Factors affecting the formation of nurses' moral sensitivity in cardiopulmonary resuscitation settings: A qualitative study.

Background: Certain factors may facilitate or inhibit the formation of moral sensitivity in nurses performing cardiopulmonary resuscitation (CPR). The identification of these factors in the context can help develop strategies to promote nurses' moral sensitivity and offer new insights into the consequences of their moral decisions.Objective: Taking into account the possibly multi-factorial nature of moral sensitivity, this study aimed to identify the factors affecting the formation of nurses' moral sensitivity in CPR settings.Research design and methods: This study performed a conventional qualitative content analysis. Twenty-one participants were selected via purposive and theoretical sampling. The data were collected through in-depth semi-structured interviews and simultaneously analyzed via content analysis.Participants and research context: In total, twenty-one participants (fourteen clinical care nurses, three head nurses, two educational supervisors, and two faculty members) from different cities of Iran were interviewed.Ethical considerations: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran (IR.UMSU.REC.1399.337).Findings: Four categories (underlying factors, professional factors, organizational inhibitors of ethics, and professional limitations) and 13 sub-categories were extracted.Discussion: The formation of moral sensitivity requires a range of ethical standards and their maintenance, not only at the individual level but also at the profession, organization, and community levels. So eliminating inhibitors of ethics in these contexts can improve nurse's ethical performance in CPR settings.Conclusion: Any measures taken or decisions made by nurses in CPR are driven by numerous ethical issues to which nurses must be morally sensitive. Some factors facilitate and some inhibit the formation of moral sensitivity in nurses.

Critical care nurses' moral sensitivity during cardiopulmonary resuscitation: Qualitative perspectives.

BACKGROUND: Cardiopulmonary Resuscitation (CPR) is one of the areas in which moral issues are of great significance, especially with respect to the nursing profession, because CPR requires quick decision-making and prompt action and is associated with special complications due to the patients' unconsciousness. In such circumstances, nurses' ability in terms of moral sensitivity can be determinative in the success of the procedure. Identifying the components of moral sensitivity in nurses in this context can promote moral awareness and improve moral performance. OBJECTIVE: This study was conducted to explore and identify the experiences of critical care nurses about moral sensitivity components in CPR. RESEARCH DESIGN AND METHODS: This study was implemented with a qualitative approach. Data were collected via 22 in-depth semi-structured interviews held with 20 eligible participants with maximum variation. The data were then analyzed using the grounded theory approach. PARTICIPANTS AND RESEARCH CONTEXT: In total, thirteen clinical nurses, three head nurses, two educational supervisors, and two faculty members from different universities of Iran were interviewed. ETHICAL CONSIDERATIONS: This study was conducted with the ethical approval (IR.UMSU.REC.1399.337) of the Ethics Committee of Urmia University of Medical Sciences. FINDINGS: Four themes and 12 sub-themes were extracted from the analysis of the data, including "Consciously and compassionate attention to resuscitate the patient," "Awareness of families' anxiety," "Understanding the teamwork and interactive guidance of the CPR process," and "Compulsory violation of moral principles." DISCUSSION: It is anticipated that this discussion will prompt further debate, raise awareness and help clarify the dimensions of moral sensitivity in unconscious patients especially during CPR, so that it can be more clearly named and defended as a moral authority in CPR. CONCLUSION: identifying the components of moral sensitivity in nurses, facilitates their encounter with moral issues and can improve their moral performance and encourage right decisions.

Workplace challenges and nurses recovered from COVID-19.

BACKGROUND: Although many studies have addressed COVID-19, the challenges faced by nurses in their workplace after recovering from this disease have not been investigated. As the backbone of the health system and at the forefront of the fight against COVID-19, nurses are exposed to serious risks of infection and even death. They may also face numerous challenges in their workplace after recovering from COVID-19. It is therefore ethically recommended that the problems of these nurses be solved to increase their job satisfaction and encourage them to remain in their profession. OBJECTIVES: The present research was conducted to determine the workplace challenges faced by nurses who had recovered from COVID-19. METHODS: This qualitative study was conducted using the interpretive phenomenological approach proposed by van Manen. The data collected through 17 in-depth semi-structured interviews with 14 eligible nurses at different occupational levels were analyzed using the six steps proposed by van Manen. These nurses had also recovered from COVID-19. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1399.318). FINDINGS: Four themes and 20 subthemes extracted from analyzing the data explained the challenges faced by the nurses after their return to work. The themes included declined ethical values (four subthemes), infected nurses, forgotten patients (three subthemes), gradually leaving the job (six subthemes), and corona phobia (seven subthemes). CONCLUSION: The present findings can be used to lay the foundations for adopting humanitarian policies in health organizations in terms of ethical care provision during future pandemics.

The effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure: an experimental study.

BACKGROUND: Heart failure is a common and chronic heart condition with high prevalence and mortality rates. This debilitating disease as an important predictor of health outcomes is directly related to patients' quality of life. Given that one of the main goals of heart failure treatment is to promote patients' quality of life and health status, conducting effective nursing interventions seems to be necessary in this regard. Therefore, the present study aimed to determine the effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure. METHODS: This is an experimental study in which a total of 80 patients with heart failure were recruited and randomly allocated to two groups of intervention and control (n = 40 in each group). The educational program was designed based on Pender's health promotion model and then provided for the patients in the intervention four subgroups (10 person in each group) during six sessions. Data were collected at three time-points of before, immediately after, and three months after the intervention using a demographic questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were then analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA) and p value less than 0.05 was taken as statistically significant. RESULTS: Based on the results of the present study, no statistically significant difference was shown in terms of demographic characteristics between the two groups. It was also indicated that there was a statistically significant difference in the mean scores of all dimensions of quality of life (except in the physical dimension) between the two groups so that the overall mean score of quality of life increased significantly in the intervention group after the intervention (p < .05). Moreover, there were significant increases in the mean scores of health-promoting behaviors (except in the domain of physical activity) in the intervention group compared to the control group (p < .05) after intervention. CONCLUSIONS: This study demonstrates a trend that Pender's health promotion model is effective in improving the quality of life of patients with heart failure except of the physical dimension, and strengthening their health-promoting behaviors in all dimensions except of the physical activity dimension.

The organisational and managerial challenges experienced by nurses recovered from COVID-19: A phenomenological study.

AIM: This study was conducted to discover the organisational and managerial challenges of nurses recovered from COVID-19. BACKGROUND: Nurses, who are at the front line of fighting against COVID-19, face numerous organisational and managerial challenges that impose a burden on their already heavy burden of infection. Working in challenging situations can affect the quality of nursing care. METHODS: This qualitative study was conducted through an interpretive phenomenological approach. To collect the data, 18 semistructured interviews were held with 15 recovered nurses, which were then analysed using van Manen's method. RESULTS: The data analysis led to the extraction of four themes: nurses as victims of organisational prejudice, a profession surrounded by problems, insufficient sources for dealing with COVID-19 and post-COVID-19 development. CONCLUSION: This study showed the organisational and managerial challenges of recovered nurses from COVID-19. Although these nurses had positive experiences, they needed eliminating organisational prejudice, minimizing concerns and sufficient resources to deal with the crisis. IMPLICATIONS FOR NURSING MANAGEMENT: It is believed that these results can be used as a guide to nurse managers to improve the experience of recovered nurses from COVID-19 by treating all employees with equal kindness, considering to their problems and minimizing burden by actively providing resources.