Moral courage in nursing: A concept analysis

2016 ◽  
Vol 24 (8) ◽  
pp. 878-891 ◽  
Author(s):  
Olivia Numminen ◽  
Hanna Repo ◽  
Helena Leino-Kilpi
Keyword(s):  
Final Analysis ◽  
Concept Analysis ◽  
Moral Courage ◽  
Ethical Sensitivity ◽  
Ethical Practice ◽  
Validity And Reliability ◽  
Moral Integrity ◽  
Ethical Considerations ◽  
Exclusion Criteria ◽  
Expert Opinions

Background: Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. Objective: This article is an analysis of the concept of moral courage in nursing. Design: Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis. Data sources: The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Results: Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. Discussion and conclusion: This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.

Concept analysis of moral courage in nursing: A hybrid model

2016 ◽  
Vol 25 (1) ◽  
pp. 6-19 ◽  
Author(s):  
Afsaneh Sadooghiasl ◽  
Soroor Parvizy ◽  
Abbas Ebadi
Keyword(s):  
Hybrid Model ◽  
Final Analysis ◽  
Field Work ◽  
Concept Analysis ◽  
Moral Courage ◽  
Nursing Profession ◽  
Human Beings ◽  
Spiritual Beliefs ◽  
Peace Of Mind ◽  
Analysis Phase

Background: Moral courage is one of the most fundamental virtues in the nursing profession, however, little attention has been paid to it. As a result, no exact and clear definition of moral courage has ever been accessible. Objective: This study is carried out for the purposes of defining and clarifying its concept in the nursing profession. Methods: This study used a hybrid model of concept analysis comprising three phases, namely, a theoretical phase, field work phase, and a final analysis phase. To find relevant literature, electronic search of valid databases was utilized using keywords related to the concept of courage. Field work data were collected over an 11 months’ time period from 2013 to 2014. In the field work phase, in-depth interviews were performed with 10 nurses. The conventional content analysis was used in two theoretical and field work phases using Graneheim and Lundman stages, and the results were combined in the final analysis phase. Ethical consideration: Permission for this study was obtained from the ethics committee of Tehran University of Medical Sciences. Oral and written informed consent was received from the participants. Results: From the sum of 750 gained titles in theoretical phase, 26 texts were analyzed. The analysis resulted in 494 codes in text analysis and 226 codes in interview analysis. The literature review in the theoretical phase revealed two features of inherent–transcendental characteristics, two of which possessed a difficult nature. Working in the field phase added moral self-actualization characteristic, rationalism, spiritual beliefs, and scientific–professional qualifications to the feature of the concept. Conclusion: Moral courage is a pure and prominent characteristic of human beings. The antecedents of moral courage include model orientation, model acceptance, rationalism, individual excellence, acquiring academic and professional qualification, spiritual beliefs, organizational support, organizational repression, and internal and external personal barriers. Professional excellence resulting from moral courage can be crystallized in the form of provision of professional care, creating peace of mind, and the nurse’s decision making and proper functioning.

scholarly journals Evaluating the Connection between Thermal Comfort and Productivity in Buildings: A Systematic Literature Review

Buildings ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 244
Author(s):  
Ana Maria Bueno ◽  
Antonio Augusto de Paula Xavier ◽  
Evandro Eduardo Broday
Keyword(s):  
Literature Review ◽  
Thermal Comfort ◽  
Systematic Literature Review ◽  
Thermal Environment ◽  
Final Analysis ◽  
Personal Factors ◽  
Exclusion Criteria ◽  
Environment Variables ◽  
Main Factors ◽  
Combination Of Methods

The thermal environment is one of the main factors that influence thermal comfort and, consequently, the productivity of occupants inside buildings. Throughout the years, research has described the connection between thermal comfort and productivity. Mathematical models have been established in the attempt to predict changes in productivity according to thermal variations in the environment. Some of these models have failed for a number of reasons, including the understanding of the effect that several environment variables have had on performance. From this context, a systematic literature review was carried out with the aim of verifying the connection between thermal comfort and productivity and the combinations of different thermal and personal factors that can have an effect on productivity. A hundred and twenty-eight articles were found which show a connection between productivity and some thermal comfort variables. By means of specific inclusion and exclusion criteria, 60 articles were selected for a final analysis. The main conclusions found in this study were: (i) the vast majority of research uses subjective measures and/or a combination of methods to evaluate productivity; (ii) performance/productivity can be attained within an ampler temperature range; (iii) few studies present ways of calculating productivity.

