Aim
To explore and understand moral distress from the perspective of and as experienced by critical care nurses in Korea.
Background
The concept of moral distress among critical care nurses must be ...more broadly explored using a qualitative approach.
Design
Giorgi's phenomenological research approach was used.
Methods
A purposive sampling was used to select 14 critical care nurses. In‐depth face‐to‐face interviews were performed in Korea from March 2012–December 2013.
Findings
Five main themes of moral distress emerged: (1) ambivalence towards treatment and care (notably prioritizing work tasks over human dignity, unnecessary medical treatments and the compulsory application of restraints); (2) suffering resulting from a lack of ethical sensitivity; (3) dilemmas resulting from nurses' limited autonomy in treatments; (4) conflicts with physicians; and (5) conflicts with institutional policy.
Conclusion
Staff shortages are aggravated by high staff turnover caused by ethical suffering. The resulting lack of staff can, in turn, give rise to added ethical conflicts as part of a vicious circle, leading to decreased patient satisfaction.
Cancer is a leading cause of death worldwide, and most patients with cancer in South Korea die in hospitals. Oncology nurses experience physical, emotional, and occupational challenges associated ...with the psychological burden of caring for dying patients.
This study explored the coping strategies used by oncology nurses to deal with the psychological burden of patient deaths.
In this descriptive qualitative study, 10 oncology nurses who had recently experienced a patient's death were recruited via snowball sampling. All were female, with a mean age of 32.9 years (range, 27-44 years), and their mean working duration was 9.9 (range, 3-23) years. Participants were interviewed individually face-to-face 3 times, with each interview lasting 1 to 1.5 hours.
Oncology nurses coped with the psychological burden of a patient's death in the following 4 ways: ( a ) avoiding patient deaths to the extent possible, ( b ) reflecting upon the meaning of life and death, ( c ) suppressing their emotional distress over the patient's death, and ( d ) becoming kinder and more caring toward people around them.
The findings suggest that oncology nurses struggle to cope with the psychological burden of patient deaths. Oncology nurses are affected both negatively and positively by experiencing death as they provide end-of-life care.
Oncology nurses need education or counseling to reduce the psychological burden of caring for dying patients with cancer. Hospital administrators need to continuously identify ways to reduce the psychological burden of oncology nurses providing end-of-life care.
As the number of older adults with dementia increases, early diagnosis and intervention are crucially important. The purpose of this study was to conduct dementia screening on older adults to ...determine whether there are differences in depression, loneliness, social support, daily activities of living, and life satisfaction between older adults at high-risk for dementia compared with low-risk older adults. We hypothesized a negative relationship between high-risk older adults and these factors. This study also hypothesized a moderating effect for social support on the relationship between daily living activities and life satisfaction. This study used a cross-sectional design with survey data. Participants were recruited at 15 public community health centers in South Korea. A total of 609 older adults (male 208, female 401) living in the community were screened for early dementia, and 113 participants (18.9%) were assigned to the high-risk group. As hypothesized, participants in the high-risk group showed significantly more negative results in terms of activities of daily living, depression, loneliness, social support, and life satisfaction compared with participants in the low-risk group. The findings of this study provide a theoretical basis for the importance of early screening for dementia and policies for effective dementia prevention.
Background:
Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think ...their ethical difficulties have been explored sufficiently from their own perspective.
Objectives:
This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children.
Methods:
A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea.
Ethical considerations:
Ethical review was obtained from an ethics committee. The participants were informed about the aim of the study, and voluntary participation, anonymous response, and confidentiality were explained to them.
Findings:
Three themes emerged from the analysis: ethical numbness in a task-oriented context, negative feelings toward family caregivers, and difficulty in expressing oneself in an authoritative climate. Conclusion and implications: We need to develop strategies to manage ethical difficulties at an institutional level. Furthermore, it is important that pediatric nurses have the opportunity to communicate with fellow nurses and other medical staff regarding ethical difficulties. In addition, cultivation of pediatric nurses’ moral, ethical, and philosophical thinking patterns requires the immediate provision of continuous education in nursing ethics at the site of clinical nursing, time to discuss ethical difficulties, and other supportive measures. Findings indicated that, to provide high-quality patient-centered care, we should enhance nurses’ ethical sensitivity and autonomy and improve the ethical climate in hospitals.
Many adolescents spend a great deal of time playing online games and may be exposed to sexism while playing. The present study aimed to understand the sexism experienced by adolescents in online ...gaming in South Korea. Data were collected from July to September 2018 from 25 high school students (15 female, 10 male), recruited via purposive sampling, who participated in individual interviews or focus groups. Participants were 15–18 years-old, with the average gaming experience of 6.14 years (range = .5–13). A descriptive phenomenological research method was used to analyze the interview data, and three themes emerged for adolescents’ experiences with sexism in online gaming: gender stereotyping about online gaming skills, gender differences in game character’s appearance and sexual objectification, and gender differences in active versus passive coping. According to the results of our study, not only young women but also young men were subject to sexism in online games, and players did not know how to deal with sexism in online games. There is a system that reports sexism in online games, but the players do not use the reporting system actively because they think it is not effective. Our study is expected to contribute to the reduction of sexism in online games by helping game policy developers, game developers, and game players to understand sexism in online gaming.
