Yenidoğan Yoğun Bakım Hemşirelerinde Karşılanamayan Bakım Nedenleri ve Vicdan: Kalitatif ve Kantitatif Bir Araştırma

Yıl 2024, Cilt: 7 Sayı: 1, 113 - 126, 25.03.2024

Serap Özdemir , Erhan Elmaoğlu

https://doi.org/10.38108/ouhcd.1174873

Cited By: 1

Öz

Amaç: Bu çalışma, yenidoğan yoğun bakım hemşirelerinde karşılanamayan bakım nedenlerinin ve vicdan deneyimlerinin kalitatif ve kantitatif olarak incelenmesini amaçlamaktadır.
Yöntem: Araştırmanın tipi tanımlayıcı ve fenomonolojiktir. Araştırmanın evrenini; 15 Şubat-15 Mart 2022 tarihleri arasında bir kadın doğum ve çocuk hastalıkları hastanesinde çalışan yenidoğan yoğun bakım hemşirelerinden oluşmaktadır. Araştırmanın örneklem sayısı gelişigüzel örnekleme yöntemi ile 106 hemşireden oluşturmaktadır. Nitel verilerin örneklemini ise 106 hemşire içerisinden rastgele kura yöntemi seçilen 15 hemşireden oluşmaktadır. Veri toplama araçları; yenidoğan yoğun bakım hemşirelerinin sosyo-demografik özellikleri ve mesleki özelliklere ilişkin bir soru formu, Pediatri hemşireliğinde karşılanamayan bakım ve nedenleri-pediatrik versiyon anketi, Vicdan Algısı Ölçeği ve 6 maddeli yarı yapılandırılmış görüşme formundan oluşmaktadır.
Bulgular: Vicdan algısı ölçeğinin toplam puan ortalaması ile karşılanamayan bakım nedenleri arasında negatif yönde anlamlı olmayan ilişki olduğu belirlendi. Görüşmelerin sonucunda elde edilen veri analizleri hemşirelerin karşılayamadıkları bakım nedenlerinin vicdan deneyimlerine yönelik 4 ana tema ve bunların alt temaları belirlendi.
Sonuç: Araştırmada karşılanamayan bakım nedenleri ile vicdan arasında anlamlı olmayan ilişki bulunmasına rağmen, hemşirelerin bakımdaki vicdan deneyimlerinin çarpıcı olduğu ve yenidoğan yoğun bakım hemşirelerinin bebek bakımı esnasındaki vicdan deneyimlerinin neler olduğu bulundu.

Anahtar Kelimeler

hemşire, karşılanamayan bakım, vicdan, yenidoğan yoğun bakım

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

Çalışmaya en içten duyguları ile katılım sağlayan değerli yenidoğan yoğun bakım hemşirelerine teşekkür ederiz.

Reasons for Missed Care and Conscience in Neonatal Intensive Care Nurses: A Qualitative and Quantitative Study

Öz

Objective: This study aims to examine qualitatively and quantitatively the reasons for unmet care and experiences of conscience in neonatal intensive care nurses.
Method: The type of research is descriptive and phenomenological. The universe of the research; Neonatal intensive care nurses working at a gynecology and pediatrics hospital between 15 February and 15 March 2022 were formed. The sample size of the study consists of 106 nurses with the random sampling method. The sample of qualitative data consisted of 15 randomly selected nurses from among 106 nurses. Data collection tools; A questionnaire about socio-demographic characteristics and professional characteristics of neonatal intensive care nurses, missed care in pediatric nursing and its causes-pediatric version questionnaire, Conscience Perception Scale, and a 6-item semi-structured interview form were used.
Results: It was determined that there was a negative and insignificant relationship between the total mean score of the sense of conscience scale and the reasons for missed care. The data analysis obtained as a result of the interviews identified 4 main themes and their sub-themes regarding the conscience experiences of the reasons for the care that the nurses could not meet.
Conclusion: Although there was insignificant relationship between the reasons for missed care and conscience in the study, it was found that nurses' experiences of conscience in care were striking and what were the experiences of conscience of neonatal intensive care nurses during newborn care.

