Intensive Care Nurses’ Ethical Challenges Caring for People with COVID-19: A Qualitative Study

ÖZET Amaç: Bu çalışma, hemşirelik öğrencilerinin problem çözme becerileri ile sağlık hizmetlerinde bilgisayar kullanımına yönelik tutumları arasındaki ilişkiyi belirlemek amacıyla yapıldı. Yöntemler: Bu, Türkiye'nin kuzeydoğu bölgesindeki bir üniversitenin sağlık bilimleri fakültesi hemşirelik bölümünde 3-7 Aralık 2018 tarihleri arasında yürütülen tanımlayıcı ve kesitsel bir çalışmadır. Araştırmanın örneklemini, hemşirelik öğrencilerinin 587'si (% 73) oluşturmaktadır. Veriler, tanımlayıcı özellikler formu, Problem Çözme Envanteri ve Sağlık Bakımında Bilgisayar Kullanımına Yönelik Tutum Ölçeği kullanılarak toplanmıştır. Ölçek toplam puanları ile alt ölçek ve alt grup ortalamaları hesaplanmıştır. Tanımlayıcı istatistikler sayı ve yüzde olarak sunuldu. Veriler, Mann – Whitney U, Kruskal – Wallis H ve Spearman korelasyon testleri kullanılarak analiz edildi. Bulgular: Katılımcıların ortalama yaşı 20.66±1.79 yıldı. Katılımcıların% 61.0'ı kadındı. Sağlık Bakımında Bilgisayar Kullanımına Yönelik Tutum Ölçeği toplam puan ortalaması 8.36±9.58, Problem Çözme Envanteri toplam puan ortalaması ise 93.41±18.73’dir. Problem Çözme Envanteri ile Sağlık Bakımında Bilgisayar Kullanımına Yönelik Tutum Ölçeği arasında negatif yönlü, zayıf anlamlı korelasyon vardı (p = 0.000, r = -0.363). Sonuç: Bu çalışmada, Problem Çözme Envanterinden düşük puan alan, yani daha güçlü problem çözme becerisine sahip hemşirelik öğrencilerinin sağlık bakımında bilgisayar kullanımına yönelik daha olumlu tutumlar sergiledikleri bulunmuştur.

Anahtar Kelimeler:

Bilgisayara karşı tutum, , bilgisayar, , hemşirelik öğrencileri, , problem çözme,

Intensive Care Nurses’ Ethical Challenges Caring for People with COVID-19: A Qualitative Study

ABSTRACTAim: This study aimed to determine the relation between nursing students’ problem-solving skills and attitudes toward computer use in health care.Methods: This was a cross-sectional and correlational study conducted between December 3 and 7, 2018 in the nursing department of the faculty of health sciences of a university in the northeastern region of Turkey. The study sample comprised 587 (73%) of nursing students. Data were collected using a descriptive characteristics form, the Problem-Solving Inventory and the Pretest for Attitudes Toward Computers in Healthcare scale. Scale total scores and subscale and subgroup mean scores were calculated. Descriptive statistics were presented as numbers and percentages. Data wereanalyzed using the Mann–Whitney U, Kruskal–Wallis H, and Spearman correlation tests.Results: The mean age of participants was 20.66±1.79 years. Of the participants, 61.0% were women. They had mean scores of 93.41±18.73 and 8.36±9.58 on the Problem-Solving Inventory and the Pretest for Attitudes Toward Computers in Healthcare scale, respectively. The Problem-Solving Inventory was weakly and negatively related with the Pretest for Attitudes Toward Computers in Healthcare scale (p = 0.000, r = -0.363).Conclusion: This study found that nursing students who had low scores on the Problem-Solving Inventory, that is, stronger problem-solving skills, demonstrated more positive attitudes toward computer use in health care. Based on these results, the following recommendations were made. Students’ problem-solving skills should be evaluated at the beginning of each academic year. During clinical internships, mentor nurses should introduce students to nursing informatics.

Keywords:

Attitude to computers , computers, , health care, , nursing students, , problem solving.,

