Moral Resilience against Moral Distress in Nurses: Definition, Components and Development

Yıl 2022, Cilt: 5 Sayı: 1, 132 - 138, 06.04.2022

Emel Bahadır Yılmaz

https://doi.org/10.38108/ouhcd.900195

Öz

This article is aimed to examine moral distress, its causes and consequences, the definition of moral resilience, its components, and practices to improve moral resilience. Nurses may experience moral distress when faced with ethical problems in clinical settings. Moral distress is defined as “a form of moral suffering that reflects suffering in response to moral harm, wrongdoing, or failure, and often creates a feeling that one's integrity has been compromised.” Moral problems cause nurses to experience physical and psychological health problems such as anger and guilt, stress response, and gastrointestinal disorders. In addition, it causes low self-worth, burnout, intention to leave the profession, and desensitization to patients among nurses. This impairs the quality of nursing care. Improving moral resilience is considered a solution so that nurses can cope with their moral distress, recover and restore. It is defined as the capacity of an individual to maintain or restore integrity in response to moral complexity, confusion, distress, or setbacks. Moral resilience consists of personal integrity, relational integrity, buoyancy, self-regulation, self-stewardship, and moral efficacy. Ethical education, development of coping and problem-solving skills, mindfulness-based interventions, and addressing the concepts such as self-regulation, self-awareness, and moral courage are important in developing moral resilience. In conclusion, in this review article, it is recommended to improve moral resilience to increase the quality of health care and reduce nurses' moral distress in the face of ethical problems. Keywords: Morals, resilience, ethics, nursing, nursing ethics.

Anahtar Kelimeler

Nursing, Morals, resilience, ethics, nursing ethics

Hemşirelerde Ahlaki Sıkıntıya Karşı Ahlaki Sağlamlık: Tanımı, Bileşenleri ve Geliştirilmesi

Öz

Bu makalede ahlaki sıkıntı, nedenleri ve sonuçları ile ahlaki sağlamlığın tanımı, bileşenleri ve ahlaki sağlamlığı geliştirmeye yönelik uygulamaların incelenmesi amaçlanmıştır. Hemşireler, klinik ortamlarda karşılaştıkları etik sorunlar karşısında ahlaki sıkıntı yaşayabilmektedir. Ahlaki sıkıntı; “ahlaki zararlara, yanlışlara veya başarısızlıklara tepki olarak yaşanan acıyı yansıtan ve genellikle kişinin bütünlüğünün tehlikeye girdiği hissini oluşturan bir ahlaki acı çekme biçimi” olarak tanımlanmaktadır. Ahlaki sıkıntılar hemşirelerin öfke ve suçluluk duyguları, stres tepkisi ve mide-bağırsak rahatsızlıkları gibi hem fiziksel hem de psikolojik sağlık sorunları yaşamasına neden olmaktadır. Ayrıca, hemşireler arasında, düşük benlik değerine, tükenmişliğe, mesleği bırakma niyetine ve hastalara karşı duyarsızlaşmaya yol açmaktadır. Bu durum verilen bakımın kalitesini bozmaktadır. Hemşirelerin ahlaki sıkıntıları ile baş edebilmeleri, toparlayabilmeleri ve yenilenebilmeleri için ahlaki sağlamlığın geliştirilmesi bir çözüm olarak düşünülmektedir. Bir bireyin ahlaki karmaşıklık, kafa karışıklığı, sıkıntı veya aksaklıklara yanıt olarak bütünlüğünü sürdürme veya eski haline dönebilme kapasitesi olarak tanımlanmaktadır. Ahlaki sağlamlık; kişisel bütünlük, ilişkisel bütünlük, toparlayabilme, öz düzenleme, öz yönetim ve ahlaki yeterlilik gibi bileşenlerden oluşmaktadır. Ahlaki sağlamlığın geliştirilmesinde, etik eğitimi, stresle baş etme ve sorun çözme becerilerinin geliştirilmesi, bilinçli farkındalık temelli girişimler, öz düzenleme, öz farkındalık, ahlaki cesaret gibi kavramların ele alınması önem taşımaktadır. Sonuç olarak, bu makalede, sağlık bakım kalitesinin artırılması ve hemşirelerin etik sorunlar karşısında yaşadıkları ahlaki sıkıntının azaltılması için ahlaki sağlamlığın geliştirilmesi önerilmiştir.

Anahtar Kelimeler

hemşirelik, Ahlak, sağlamlık, etik, hemşirelik etiği

Kaynakça

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