[Psychological reaction of nurses to the context in ethical decision making]

ABSTRACT

Ethical decision making is an essential element in nursing practice. There are various contextual factors which can result in ethical conflicts that demand the nurse's abilities to recognize moral dilemmas and make appropriate moral decisions. The aim of this article is description of psychological reactions of nurses to the context in ethical decision making in patients care. The present study was conducted by grounded theory method. Participants were 17 Iranian employed nurses. Semi-structured, unstructured and in-depth interview were used for data gathering. All interviews were transcribed verbatim and coded according to Strauss and Corbin method in coding and constant comparative analysis. Job stress and moral distress were identified as a major reaction of nurses to the context in ethical decision making. Satisfaction vs. dissatisfaction, increasing motivation vs. decreasing motivation, happiness vs. fatigue and impatience, hopefully vs. demoralization, worthiness sense vs. unworthiness sense, adaptation and sensitivity vs. be habitual and apathy were other psychological reactions of nurses to the context in ethical decision making. According to the nurses ethical decision making context which include nurse individual and job characteristics, patient and his/her family characteristics, physician characteristics, and structural and nursing management constraints are influence factors in their psychological reactions. Thus, it is necessary that the nurses consider the context in their own psychological reactions. Also, structural involving agents and nursing managers must be attempt to reform and improve the context especially structural conditions