Showing 10 results for Intensive Care Unit
Ali Beikmoradi, Somayyeh Rabiee, Mahnaz Khatiban, , Mohammad Ali Cheraghi,
Volume 5, Issue 2 (4-2012)
Abstract
In spite of increasing advances in technology, medical equipments, costs, geriatric population, consideration to ethical and legal issues has increased in nursing profession. This study aimed to explore ethical codes and consideration of ethical issues and severity of ethical distress experienced by nurses at intensive care units.
A cross-sectional survey using questionnaire was conducted by a census of nurses in intensive care units in educational and treatment centers of Hamadan.
Nurses value most the ethical codes related to responsibility (95.1%), accountability (95.1%), patient support (77.3%), secret keeping (83.4%), and honesty (78.5%). They studied patient rights statement 2.47 times with standard deviation of 2.86. Only 50.3 percent of nurses had education about professional ethics. Nurses had mean of mark in severity of ethical distress 99.34 ±46.61.
Severity of ethical distress was moderate in nurses. There was not significant relationship between demographic data and severity of ethical distress. There are more needs to assess for effects and effective factors on ethical distress in intensive care units nurses.
Ahmad Izadi, Hlham Imani, Zahra Khademi, Fariba Fariasadi Noughabi, Nina Hajizadeh, Fatemeh Naghizadeh ,
Volume 6, Issue 2 (5-2013)
Abstract
Nurses encounter challenging ethical issues in practice that can make decision making tough for them. The purpose of this study was to determine the moral sensitivity of critical care nurses in clinical decision making and its correlation with their caring behavior in teaching hospitals of Bandar Abbas in 2012.This research is a descriptive analytic study with intensive care unit nurses as its participants. A demographic and background questionnaire, a standard questionnaire of the nurses’ moral sensitivity, and a caring behavior questionnaire were used to collect information. Data were analyzed using SPSS16 software, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis, and Spearman’s correlation.The mean score of the nurses’ moral sensitivity was 70.15 ± 6.90 (maximum score was 96 and minimum score was 49) that was moderate in 85.6% of the nurses. The mean score of the nurses’ caring behavior was 108.90 ± 10.62 (maximum score was 120 and minimum score was 69). There was no significant correlation between moral sensitivity and caring behavior scores, but both scores were significantly associated with the place where the nurses were working. The dimension of respect for patient autonomy had a significant relationship with participation in medical ethics seminars or workshops.The moral sensitivity of the nurses in this study was moderate and did not have a significant correlation with caring behavior scores. In view of the fact that nurses deal with serious situations in patient care that call for adequate ethical abilities for decision-making as well as good performance, it is necessary for them to be familiar with and sensitive to ethical issues related to their profession.
Somayeh Mohammadi, Fariba Borhani, Leili Roshanzadeh, Mostafa Roshanzadeh,
Volume 7, Issue 2 (7-2014)
Abstract
Moral distress is one of the ethical challenges that nurses face due to the nature of their career. Nurses' frequent confrontation with this phenomenon can have different outcomes such as frustration and boredom in providing patient care. This will lead directly to a decline in care quality and can hamper the accomplishment of health goals. Therefore, the present study examined the relationship between moral distress and compassion fatigue in nurses.This cross-sectional study was conducted on 260 nurses of intensive care units in Kerman who were selected through convenience sampling method. In this study, Corley’s moral distress scale and Figley’s Compassion Fatigue Scale were used for data collection. The collected data were analyzed using the SPSS software and descriptive and analytical statistics.The results of this study indicate that there is a significantly positive relationship between moral distress and compassion fatigue (P<0.05). From a total range of 0 to 5, the average score of moral distress was 3.5±0.8 in terms of intensity, and 3.9±0.55 in terms of frequency. The mean of compassion fatigue score was 3.5±0.68 from a range of 0 to 5.Moral distress and its association with compassion fatigue suggest that conditions contributing to moral distress can have an important role in the quality of care. It is clear that strategies should be adopted to prevent the occurrence of these conditions. Informing nurses about moral distress and its consequences as well as periodic consultations will play an important part in the identification and management of moral distress and its consequences.
Somaye Rostami, Ravanbakhsh Esmaeali, Hedayat Jafari, Jamshid Yazdani Charati, Seyed Afshin Shorofi,
Volume 10, Issue 0 (3-2017)
Abstract
Futile medical care is considered as the care or treatment that does not benefit the patient. Thus, perception of the clinical team regarding futile care is of great importance and it has an important role in the quality of nursing care and health of clinical team. This study aimed to determine the relationship between perception of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units. This correlational, analytical study was performed on 181 nursing staff of the intensive care units (ICUs) of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a two-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were used. Pearson’s correlation coefficient, partial correlation, t-test, and ANOVA tests were performed to assess the relationship between the variables. Findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care. In addition, it was only the mean working hours per week among the demographic variables that had a statistically significant relationship with perception of futile care (P<0.05). Given the moderate perception of nurses concerning futile care, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.
