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Parvari S, Farajidana H, Mahmoodi Z, Mohamadi F, Kabir K, Boostanchi M, Mohammadian Khonsari N. Components related to ethical decision making in medical science students: A structural equation model. PLoS One 2024; 19:e0297494. [PMID: 38630768 PMCID: PMC11023167 DOI: 10.1371/journal.pone.0297494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 01/06/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Evaluating moral principles in the Society of Medical Sciences and health care workers (HCWs) is imperative due to their direct contact with the community and the significant impact of their attitudes and decisions on people's lives. This study aimed to determine the components related to ethical decisions in medical sciences students. METHODS One thousand two hundred thirty-five eligible students in the Alborz University of Medical Sciences participated in this descriptive study. We gathered their socio-demographic information, assessed their moral reasoning, and used the ethical decisions questionnaire, Lutsen moral sensitivity questionnaire, and general health questionnaire (GHQ) for data gathering. The data were analyzed with SPSS software version 25 and LISREL version 8.8. RESULTS According to the path analysis test findings, ethical reasoning significantly correlated with ethical decision-making (B = 0.40). The number of clinical courses passed, moral sensation (moral sensitivity), and the total number of passed academic semesters had the greatest positive and negative association with ethical decision-making, respectively. (B = 0.54), (B = 0.524) and (B = -0.11). CONCLUSION Based on the findings of the moral reasoning test, the moral sensation was associated with ethical decision-making, which indicates the necessity of attending to ethical aspects, promoting moral reasoning, sensitivity, and students' accuracy.
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Affiliation(s)
- Soraya Parvari
- Department of Anatomy, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hoorvash Farajidana
- Department of Clinical Toxicology, Kosar Hospital Poison Center, Emergency Department, Alborz University of Medical Science, Karaj, Iran
- Department of Forensic Medicine and Medical Ethics, Alborz University of Medical Sciences, Karaj, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farima Mohamadi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kourosh Kabir
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehrad Boostanchi
- Student Research Committee, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Alborz, Iran
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Ahansaz N, Adib-Hajbaghery M, Baghaei R. Missed nursing care and its relationship with nurses' moral sensitivity: a descriptive-analytical study. BMC Nurs 2024; 23:169. [PMID: 38475743 DOI: 10.1186/s12912-024-01854-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/07/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Missed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients' needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses' moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran. METHODS A cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis. RESULTS Most participants (52.97%) showed moderate moral sensitivity. Nurses' mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (β = 0.213, p < 0.001), age (β = 0.131, p < 0.001), working in rotating shifts (β = 0.183, p < 0.001), monthly income (β = 0.079, p = 0.004), work experience (β = 0.030, p = 0.010), and monthly work hours (β = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables. CONCLUSION Our nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.
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Affiliation(s)
- Naiier Ahansaz
- Departmentof Medical Surgical Nursing, Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Adib-Hajbaghery
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, 5th of Qotb -e Ravandi Blvd, P.O.Box: 8715981151, Kashan, Iran.
| | - Rahim Baghaei
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
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Ko YK, Cho C, Sun S, Ngan OM, Chan HY. Moral sensitivity and academic ethical awareness of nursing and medical students: A cross-sectional survey. Nurs Ethics 2024:9697330241226604. [PMID: 38315791 DOI: 10.1177/09697330241226604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. OBJECTIVE The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. RESEARCH DESIGN A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. PARTICIPANTS AND RESEARCH CONTEXT A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. ETHICAL CONSIDERATION Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. FINDINGS Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the 'conflicts' domain with increased clinical exposure. CONCLUSION Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings.
