Factors affecting the formation of nurses' moral sensitivity in cardiopulmonary resuscitation settings: A qualitative study.

Background: Certain factors may facilitate or inhibit the formation of moral sensitivity in nurses performing cardiopulmonary resuscitation (CPR). The identification of these factors in the context can help develop strategies to promote nurses' moral sensitivity and offer new insights into the consequences of their moral decisions.Objective: Taking into account the possibly multi-factorial nature of moral sensitivity, this study aimed to identify the factors affecting the formation of nurses' moral sensitivity in CPR settings.Research design and methods: This study performed a conventional qualitative content analysis. Twenty-one participants were selected via purposive and theoretical sampling. The data were collected through in-depth semi-structured interviews and simultaneously analyzed via content analysis.Participants and research context: In total, twenty-one participants (fourteen clinical care nurses, three head nurses, two educational supervisors, and two faculty members) from different cities of Iran were interviewed.Ethical considerations: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran (IR.UMSU.REC.1399.337).Findings: Four categories (underlying factors, professional factors, organizational inhibitors of ethics, and professional limitations) and 13 sub-categories were extracted.Discussion: The formation of moral sensitivity requires a range of ethical standards and their maintenance, not only at the individual level but also at the profession, organization, and community levels. So eliminating inhibitors of ethics in these contexts can improve nurse's ethical performance in CPR settings.Conclusion: Any measures taken or decisions made by nurses in CPR are driven by numerous ethical issues to which nurses must be morally sensitive. Some factors facilitate and some inhibit the formation of moral sensitivity in nurses.

Critical care nurses' moral sensitivity during cardiopulmonary resuscitation: Qualitative perspectives.

BACKGROUND: Cardiopulmonary Resuscitation (CPR) is one of the areas in which moral issues are of great significance, especially with respect to the nursing profession, because CPR requires quick decision-making and prompt action and is associated with special complications due to the patients' unconsciousness. In such circumstances, nurses' ability in terms of moral sensitivity can be determinative in the success of the procedure. Identifying the components of moral sensitivity in nurses in this context can promote moral awareness and improve moral performance. OBJECTIVE: This study was conducted to explore and identify the experiences of critical care nurses about moral sensitivity components in CPR. RESEARCH DESIGN AND METHODS: This study was implemented with a qualitative approach. Data were collected via 22 in-depth semi-structured interviews held with 20 eligible participants with maximum variation. The data were then analyzed using the grounded theory approach. PARTICIPANTS AND RESEARCH CONTEXT: In total, thirteen clinical nurses, three head nurses, two educational supervisors, and two faculty members from different universities of Iran were interviewed. ETHICAL CONSIDERATIONS: This study was conducted with the ethical approval (IR.UMSU.REC.1399.337) of the Ethics Committee of Urmia University of Medical Sciences. FINDINGS: Four themes and 12 sub-themes were extracted from the analysis of the data, including "Consciously and compassionate attention to resuscitate the patient," "Awareness of families' anxiety," "Understanding the teamwork and interactive guidance of the CPR process," and "Compulsory violation of moral principles." DISCUSSION: It is anticipated that this discussion will prompt further debate, raise awareness and help clarify the dimensions of moral sensitivity in unconscious patients especially during CPR, so that it can be more clearly named and defended as a moral authority in CPR. CONCLUSION: identifying the components of moral sensitivity in nurses, facilitates their encounter with moral issues and can improve their moral performance and encourage right decisions.

The effect of guided imagery on the quality and severity of pain and pain-related anxiety associated with dressing changes in burn patients: A randomized controlled trial.

Pain and anxiety caused by burn dressing change are one of the major issues in burn patients. In this regard, guided imagery as a complementary method can be effective in reducing the levels of anxiety and pain. This method is the process of creating mental images and using sensory features through the individual's imagination and memory that facilitate the achievement of desired therapeutic outcomes. Therefore, this study was aimed at determining the effect of guided imagery on the quality and severity of pain and pain-related anxiety associated with dressing change in burn patients. This is a single-blinded randomized controlled trial in which a total of 70 burn patients were enrolled using convenience sampling and randomly allocated to two groups of intervention and control (n = 35 in each group). Each patient in the intervention group received four sessions of guided imagery during four consecutive days (one session a day) using a headphone. Then in both groups, the level of pain was assessed after the dressing change and the level of pain-related anxiety was assessed before the dressing change (between the end of the intervention and the initiation of dressing change). Data were collected using a demographic questionnaire, the Visual Analog Scale (VAS), the short-form McGill Pain Questionnaire (SF-MPQ), and the Burn Specific Pain Anxiety Scale (BSPAS). Data were first entered into the IBM SPSS Statistics for Windows, version 25.0 and then analyzed using repeated-measures Analysis of Variance. The repeated measures ANOVA indicated the mean score of the quality and severity of pain and pain-related anxiety differed statistically and significantly after the intervention (during the four sessions) compared to before it (baseline) in the intervention group (p < 0.001). The independent-samples t-test indicated a statistically significant difference in the mean scores of the quality and severity of pain and pain-related anxiety between the two groups (p < 0.001). This difference was found to be significant from the second session onwards (p < 0.001). Medical staff, including physicians, nurses and other healthcare professionals, are responsible for developing strategies to manage complications of burn injuries. Considering the effectiveness of guided imagery in reducing anxiety and pain in burn patients, it is recommended to use this method of complementary medicine to manage stress, anxiety, and pain in these patients.

"It was like nobody cared about what I said?" Iranian women committed self-immolation: a qualitative study.

BACKGROUND: Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social, and economic impacts of suicide and suicide attempts. METHODS: A qualitative descriptive approach using open-ended, in-depth, face-to-face interviews was conducted in a purposive sample of 16 married Iranian women aged 16-40 years in the burn centers in Urmia city, a place in northwest Iran. Conventional content analysis was used to analyze the data. RESULTS: Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes. CONCLUSIONS: The study highlights the demand for health professionals to support self-immolation survivors to continue their normal lives. According to survivors' needs, a comprehensive supportive program is recommended to support their pathways to recovery in all its complexities. Health professionals should also not forget that the survivors' family also will need help to overcome this trauma. A family counseling program may also be provided.