Investigation of physical education teachers’ first aid response with vignette technique

2021 ◽  
Vol 9 (1) ◽  
pp. 259-272
Author(s):  
Aysel Kizilkaya Namli ◽  
Keyword(s):  
Content Analysis ◽  
Physical Education ◽  
Random Sampling ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
First Aid ◽  
Physical Education Teachers ◽  
Validity And Reliability ◽  
Expert Opinions ◽  
First Aid Training

In the study, the aim is to determine the effects of the application of first aid training lessons on sports injuries. The group of the study was determined by the simple random sampling method included in the random sampling technique and consists of 20 physical education teachers who are still on duty in the 2020-2021 academic year. All of the physical education teachers are experienced teachers who have taken first aid lessons in undergraduate education. Vignette technique, one of the qualitative research methods, was used in the research. With the technique in question, teachers were asked to express their opinions following the first aid scenarios. The interviews were made over the phone and recorded with the consent of the participants. Content analysis was used in the study, and the validity and reliability of the data were provided. The opinions received from the participants were examined and themes were created by the content analysis and given with direct quotations. The opinions of the participants were interpreted by comparing with the findings of the experts in the field in accordance with the vignette technique. According to the results of the study, it was determined that physical education teachers gave similar answers to expert opinions about all scenarios. However, the accuracy rates of these answers vary with the scenarios. Therefore, it was determined that teachers' first aid knowledge varies, in some cases, they behave closely to expert opinions, and in some others, they move away from expert opinions. It has been observed that this situation resembles similar studies in the literature. When the mentioned results are compared with the literature; it is recommended that first aid training be sustainable and implementation techniques are continuously improved.

scholarly journals THE EFFECT OF YOGA ON FALL PREVENTION OUTCOMES IN ADULTS 50 YEARS AND OLDER: A SYSTEMATIC REVIEW OF THE LITERATURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S289-S290
Author(s):  
Chinelo K Nsobundu ◽  
Margaret J Foster ◽  
Yan Hong
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Final Analysis ◽  
Exclusion Criteria ◽  
Face To Face ◽  
Ovid Medline ◽  
The Impact ◽  
Fall Prevention Intervention

Abstract Falls constitute a multitude of injuries irrespective of age. To combat these challenges, older adults are encouraged to engage in recreational activities. Yoga has been identified as an effective physical activity to promote mobility and balance for older adults. This study aims to systematically review the literature about yoga as a fall prevention intervention and synthesize the outcomes. Major databases (Ovid Medline & CINAHL) were searched for relevant articles. Studies were included if they met the criteria of 1) being a face to face yoga program, 2) aimed to recruit participants 50 years or older, and 3) reported at least one fall-related outcome (e.g., balance, mobility, fear of falling) as a result of the yoga program. 57 studies were identified: 32 from Ovid Medline and 25 from CINAHL. After removing the duplicates and applying a strict inclusion and exclusion criteria, 11 articles were included in the final analysis. A detailed synthesis of the results will be presented and quality assessment of included articles will be performed using the Modified Downs and Black checklist which appraises the methodological quality of both randomized and non-randomized studies. More research is needed to understand the impact of yoga in preventing falls among older adults at least 50 years of age. Additionally, research should establish a gold standard index that identifies which specific yoga programs ( based on type- individual vs. group; hatha, iyengar, kundalini, ashtanga, and etc.; frequency, and duration) have an enhanced effect on fall prevention.

scholarly journals Dentoskeletal Class II Malocclusion: Maxillary Molar Distalization with No-Compliance Fixed Orthodontic Equipment

2020 ◽  
Vol 8 (1) ◽  
pp. 26
Author(s):  
Vincenzo Quinzi ◽  
Enrico Marchetti ◽  
Luigi Guerriero ◽  
Floriana Bosco ◽  
Giuseppe Marzo ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Final Analysis ◽  
Class Ii ◽  
Dental Arch ◽  
Class Ii Malocclusion ◽  
Exclusion Criteria ◽  
Molar Distalization ◽  
Maxillary Molars ◽  
Maxillary Molar ◽  
Orthodontic Devices

