Volume 10, Issue 1 (March 2023)
Health Spiritual Med Ethics 2023, 10(1): 55-62 |
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Tahmasbi S, Alavi A. Ethical Sensitivity and Moral Self-concept of Nursing Students During Internship: Factors and Assessment. Health Spiritual Med Ethics 2023; 10 (1) :55-62
URL: http://jhsme.muq.ac.ir/article-1-511-en.html
URL: http://jhsme.muq.ac.ir/article-1-511-en.html
1- Department of Nursing, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran., Islamic Azad University,Rahmatieh , Shahrekord, Iran. (Corresponding author, Email: tahmas.s2004@gmail.com Tel: 09133814926 , tahmas_s2004@yahoo.co.uk
2- Department of Nursing, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran., Islamic Azad University,Rahmatieh , Shahrekord, Iran. Email: azam_alavi92@yahoo.com Tel: 09133839963
2- Department of Nursing, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran., Islamic Azad University,Rahmatieh , Shahrekord, Iran. Email: azam_alavi92@yahoo.com Tel: 09133839963
Abstract: (790 Views)
Background and Objectives: Ethical sensitivity prevents moral dilemmas; moral self-concept develops via adaptation to others’ expectations. Nursing education provides an opportunity to internalize ethical sensitivity and improve moral self-concept because nurses are often faced with serious situations that require higher ethical knowledge. Therefore, we assessed sensitivity and moral self-concept in nursing students and related factors.
Methods: This quasi-experimental study was designed for one group to investigate the degree of students’ moral self-concept and ethical sensitivity in an internship program (12 months) and their related factors. Thirty-nine undergraduate nursing students were selected by census sampling method. The inclusion criteria included senior bachelor’s degree students and their desire to participate in the study. Lutzen’s ethical sensitivity questionnaire (25 items) and Lutzen’s moral self-concept questionnaire (18 items) were used. Data were analyzed by SPSS software, version 22 using described by number, percentage, Mean±SD and assessed by the paired t-test.
Results: The majority of the participants (74.4%) were women (76.9%) and single, (48.7%) aged 23 years, and (76.9%) reported participation in the ethics workshops. The mean score of students’ ethical sensitivity before the internship was at a medium level (109.64±9.51), which improved to a higher level (115.56±8.88) after the internship. There was a significant difference between the mean score of ethical sensitivity before and after the internship (P<0.001). This difference was not significant for the mean score of moral self-concept. The correlation of study variables with gender, marital status, and age was not significant, while there was a significant difference regarding participation in the workshop (P<0.02).
Conclusion: Ethical sensitivity was influenced by participating in ethics workshops; thus, continuous training can be effective to improve it. It can enhance ethical sensitivity and reduce the risk of unethical behavior among nurses in the future.
Methods: This quasi-experimental study was designed for one group to investigate the degree of students’ moral self-concept and ethical sensitivity in an internship program (12 months) and their related factors. Thirty-nine undergraduate nursing students were selected by census sampling method. The inclusion criteria included senior bachelor’s degree students and their desire to participate in the study. Lutzen’s ethical sensitivity questionnaire (25 items) and Lutzen’s moral self-concept questionnaire (18 items) were used. Data were analyzed by SPSS software, version 22 using described by number, percentage, Mean±SD and assessed by the paired t-test.
Results: The majority of the participants (74.4%) were women (76.9%) and single, (48.7%) aged 23 years, and (76.9%) reported participation in the ethics workshops. The mean score of students’ ethical sensitivity before the internship was at a medium level (109.64±9.51), which improved to a higher level (115.56±8.88) after the internship. There was a significant difference between the mean score of ethical sensitivity before and after the internship (P<0.001). This difference was not significant for the mean score of moral self-concept. The correlation of study variables with gender, marital status, and age was not significant, while there was a significant difference regarding participation in the workshop (P<0.02).
Conclusion: Ethical sensitivity was influenced by participating in ethics workshops; thus, continuous training can be effective to improve it. It can enhance ethical sensitivity and reduce the risk of unethical behavior among nurses in the future.
