Critical Care Nurses’ Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity

Abstract

Background. Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses’ adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS). Methods. In this descriptive-correlational study, data were collected using the moral sensitivity questionnaire (MSQ) by Lützén et al., Paloutzian and Ellison’s spiritual well-being scale (SWBS), and the adherence to ethical codes questionnaire. The study was conducted on 298 nurses working in critical care units of hospitals affiliated with Shiraz University of Medical Sciences in southern Iran in 2019. This study was examined and approved by the Ethics Committee of Shiraz University of Medical Sciences. Results. The majority of the participants were female (76.2%) and single (60.1%), with a mean age of 30.69 ± 5.74 years. The mean scores of adherence to ethical codes, SWB, and MS were 64.06 (good), 91.94 (moderate), and 134.08 (moderate), respectively. Adherence to ethical codes had a positive correlation with the total score of SWB ( P < 0.001 , r = 0.25) and MS ( P < 0.001 , r = 0.27). A positive correlation was also observed between MS and SWB ( P < 0.001 , r = 0.41). Meanwhile, MS (β = 0.21) had a greater effect than SWB (β = 0.157) on adherence to ethical codes. Conclusion. Critical care nurses showed a good adherence to ethical codes. MS and SWB also positively affected their adherence to ethical codes. Nursing managers can use these findings to devise plans for the promotion of MS and SWB in nurses and thus help improve their ethical performance.

Critical and Medical-Surgical Nurses' Adherence to Professional Nursing Code of Ethics and Quality of Nursing Care Satisfaction

“…This study was supported by a study in Gambia (2018) which found that educational level affected the proper practicing code of ethics among nurses (Bah & Sey-Sawo, 2018 However, the current finding was incongruent with the Egyptian study in 2016 which found that the nurses had adequate practice of the professional code of ethics among nurses in outpatient and hemodialysis units (Hafez et al, 2016;Ali et al, 2018). The present study also disagreed with other studies in Iran (2016 and 2023) (Momennasab et al, 2016;Momennasab et al, 2023), Ethiopia (2022) (Haile, 2022) and Indonesia (2020) (Safitri et al, 2020), which found that nurses' adherence to NECP was at a satisfactory level.…”

“…A similar finding was found in studies in Egypt ( 2015 However, regarding provision of nursing care practice, a significantly higher adherence to NCEP was noticed among nurses in critical care units compared to medical-surgical care units, especially in helping patient decision making and correct provision of care, in a timely manner and cooperating with other health care providers. These findings were not surprising because patients in critical care units are highly vulnerable, requiring complex care and rapid response compared to other hospital wards (Momennasab et al, 2023).…”

“…Nurses need to address the nursing code of ethical practice (NCEP) in their daily activities to regulate their specific actions and guide their nursing decisions to face ethical dilemmas and new challenges in health care settings (Poorchangizi et al , 2019 ;Beykmirza et al, 2022;Momennasab et al, 2023). When nurses are properly guided to use NCEP in their practice, this would enhance proper patient care and satisfaction constituting (Yeboahasuama, 2015; Abd El-mawgood et al, 2018).…”

“…It guides nurses' behaviors to achieve the standards of the nursing profession, quality of nursing care and patient safety (Abd El-mawgood et al, 2018; Poreddi et al, 2022). Nurses should pay their attention to adhere to the NCEP for safeguarding patients' rights and achieving patient satisfaction with the quality of nursing care (Bah & Sey-Sawo, 2018;Momennasab et al, 2023).…”

“…Nurses in critical and medical-surgical care units need to continually adhere to the NCEP to ensure optimal patient care and make the best decisions for their patients when faced with challenges that require clinical and ethical decision-making. Patients in critical care units and medical-surgical care units are a highly vulnerable group and it is thus necessary to be sensitive to observing their rights and their provision of nursing care (Bah & Sey-Sawo, 2018;Toumová et al, 2021, Momennasab et al, 2023.…”