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      Estratégias para o desenvolvimento da sensibilidade moral: perspectiva dos enfermeiros de unidades de terapia intensiva Translated title: Estrategias para eldesarrollo de lasensibilidad moral: perspectiva de lãs enfermerasen unidades de cuidados intensivos Translated title: Strategies to develop moral sensitivity: a perspective of intensive care unit nurses

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          Abstract

          Resumo Objetivo conhecer estratégias para o desenvolvimento da sensibilidade moral na perspectiva dos enfermeiros que atuam em unidades de terapia intensiva. Método pesquisa qualitativa, do tipo exploratório descritiva, realizada com 19 enfermeiros atuantes em três unidades de terapia intensiva de um hospitalfilantrópico do Sul do Brasil através de entrevistas semiestruturadas, analisadas mediante análise textual discursiva. Resultados emergiram duas categorias: desenvolvimento da sensibilidade moral a partir da formação acadêmica e desenvolvimento da sensibilidade moral a partir da experiência profissional. Entre as estratégias verificadas destacaram-se as discussões e reflexões acerca de problemas éticos, a vivência de atividades extracurriculares, a comunicação efetiva, o trabalho multidisciplinar, a realização de reuniões, a busca pelo conhecimento e a educação permanente em saúde. Conclusões e implicações para a prática o desenvolvimento da sensibilidade moral dos enfermeiros pode auxiliá-los no reconhecimento e enfrentamento de situações eticamente inadequadas, de modo a favorecer o exercício da autonomia e a capacidade de lidar com os conflitos éticos emergentes do contexto de trabalho. Neste estudo, foi possível conhecer ainda, que priorizar espaços para a reflexão e discussão coletiva nos ambientes de formação e atuação da enfermagem, oportuniza o fortalecimento de tomadas de decisões éticas, coerentes, autônomas e eficientes.

          Translated abstract

          Resumen Objetivo conocer estrategias para el desarrollo de la sensibilidad moral desde la perspectiva de las enfermeras que trabajan en unidades de cuidados intensivos. Método investigación cualitativa, exploratoria, descriptiva, realizada con 19 enfermeras que trabajan entres unidades de cuidados intensivos de un hospital filantrópico em el Sur de Brasil a través de entrevistas semiestructuradas, analizadas mediante análisis textual discursivo. Resultados surgieron dos categorías: desarrollo de la sensibilidad moral de la formación académica y desarrollo de la sensibilidad moral de la experiência profesional. Entre lãs estrategias verificadas, discusiones y reflexiones sobre problemas éticos, se destacó la experiencia de actividades extracurriculares, comunicación efectiva, trabajo multidisciplinario, reuniones, búsqueda de conocimiento y educación permanente em salud. Conclusiones e implicaciones para la práctica el desarrollo de la sensibilidad moral de lãs enfermeras puede ayudarlas a reconocer y hacer frente a situaciones éticamente inapropiadas, a fin de favorecer el ejercicio de la autonomía y lacapacidad de lidiar com los conflictos éticos que surgen del contexto laboral. En este estudio, también fue posible saber que priorizar los espacios de reflexión y discusión colectiva em los entornos de educación y desempeño em enfermería, brinda oportunidades para fortalecer la toma de decisiones éticas, coherentes, autónomas y eficientes.

          Translated abstract

          Abstract Objective identify strategies, which from the perspective of intensive care unit nurses support the development of moral sensitivity. Method this qualitative, descriptive and exploratory study addressed 19 nurses working in three intensive care units of a philanthropic hospital located in southern Brazil, using semi-structured interviews and discursive textual analysis. Results two categories emerged: development of moral sensitivity during academic training and development of moral sensitivity during professional experience. Discussion and reflection upon ethical problems, extracurricular activities, effective communication, multidisciplinary work, meetings, and the search for knowledge along with continuous health education stood out among strategies. Conclusions and implications for practice the development of moral sensitivity among nurses can support help them recognizing and dealing with ethically inappropriate situations, favoring nurses’ autonomy and ability to deal with ethical conflicts emerging in the workplace. This study’s results show that giving priority to collective reflection and discussion in both training and care settings strengthen ethical, coherent, autonomous and efficient decision-making.

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          Developing the concept of moral sensitivity in health care practice.

          The aim of this Swedish study was to develop the concept of moral sensitivity in health care practice. This process began with an overview of relevant theories and perspectives on ethics with a focus on moral sensitivity and related concepts, in order to generate a theoretical framework. The second step was to construct a questionnaire based on this framework by generating a list of items from the theoretical framework. Nine items were finally selected as most appropriate and consistent with the research team's understanding of the concept of moral sensitivity. The items were worded as assumptions related to patient care. The questionnaire was distributed to two groups of health care personnel on two separate occasions and a total of 278 completed questionnaires were returned. A factor analysis identified three factors: sense of moral burden, moral strength and moral responsibility. These seem to be conceptually interrelated yet indicate that moral sensitivity may involve more dimensions than simply a cognitive capacity, particularly, feelings, sentiments, moral knowledge and skills.
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            Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students

            Background: Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students. Aim/objective: The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students. Research design: The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students. Participants and research context: A total of 293 baccalaureate Filipino nursing students who have been exposed to various clinical areas participated in the study. Ethical considerations: Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants. Findings: Results indicate that a majority of the nursing students in the clinical areas encounter morally distressing situations that compromise quality patient care. However, despite the fact that they want to do what is in the best interest of their patients, their perception of being the inexperienced among the healthcare team drives the majority of them to ignore morally distressing situations to avoid conflict and confrontation. Another interesting finding is that 79.20% of the respondents hardly consider quitting the nursing profession even if they frequently encounter morally distressing situations. Analysis also shows associations between moral distress intensity and frequency ( r = 0.13, p < 0.05) and moral distress intensity and moral sensitivity ( r = 0.25, p < 0.05). The dimensions of moral courage are also related to both moral distress and moral sensitivity. Conclusion: Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators.
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              The effect of ethics training on students recognizing ethical violations and developing moral sensitivity.

              Moral sensitivity is a life-long cognitive ability. It is expected that nurses who work in a professional purpose at "curing human beings" should have a highly developed moral sensitivity. The general opinion is that ethics education plays a significant role in this sense to enhance the moral sensitivity in terms of nurses' professional behaviors and distinguish ethical violations.
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                Author and article information

                Journal
                ean
                Escola Anna Nery
                Esc. Anna Nery
                Universidade Federal do Rio de Janeiro (, RJ, Brazil )
                1414-8145
                2177-9465
                2020
                : 24
                : 3
                : e20190311
                Affiliations
                [01] Rio Grande Rio Grande do Sul orgnameUniversidade Federal do Rio Grande orgdiv1Escola de Enfermagem Brazil
                [02] Rio Grande Rio Grande do Sul orgnameUniversidade Federal do Rio Grande orgdiv1Programa de Pós-Graduação em Enfermagem Brazil
                Article
                S1414-81452020000300212 S1414-8145(20)02400300212
                10.1590/2177-9465-ean-2019-0311
                3dcbcb4d-fcd7-4028-92fb-b9cadb6811a5

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 November 2019
                : 27 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 0
                Product

                SciELO Revista de Enfermagem


                critical care,ethics in nursing,enfermagem,Desarrollo moral,enfermería,la ética em enfermería,Desenvolvimento moral,cuidados críticos,ética em enfermagem,Moral development,nursing

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