Clinical nurse adherence to professional ethics: A grounded theory.

BACKGROUND: Professional ethics is the regulation and discipline of nurses' daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are few studies on nurses' adherence to professional ethics. RESEARCH AIM: An analysis of nursing adherence to nursing ethics from the perspective of clinical nurses in the Chinese public health system. RESEARCH DESIGN: This study adopts the grounded theory approach proposed by Strauss and Corbin. PARTICIPANTS AND RESEARCH CONTEXT: Between July 2021 and January 2022, Clinical nurses were recruited for online video interviews using purposive and theoretical sampling methods in seven hospitals in Beijing, Tianjin, Shanxi, Henan, Guangdong, and Fujian, China. Data analysis was conducted using Strauss and Corbin's coding approach. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee of Sanming First Hospital (MingYiLun 71/2021). FINDINGS: A total of 27 participants were included. A theoretical model of nursing staff adherence to professional ethics was constructed. The main core was adherence to professional ethics and the other cores were (1) causal conditions: professional ethics code, individual conscience; (2) intervening conditions: personal growth, social support system, matching career compensation, prediction of adverse consequences; (3) action strategies: sticking to professional values, self-regulation, flexible response, post-event improvement; and (4) outcomes: self-harmony, reduced medical disputes. CONCLUSIONS: This study provides an interpretive understanding of why clinical nurses adhere to professional ethics in China and describes the challenges and issues posed by nurses' use of strategies to cope with ethical adversity. The findings can be used to develop future complex studies.

The impact of resilience on clinical nurses' moral courage during COVID-19: A moderated mediation model of ethical climate and moral distress.

AIM: The purpose of this study was to explore whether clinical ethical climate mediates the relationship between resilience and moral courage in a population of clinical nurses during COVID-19, and if moral distress faced by nurses is a moderating factor. BACKGROUND: Resilience can help nurses maintain their personal health during COVID-19 when they face great physical and psychological shock and are prone to health problems. Moral courage, as an ethical competency, helps nursing staff in adhering to the principles and values of professional ethics. There is a strong correlation between resilience and moral courage, but the mechanism by which resilience contributes to moral courage is unclear. METHOD: A cross-sectional study research is designed. Three hundred thirty clinical nurses from six hospitals in Beijing, Sichuan, and Fujian of China were included between August 2021 and March 2022. The survey instruments include the Nurses' Moral Courage Scale (NMCS), Connor-Davidson Resilience Scale (CD-RISC), Moral Distress Scale-Revised (MDS-R), and Hospital Ethical Climate Scale (HECS). RESULTS: Ethical climate mediates 15% of the relationship between resilience and moral courage. The association between resilience and ethical climate, as well as the indirect relationship between resilience and moral courage, was modified by moral distress. DISCUSSION: This study investigated the mechanisms by which resilience affects moral courage in clinical nurses in the context of COVID-19, suggesting that moral courage can be increased by alleviating moral distress and increasing ethical climate. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study confirms the mediating effect of moral climate on the relationship between resilience and moral courage, as well as the moderating effect of moral distress. Hospital policymakers should value nurses' psychological resilience and moral courage, develop effective policies to prevent and manage stressors, build social support systems, and create a positive ethical climate.

Reliability and validity of the Mandarin version of the Trust in Nurses Scale.

AIMS: This study aimed to translate and validate the Trust in Nurses Scale (TINS) and then test and implement the tool. BACKGROUND: Trust is the core feature of the nurse-patient relationship, and a simple and universal instrument to measure patients' trust in nurses in China is lacking. METHODS: Exploratory and confirmatory factor analyses (EFA and CFA) were performed to verify structural validity. Content validity and reliability analyses were also conducted. RESULTS: The Cronbach's alpha of the TINS was .817, and the test-retest reliability coefficient was .852. EFA revealed two factors and explained 59.702% of the total variation. CFA proved that all the goodness-of-fit indicators were acceptable. CONCLUSION: The TINS exhibited satisfactory reliability and validity, and it can be universally applied to survey Chinese patients' trust in nurses. IMPLICATIONS FOR NURSING MANAGEMENT: The TINS can be used by nursing managers to assess patients' trust in nurses, and appropriate programmes can be developed to improve patients' trust.