PURPOSE: This paper was aimed to inquire into Ricoeur's self -hermeneutics and narrative ethics, and apply it to personal identity constituting caring and care ethics in the practice of nursing. Its purpose is to provide a philosophical foundation for caring in nursing. METHOD: According to Ricoeur's narrative identity, ontological caring was interpreted as personal identity constituting caring. His ethics were described as care ethics, which contributed to preserving and promoting the personal dignity of the client, as self in search for the good life in the nursing practice. RESULTS: Narrative understanding of the client pointed to the ontological role of care in the constitution of personal identity. From an ethical aspect of the narrative, respect for personal identity and personal dignity of the client was crucial to an ethical caring attitude, promoting self-esteem in the nursing practice. CONCLUSION: This paper suggested that Ricoeur's ethics could provide a philosophical basis for understanding ontological and ethical caring in nursing. This contributed to protection of the client from the threat of personal identity, as well as respecting their personal dignity.
Nursing Care/*ethics ; Humans

PURPOSE: This study was aimed at identifying the types of perceptions of ethical issues among perioperative nurses. METHODS: Q-methodology focusing on individual subjectivity was used with data collected in November 2016. Thirty-four Q-statements were selected and scored by the 35 participants on a 9-point scale with normal distribution. Participants were perioperative nurses working in advanced general hospitals and general hospitals. The data were analyzed using the PC-QUANL program. RESULTS: total of 35 perioperative nurses were classified into 4 factors based on the following viewpoints: self-centered (type 1), onlooking and avoiding (type 2), patient-centered (type 3), and problem-centered (type 4). The 4 factors accounted for 57.84% of the total variance. Individual contributions of factors 1, 2, 3, and 4 were 41.80%, 7.18%, 5.20%, and 3.66%, respectively. CONCLUSION: The major contribution of this study is the clarification of perioperative nurses' subjective perceptions of ethical issues. These findings can be used in formulating effective strategies for nursing educators, professional nurses, and nursing administrators to improve ethical decision-making abilities and to perform ethical nursing care by the appropriate management of ethical issues in everyday nursing practice.
Administrative Personnel ; Ethics* ; Ethics, Nursing ; Hospitals, General ; Humans ; Nursing ; Nursing Care ; Perioperative Nursing ; Q-Sort

Informed consent should not be regarded as a rigid process. Instead, it should be regarded as a flexible process that provides patient with the right amount of information required to facilitate meaningful decision-making. Informed consent is an important ethical and practical part of patient care. Understanding the moral foundation of informed consent can help to guide therapists in their communication with all patients. Nurses, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the treatment process. But in this process, there are some challenges that make it difficult. This paper describes the underlying ethical and regulatory requirements as well as related challenges regarding informed consent in the context of a nursing practice in Iran.
Ethics, Nursing ; Humans ; Informed Consent* ; Iran ; Nursing* ; Patient Care

PURPOSE: This study was done to develop a death education program for nursing students and evaluate the effects of the program. METHODS: The education program was developed based on ADDIE model. The death education program was developed on the base of educational needs, a comprehensive review of the literature and focus group interviews and then evaluated with 53 nursing students, 27 in the experimental and 26 in the control group. Measurement was done for the meaning of life using the tool by Choi et al (2005) for attitudes concerning death, the tool Thorson and Powell (1998) revised by Kim (2006) and for attitude to end-of-life patient care, the Attitudes toward Nursing Care of the Dying Scale by Frommelt (1991) translated by Cho and Kim (2005). RESULTS: The program consisted of five sessions: Understanding of death, Family bereavement care, Communication and End-of-life patient care, Professional role, and Ethics and legal issues There was a statistically significant difference between pretest and posttest for the meaning of life in the experimental group compared to the control group. About 82% of students in the experimental group were satisfied with the program. CONCLUSION: The results indicate that this program can be used to educate nursing students.
Education* ; Ethics ; Focus Groups ; Hospice Care ; Humans ; Nursing Care ; Nursing* ; Patient Care ; Professional Role ; Students, Nursing*

PURPOSE: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. METHOD: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characte-ristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. RESULTS: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was 36.76 55.7 hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. CONCLUSION: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.
Child ; Ethics ; Humans ; Intensive Care Units ; Nursing ; Nursing Care ; Patient Rights ; Restraint, Physical* ; Surveys and Questionnaires