Type of Study: Original Article |
Subject:
Special
Received: 2022/12/10 | Accepted: 2023/08/15 | Published: 2023/08/1
Received: 2022/12/10 | Accepted: 2023/08/15 | Published: 2023/08/1
References
1. Lamar University. The role of ethics in nursing [Internet]. 2017 [2023 August 12]. Available from: [Link]
2. Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M. Nursing ethical values and definitions: A literature review. Iran J Nurs Midwifery Res. 2013; 18(1):1-8. [PMID]
3. Oh Y, Gastmans C. Moral distress experienced by nurses: A quantitative literature review. Nurs Ethics. 2015; 22(1):15-31. [DOI:10.1177/09697330135028] [PMID] [DOI:10.1177/0969733013502803]
4. Escolar-Chua RL. Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students. Nurs Ethics. 2018; 25(4):458-69. [DOI:10.1177/0969733016654] [PMID] [DOI:10.1177/0969733016654317]
5. Lützén K, Nordin C. The influence of gender, education and experience on moral sensitivity in psychiatric nursing: A pilot study. Nurs Ethics. 1995; 2(1):41-50. [DOI:10.1177/096973309500200106] [PMID] [DOI:10.1177/096973309500200106]
6. Weaver K, Morse JM. Pragmatic utility: Using analytical questions to explore the concept of ethical sensitivity. Res Theory Nurs Pract. 2006; 20(3):191-214. [DOI:10.1891/rtnp.20.3.191] [PMID] [DOI:10.1891/rtnp.20.3.191]
7. Esmaelzadeh F, Abbaszadeh A, Borhani F, Peyrovi H. Ethical sensitivity in nursing ethical leadership: A content analysis of Iranian nurses experiences. Open Nurs J. 2017; 11:1-13. [DOI:10.2174/1874434601711010001] [PMID] [DOI:10.2174/1874434601711010001]
8. Seo H, Kim K. Factors influencing public health nurses' ethical sensitivity during the pandemic. Nurs Ethics. 2022; 29(4):858-71. [DOI:10.1177/09697330211072367] [PMID] [PMCID] [DOI:10.1177/09697330211072367]
9. Kim YS, Park JW, Son YJ, Han SS. Nurse managers' moral self concept and ethical sensitivity. J Korean Acad Nurs. 2002; 32(7):1072-8. [Link] [DOI:10.4040/jkan.2002.32.7.1072]
10. Borhani F, Keshtgar M, Abbaszadeh A. Moral self-concept and moral sensitivity in Iranian nurses. J Med Ethics Hist Med. 2015; 8:4. [PMID] [PMCID]
11. Kim JI. Critical thinking disposition, professional self-concept and moral sensitivity in nursing students. J Korea Acad Ind Coop Soc. 2015; 16(9):6053-60. [DOI:10.5762/KAIS.2015.16.9.6053] [DOI:10.5762/KAIS.2015.16.9.6053]
12. Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses' moral sensitivity. Nurs Ethics. 2017; 24(6):732-43. [DOI:10.1177/0969733015623095] [DOI:10.1177/0969733015623095]
13. Öztürk EA, Şener A, Koç Z, Duran L. Factors influencing the ethical sensitivity of nurses working in a university hospital. East J Med. 2019; 24(3):257-64. [DOI:10.5505/ejm.2019.05025] [DOI:10.5505/ejm.2019.05025]
14. Ertuğ N, Aktaş D, Faydali S, Yalçin O. Ethical sensitivity and related factors of nurses working in the hospital settings. Acta Bioeth. 2014; 20(2):265-70. [DOI:10.4067/S1726-569X2014000200014] [DOI:10.4067/S1726-569X2014000200014]
15. Borhani F, Alhani F, Mohammadi E, Abbaszadeh A. [Nursing students perception of barriers of acquiring professional ethics: A qualitative research (Persian)]. Strides Dev Med Educ. 2011; 8(1):67-80. [Link]
16. McPhail K. The other objective of ethics education: Re-humanising the accounting profession-a study of ethics education in law, engineering, medicine and accountancy. J Bus Ethics. 2001; 34(3):279-98. [DOI:10.1023/A:1012576631990] [DOI:10.1023/A:1012576631990]
