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护理学报 ›› 2024, Vol. 31 ›› Issue (20): 33-38.doi: 10.16460/j.issn1008-9969.2024.20.033

• 文献研究 • 上一篇    下一篇

ICU护士的伦理冲突研究进展

何青云1a, 黄春美1b   

  1. 1.浙江省立同德医院 a.急诊重症监护室; b.医院感染管理科,浙江 杭州 310000
  • 收稿日期:2024-06-15 出版日期:2024-10-25 发布日期:2024-11-07
  • 通讯作者: 黄春美(1981-),女,浙江杭州人,研究生学历,主任护师,副科长,硕士研究生导师。E-mail:562223037@qq.com
  • 作者简介:何青云(1990-),女,四川广元人,本科学历,硕士研究生在读,主管护师。
  • 基金资助:
    浙江省中医药科学研究基金项目(2022ZA042)

  • Received:2024-06-15 Online:2024-10-25 Published:2024-11-07

摘要: 目的 阐述ICU护士的伦理冲突的相关研究进展,为进一步制订策略提供参考。方法 总结国内外文献研究,对ICU护士的伦理冲突的概述、评估工具、研究现状、影响因素及干预措施进行综述。结果 伦理冲突分为道德不确定性、道德两难、道德困境、道德愤怒、道德冷漠、道德幸福6种类型,ICU护士的伦理冲突的评估工具有:护士伦理冲突问卷-重症监护版、新冠肺炎伦理冲突量表和特殊情况下护士伦理冲突量表,其在国外研究较多,我国相关研究处于初步阶段,ICU护士的伦理冲突受个人因素、环境因素和管理因素的影响,干预措施有:伦理在职教育、伦理研讨会、伦理授权计划和伦理咨询服务等。结论 ICU护士的伦理冲突不容忽视,未来可基于现有研究,开发专门应用于我国ICU护士的伦理冲突评估工具,根据我国ICU护士工作内容及特点,探索符合我国国情的伦理冲突干预方案,并开展相关干预研究。

关键词: 重症监护病房, 护士, 伦理冲突, 护理伦理学, 综述

中图分类号: 

