Abstract
DETERMINANTS OF MORAL SENSITIVITY OF MIDWIVES AND NURSES – CURRENT STATE OF KNOWLEDGE
Introduction. Midwives and nurses experience ethical dilemmas during providing patient care. The manner of coping with them plays an important role in shaping the nature of care.
Aim. The aim was to analyse the scientific literature on moral sensitivity characterising midwives, nurses and to answer the question of which determinants influence it.
Method. A critical review of the literature was performed, using a combination of key words: moral sensitivity, nurses, midwives, work, hospital. Articles were identified using three databases (PubMed, CINAHAL Complete, SCOPUS). The results were narrowed to original articles in English published between 2011 and 2021. The analysis covered 15 articles.
Summary. The moral sensitivity of midwives and nurses exhibits a correlation with sociodemographic variables such as age, education, job seniority, and the hospital’s ethical climate and decision-making which is consistent with the principles of professional ethics. An important task of the academic, managerial staff of hospitals is to shape nurses’ and midwives’ moral sensitivity during their education.
References
1. Hallgren J, Larsson M, Kjellén M, et al. ‚Who will do it if I don’t?’ Nurse anaesthetists’ experiences of working in the intensive care unit during the COVID-19 pandemic. Aust Crit Care. 2022;35(1):52-58. https://doi.org/10.1016/j.aucc.2021.11.003.
2. Liang HF, Wu YC, Wu CY. Nurses’ experiences of providing care during the COVID-19 pandemic in Taiwan: A qualitative study. Int J Ment Health Nurs. 2021;30(6):1684-1692. https://doi.org/10.1111/inm.12921.
3. Joob B, Wiwanitkit V. Traumatization in medical staff helping with COVID-19 control. Brain Behav Immun. 2020;S0889-1591-(20)30356-1. https://doi.org/10.1016/j.bbi.2020.03.020.
4. Ruiz-Fernández, MD, Ramos-Pichardo, JD, Ibáñez-Masero, O, et al. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs. 2020; 29: 4321-4330. https://doi.org/10.1111/jocn.15469.
5. Neves N, Bitencourt F, Bitencourt A. Ethical dilemmas in COVID-19 times: how to decide who lives and who dies? Revista da Associacao Medica Brasileira (1992), 2020;106-111. https://doi.org/10.1590/1806-9282.66.S2.106.
6. Pawlikowski J. The ethical dimension of prioritization and allocation decisions within the context of the coronavirus disease 2019 pandemic. Polish archives of internal medicine, 2020;130(5), 466-472. https://doi.org/10.20452/pamw.15334.
7. Code of Professional Ethics of a Nurse and Midwife of the Republic of Poland. https://nipip.pl/prawo/samorzadowe/krajowy-zjazd-pielegniarek-i-poloznych/kodeks-etyki-zawodowej-pielegniarki-i-poloznej-rzeczypospolitej-polskiej, [Accessed May 15, 2022].
8. The ICN Code Of Ethics for nurses. https://www.icn.ch/system/files/2021-10/ICN_Code-of-Ethics_EN_Web_0.pdf#page=2&zoom=auto,-418,103 [Accessed May 15, 2022].
9. Ulrich CM, Taylor C, Soeken K, et al. Everyday ethics: Ethical issues and stress in nursing practice. Journal of Advanced Nursing, 2010;66, 2510-2519.
10. Winterstein TB. Nurses’ experiences of the encounter with elder neglect. Journal of Nursing Scholarship, 2012;44, 55-62. https://doi.org/10.1111/j.1547¬5069.2011.01438.x.
11. Hemberg J, Hemberg H. Ethical competence in a profession: Healthcare professionals’ views. Nursing Open. 2020;7:1249-1259. https://doi.org/10.1002/nop2.501.
12. Lechasseur K, Caux C, Dollé S, et al. Ethical competence: An integrative review. Nurs Ethics. 2018;25(6):694-706. https://doi.org/10.1177/0969733016667773.
13. Paganini MC, Yoshikawa Egry E. The ethical component of professional competence in nursing: an analysis. Nurs Ethics. 2011;18(4):571-582. doi:10.1177/0969733011408041.
14. Lützén K, Cronqvist A, Magnusson A, et al. Moral stress: synthesis of a concept. Nurs Ethics. 2003; 10(3): 312- 22. https://doi.org/10.1191/0969733003ne608oa.
15. Erdil F, Korkmaz F. Ethical problems observed by student nurses. Nurs Ethics, 2009;16, 589-598.
16. Akça NK, Şimşek N. Arslan D, et al. Moral Sensitivity among Senior Nursing Students in Turkey. International Journal of Caring Sciences 2017;10;1031-9.
17. Dalla Nora CR, Zoboli EL, Vieira MM. Validation of a Brazilian version of the moral sensitivity questionnaire. Nursing Ethics. 2019;26(3):823-832. https://doi.org/10.1177/0969733017720849.
18. Lützen K, Barbosa da Silva A, Nordin C. An analysis of the concept of moral sensing, exemplified in psychiatric nursing practice. Schol. Inq. Nurs. Pract., 1995;9: 57-66.
19. Lützén K, Dahlqvist V, Eriksson S. Developing the concept of moral sensitivity in health care practice. Nurs Ethics, 2006; 13(2): 187-196.
20. Glasberg AL, Eriksson S, Norberg, A. Factors associated with ‘stress of conscience’ in healthcare. Scandinavian Journal of Caring Sciences, 2008;22: 249-258. https://doi.org/10.1111/j.1471-6712.2007.00522.x.
