The Relationship Between Nurses’ Ethical Reasoning with the Quality of Nursing Care

Abstract

Context A high quality of nursing care is an important priority of nursing profession and directly associated with increased patient satisfaction. Evidence shows that ethical professional issues are challenging with significant influences on the quality of nursing care. Aims The aim of this study was to determine how quality of patient care relates to the nurses’ ethical reasoning as viewed by patients in medical wards. Settings and Design This study used a descriptive correlational design. Subjects and Methods Data collection tools included a Nursing Dilemma Test and Quality Patient Care Scale. In total, 180 hospitalized patients and 180 nurses who worked in medical wards of Hospitals in 2017 were enrolled. Sample selection was done by the census method. Statistical Analysis Used Data were analyzed by the SPSS software version 22. Results The means score for nurses’ quality care was 91.71 ± 14.81. Furthermore, the mean score for ethical reasoning among nurses was at an average level of 45.07 ± 6.12. There was no significant relationship between the quality of care and nurse’s ethical reasoning ( P > 0.05). Conclusions: The results revealed that factors other than ethical reasoning of nurses are related to quality of care. Furthermore, nurses showed an average ability in ethical reasoning. So to improve this situation, healthcare system administrators can offer professional training programs to increase ethical sensitivity and reasoning among the nurses who face daily ethical issues.

The mediating role of moral reasoning in spiritual intelligence and caring behaviors in Iranian emergency nurses

“…Also, our results indicated that there was a significant positive relationship between SI and the caring behavior of nurses working in the emergency department, which was in agreement with the study of Sunaryo et al (2018) suggesting the positive association between SI and caring behavior ( 44 ).…”

“…In their study, Sonaryo et al (2018) found that both emotional intelligence and SI had a direct effect on caring behavior. On the other hand, SI had an indirect effect on caring behavior via the mediating role of job burnout, which was in line with our study ( 44 ). According to the results of the present study, ethical reasoning playing the mediating role in the relationship between SI and the caring behavior of nurses was revealed using the SEM.…”

“…Moral reasoning is a mental process, leading to the recognition of an ethical issue and the correct reaction to it, and the nurse decides based on what is right ( 10 ). According to the Kohlberg’s theory, the development of ethical reasoning occurs at three levels of two stages each: pre-conventional reasoning, conventional reasoning, and post-conventional reasoning ( 11 ). Nurses must have some level of moral reasoning, skill, and knowledge that are required to resolve ethical conflicts and are essential to high-quality nursing care.…”

“…Nurses must have some level of moral reasoning, skill, and knowledge that are required to resolve ethical conflicts and are essential to high-quality nursing care. The lack of ethical reasoning skills has excluded the majority of nurses from having a significant role in the process of decision-making and hindered daily practice routine ( 11 , 12 ), Also, it can result in making the wrong decisions about end-of-life, and human and edication errors in the complex clinical situations ( 13 ). which can have adverse consequences for the patient and his/her family members and even the nurse…”

“…SI is a relatively new concept in the field of psychology and spirituality that is defined as a set of capabilities people to use religious and spiritual resources, and adaptive behavior in problem-solving embodies the highest levels of cognitive, moral, emotional, and interpersonal development and also the person can solve life problems using spiritual resources ( 13 , 16 , 17 ). The different four dimensions of SI (proposed by King & DeCicco, 2009) are as follows: (1) CET (standing for critical existential thinking), (2) PMP (signifying personal meaning production), (3) TA (standing for transcendental awareness), and (4) SE (signifying conscious state expansion) ( 11 ). Given that nursing is a stressful profession; therefore, SI and its dimensions can lessen the effects of stress.…”