| 1. |
- Berggren, Ingela, et al.
(författare)
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The influence of clinical supervision on nurses' moral decision making.
- 2000
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Ingår i: Nursing Ethics. - London : Edward Arnold. - 0969-7330 .- 1477-0989. ; 7:2, s. 124--133
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the influence of clinical supervision on nurses´ moral decision making. The sample consisted of 15 registered nurses who took part in clinical supervision sessions. Data were obtained from interviews and analysed by a hermeneutic transformative process. The hermeneutic interpretation revealed four themes: increased self-assurance, an increased ability to support the patient, an increased ability to be in a relationship with the patient, and an increased ability to take responsibility. In conclusion, it seems that clinical supervision enhances nurses´ ability to provide care on the basis of their decision making. However, the qualitative and structural aspects of clinical supervision have to be investigated further in order to develop professional insight into the way that nurses think and react.
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| 2. |
- Bolmsjö, Ingrid, et al.
(författare)
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Conflicts of interest: experiences of close relatives of patients suffering from amyotrophic lateral sclerosis.
- 2003
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Ingår i: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 10:2, s. 186-198
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Tidskriftsartikel (refereegranskat)abstract
- It is well known that close relatives of terminally ill patients endure great emotional stress. Many factors, such as existential concerns, contribute to the distress of these relatives. In this study, interviews were conducted to explore experiences concerning life restrictions, emotional distress, and limited support, in a group of close relatives of patients with amyotrophic lateral sclerosis (ALS). The purpose was to identify, illuminate and clarify ethical problems related to these experiences. The results indicate that close relatives of patients with ALS need someone to talk to, as well as more information about the disease and its process. Furthermore, the study illustrates how ethical problems are related to choices and conflicts, and that a process including shared decision making is often an ideal when trying to find a solution to ethical problems.
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| 3. |
- Cronqvist, Agneta, et al.
(författare)
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Caring about--caring for : moral obligations and work responsibilities in intensive care nursing.
- 2004
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 11:1, s. 63-76
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse experiences of moral concerns in intensive care nursing. The theoretical perspective of the study is based on relational ethics, also referred to as ethics of care. The participants were 36 intensive care nurses from 10 general, neonatal and thoracic intensive care units. The structural characteristics of the units were similar: a high working pace, advanced technology, budget restrictions, recent reorganization, and shortage of experienced nurses. The data consisted of the participants' examples of ethical situations they had experienced in their intensive care unit. A qualitative content analysis identified five themes: believing in a good death; knowing the course of events; feelings of distress; reasoning about physicians' 'doings' and tensions in expressing moral awareness. A main theme was formulated as caring about--caring for: moral obligations and work responsibilities. Moral obligations and work responsibilities are assumed to be complementary dimensions in nursing, yet they were found not to be in balance for intensive care nurses. In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing.
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| 4. |
- Fredriksson, Lennart, et al.
(författare)
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The ethics of the caring conversation
- 2003
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 10:2, s. 138-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the ethical foundations for a caring The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to metrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible.
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| 5. |
- Hallström, Inger, et al.
(författare)
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An observational study of the level at which parents participate in decisions during their child's hospitalization.
- 2002
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Ingår i: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 9:2, s. 202-214
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Tidskriftsartikel (refereegranskat)abstract
- When a child is hospitalized, the parents find themselves in an unfamiliar environment and their parental role changes. They are in a stressful and often anxiety-filled situation and it may be difficult for them to participate in decisions. The purpose of this study was to examine the extent to which parents participate in decisions during the course of events when their child is hospitalized. Thirty-five parents of 24 children (aged 5 months to 18 years) were followed by mobile observation during their child's hospitalization in a paediatric department in Sweden. Three researchers analysed field notes in three steps, using manifest and latent coding. In step 1, 119 situations that included a decision process were identified. In step 2, the situations were assessed according to a five-level scale concerning how the parents' wishes, desires or values had been respected. In step 3, each situation was scrutinized with respect to factors influencing the extent of the parents' participation. The results showed that parents have varying ability to be involved in decision making. Professionals need to communicate more openly with them in order to identify and satisfy their needs because some parents are unwilling or incapable of expressing them.
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| 6. |
- Hallström, Inger, et al.
