在临床实践中检查道德伤害:叙事文献综述
Emily K Mewborn1, Marianne L Fingerhood2, Linda Johanson3
1The University of Tennessee Health Science Center, Memphis, TN, USA.
Nursing ethics
|May 29, 2023
概括
医疗保健工作者因系统性问题而面临道德伤害 (MI),而不仅仅是个人因素. 在医疗保健系统内解决根本原因对于预防倦怠和改善留守至关重要.
科学领域:
- 医疗保健道德 医疗保健道德
- 职业健康心理学 职业健康心理学
- 医学社会学 医学社会学
背景情况:
- 道德伤害 (MI) 是对医疗保健工作人员的重大威胁,源于违反医疗保健工作者的道德准则.
- 肌痛性心脏病会对工作满意度和工作持久性产生负面影响,并可能导致医疗错误,抑郁,焦虑和职业功能障碍.
研究的目的:
- 在医疗保健环境中区分概念并定义道德伤害的原因.
- 探索导致道德伤害的系统和个人因素.
主要方法:
- 通过使用SCOPUS,CINAHL和PubMed进行了叙事文献综述.
- 分析了2017年至2023年间发表的英语同行评审文章,使用搜索术语"道德伤害"和"道德痛苦".
主要成果:
- 肌痛性心脏病的根本原因主要是系统性的,包括行政负担,机构背叛,缺乏自主权,医疗保健企业化和资源不足.
- 个人风险因素可以使工人易患MI,但系统性故障是根本的驱动因素.
- 肌痛性心脏病可以导致道德性或残留,表现为倦怠,工作放弃和创伤后压力.
结论:
- 医疗机构必须实施行政和气候干预措施,以预防和解决MI.
- 管理策略应优先考虑自主,支持,减少行政负担,多样化的领导力和有效的沟通.
- 个人可以发展道德性,以减轻道德压力因素和潜在的道德伤害事件 (PMIEs) 的影响.
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