Dentoskeletal class II malocclusion due to a protruded upper dental arch is a major reason for an orthodontic treatment. In these cases, the correction of class II can be hindered by molar distalization, obtained with ‘no-compliance therapy’ that involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. The aim of this review was to outline the effectiveness of no-compliance fixed orthodontic devices in the molar distalization. After selection according to the inclusion/exclusion criteria, 16 articles from 2000 to 2019 were qualified for the final analysis. The literature shows various no-compliance fixed devices whose effect is to distalize the maxillary molars. The present revision allows to conclude that there is a need to increase the number of studies, especially with regard to the most recently introduced devices in the literature. The analysed studies allow to hypothesize that these appliances act with a minimal variability of molar distalization and disto-inclination among them, although different effects among the appliances can be observed as regards to the anchorage.

scholarly journals Analysis of graduating nursing students’ moral courage in six European countries

2020 ◽  
pp. 096973302095637
Author(s):  
Sanna Koskinen ◽  
Elina Pajakoski ◽  
Pilar Fuster ◽  
Brynja Ingadottir ◽  
Eliisa Löyttyniemi ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Nursing Students ◽  
Ethics Education ◽  
Professional Competence ◽  
Moral Courage ◽  
National Standards ◽  
European Countries ◽  
Negative Consequences ◽  
Ethical Considerations ◽  
Cross Sectional

Background: Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career. Aim: To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries. Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables. Participants and research context: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. Ethical considerations: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. Results: The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. Discussion and conclusions: In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

Validation of a Brazilian version of the moral sensitivity questionnaire

2017 ◽  
Vol 26 (3) ◽  
pp. 823-832 ◽  
Author(s):  
Carlise R Dalla Nora ◽  
Elma LCP Zoboli ◽  
Margarida M Vieira
Keyword(s):  
Reliability And Validity ◽  
Ethical Practice ◽  
Moral Sensitivity ◽  
Ethical Considerations ◽  
Cronbach’S Alpha ◽  
Four Dimensions ◽  
Cronbach's Alpha ◽  
Interpersonal Orientation ◽  
Brazilian Version ◽  
The University

Background: Moral sensitivity has been identified as a foundational component of ethical action. Diminished or absent moral sensitivity can result in deficient care. In this context, assessing moral sensitivity is imperative for designing interventions to facilitate ethical practice and ensure that nurses make appropriate decisions. Objective: The main purpose of this study was to validate a scale for examining the moral sensitivity of Brazilian nurses. Research design: A pre-existing scale, the Moral Sensitivity Questionnaire, which was developed by Lützén, was used after the deletion of three items. The reliability and validity of the scale were examined using Cronbach’s alpha and factor analysis, respectively. Participants and research context: Overall, 316 nurses from Rio Grande do Sul, Brazil, participated in the study. Ethical considerations: This study was approved by the Ethics Committee of Research of the Nursing School of the University of São Paulo. Findings: The Moral Sensitivity Questionnaire contained 27 items that were distributed across four dimensions: interpersonal orientation, professional knowledge, moral conflict and moral meaning. The questionnaire accounted for 55.8% of the total variance, with Cronbach’s alpha of 0.82. The mean score for moral sensitivity was 4.45 (out of 7). Discussion and conclusion: The results of this study were compared with studies from other countries to examine the structure and implications of the moral sensitivity of nurses in Brazil. The Moral Sensitivity Questionnaire is an appropriate tool for examining the moral sensitivity of Brazilian nurses.

Spirituality in nursing: A concept analysis

2020 ◽  
Vol 27 (5) ◽  
pp. 1327-1343 ◽  
Author(s):  
Carla Murgia ◽  
Ippolito Notarnicola ◽  
Gennaro Rocco ◽  
Alessandro Stievano
Keyword(s):  
Ethnic Diversity ◽  
Scientific Practice ◽  
Concept Analysis ◽  
Social Contexts ◽  
Cultural Dimensions ◽  
Inductive Method ◽  
Work Organizations ◽  
Ethical Considerations ◽  
Spiritual Nature ◽  
History Of