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Affiliation(s)
- Yuet Kiu Ko
- Faculty of Medicine, The Chinese University of Hong Kong
| | - Cordelia Cho
- Faculty of Medicine, The Chinese University of Hong Kong
| | - Sihan Sun
- CUHK Centre of Bioethics, Faculty of Medicine, The Chinese University of Hong Kong
| | - Olivia My Ngan
- Medical Ethics and Humanities Unit and Centre for Centre for Medical Ethics and Law, The University of Hong Kong
| | - Helen Yl Chan
- School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
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Khoobi M, Ahmadi F. Maintaining Moral Sensitivity as an Inevitable Necessity in the Nursing Profession. J Caring Sci 2024; 13:1-2. [PMID: 38659440 PMCID: PMC11036170 DOI: 10.34172/jcs.2023.33147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/26/2023] [Indexed: 04/26/2024] Open
Affiliation(s)
- Mitra Khoobi
- Department of nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Khaghanizadeh M, Koohi A, Ebadi A, Vahedian-Azimi A. The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial. BMC Med Ethics 2023; 24:58. [PMID: 37542315 PMCID: PMC10403849 DOI: 10.1186/s12910-023-00938-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/25/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses' moral reasoning, moral distress and moral sensitivity. METHODS In this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals. RESULTS Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238-15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171-2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15-5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043-12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454-16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015-0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015-0.547, P = 0.009). CONCLUSIONS The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students. REGISTRATION This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016.
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Affiliation(s)
- Morteza Khaghanizadeh
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Aliakbar Koohi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Sheykh bahayi Street, Vanak Square Tehran, Tehran, P.O. Box 19575-174, Iran
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Goktas S, Aktug C, Gezginci E. Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic. Nurs Crit Care 2023; 28:261-271. [PMID: 35821613 PMCID: PMC9350110 DOI: 10.1111/nicc.12820] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. AIM The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID-19 pandemic. DESIGN Descriptive cross-sectional survey. METHODS A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. RESULTS In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = -.176, p = .001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p = .007). Total moral courage scores increased significantly with education level (p = .012), years of nursing experience (p = .016), and willingness to work in the ICU (p < .001). CONCLUSION The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. RELEVANCE TO CLINICAL PRACTICE The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses.
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Affiliation(s)
- Sonay Goktas
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| | - Cemile Aktug
- Faculty of Health Sciences, Department of Nursing, Gümüşhane University, Gumushane, Turkey
| | - Elif Gezginci
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
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Choe K, Kwon S, Kim S. How do ethically competent nurses behave in clinical nursing practice? A qualitative study. J Nurs Manag 2022; 30:4461-4471. [PMID: 36326092 DOI: 10.1111/jonm.13884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/30/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM This study explored how ethically competent nurses behave in clinical nursing practice. BACKGROUND Nurses' ethical competency is crucial in nursing practice as it promotes patients' safety and quality of care. METHODS Using a purposive sampling technique, 20 clinical nurses in South Korea were interviewed via an online video platform. The data were analysed using a thematic analysis based on phenomenological approach. RESULTS The main theme found among the participating nurses' ethical competency was caring beyond egocentrism, with two subthemes: (1) patient-centred care based on compassion and (2) responsible behaviour based on nursing professionalism. Factors that enabled this included (1) reasonable work conditions, (2) interpersonal relationships, and (3) nurses' rich personal experiences. CONCLUSIONS Nurses' ethical competency depends on how far they can move away from their own egocentrism and act for their clients' benefit, wherein an appropriate workload and warm human relationships with one's colleagues are essential. Nurses should thus receive education on ethics and professionalism and participate in volunteer and leisure activities that cultivate their degree of empathy. IMPLICATION FOR NURSING MANAGEMENT Nursing leaders and managers should understand nurses' ethical competency and its enabling factors to devise effective strategies to promote it.