Mohammad Aminizadeh, Mansoor Arab, Roghieh Mehdipour,
Volume 10, Issue 0 (3-2017)
Abstract
Nurses in the intensive care unit face a variety of ethical issues that can lead to moral distress. Nurses need moral courage for correct moral performance in a state of moral distress. The aim of this study was to investigate the relationship between moral courage and moral distress in nurses. The descriptive-analytic study of correlation type which aimed to investigate the relationship between moral courage and moral distress in nurses. A total of 310 nurses from special units of educational hospitals in Kerman were selected by census method. The tools Sekerka's moral courage and Corley's moral distress were used to collect data. Data were analyzed by descriptive and analytical tests of SPSS version 24. Mean score of moral courage of nurses was 42.71 ± 9.67. Moral courage was the highest in moral agent. The mean of moral distress was 56.03 ± 18.21 and the most moral distress was in the dimension of errors. There was a significant and negative relationship between moral courage and moral distress (R = -0.166; p = 0.003). Moral courage was different in position, type of department, and marital status. Moral distress differed only from type of department. The results of study indicated a significant and negative relationship between moral courage and moral distress. Strengthening the moral courage of nurses plays an important role in controlling and reducing moral distress. Therefore, nurses can reduce their moral distress by reinforcing moral courage and, instead, increasing the quality of care for patients.
Mehri Doosti Irani, Batool Alidoost, Leila Rafiee Vardanjani, Zahra Tayebi, Kobra Noorian,
Volume 13, Issue 0 (3-2020)
Abstract
Hospitalization in Intensive Care Units (ICUs) is a very stressful experience for the patient and family and their separation has not been confirmed in any of the studies. At present, ICU visiting is limited that makes several challenges. Therefore, this descriptive-exploratory study, aimed to explore strategies for overcoming the challenges of visiting This was a descriptive-exploratory qualitative study conducted through in-depth semi-structured interviews with 35 participants in educational hospitals of Shahrekord University of Medical Sciences including 6 patients, 9 patients' family members or friends, and 20 nurses during 2018. Interviews were continued until data saturation and then data analysis was performed using inductive thematic analysis approach. Participants stated two main themes for stepping out of visiting-related Challenges. (1) "Reducing the Need to Meet" through "Education about visiting rules", "Improving the Environment" and "Family Interaction" and (2) "Modified Meetings" through "Upgrading the Meeting Behind the windows", "using permanent monitor" and "flexible meeting". The ICU visits in Shahrekord hospitals, are limited like in other parts of the country. However, it is hoped that implementation of the extracted strategies in ICUs will solve many of visiting-related issues and eliminate the conflicting experience of patients, peers, and staff.
Maryam Kashani, Mansoureh Ashqli Farahani, Fatemeh Golestan,
Volume 17, Issue 0 (12-2024)
Abstract
The intensive care unit (ICU) environment presents numerous ethical challenges, contributing to significant levels of moral distress among ICU nurses. This distress negatively impacts their well-being and job satisfaction. Recognizing this critical issue, researchers have investigated the potential of moral empowerment programs to alleviate moral distress. This scoping review aimed to systematically synthesize existing literature on these programs and evaluate their efficacy in mitigating moral distress among ICU nurses. A comprehensive search of PubMed, Scopus, and CINAHL databases was conducted, utilizing keywords such as "moral empowerment," "moral distress," and "intensive care unit nurses." Fifteen articles meeting predefined inclusion criteria, including publication between 2010 and 2022 and a specific focus on moral empowerment programs for ICU nurses, were selected for analysis. The scoping review revealed that moral empowerment programs demonstrated positive outcomes in reducing moral distress among ICU nurses. These programs, encompassing workshops, case-based discussions, reflective exercises, and role-playing simulations, were designed to enhance moral reasoning, ethical decision-making, and moral resilience. Consistent findings indicated a significant decrease in moral distress among nurses who participated in these programs. Participants reported increased confidence in navigating ethical dilemmas, making sound clinical decisions, and effectively advocating for patients' rights. Moreover, moral empowerment programs fostered a sense of moral agency, empowering nurses to address ethical challenges proactively. Moral distress poses a significant challenge for ICU nurses, impacting their well-being and potentially compromising the quality of patient care. Moral empowerment programs offer a promising approach to mitigating this distress and enhancing ethical decision-making capabilities. The successful implementation of these programs requires a supportive work environment that fosters open dialogue and ethical reflection. Nurse leaders and educators play a crucial role in collaborating with ethics committees to develop and implement tailored interventions, including integrating moral empowerment modules into new nurse orientations and ongoing professional development programs. Continuous support through follow-up sessions, mentoring, and debriefing is essential to sustain the long-term benefits of these programs. Ethical consultation services and interprofessional collaboration further contribute to the ethical well-being of ICU nurses. While this review provides valuable insights, further research is warranted to investigate the long-term effects and broader implications of moral empowerment programs in the ICU setting.
