped into five themes shaping the main characteristics of moral distress:1)experiencing a moral situation,with five ethically conflicted situations identified,including treatment plans,professional and personal moral values,team dynamics,complex contexts,clinical practices,and patient-centered care;2)making a moral judgment,where nurses experience moral distress when they cannot act consistently with their values,ethical principles,and moral duties;3)the presence of constraints,categorized at three levels:individual factors related to the nurse,patient,and patient’s family;team factors related to the team or unit involved;and system factors,including institutional and policy elements;4)moral wrongdoing,which occurs when nurses are unable to perform the right moral action;and 5)moral suffering,with studies showing that moral distress impacts physical,emotional,and psychological well-being.Conclusion:The findings enhance the understanding of moral distress characteristics among nursing staff,highlighting the concept of the crescendo effect,which underscores the cumulative and escalating nature of unresolved moral distress,emphasizing the need to address moral conflicts proactively to prevent the erosion of moral integrity and professional satisfaction.展开更多
文摘目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用CiteSpace可视化分析软件对检索到的文献进行国家合作、发文机构、关键词共现、文献共被引等分析。结果共筛选出630篇文献,1995—2022年,有关护理领域道德困扰的发文量总体呈上升的趋势,其中美国、加拿大等发达国家及其机构在护理领域道德困扰方面的研究成果较多。工作满意度、伦理氛围、生命维持治疗、重症监护护士等12个方向是该领域的研究热点,新生儿学、沟通、伦理决策、量表研制等11个方向是该领域的研究前沿。结论美国、加拿大等发达国家在护理领域道德困扰方面的研究成果较多,我国目前仍处于探索与发展的初始阶段,研究成果相对较少,今后应结合我国文化与医疗背景,加强国际间的交流与合作,促进我国有关护理领域道德困扰研究的发展。
文摘目的了解和分析神经外科重症监护病房(intensive care unit,ICU)护士经历的道德困扰,为制定适宜的干预措施提供依据。方法采用质性研究中的现象学方法,对浙江省绍兴市中心医院11名神经外科ICU护士进行半结构式访谈,运用Colaizzi的7步分析法进行分析,提炼主题。结果神经外科ICU护士承受着无效护理、医护沟通障碍、人力短缺等多方面因素的道德困扰,不仅影响护士的身心健康,还影响护士的职业认同感,并导致护士的职业倦怠。ICU护士因为性格、价值观、沟通能力等不同其应对道德困扰的方式各异。结论神经外科ICU护士道德困扰体验呈现多维度,管理者应当优化管理模式,减少道德困扰来源,加强护士道德韧性,降低护士职业倦怠,加强支持系统提高护士心理防御能力,多管齐下减轻护士道德困扰的发生。
文摘Objective:This integrative review aimed to identify the common characteristics of moral distress in nursing and distinguish it from other types of distress by examining nurses’perspectives in the literature.These insights will help update existing tools and create new ones to capture moral distress better,guiding the development and implementation of strategies to support nurses in addressing this challenge.Methods:Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in three databases(EBSCO Medline,CINAHL,and PubMed).Additionally,two journals,Bioethics and Nursing Ethics,were manually searched to reduce search bias.The included studies were primary resources published in English between 2018 and 2023,utilizing quantitative,qualitative,or mixed methods to examine moral distress’s characteristics,components,and definitions.All of identified studies were screened,extracted,and analyzed independently by two researchers.Results:Nineteen studies were included.The results were grouped into five themes shaping the main characteristics of moral distress:1)experiencing a moral situation,with five ethically conflicted situations identified,including treatment plans,professional and personal moral values,team dynamics,complex contexts,clinical practices,and patient-centered care;2)making a moral judgment,where nurses experience moral distress when they cannot act consistently with their values,ethical principles,and moral duties;3)the presence of constraints,categorized at three levels:individual factors related to the nurse,patient,and patient’s family;team factors related to the team or unit involved;and system factors,including institutional and policy elements;4)moral wrongdoing,which occurs when nurses are unable to perform the right moral action;and 5)moral suffering,with studies showing that moral distress impacts physical,emotional,and psychological well-being.Conclusion:The findings enhance the understanding of moral distress characteristics among nursing staff,highlighting the concept of the crescendo effect,which underscores the cumulative and escalating nature of unresolved moral distress,emphasizing the need to address moral conflicts proactively to prevent the erosion of moral integrity and professional satisfaction.