  • R473
[1] Liu Y,Wang X,Wang Z,et al.Ethical conflict in nursing: a concept analysis[J].J Clin Nurs,2023,32(15/16):4408-4418.DOI: 10.1111/jocn.16563.
[2] 姜小鹰,刘俊荣,范宇莹.护理伦理学[M].3版.北京:人民卫生出版社,2022:177.
[3] Mcandrew NS, Hardin JB.Giving nurses a voice during ethical conflict in the intensive care unit[J]. Nursing Ethics,2020, 27(8):1631-1644.DOI: 10.1177/0969733020934148.
[4] 刘苑菲,徐语同,马亚君,等.三级综合医院成人ICU护士伦理冲突现状及影响因素研究[J].中华护理杂志,2023,58(8):915-921. DOI:10.3761/j.issn.0254-1769.2023.08.003.
[5] 官兰妹,张小茹. 组织伦理氛围管理模式对手术室护士职业认同感和工作满意度的影响[J].保健医学研究与实践,2022,19(12):199-202.DOI:10.11986/j.issn.1673-873X.2022.12.047.
[6] Alan H,Gül D,Baykal ü.The relationship between the conflict management strategies and ethical leadership behaviours of nurse managers perceived by nurses[J]. J Nurs Manag,2022,30(7):2370-2378. DOI: 10.1111/jonm.13840.
[7] Saberi Z, Shahriari M,Yazdannik AR.The relationship between ethical conflict and nurses' personal and organisational characteristics[J].Nursing Ethics,2019,26(7/8):2427-2437. DOI: 10.1177/0969733018791350.
[8] Usberg G,Uibu E,Urban R,et al.Ethical conflicts in nursing: an interview study[J]. Nursing Ethics, 2021, 28(2): 230-241. DOI: 10.1177/0969733020945751.
[9] Abbasi S, Ghafari S, Shahriari M, et al.Effect of moral empowerment program on moral distress in intensive care unit nurses[J].Nurs Ethics,2019,26(5):1494-1504.DOI: 10.1177/0969733018766576.
[10] 吴秀强,杨珍,谢志勤,等.护士道德困境干预的最佳证据总结[J].护理学报, 2023, 30(1):47-52. DOI:10.16460/j.issn1008-9969.2023.01.047.
[11] Khanal A,Franco-Correia S,Mosteiro-Diaz M.Ethical conflict among critical care nurses during the COVID-19 pandemic[J].Nursing Ethics,2022,29(4):819-832.DOI:10.1177/09697330211066574.
[12] Redman BK,Fry ST.Nurses' ethical conflicts: what is really known about them?[J]. Nurs Ethics,2000,7(4):360-366.DOI: 10.1177/096973300000700409.
[13] Falcó-Pegueroles A,Lluch-Canut T,Roldan-Merino J,et al.Ethical conflict in critical care nursing[J].Nursing Ethics,2015,22(5): 594-607.DOI: 10.1177/0969733014549883.
[14] Pishgooie A, Barkhordari-Sharifabad M, Atashzadeh-Shoorideh F,et al.Ethical conflict among nurses working in the intensive care units[J]. Nursing Ethics, 2019,26(7/8):2225-2238. DOI: 10.1177/0969733018796686.
[15] 张玉芬,汪晖,胡凯利. 临床护士道德困境的潜在剖面分析及其与道德敏感性的关系研究[J]. 护理学报, 2023, 30(3): 20-25. DOI:10.16460/j.issn1008-9969.2023.03.020.
[16] 戴红梅,李莹,吴红艳. 护理人员道德勇气与道德困境的相关性研究[J]. 护理学杂志, 2022, 37(21): 53-57. DOI: 10. 3870/j. issn. 1001-4152. 2022. 21. 053.
[17] Lluch-Canut T,Sequeira C,Falcó-Pegueroles A,et al.Ethical conflicts and their characteristics among critical care nurses[J]. Nursing Ethics, 2020, 27(2): 537-553. DOI: 10.1177/0969733019857785.
[18] Falco-Pegueroles A,Lluch-Canut T,Guardia-Olmos J.Development process and initial validation of the Ethical Conflict in Nursing Questionnaire-Critical Care Version[J]. BMC Med Ethics, 2013, 14(1): 22. DOI: 10.1186/1472-6939-14-22.
[19] Motaharifar F,Atashzadeh-Shoorideh F, Pishgooie AH,et al.Translation and psychometric properties of the “ethical conflict in nursing questionnaire: critical care version” in Iran[J]. Electronic Physician, 2017, 9(2): 3776-3785. DOI: 10.19082/3776.
[20] Bonetti L,Terzoni S,Ferrara P,et al.Adaptation and validation of the Ethical Conflict Nursing Questionnaire-Critical Care Version to Italian language[J]. Acta Biomed, 2021, 92(S2): e2021505. DOI: 10.23750/abm.v92iS2.11761.
[21] Liu Y,Cui N,Zhang Y,et al.Psychometric properties of the ethical conflict in nursing questionnaire critical care version among Chinese nurses: a cross-sectional study[J]. BMC Nurs, 2021, 20(1):133. DOI: 10.1186/s12912-021-00651-x.
[22] Villa M,Balice-Bourgois C,Tolotti A,et al.Ethical conflict and its psychological correlates among hospital nurses in the pandemic:a cross-sectional study within swiss COVID-19 and Non-COVID-19 wards[J]. Int J Envir Res Pub Health, 2021, 18(22):12012.DOI:10.3390/ijerph182212012.
[23] Ciriş Yıldız C, Yildirim D, Ergin E, et al. Development of ethical conflict scale for nurses in extraordinary circumstances and psychometric testing[J]. J Adv Nurs, 2024, 80(3): 1132-1143. DOI: 10.1111/jan.15857.
[24] Falcó-Pegueroles A,Lluch-Canut MT,Martínez-Estalella G,et al.Levels of exposure to ethical conflict in the ICU: correlation between sociodemographic variables and the clinical environment[J]. Intens and Crit Care Nurs, 2016, 33: 12-20. DOI: 10.1016/j.iccn.2015.10.004.