Simin Kokabi Asl, Sareh Zekavat, Somayeh Rostamkhan, Abolfazl Dehbanizadeh, Mahsa Ghaemizadeh, Milad Amiri,
Volume 17, Issue 1 (3-2024)
Abstract
The intensive care unit (ICU) is a challenging and stressful environment where nurses encounter difficult ethical decisions daily. Therefore, this study aimed to determine the correlation between moral reasoning and clinical belongingness among Iranian ICU nurses. This cross-sectional, descriptive-analytical study was conducted on 126 nurses working in the adult ICUs of hospitals in Yasuj, Iran in 2023 using census sampling. Questionnaires measuring clinical belongingness and moral reasoning were used to collect data. Data were analyzed using independent samples t-test, ANOVA, regression, and Pearson’s correlation coefficient via SPSS-26 software. The findings revealed that the mean scores for clinical belongingness and moral reasoning among the nurses were 109.68 ± 13.75 and 36.07± 5.50, respectively, indicating good clinical belongingness and moderate moral reasoning. Moreover, a statistically significant relationship was identified between the place of service and clinical belongingness (p = 0.02), while no significant relationship was found between clinical belongingness and moral reasoning (p>0.05). Although no significant relationship was established between clinical belongingness and moral reasoning, certain demographic characteristics showed a significant predictive relationship with nurses' clinical belongingness. Accordingly, it is recommended that nursing officials and managers utilize these findings to improve moral reasoning and the sense of belonging to the clinical environment among nurses.
Mohammadmahdi Pazhavand, Maasoumeh Barkhordari-Sharifabad, Khadijeh Nasiriani,
Volume 18, Issue 1 (3-2025)
Abstract
Identifying an effective coping strategy for moral distress, as an important and common phenomenon among intensive care unit nurses, seems essential. The knowledge-to-action model aims to identify effective methods for implementing evidence into clinical practice. The present study sought to determine the effect of an intervention based on the knowledge-to-action model on moral distress among nurses working in intensive care units. This was an experimental study, and the statistical population included nurses working in the intensive care units of Namazi Hospital in Shiraz, Iran. A total of 100 eligible nurses were selected through convenience sampling and then randomly assigned to intervention and control groups. For the intervention group, the knowledge-to-action model was implemented. Data were collected using the Hamric Moral Distress Scale before and one month after the intervention. Both groups completed the questionnaire at these time points. Data were analyzed using descriptive and inferential statistics with SPSS version 19. The findings showed that the two groups were similar in terms of demographic characteristics and mean moral distress scores before the intervention. After the intervention, the mean scores of moral distress in the intervention group were significantly reduced in the frequency dimension (2.12±0.34) and severity dimension (2.32±0.46) compared to the control group (frequency: 2.51±0.43; severity: 2.57±0.55) (p<0.001). The results indicated that implementing the knowledge-to-action model reduces moral distress in intensive care unit nurses. Therefore, it is recommended that nursing managers adopt this model to improve the quality of care.
Parsa Farmahin Farahany, Zahra Torkashvand,
Volume 18, Issue 1 (3-2025)
Abstract
One of the key ethical-legal concerns in the medical profession is patients’ trust in the quality of care and adherence to professional standards. This viewpoint explored the ethical-legal dimensions of using surveillance cameras in Intensive Care Units (ICUs), focusing on a specific legal-ethical case. In this scenario, the patients’ family caregivers express doubt about the quality of care and request access to recorded footage. From an ethical-legal perspective, documenting events by the medical team—provided that privacy, data protection regulations, and visual monitoring standards are respected—can help safeguard patients’ rights, clarify staff performance, and prevent legal misunderstandings. While acknowledging the potential benefits, this study also outlined legal considerations, such as patient notification, access limitations, and data management protocols. The key conclusion is that the use of cameras in ICUs, if aligned with legal and institutional requirements, can enhance trust, demonstrate ethical compliance, and reduce legal complaints.