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Affiliation(s)
- Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Soojin Kwon
- Department of Nursing, Ansan University, Ansan, Republic of Korea
| | - Sunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
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A Study of How Moral Courage and Moral Sensitivity Correlate with Safe Care in Special Care Nursing. ScientificWorldJournal 2022; 2022:9097995. [PMID: 35874846 PMCID: PMC9300363 DOI: 10.1155/2022/9097995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Nursing is a caring profession, and nurses who have moral sensitivity and moral courage presumably can provide safe and better care for patients. This study aims at investigating how moral courage and moral sensitivity correlate with safe care in special care nursing. Methods This study is a descriptive work of research. The participants consisted of 524 nurses who were in practice in the ICU (intensive care unit), CCU (C\coronary care unit), post-CCU (postcoronary care unit), and dialysis of four hospitals located in the south of Iran selected via census sampling. Data were collected from April to September 2020 using the moral sensitivity questionnaire (MSQ), professional moral courage questionnaire (PMCQ), and the assessment of safe nursing care questionnaire (ASNCQ). The collected data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient in SPSS v. 22. Results The mean ± SD of the nurses' age was 33.89 ± 6.91 years, and the mean ± SD of their work experience was 9.16 ± 4.67 years. The total mean score ± SD of the nurses' moral sensitivity was found to be 93.41 ± 2.68, the total mean score ± SD of their moral courage was found to be 96.38 ± 3.63, and the total mean score ± SD of their safe care scores was found to be 321.80 ± 9.76. The values of Pearson's correlation coefficients showed significant correlations between moral courage and safe care (r = 0.54, p < 0.001), moral sensitivity and safe care (r = 0.59, p < 0.001), and moral sensitivity and moral courage (r = 0.52, p < 0.001). Conclusion There is a positive correlation between moral sensitivity and moral courage. Both positively correlated with special care nursing. Accordingly, through effective planning, education, and giving their support, nurse administrators can promote the abovementioned ethical virtues in the nursing staff, thereby improving the quality of care.
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Nazari S, Poortaghi S, Sharifi F, Gorzin S, Afshar PF. Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. BMC Health Serv Res 2022; 22:840. [PMID: 35773700 PMCID: PMC9244299 DOI: 10.1186/s12913-022-08258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The quality of care has a significant impact on the condition of elderly patients. Many factors affect the quality of care, including ethical considerations. Ethical considerations, such as moral sensitivity, change in times of crisis. The present study was conducted to assess the relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. METHODS This was a cross-sectional descriptive correlational study. The participants included 445 nurses that were selected by quota sampling method from hospitals admitting COVID-19 patients. The data were collected using the Moral Sensitivity Questionnaire (MSQ) and Quality Patient Care Scale (QUALPAC) as self-reports. We used the SPSS software v.16 for statistical analysis. RESULTS The total score of moral sensitivity and quality of care was 52.29 ± 16.44 and 2.83 ± 0.23, respectively. Moral sensitivity negatively correlates with psychological, social, and physical aspects (P < 0.05). Modifying autonomy, interpersonal orientation, and experiencing moral conflict predicted β = 0.10 of the psychosocial aspect of quality of care. Structural moral meaning and expressing benevolence predicted the changes in the physical dimension of quality of care (β = 0.02). CONCLUSION The quality of care had a significant inverse correlation with moral sensitivity. Multiple regression analysis showed that modifying autonomy, interpersonal orientation, and experiencing moral conflict could predict the psychosocial dimensions. Structuring moral meaning could predict the physical dimension. The communication aspects were not related to any of the dimensions of moral sensitivity.
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Affiliation(s)
- Shima Nazari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarieh Poortaghi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Science, Tehran, Iran
| | - Shaghayegh Gorzin
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouya Farokhnezhad Afshar
- Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Shahid Mansouri Street, Niyayesh Street, Satarkhan Avenue, Tehran, 1445613111, Iran.
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Faraco MM, Gelbcke FL, Brehmer LCDF, Ramos FRS, Schneider DG, Silveira LR. Moral distress and moral resilience of nurse managers. Nurs Ethics 2022; 29:1253-1265. [PMID: 35549481 DOI: 10.1177/09697330221085770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience. AIM The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil. RESEARCH DESIGN The research design is the qualitative study with discursive textual analysis. PARTICIPANTS AND RESEARCH CONTEXT : 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions. ETHICAL CONSIDERATIONS The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity. FINDINGS Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation. CONCLUSION From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.