Background: Spirituality has always been present in the history of nursing and continues to be a topic of nursing interest. Spirituality has ancient roots. The term ‘spirituality’ is interpreted as spirit and is translated as breath and soul, whereas spirituality (immateriality) is spiritual nature. Historically, the term spirituality is associated with the term religiosity, a definition that persists today, and often the two terms are used interchangeably. In the healthcare context, the construct is still. Objective To clarify the concept of spirituality in nursing. Research design In this article spirituality was explored using Rodgers' evolutionary and inductive method of concept analysis. Participants and research context For this analysis, a sample of 71 articles published in English, from 2008 to 2018 from PubMed/Medline, CINAHL Plus with full text, PsycINFO, SciELO databases were retrieved. It was also accomplished an empirical search of dictionaries and e-books. Ethical considerations This study was conducted according to good scientific practice. Findings It emerged that “spirituality” is a dynamic process and has a range of attributes. The cultural dimensions, the religious and spiritual traditions, the ethnic diversity and the influence of the historical and social contexts represent the societal and historical conditions ingrained in the Western thought that influence the emergence of spirituality as a concept. Antecedents, attributes and onsequences appeared to inform and strengthen one another over time. Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients and for work organizations.

scholarly journals Developing the Turkish version of the exercise benefits/barriers for the elderly scale

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Erol ◽  
O Erdem ◽  
H Koç ◽  
F Çetin ◽  
N Erkek
Keyword(s):  
Factor Analysis ◽  
Family Health ◽  
Healthcare Facility ◽  
The Elderly ◽  
Fit Indices ◽  
Validity And Reliability ◽  
Psychological Benefits ◽  
Turkish Version ◽  
Expert Opinions ◽  
Confirmatory Factor

Abstract Objective The aim of this study was develop the Turkish version of the exercise benefits and barriers scale for elderly people. Methods The study was carried out with the methodological research design with a total of N = 300 individuals living in a nursing home (n = 134) and applying to the Family Health Center (n = 131) between October 2017 and May 2018. The study included subjects aged 65 years and older who had no dementia, communication or physical disability. The item pool of the scale consisted of 36 items. Items were structured in five-likert form. Expert opinions of eleven individuals were received for Content Validity Index (CVI). The data of the study were collected with 26-question socio-demographic characteristics form, the Mini Mental Test and the Exercise Benefits/Barriers Scale for the Elderly (EBBSE). Approval and consents were obtained from the relevant Ethics Committee, from the healthcare facility and participants. For the validity and reliability; CVI, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) Hotelling’s T2, paired sample t test have been carried out. Results The mean age of the subjects was 72.44±5.94 years. Scale’s CVI was 90. The factor analysis demonstrated that the scale included three sub-dimensions of 18 items in Physical and Psychological Benefits of Exercise, 2 items in Social Benefits of Exercise and 8 items inExercise Barriers accounting for 55.36 % of the total variance of the scale. Cronbach Alpha internal consistency coefficients of the scale was .84. All of the four fit indices obtained in the CFA had desirable magnitudes (RMR=.05;RMSEA=,07;NFI=.81;CFI=.87), indicating a good fit between the model and the data. The item total score correlations ranged from .40 to .69. The scale’s test-retest correlation was .99. Conclusions EBBSE is a valid and reliable scale that can be used to evaluate benefits and barriers perceptions in physical activity practices. Key messages Developed EBBSE can be used to determine the perceptions of exercise for elderly. Developed EBBSE can be used to change barrier perceptions of exercise.

A Scoping Review of Ethical Considerations in Spiritual/Religious Counseling and Psychotherapy

2019 ◽  
Vol 73 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Sally I. Maximo
Keyword(s):  
Scoping Review ◽  
Cultural Sensitivity ◽  
Self Determination ◽  
Ethical Practice ◽  
Ethical Considerations ◽  
Moral Principles ◽  
Competency Based ◽  
Recommended Guidelines ◽  
Religious Counseling

Four overarching themes from this scoping review were identified, namely: (a) clients’ right for autonomy and self-determination; (b) cultural sensitivity; (c) practitioner competency issues; and (d) recommended guidelines for ethical practice. These themes were aligned with the moral principles that guide professional ethical practice. A competency-based model was designed based on findings to enhance counselor/clinician competencies by enhancing sensitivity to spiritual and religious sentiments, which allows greater responsiveness to the clients’ needs, values and preferences.

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