(författare)
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Needs during hospitalization: definitions and descriptions made by patients
- 2001
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Ingår i: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 8:5, s. 409-418
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Tidskriftsartikel (refereegranskat)abstract
- Patients are supposed to be given care according to their needs. This concept is, however, difficult to define and patients and caregivers may have different opinions about a patient's needs. Twenty patients were interviewed and asked to give a definition of need, describe their needs while hospitalized and depict what they do to make sure their needs are fulfilled. Ten groups of needs were identified: communication, basic care, contact with other people, behaviour of staff, empathy, competent caregivers, continuity, integrity, participation in decision making, and pain relief. The descriptions patients gave of how they ensured their needs were met could be divided into two groups: openly seeking attention; or not wanting to disturb the staff. Interviews with patients emphasized the importance of recognizing that they have individual needs and varying abilities to see that their needs are fulfilled.
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| 7. |
- Hamrin, Elisabeth, et al.
(författare)
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Ethical values in health care : an Indian-Swedish co-operation
- 2002
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 9:4, s. 439-444
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this report is to present an example of a multidisciplinary Indian-Swedish co-operation on ethics in health care. It is based on a conference held in Asia Plateau, Panchgani, Maharasthra, India in 1998. The emphasis is on ethical values that are important for consumers of health care and professionals, and also for different cultures in developed and developing countries. The importance of human dignity is stressed. Sixteen recommendations are given in an appendix.
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| 8. |
- Lutzen, K, et al.
(författare)
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Moral sensitivity: some differences between nurses and physicians
- 2000
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Ingår i: Nursing ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 7:6, s. 520-530
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Tidskriftsartikel (refereegranskat)abstract
- We report the results of an investigation of nurses’ and physicians’ sensitivity to ethical dimensions of clinical practice. The sample consisted of 113 physicians working in general medical settings, 665 psychiatrists, 150 nurses working in general medical settings, and 145 nurses working in psychiatry. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health care practice. Each of these assumptions was categorized into a theoretical dimension of moral sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following the rules. Significant differences in responses were found between health care professionals from general medical settings and those working in psychiatry. The former agreed to a greater extent with the assumptions in the categories ‘meaning’ and ‘autonomy’ and to a lesser degree with the categories ‘benevolence’ and ‘conflict’. Moreover, those from the psychiatric sector agreed to a greater extent to the use of coercion if necessary. Significant differences were also found for some of the MSQ categories, between physicians and nurses, and between males and females.
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| 9. |
- Lützén, Kim, et al.
(författare)
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Moral stress : synthesis of a concept
- 2003
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 10:3, s. 312-322
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to describe the synthesis of the concept of moral stress and to attempt to identify its preconditions. Qualitative data from two independent studies on professional issues in nursing were analysed from a hypothetical-deductive approach. The findings indicate that moral stress is independent of context-given specific preconditions: (1) nurses are morally sensitive to the patient's vulnerability; (2) nurses experience external factors preventing them from doing what is best for the patient; and (3) nurses feel that they have no control over the specific situation. The findings from this analysis are supported by recent research on stress in the workplace but differ that the imperatives directing work are moral in nature. Stress researchers have found that persons who experience that they have no control over their work situation and at the same time experience high demands may be prone to cardiovascular diseases. An important question raised by this study is whether moral stress should be recognized as a health risk in nursing. Further research is required in order to generate intervention models to prevent or deal with moral stress.
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| 10. |
- Norberg, Astrid, et al.
(författare)
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A model of consolation
- 2001
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 8:6, s. 544-553
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Tidskriftsartikel (refereegranskat)abstract
- Consolation is needed when a human being suffers (i.e. feels alienated from him- or herself, from other people, from the world or from his or her ultimate source of meaning). The aim of this study was to illuminate the meaning of consolation. Tape-recorded narrative interviews were carried out with 18 professionals from various spheres. The transcribed interviews were interpreted hermeneutically. A model of consolation is outlined in a drawing. It states that the mediator and the receiver of consolation must become ready for consolation before it can take place. To be ready means to be present and available. Availability means expressing suffering and listening respectively, and thereby opening up for communion and consoling dialogue. Communion brings about contact with the sacred dimension that human beings share and thus with goodness, light, joy, beauty and life. Consolation involves a shift of perspective and an experience of meaning in spite of suffering.
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