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Miraghaie AM, Pouretemad H, Villa AEP, Mazaheri MA, Khosrowabadi R, Lintas A. Electrophysiological Markers of Fairness and Selfishness Revealed by a Combination of Dictator and Ultimatum Games. Front Syst Neurosci 2022; 16:765720. [PMID: 35615426 PMCID: PMC9124946 DOI: 10.3389/fnsys.2022.765720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Individual behavior during financial decision making is motivated by fairness, but an unanswered question from previous studies is whether particular patterns of brain activity correspond to different profiles of fairness. Event Related Potentials (ERPs) were recorded from 39 participants who played the role of allocators in a Dictator Game (DG) and responders in an Ultimatum Game (UG). Two very homogeneous groups were formed by fair and selfish individuals. At fronto-central cortical sites, the latency of ERP early negativity (N1) was 10 ms shorter in selfish participants than in fair participants. In fair DG players, the subsequent positive wave P2 suggested that more cognitive resources were required when they allocated the least gains to the other party. P2 latency and amplitude in the selfish group supported the hypothesis that these participants tended to maximize their profit. During UG, we observed that medial frontal negativity (MFN) occurred earlier and with greater amplitude when selfish participants rejected less favorable endowment shares. In this case, all players received zero payoffs, which showed that MFN in selfish participants was associated with a spiteful punishment. At posterior-parietal sites, we found that the greater the selfishness, the greater the amplitude of the late positive component (LPC). Our results bring new evidence to the existence of specific somatic markers associated with the activation of distinct cerebral circuits by the evaluation of fair and unfair proposals in participants characterized by different expressions of perceived fairness, thus suggesting that a particular brain dynamics could be associated with moral decisions.
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Affiliation(s)
- Ali M. Miraghaie
- Faculty of Psychology, Shahid Beheshti University, Tehran, Iran
- NeuroHeuristic Research Group, HEC-Lausanne, University of Lausanne, Lausanne, Switzerland
- *Correspondence: Ali M. Miraghaie
| | - Hamidreza Pouretemad
- Department of Clinical and Health Psychology, Shahid Beheshti University, Tehran, Iran
- Hamidreza Pouretemad
| | - Alessandro E. P. Villa
- NeuroHeuristic Research Group, HEC-Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Mohammad A. Mazaheri
- Department of Clinical and Health Psychology, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Science, Shahid Beheshti University, Tehran, Iran
| | - Alessandra Lintas
- NeuroHeuristic Research Group, HEC-Lausanne, University of Lausanne, Lausanne, Switzerland
- LABEX, HEC-Lausanne, University of Lausanne, Lausanne, Switzerland
- Alessandra Lintas
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Hajibabaee F, Salisu WJ, Akhlaghi E, Farahani MA, Dehi MMN, Haghani S. The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic. BMC Nurs 2022; 21:58. [PMID: 35277159 PMCID: PMC8913325 DOI: 10.1186/s12912-022-00834-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Caring for patients during a pandemic can be difficult for healthcare workers, the patients themselves, and healthcare systems. Nurses are expected to recognize ethical dilemmas and make sound judgments when confronted with them. Sensitizing nurses to ethical issues strengthen their ability to identify ethical dilemmas and make ethical choices. As a result, this study aimed to determine a relationship between moral sensitivity and caring behavior among nurses during the coronavirus (COVID-19) pandemic. Method The current study is a cross-sectional study of 406 nurses who worked in a single hospital during the COVID-19 epidemic. We used a demographic questionnaire and the caring behavior inventory (CBI) tool to collect data online. The data were analyzed using descriptive and correlational statistics. Findings Eighty-three point seven percent of participants in this study were female, and 71.9% were married. 47.5% reported caring for a COVID-19 patient for longer than a month; their average work experience was 13.1 years. Additionally, Moral Sensitivity correlated positively with caring behavior and its dimensions (r = 0.164, P = 0.001). However, a significant and inverse link existed between the dimension "following the rules" and the nurse's caring conduct (r = -0.117, P = 0.019). Conclusion During the pandemic, nurses' moral sensitivity was moderate and significantly connected with their caring behavior. Because nurses encounter numerous obstacles while caring for patients in critical conditions, they require ethical empowerment to perform correctly, as caring behavior improves with increased moral sensitivity.