[25] Salas-Bergues V, Lizarazu-Armendariz E, Eraso-Perez DUM,et al.Levels of burnout and exposure to ethical conflict and assessment of the practice environment in nursing professionals of intensive care[J]. Enferm Intensiva (Engl Ed), 2023, 34(4):195-204. DOI: 10.1016/j.enfie.2023.02.003.
[26] Caro-Alonso Pá,Rodríguez-Martín B,Rodríguez-Almagro J,et al.Nurses' perceptions of ethical conflicts when caring for patients with COVID-19[J]. Int J Envir Res Pub Health, 2023, 20(6): 4763. DOI: 10.3390/ijerph20064763.
[27] 陈少莹,蒋辉. 基于研究者伦理抉择能力构建临床研究伦理培训体系[J]. 中国医学伦理学, 2023, 36(3): 249-254. DOI:10.12026/j.issn.1001-8565.2023.03.03.
[28] 胡娟,杨敏. 护理专业学生伦理敏感性的研究进展[J]. 护理学杂志, 2023, 38(5):117-120. DOI:10.3870/j.issn.1001-4152.2023.05.117.
[29] Mcandrew NS, Schiffman R, Leske J.Relationships among climate of care, nursing family care and family Well-being in ICUs[J]. Nursing Ethics, 2019, 26(7/8): 2494-2510. DOI: 10.1177/0969733019826396.
[30] 陈思佳. 伊朗婚姻家庭法变迁中妇女地位的研究[D]. 南京:南京师范大学,2020.
[31] Kim M, Oh Y, Kong B.Ethical conflicts experienced by nurses in geriatric hospitals in south korea:“if you can't stand the heat, get out of the kitchen”[J]. Int J Envir Res Pub Health,2020,17(12):4442.DOI:10.3390/ijerph17124442.
[32] Chen P, Lee H, Huang S, et al.Nurses' perspectives on moral distress:a qmethodology approach[J]. Nursing Ethics, 2018, 25(6): 734-745. DOI: 10.1177/0969733016664976.
[33] Liu Y, Zhang Y, Jin J.The relationships of ethical climate, physician-nurse collaboration and psychological empowerment with critical care nurses' ethical conflict in China: a structural equation model[J]. J Nurs Manag, 2022, 30(7): 2434-2441. DOI: 10.1111/jonm.13848.
[34] Xing S.Ethical conflict and knowledge hiding in teams: moderating role of workplace friendship in education sector[J]. Frontiers in Psychology, 2022, 13(10):824485. DOI: 10.3389/fpsyg.2022.824485.
[35] 中华护理学会. 中国护士伦理准则[J]. 中国医学伦理学, 2020, 33(10):1232-1233. DOI:10.12026 /j.issn.1001-8565. 2020. 10. 13.
[36] Bremer A, Holmberg M.Ethical conflicts in patient relationships: experiences of ambulance nursing students[J]. Nursing Ethics,2020,27(4):946-959.DOI:10.1177/0969733020911077.
[37] Tsuruwaka M.Current trends and obstacles in off-the-job nursing ethics training in Japanese hospitals: a cross-sectional study[J]. Int J Med Educ,2024,15(8):84-98. DOI: 10.5116/ijme.669f.70b3.
[38] Okumoto A, Yoneyama S, Miyata C, et al.The relationship between hospital ethical climate and continuing education in nursing ethics[J]. PLoS One,2022,17(7):e0269034. DOI: 10.1371/journal.pone.0269034.
[39] Zhen C, Zonghua W, Yu L, et al.Development and application of an online learning platform for nursing ethics: a teaching practice research[J]. Nurse Educ Today,2022,112:105336. DOI: 10.1016/j.nedt.2022.105336.
[40] Malak MZ,Abu SA.Association between work-related psychological empowerment and quality of nursing care among critical care nurses[J]. J Nurs Manag, 2022, 30(6): 2015-2022. DOI: 10.1111/jonm.13641.
[41] Tanaka M,Tezuka S.A scoping review of alternative methods of delivering ethics education in nursing[J].Nurs Open, 2022, 9(6): 2572-2585. DOI: 10.1002/nop2.987.
[42] Falcó Pegueroles A,Viola E,Poveda Moral S,et al.Protective factors of ethical conflict during a pandemic—Quali-Ethics-COVID-19 research part 2: an international qualitative study[J]. J Clin Nurs, 2023, 32(17/18): 6677-6689. DOI: 10.1111/jocn.16754.
[43] Choe K, Kim S, Lee C, et al.Effect of ethics seminar on moral sensitivity and ethical behavior of clinical nurses[J]. Int J Environ Res Public Health,2020,18(1):241. DOI: 10.3390/ijerph18010241.
[44] 张一帆,徐晓霞,王子佼,等.肿瘤科护士道德勇气的潜在类别及影响因素分析[J].护理学报,2024,31(13):7-11.DOI:10.16460/j.issn1008-9969.2024.13.007.
[45] Emami ZA, Ghazanfari MJ, Suhonen R, et al.Effective interventions for reducing moral distress in critical care nurses[J]. Nurs Ethics,2022,29(4):1047-1065. DOI: 10.1177/09697330211062982.
[46] Jamshidian F, Shahriari M, Aderyani MR.Effects of an ethical empowerment program on critical care nurses' ethical decision-making[J]. Nurs Ethics,2019,26(4):1256-1264. DOI: 10.1177/0969733018759830.
[47] 张肖阳,肖巍. 欧美生命伦理委员会的机构建设与咨询服务[J]. 医学与哲学, 2020, 41(2): 27-31. DOI:10.12014/j.issn.1002-0772.2020.02.07.
[48] Jones J,Ford P J,Birchley G,et al.Perspectives on the role of the nurse ethicist[J]. Nurs Ethics, 2023, 30(5): 652-658. DOI: 10.1177/09697330231189034.
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