17. Karimi A, Heravi-karimooi M, Rrejeh N, Javanmard S. [Professional self-concept in nurses working in intensive care units (Persian)]. J Crit Care Nurs. 2019; 12(2):21-7. [Link]
18. Joolaee S, Jafarian Amiri SR, Farahani MA, Varaei S. Iranian nursing students' preparedness for clinical training: A qualitative study. Nurse Educ Today. 2015; 35(10):e13-7. [DOI:10.1016/j.nedt.2015.07.026] [PMID] [DOI:10.1016/j.nedt.2015.07.026]
19. Ahanchian M, Sharafi S, Vafaee M, Hajiabadi F. [Evaluate the effectiveness of internship program in nursing student using Kirkpatrick's model (Persian)]. Res Med Educ. 2017; 9(1):17-9. [DOI:10.18869/acadpub.rme.9.1.17] [DOI:10.18869/acadpub.rme.9.1.17]
20. Alhani F, Aein F, Anoosheh M. Using the educational experience of the nursing students in the last term in the clinical education of the first term students. Iran J Med Educ. 2009; 9(3):191-9. [Link]
21. Sabet Sarvestani R, Khani Jeihooni A, Fereidouni Z, Moradi Z, Amirkhani M, Karimi S. [The effect of teaching ethical principles through role playing on nursing students internship skills (Persian)]. Teb va Tazkieh. 2017; 26(3):159-70. [Link]
22. Auvinen J, Suominen T, Leino-Kilpi H, Helkama K. The development of moral judgment during nursing education in Finland. Nurse Educ Today. 2004; 24(7):538-46. [DOI:10.1016/j.nedt.2004.07.005] [PMID] [DOI:10.1016/j.nedt.2004.07.005]
23. Borhani F, Abbaszadeh A, Mohsenpour M. Nursing students' understanding of factors influencing ethical sensitivity: A qualitative study. Iran J Nurs Midwifery Res. 2013; 18(4):310-5. [PMID] [PMCID]
24. Abdollahimohammad A, Firouzkouhi M. [Sample size estimation in randomized clinical trials (RCTs) (Persian)]. J Diabetes Nurs. 2019; 7(1):737-9. [Link]
25. References
26. Lamar University. The role of ethics in nursing [Internet]. 2017 [2023 August 12]. Available from: [Link]
27. Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M. Nursing ethical values and definitions: A literature review. Iran J Nurs Midwifery Res. 2013; 18(1):1-8. [PMID]
28. Oh Y, Gastmans C. Moral distress experienced by nurses: A quantitative literature review. Nurs Ethics. 2015; 22(1):15-31. [DOI:10.1177/09697330135028] [PMID] [DOI:10.1177/0969733013502803]
29. Escolar-Chua RL. Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students. Nurs Ethics. 2018; 25(4):458-69. [DOI:10.1177/0969733016654] [PMID] [DOI:10.1177/0969733016654317]
30. Lützén K, Nordin C. The influence of gender, education and experience on moral sensitivity in psychiatric nursing: A pilot study. Nurs Ethics. 1995; 2(1):41-50. [DOI:10.1177/096973309500200106] [PMID] [DOI:10.1177/096973309500200106]
31. Weaver K, Morse JM. Pragmatic utility: Using analytical questions to explore the concept of ethical sensitivity. Res Theory Nurs Pract. 2006; 20(3):191-214. [DOI:10.1891/rtnp.20.3.191] [PMID] [DOI:10.1891/rtnp.20.3.191]
32. Esmaelzadeh F, Abbaszadeh A, Borhani F, Peyrovi H. Ethical sensitivity in nursing ethical leadership: A content analysis of Iranian nurses experiences. Open Nurs J. 2017; 11:1-13. [DOI:10.2174/1874434601711010001] [PMID] [DOI:10.2174/1874434601711010001]
33. Seo H, Kim K. Factors influencing public health nurses' ethical sensitivity during the pandemic. Nurs Ethics. 2022; 29(4):858-71. [DOI:10.1177/09697330211072367] [PMID] [PMCID] [DOI:10.1177/09697330211072367]