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Jang SJ, Kim EH, Lee H. Moral sensitivity and person-centered care among mental health nurses in South Korea: A cross-sectional study. J Nurs Manag 2022; 30:2227-2235. [PMID: 35119156 DOI: 10.1111/jonm.13554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022]
Abstract
AIM To identify the predictors of mental health nurses' person-centered care, including moral sensitivity. BACKGROUND Person-centered care meets patients' ethical needs by protecting their autonomy and dignity, and respecting their choices; it is essential to enhance patient outcomes. Therefore, it is important to identify the predictors of the practice of advocating patients' rights and dignity, and providing person-centered care among mental health nurses to foster competency and ensure the highest quality of care. METHODS This cross-sectional study included 220 mental health nurses in South Korea. It measured their general and work-related characteristics, moral sensitivity, and person-centered care. Multiple regression analysis was conducted to identify the person-centered care predictors. RESULTS The most potent person-centered care predictor was moral sensitivity (β=.35, p<.001). Other predictors included prior biomedical ethics education (β=.15, p=.013) and marital status (β=.14, p=.025). The regression model had 28.0% explanatory power. CONCLUSIONS Mental health nurses' moral sensitivity must be increased to improve their person-centered care. IMPLICATIONS FOR NURSING MANAGEMENT Nurses should receive continuous education to remain aware of and maintain a high level of moral sensitivity and be encouraged to continue the person-centered practice. Organizational and policy support is needed to promote the practice of person-centered care in the workplace.
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Affiliation(s)
- Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Eun Hye Kim
- Dawongongdongche, Mental Rehabilitation Facilities, Daejeon, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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Khodaveisi M, Oshvandi K, Bashirian S, Khazaei S, Gillespie M, Masoumi SZ, Mohammadi F. Moral courage, moral sensitivity and safe nursing care in nurses caring of patients with COVID-19. Nurs Open 2021; 8:3538-3546. [PMID: 33945661 PMCID: PMC8242869 DOI: 10.1002/nop2.903] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/10/2021] [Accepted: 02/28/2021] [Indexed: 12/28/2022] Open
Abstract
AIM Evaluation the moral courage, moral sensitivity and safe nursing care in nurses caring of infected patients by the COVID-19. DESIGN This study employed cross-sectional research. METHODS 520 nurses caring for COVID-19 patients in 5 hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. RESULTS Findings showed that moral courage has a strong and direct correlation with moral sensitivity (p < .001, r = 0-.70) and safe nursing care (p < .001, r = 0-.74). Variables of moral sensitivity, safe nursing care, work experience, age and employment status can predict 64.76% of the variance in moral courage in these nurses. Nursing care of patients with COVID-19 have reported high moral courage in recent months, and in spite of the numerous tensions and stresses in terms of caring these patients during this relative long period, they are still diligent in providing safe and high sensitive care to these patients.