21. Yılmaz E, Vermisli S. Effect of professionalism on job satisfaction ın nurses who work ın intensive care units. Yıldırım Beyazıt University, Journal of Nursing, 2016;4(1), 17-27.
22. Ineichen C, Christen M, Tanner C. Measuring value sensitivity in medicine. BMC medical ethics, 2017;18(1).
23. Lützén K, Nordin C. Modifying autonomy, derived in a grounded theory study of nurses’ experience of moral decision making in psychiatric settings. J. Med. Ethics, 1994; 20, 101-7.
24. Lützén K, Nordin, C. Benevolence, a central moral concept derived in a grounded theory study of nursing decision making in psychiatric settings. J. Ado. Nurs., 1993a.;18, 1106-11.
25. Lützén K, Nordin, C. Structuring moral meaning n psychiatric nursing. Scand. J. Caring Sci., 1993b.;7, 175-80.
26. Lützen K, Nordin C, Brolin G. Conceptualization and instrumentation of nurses’ moral sensitivity in psychiatric practice. Int. J. Methods Psych. Res., 1994;4, 241-8.
27. Han SS, Kim J, Kim YS. Validation of a Korean version of the moral sensitivity questionnaire. Nurs Ethics, 2010; 17(1): 99-105.
28. Borhani F, Abbaszadeh A, Mohamadi E. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics, 2015; 28: 1-9.
29. Tosun H. Determining sensitivity of the nurses and the physicians against the ethical dilemmas which experienced at the health care practises. PhD Thesis, University of Istanbul, Istanbul, 2005.
30. Huang FF, Yang Q, Zhang J, et al. Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version. Nurs Ethics. 2016;23(7):784-793. https://doi.org/10.1177/0969733015583183.
31. Arslan FT, Calpbinici P. Moral sensitivity, ethical experiences and related factors of pediatric nurses: a cross-sectional, correlational study. Acta Bioethica 2018; 24 (1): 9-18.
32. Ozdemir A, Gultekin A, Kavak F. Determination of Moral Sensitivities of Healthcare Personnel. International Journal of Caring Sciences, 2019; 12:1139.
33. Ertuğ N, Aktaş D, Faydali S, Yalçin O. Ethical sensitivity and related factors of nurses working in the hospital setting. Acta Bioethica, 2014; 20: 265-270.
34. Lim A, Kim S. Nurses’ ethical decision-making during end of life care in South Korea: a cross-sectional descriptive survey. BMC Med Ethics, 2021;22,94. https://doi.org/10.1186/s12910-021-00665-9.
35. Kavurmacı M, Tan M. Determining the Moral Sensitivities of Intensive Care Nurses. Crit Care Nurs Q. 2019;42(3):278-284. https://doi.org/10.1097/CNQ.0000000000000270.
36. Allari RS, Ismaile S, Househ M. Professional values among female nursing students in Saudi Arabia. Studies in Health Technology and Informatics, 2017;238, 231-234. https://doi.org/10.3233/978-1-61499-781-8-231.
37. Öztürk EA, Şener A, Koç Z, Duran L. Factors Influencing the Ethical Sensitivity of Nurses Working in a University Hospital East J Med 24(3): 257-264, 2019. https://doi.org/10.5505/ejm.2019.05025.
38. Palazoğlu CA, Koç Z. Ethical sensitivity, burnout, and job satisfaction in emergency nurses. Nursing Ethics. 2019;26(3):809-822. https://doi.org/10.1177/0969733017720846.
39. 39. 39. Jaafarpour M, Khani A. Evaluation of the Nurses’ Job Satisfaction, and Its Association with Their Moral Sensitivities and Well-being Journal of Clinical and Diagnostic Research. 2012;6(10): 1761-1764. https://doi.org/10.7860/JCDR/2012/4068.2638.
40. Amiri E, Ebrahimi H, Namdar Areshtanab H, et al. The Relationship between Nurses’ Moral Sensitivity and Patients’ Satisfaction with the Care Received in the Medical Wards. J Caring Sci, 2020, 9(2), 98-103. https://doi.org/10.34172/jcs.2020.015
41. Amiri E, Ebrahimi H, Vahidi M, et al. Relationship between nurses’ moral sensitivity and the quality of care. Nursing Ethics. 2019;26(4):1265-1273. https://doi.org/10.1177/0969733017745726.
42. Suazo I, Pérez-Fuentes MdC, Molero Jurado MdM, et al. Moral Sensitivity, Empathy and Prosocial Behavior: Implications for Humanization of Nursing Care. International Journal of Environmental Research and Public Health. 2020; 17(23):8914. https://doi.org/10.3390/ijerph17238914.
43. Kim YS, Kang SW, Ahn JA. Moral sensitivity relating to the application of the code of ethics. Nurs Ethics. 2013;20(4):470-8. https://doi.org/10.1177/0969733012455563.
44. Yeom HA, Ahn SH, Kim SJ. Effects of ethics education on moral sensitivity of nursing students Nursing Ethics 2017;24(6) 644-652.
45. Cerit B, Özveren H. Effect of hospital ethical climate on the nurses’ moral Sensitivity. Eur Res J 2019;5(2):282-290.
46. Fernández-Feito A, Basurto-Hoyuelos S, Palmeiro-Longo MR, et al. Differences in professional values between nurses and nursing students: a gender perspective. Int Nurs Rev. 2019;66(4):577-589. https://doi.org/10.1111/inr.12543.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Authors