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behavior-related issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-of-life (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behavior-related issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
Critical Care Nursing/*ethics ; Humans ; *Intensive Care Units ; Nurses ; Retrospective Studies ; Terminal Care ; Tertiary Care Centers

PURPOSE: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. METHODS: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. RESULTS: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. CONCLUSION: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.
Bioethics* ; Consent Forms ; Data Collection ; Education ; Ethics ; Ethics, Medical ; Humans ; Life Support Care ; Mortality ; Nursing* ; Students, Nursing

PURPOSE: This study was done to clarify nurses' duties, tasks and task elements and to develop a job description for clinical nurses on general and intensive care units in tertiary-level hospitals, and dramatically reflect changing medical trends in Korea. METHODS: The job description was developed based on the Developing a Curriculum Method (DACUM). The questionnaire included frequency, importance, and difficulty of duties, tasks and task elements, measured on a 4-point scale. Results were analyzed using SPSS version 21.0. Data were collected from September 4 to 7, 2017, and analyzed using descriptive statistics and a scattered graph. RESULTS: The job description consisted of 10 duties, 38 tasks, and 51 elements. Of the 10 duties, the highest duty in order of importance was ‘Direct nursing care’ followed by ‘Infection control’. The highest duties according to frequency and difficulty were ‘Document and notify’ and ‘Research and quality improvement’. ‘Safety management’ and ‘Infection control’ were considered as relatively simple duties, however, these two duties were still included as important jobs for clinical nurses. CONCLUSION: The job descriptions for clinical nurses developed from this study contain nursing ethics and safety as well as infection control, to faithfully reflect clinical nurses' jobs.
Critical Care* ; Curriculum ; Ethics, Nursing ; Infection Control ; Intensive Care Units* ; Job Description* ; Korea ; Methods* ; Nursing ; Patients' Rooms*

PURPOSE: The aim of this study was to elucidate clinical nurses' ethics germane to information literacy and perception of patient data privacy and thus help nurses to develop more positive and consolidated ethical values. METHODS: For this study a descriptive survey design was used. Participants were 142 nurses who worked in a hospital and completed self-report questionnaires. Data were collected from August 1 to 5, 2016 and were analyzed using independent t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and stepwise multiple regression with SPSS 22.0. RESULTS: Ethical value had a positive correlation with information needs (r=.25, p=.002) in information literacy as well as in direct patient care (r=.27, p=.001), shift work (r=.20, p=.016), patient information management (r=.39, p<.001), and communication (r=.24, p=.004) in perception of patient data privacy. Patient information management, educational background, and age were significant variables predicting the level of ethical values and accounted for 21% of the variance. CONCLUSION: Ethical values education with particular emphasize on managing patient information should be encouraged for nurses who are younger and have a lower education level. Findings indicate a need for education programs to guide clinical nurses to utilize appropriate information when solving ethical challenges in every day nursing practice.
Confidentiality* ; Education ; Ethics ; Humans ; Information Literacy* ; Information Management ; Nursing ; Patient Care

PURPOSE: The purposes of this study were: 1) To describe the level of awareness of patient safety culture and nursing care activities for patient safety and, 2) To identify factors affecting nursing care activities for patient safety among oncology nurses working at inpatient care units. METHODS: The study sample included 221 nurses working in oncology wards. After obtaining IRB approval, data collection was done with structured self-administered questionnaires, from September 13 to October 13, 2013. Data analysis was done using SPSS WIN 18.0. RESULTS: The mean score of awareness of patient safety culture was 3.46 and the mean score of nursing care activities for patient safety was 4.31 both on a scale of 5.0. Significant factors affecting nursing care activities for patient safety were the open attitude of the supervisor toward patient safety (beta=.19, p=.005) and the degree of patient safety within a ward perceived by the oncology ward nurses (beta=.23, p=.003). These factors explained 31% of the subjects' nursing care activities for patient safety (F=6.08, p<.001). CONCLUSION: To increase nursing care activities for patient safety in the oncology ward, a strategy such as an education program for increasing the awareness of patient safety is needed.
Data Collection ; Education ; Ethics Committees, Research ; Humans ; Inpatients ; Nursing Care* ; Oncology Nursing ; Patient Safety* ; Safety Management ; Statistics as Topic ; Surveys and Questionnaires