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Affiliation(s)
- Masoud Khodaveisi
- Department of Community Health NursingSchool of Nursing and MidwiferyChronic Diseases (Homecare) Research CenterHamadan University of Medical SciencesHamadanIran
| | - Khodayar Oshvandi
- Department of Medical Surgical NursingSchool of Nursing and MidwiferyMother and Child Care Research CenterHamadan University of Medical SciencesHamadanIran
| | - Saeid Bashirian
- Department of Public Health, Social Determinants of Health Research CenterHamedan University of Medical SciencesHamadanIran
| | - Salman Khazaei
- Department of Epidemiology, School of Public HealthHamadan University of Medical SciencesHamadanIran
| | - Mark Gillespie
- School of Health Nursing and MidwiferyUniversity of the West of ScotlandPaisleyScotland
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and MidwiferyHamadan University of Medical SciencesHamadanIran
| | - Fateme Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Autism Spectrum Disorders Research CenterHamadan University of Medical SciencesHamadanIran
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15
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Zahednezhad H, Shokrollahi N, Gheshlagh RG, Afshar PF. Does heavy mental workload affect moral sensitivity among critical care unit nursing professionals? a cross-sectional study. BMC Nurs 2021; 20:140. [PMID: 34376186 PMCID: PMC8353778 DOI: 10.1186/s12912-021-00662-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Moral sensitivity creates the basic attitude in providing effective ethical care to patients. Heavy mental workload is a major concern of critical care nursing professionals, which could adversely affect nursing staff and patients. The present study aimed to investigate the effects of mental workload and some demographic variables on the moral sensitivity of critical care nursing professionals. Methods This cross-sectional, descriptive-correlational study was performed on 181 nursing professionals working in the critical care units of Shahid Rajaei Cardiovascular Medical and Research Center in Tehran, Iran. Data were collected using a demographic questionnaire, the moral sensitivity questionnaire, and the NASA-task load index to assess mental workload. Data analysis was performed in SPSS version 22 using descriptive statistics, independent t-test, Pearson’s correlation-coefficient, and regression analysis. Results The results of regression analysis yielded no statistical significant relationship between heavy mental workload and moral sensitivity of the critical care nursing professionals, while clinical experience had a positive, significant association with moral sensitivity. Conclusions Although care nursing professionals experience a heavy mental workload in critical care units, it does not decrease their moral sensitivity. In addition, experienced nurses have higher moral sensitivity and lower mental workload. Therefore, it seems that nursing managers should pay special attention to the importance of employing experienced nurses along with younger nurses.
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Affiliation(s)
- Hosein Zahednezhad
- Department of Psychiatric Nursing and Management, School of Nursing & Midwifery, Shahid Beheshti University Of Medical sciences, Velenjak St, Shahid Chamran Highway, Tehran, Iran.
| | - Nasrin Shokrollahi
- Masters of Science in Critical Care Nursing, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tohid Square, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University Of Medical sciences, Pasdaran Blvd., Sanandaj, Iran
| | - Pouya Farokhnezhad Afshar
- School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran
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Choe K, Kim S, Lee C, Kim S. Effect of Ethics Seminar on Moral Sensitivity and Ethical Behavior of Clinical Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010241. [PMID: 33396206 PMCID: PMC7795744 DOI: 10.3390/ijerph18010241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 01/21/2023]
Abstract
While nursing is an ethical profession, unethical behavior among nurses is increasing worldwide. This study examined the effects of an ethics seminar on nurses’ moral sensitivity and ethical behavior. A total of 35 nurses (17 experimental, 18 control) were recruited. The ethics seminar was held over a six-month period from May to October 2018 and comprised six sessions held once a month for two hours. Moral sensitivity and unethical behavior were measured at the start and end of the seminar. Moral sensitivity and unethical behavior showed a negative correlation (r = −0.400, p < 0.05). After the ethics seminar, the experimental group’s moral sensitivity was not significantly increased (t = −1.039, p = 0.314). The experimental group’s mean scores of unethical behavior at pre- and posttest were 12.59 and 9.47, respectively, indicating a statistically significant difference (t = 3.363, p = 0.004). There was no statistically significant difference in the mean score in both moral sensitivity and unethical behavior at pre- and posttest in the control group. Thus, ethics seminars can reduce the risk of unethical behavior among nurses. Regular ethics seminars and training must be provided to nurses as part of their curriculum/practice.
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Affiliation(s)
- Kwisoon Choe
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea;
| | - Sunman Kim
- Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea;
| | - Chunbok Lee
- Institute for Historical Studies, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea;
| | - Sunghee Kim
- Department of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea;
- Correspondence: ; Tel.: +82-2-820-5985
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