___

1. Amiri E, Ebrahimi H, Asghari Jafarabadi M, et al. Relationship between nurses’ moral sensitivity and the quality of care. Nursing ethics 2019; 26(4): 1265-73. DOI: 10.34172/JCS.2020.015
2. Nora D, Rigon C and Zoboli Eş Vieira MM. Moral sensitivity of nurses assessed through scoping review. Cogitare Enferm 2017; 22(2):e47162. DOI: 10.5380/ce.v22i1.47162
3. Roshanzadeh M, Borhani F and Mohammadi S. Moral sensitivity and moral distress in critical care Unit Nurses. Medical Ethics Journal, 2017; 10(38):19-28.
4. Moon JY and Kim JO. Ethics in the Intensive Care Unit. Tuberc Respir Dis (Seoul). 2015;78(3):175-9. DOI:10.4046/trd.2015.78.3.175
5. Larkin ME, Beardslee B, Cagliero E, et al. Ethical challenges experienced by clinical research nurses: a qualitative study. Nurs Ethics 2019; 26(1): 172–84. DOI:10.1177/0969733017693441
6. Ejder Apay S, Gürol A and Gür E. Midwifery students’ reactions to ethical dilemmas encountered in outpatient clinics. Nurs Ethics. 2020;27(7): 1542-55. DOI:10.1177/0969733020922875
7. Lantos JD. Ethical problems in decision making in the neonatal ICU. New England Journal of Medicine, 2018; 379(19): 1851-60. DOI: 10.1056/NEJMra1801063
8. Lusignani M, Giannì ML, Re LG, et al. Moral distress among nurses in medical, surgical and intensive‐care units. Journal of Nursing Management, 2017, 25(6): 477-85. DOI: 10.1111/jonm.12431
9. Yönt GH, Korhan E A, Dizer B, et al. Determination of Ethical Problems Experienced by Nurses in the Intensive Care Units. Turkiye Klinikleri J Med Ethics. 2013;21(2):74-8.
10. Teixeira C, Ribeiro O, Fonseca AM, et al. Ethical decision making in intensive care units: a burnout risk factor? Results from a multicentre study conducted with physicians and nurses. J Med Ethics 2014;40(2):97-103. DOI: 10.1136/medethics-2012-100619
11. Kırşan M, Yıldırım D, Ceylan B. et al. Ethical Problems in Intensive Care Units: A Systematic Review Turkiye Klinikleri J Med Ethics. 2018;26(2):57-65.
12. Akın Palandöken E. COVID-19 Pandemisi ve Hemşireler için Etik Sorunlar. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2020; 5(2): 139-42.
13. World Health Organization. What are the symptoms of COVID-19, 2020, https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/ question-and-answers-hub/q-a-detail/q-a-coronaviruses
14. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating personto-person transmission: a study of a family cluster. Lancet 2020; 395(10223): 514–23. DOI:10.1016/S0140-6736(20)30154-9
15. Yuxiu J, Ou C, Zhiying X, et al. Nurses’ ethical challenges caring for people with COVID-19: A qualitative study. Nurs Ethics 2020;28(1):33- 45 DOI:10.1177/0969733020944453
16. Leblebicioğlu H and Nair Aktaş F. Covid-19 Salgınıyla Mücadele: Yoğun Bakım Hemşireliği Meslek ve Kişisel Etik Perspektifi. Yoğun Bakım Hemşireliği Dergisi 2020;24(EK-1):73-80.
17. Giorgi A. The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. J Phenomenol Psychol 1997;28:235-60.
18. Giorgi A. Concerning the application of phenomenology to caring research. Scand J Caring Sci 2000;14:11-5.
19. Tong A, Sainsbury P and Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349-57.
20. Fry TS. Conceptual Themes Basic To Cancer Nursing, Cancer Nursing: A Comprehensive Textbook, Bird, S (Ed.), Philadelphia, W.B. Saunders Company, 1991.
21. Kıraner E, Terzi B, Türkmen E, et al. Experiences of Turkish Intensive Care Nurses during the COVID-19 Outbreak. HEAD Journal of Education and Research in Nursing 2020;17(3):284-6.
22. Robert, R., Kentish-Barnes, N., Boyer, A. et al. Ethical dilemmas due to the Covid-19 pandemic. Ann. Intensive Care 2020;10(84):1-9. DOI:10.1186/s13613-020-00702-7
23. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061–9. DOI:10.1001/jama.2020.1585
24. Scott PA. Key Concepts and Issues in Nursing Ethics. Galway, Ireland. Springer International Publishing AG,2017.
25. University of Toronto Joint Centre for Bioethics Pandemic Influenza Working Group. 2005. Stand on guard for thee: Ethical considerations in preparedness planning for pandemic influenza. Available at: http://www.jcb.utoronto.ca/people/documents/upshur_stand_ guard.pdf
26. Altaker KW, Howie-Esquivel J and Cataldo, JK. Relationships among palliative care, ethical climate, empowerment, and moral distress in intensive care unit nurses. AJCC, 2018; 27(4): 295-302. DOI: 10.4037/ ajcc2018252
27. Turale S, Meechamnan C and Kunaviktikul W. Challenging times: ethics, nursing and the COVID-19 pandemic. Int Nurs Rev 2020 Jun;67(2):164-7. DOI:10.1111/inr.12598
28. Hakko A and Madenoğlu Kıvanç M. Creating Ethical Behaviors in Nursing Management. Journal of Health and Nursing Management 2018;5(3):227-32 DOI:10.5222/SHYD.2018.227
29. Barkhordari-Sharifabad M, Ashktorab T and Atashzadeh-Shoorideh F. Ethical leadership outcomes in nursing: A qualitative study. Nurs Ethics. 2018;25(8):1051-63. DOI:10.1177/0969733016687157