Depression and hope are considered pivotal variables in the recovery process of people with schizophrenia.
This study examined the moderating effect of depression on the relationship between hope and ...recovery, and the mediating effect of hope on the relationship between depression and recovery in persons with schizophrenia.
The model was tested empirically using the data of 115 persons with schizophrenia from Central Java Province, Indonesia. The Calgary Depression Scale for Schizophrenia, Schizophrenia Hope Scale-9, and Recovery Assessment Scale were used to measure participants' depression, hope, and recovery, respectively.
The findings supported the hypothesis that depression moderates the relationship between hope and recovery, and hope mediates the relationship between depression and recovery.
The findings suggest that mental health professionals need to focus on instilling hope and reducing depression to help improve the recovery of persons with schizophrenia. Furthermore, mental health professionals should actively develop and implement programs to instill hope and continuously evaluate the effectiveness of the interventions, particularly in community-based and in-patient mental health settings.
Anxiety is a common mental health problem among older persons, and the prevalence is higher in those who live alone than those who live with others. This study aimed to explore the experiences of ...anxiety in older persons living alone. A descriptive phenomenological approach was used to collect and analyze the interview data from 15 older persons (5 males, 10 females) living alone in Seoul, South Korea. Four main themes emerged from the data analysis: fear of being alone, concern about having an aged body, apprehension mixed with depression and loneliness, and fear of economic difficulties. These findings indicate that older persons living alone should receive continuous attention to prevent them from being neglected and their anxiety from worsening. Above all, it is vital to ensure comprehensive support for older persons living alone to alleviate their anxiety.
In order to help nurses advocate for the patient's human rights and ensure respect for life in clinical situations, it is of utmost importance to improve nursing students' capacity to make ethical ...decisions.
This study compares the effects of two constructivist teaching strategies (action learning and cross-examination debate) on nursing students' recognition of bioethical issues, experience of bioethical issues, and attainment of ethical competence.
This study used a quasi-experimental (two-group pretest–posttest) design.
A nursing college in South Korea.
A total of 93 Korean nursing students participated in the study (46 in the action learning group and 47 in the cross-examination debate group).
Participants took a bioethics class employing one or the other of the strategies mentioned, 2h a week for 15weeks. All participants responded twice to a set of questionnaires, at the beginning of the first session and at the end of the last session.
After their bioethics education, the students' recognition of bioethical issues improved for both classes; however, the knowledge of students who had participated in action learning improved more than that of the students in the debate-based class. Students in both groups reported more experience of bioethics and exposure to better-quality instruction in bioethics after their classes than previously. Students in both groups also reported improved ethical competency after this education.
Positive effects of action learning and cross-examination debate implemented as teaching strategies on nursing students' understanding of bioethical issues and their ethical competency were identified; these findings will be important in the essential task of teaching bioethics to nursing students in order to foster more ethical decision-making and other ethical behavior.
Intimate partner violence is a serious global social problem. While intimate partner violence is highly prevalent, few studies have examined its negative outcomes among victims in South Korea. The ...aim was to clarify the mediating roles of interpersonal dependency and anger on the relationship between intimate partner violence victimization and suicidal ideation.
In this descriptive, cross-sectional study, 301 participants (203 women and 98 men) aged 18-65 yr completed an online questionnaire on a social networking site. Data were collected between Feb and Mar 2017 in South Korea. Structural equation modeling was used to test the fitness of the conceptual model of this study.
We found significant correlations between intimate partner violence victimization, interpersonal dependency, state-trait anger, and suicidal ideation. Intimate partner violence victimization influenced anger and suicidal ideation only when the victims had high interpersonal dependency.
It is necessary to develop programs for reducing interpersonal dependency and improving anger management that are specifically targeted at intimate partner violence victims to prevent suicidal ideation.
Abstract
Background
Nurses frequently encounter ethically challenging situations in everyday practice. In these situations, nurses often know an appropriate course of action to take but are unable to ...do so. Many studies have examined the ethically challenging situations faced by nurses, but how nurses cope with these situations is not well understood. Therefore, this study aims to explore the coping strategies used or adopted in ethically challenging situations by expert nurses in South Korea.
Methods
Participants were recruited via purposive sampling. Small group interviews were conducted with 26 expert registered nurses in a general hospital in South Korea. The data were analyzed using Giorgi’s descriptive phenomenological method.
Results
The essential theme of nurses’ experience of coping with ethically challenging situations was “being faithful to the nature of caring.” This essential theme comprised three themes: self-monitoring of ethical insensitivity, maintaining honesty, and actively acting as an advocate.
Conclusions
The findings of this study suggest that the coping strategies of expert nurses are mostly consistent with the attributes of ethical competence as previously defined in healthcare, and expert nurses can address ethically challenging situations in an effective and ethical manner by faithfully adhering to the spirit of caring. System-wide early counseling and interventions should be considered for nurses who have experienced ethical difficulties.
PDF