34. Kim YS, Park JW, Son YJ, Han SS. Nurse managers' moral self concept and ethical sensitivity. J Korean Acad Nurs. 2002; 32(7):1072-8. [Link] [DOI:10.4040/jkan.2002.32.7.1072]
35. Borhani F, Keshtgar M, Abbaszadeh A. Moral self-concept and moral sensitivity in Iranian nurses. J Med Ethics Hist Med. 2015; 8:4. [PMID] [PMCID]
36. Kim JI. Critical thinking disposition, professional self-concept and moral sensitivity in nursing students. J Korea Acad Ind Coop Soc. 2015; 16(9):6053-60. [DOI:10.5762/KAIS.2015.16.9.6053] [DOI:10.5762/KAIS.2015.16.9.6053]
37. Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses' moral sensitivity. Nurs Ethics. 2017; 24(6):732-43. [DOI:10.1177/0969733015623095] [DOI:10.1177/0969733015623095]
38. Öztürk EA, Şener A, Koç Z, Duran L. Factors influencing the ethical sensitivity of nurses working in a university hospital. East J Med. 2019; 24(3):257-64. [DOI:10.5505/ejm.2019.05025] [DOI:10.5505/ejm.2019.05025]
39. Ertuğ N, Aktaş D, Faydali S, Yalçin O. Ethical sensitivity and related factors of nurses working in the hospital settings. Acta Bioeth. 2014; 20(2):265-70. [DOI:10.4067/S1726-569X2014000200014] [DOI:10.4067/S1726-569X2014000200014]
40. Borhani F, Alhani F, Mohammadi E, Abbaszadeh A. [Nursing students perception of barriers of acquiring professional ethics: A qualitative research (Persian)]. Strides Dev Med Educ. 2011; 8(1):67-80. [Link]
41. McPhail K. The other objective of ethics education: Re-humanising the accounting profession-a study of ethics education in law, engineering, medicine and accountancy. J Bus Ethics. 2001; 34(3):279-98. [DOI:10.1023/A:1012576631990] [DOI:10.1023/A:1012576631990]
42. Karimi A, Heravi-karimooi M, Rrejeh N, Javanmard S. [Professional self-concept in nurses working in intensive care units (Persian)]. J Crit Care Nurs. 2019; 12(2):21-7. [Link]
43. Joolaee S, Jafarian Amiri SR, Farahani MA, Varaei S. Iranian nursing students' preparedness for clinical training: A qualitative study. Nurse Educ Today. 2015; 35(10):e13-7. [DOI:10.1016/j.nedt.2015.07.026] [PMID] [DOI:10.1016/j.nedt.2015.07.026]
44. Ahanchian M, Sharafi S, Vafaee M, Hajiabadi F. [Evaluate the effectiveness of internship program in nursing student using Kirkpatrick's model (Persian)]. Res Med Educ. 2017; 9(1):17-9. [DOI:10.18869/acadpub.rme.9.1.17] [DOI:10.18869/acadpub.rme.9.1.17]
45. Alhani F, Aein F, Anoosheh M. Using the educational experience of the nursing students in the last term in the clinical education of the first term students. Iran J Med Educ. 2009; 9(3):191-9. [Link]
46. Sabet Sarvestani R, Khani Jeihooni A, Fereidouni Z, Moradi Z, Amirkhani M, Karimi S. [The effect of teaching ethical principles through role playing on nursing students internship skills (Persian)]. Teb va Tazkieh. 2017; 26(3):159-70. [Link]
47. Auvinen J, Suominen T, Leino-Kilpi H, Helkama K. The development of moral judgment during nursing education in Finland. Nurse Educ Today. 2004; 24(7):538-46. [DOI:10.1016/j.nedt.2004.07.005] [PMID] [DOI:10.1016/j.nedt.2004.07.005]
48. Borhani F, Abbaszadeh A, Mohsenpour M. Nursing students' understanding of factors influencing ethical sensitivity: A qualitative study. Iran J Nurs Midwifery Res. 2013; 18(4):310-5. [PMID] [PMCID]
49. Abdollahimohammad A, Firouzkouhi M. [Sample size estimation in randomized clinical trials (RCTs) (Persian)]. J Diabetes Nurs. 2019; 7(1):737-9. [Link]
50. Hoseini BL, Shomoossi N, Rakhshani MH, Norouzi ZB. Moral sensitivity among nursing and midwifery students and practitioners: A comparative report from Iran. J Biostat Epidemiol. 2020; 6(1):12-8. [DOI:10.18502/jbe.v6i1.4754] [DOI:10.18502/jbe.v6i1.4754]
51. Alnajjar HA, Abou Hashish EA. Academic ethical awareness and moral sensitivity of undergraduate nursing students: Assessment and influencing factors. Sage Open Nurs. 2021; 7:23779608211026715. [DOI:10.1177/2377960821102671] [PMID] [DOI:10.1177/23779608211026715]
52. Tuvesson H, Lützén K. Demographic factors associated with moral sensitivity among nursing students. Nurs Ethics. 2017; 24(7):847-55. [DOI:10.1177/0969733015626602] [PMID] [DOI:10.1177/0969733015626602]
53. Kim WJ, Park JH. The effects of debate-based ethics education on the moral sensitivity and judgment of nursing students: A quasi-experimental study. Nurse Educ Today. 2019; 83:104200. [DOI:10.1016/j.nedt.2019.08.018] [PMID] [DOI:10.1016/j.nedt.2019.08.018]
54. Özgönül ML, Kırca N, Karaçar Y, Bademli K. Professional self-concept and moral sensitivity in nursing students: A descriptive and correlational study. Turk J Bioeth. 2021; 8(1):25-33. [DOI:10.5505/tjob.2021.35119] [DOI:10.5505/tjob.2021.35119]
55. Jennings PL, Mitchell MS, Hannah ST. The moral self: A review and integration of the literature. J Organ Behav. 2015; 36(S1):S104-68. [DOI:10.1002/job.1919] [DOI:10.1002/job.1919]
56. Torabizadeh C, Dokoohaki R, Rambod M, Raeiskarimian F. [The correlation between academic self-concept and learning climate in nursing students after experiencing preceptorship program (Persian)]. Sadra Med J. 2016; 4(2):89-98. [Link]
57. Snowden A, Stenhouse R, Young J, Carver H, Carver F, Brown N. The relationship between emotional intelligence, previous caring experience and mindfulness in student nurses and midwives: A cross sectional analysis. Nurse Educ Today. 2015; 35(1):152-8. [DOI:10.1016/j.nedt.2014.09.004] [PMID] [DOI:10.1016/j.nedt.2014.09.004]
58. Ekramifar F, Farahaninia M, Mardani Hamooleh M, Haghani H. The effect of spiritual training on the moral sensitivity of nursing students. J Client Cent Nurs Care. 2018; 4(4):213-22. [DOI:10.32598/jccnc.4.4.213] [DOI:10.32598/jccnc.4.4.213]
59. Soltani Y, Moosazadeh Z, Alipour A, Esmaeili S. Effective interventions for improvement of moral sensitivity among nurses: A systematic review. J Nurs Rep Clin Pract. 2023; 1(1):30-7. [DOI:10.32598/JNRCP.23.20] [DOI:10.32598/JNRCP.23.20]
60. Abbaszadeh A, Borhani F, Moazen NL. The comparison of the level of moral sensitivity in nursing students and nursing staffs in Kerman in 1389. Med Ethics J. 2010; 4(12):39-54. [Link]
61. Park M, Kjervik D, Crandell J, Oermann MH. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nurs Ethics. 2012; 19(4):568-80. [DOI:10.1177/0969733011433922] [PMID] [DOI:10.1177/0969733011433922]
62. Izadi A, Imani H, Noughabi F, Hajizadeh N, Naghizadeh F. [Moral sensitivity of critical care nurses in clinical decision making and its correlation with their caring behavior in teaching hospitals of Bandar Abbas in 2012 (Persian)]. Iran J Med Ethics Hist Med. 2013; 6(2):43-56. [Link]
63. Kim YS, Park JW, You MA, Seo YS, Han SS. Sensitivity to ethical issues confronted by Korean hospital staff nurses. Nurs Ethics. 2005; 12(6):595-605.[DOI:10.1191/0969733005ne829oa] [PMID] [DOI:10.1191/0969733005ne829oa]
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