Anahtar Kelimeler

Conscience, missed care, neonatal intensive care, nurse

Proje Numarası

YOK

Kaynakça

• Aksoy SD, Mert K, Çeti̇n İ. (2019). Vicdan algısı ölçeği’ nin Türkçe geçerlilik güvenilirliği. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 6(3), 148–153. https://doi.org/10.34087/cbusbed.599744
• Alipour Hamze Kandi N, Zeinali A. (2017). Relationship between personality characteristics, ınternal locus of control, psychological hardiness and nurses’ quality of life. Journal of Research Development in Nursing and Midwifery, 14(1), 8–15. https://doi.org/10.29252/jgbfnm.14.1.8
• Bagnasco A, Zanini M, Aleo G, Catania G, Kalisch BJ, Sasso L. (2018). Development and validation of the MISSCARE survey-pediatric version. Journal of Advanced Nursing, 74(12), 2922–2934. https://doi.org/10.1111/jan.13837
• Baki A, Gökçek T. (2012). Karma yöntem araştırmalarına genel bir bakış. Elektronik Sosyal Bilimler Dergisi, 11(42), 1–21.
• Blackman I, Henderson J, Weger K, Willis E. (2020). Causal links associated with missed residential aged care. Journal of Nursing Management, 28(8), 1909–1917. https://doi.org/10.1111/jonm.12889
• Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, ve ark. (2015). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1–2), 47–56. https://doi.org/10.1111/jocn.12688
• Calikusu Incekar M, İspir Ö, Sönmez B, Selalmaz M, Kartal Erdost Ş. (2020). Turkish validation of the MISSCARE survey-pediatric version. Journal of Pediatric Nursing, 53, e156–e163. https://doi.org/10.1016/j.pedn.2020.03.012
• Castner J, Wu YWB, Dean-Baar S. (2015). Multi-level model of missed nursing care in the context of hospital merger. Western Journal of Nursing Research, 37(4), 441–461. https://doi.org/10.1177/ 0193945914535670
• Catlin A, Armigo C, Volat D, Vale E, Hadley MA, Gong W, ve ark. (2008). Conscientious objection: A potential neonatal nursing response to care orders that cause suffering at the end of life? Study of a concept. Neonatal Network: NN, 27(2), 101–108. https://doi.org/10.1891/0730-0832.27.2.101
• Cleary M, Lees D. (2019). The Role of conscience in nursing practice. Issues in Mental Health Nursing, 40(3), 281–283. https://doi.org/10.1080/01612840 .2019.1548852
• Drach-Zahavy A, Srulovici E. (2019). The personality profile of the accountable nurse and missed nursing care. Journal of Advanced Nursing, 75(2), 368–379. https://doi.org/10.1111/jan.13849
• Eagen-Torkko M, Levi AJ. (2020). The Ethical justification for conscience clauses in nurse-midwifery practice: context, power, and a changing landscape. Journal of Midwifery & Women’s Health, 65(6), 759–766. https://doi.org/10.1111/jmwh.13170
• Elmaoğlu E, Özdemi̇r S. (2022). Pediatri hemşireleri tarafından karşılanamayan bakım ve nedenleri. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 15(2), 175–185. https://doi.org/10.46483 /deuhfed.971502
• Ford NJ, Austin W. (2018). Conflicts of conscience in the neonatal intensive care unit: Perspectives of Alberta. Nursing Ethics, 25(8), 992–1003. https://doi.org/ 10.1177/ 0969733016684547
• Gorbanzadeh B, Rahmani A, Mogadassian S, Behshid M, Azadi A, Taghavy S. (2015). Levels of conscience and related factors among Iranian oncology nurses. Asian Pacific Journal of Cancer Prevention: APJCP, 16(18), 8211–8214. https://doi.org/10.7314/apjcp .2015.16.18.8211
• Jasemi M, Purteimor S, Zabihi RE, Pak MHM, Eghtedar S. (2019). Nurses’ strategies for conscience-based care delivery: A qualitative study. Indian Journal of Palliative Care, 25(4), 517–522. https://doi.org/ 10.4103/IJPC.IJPC_65_19
• Jones JW, Whiting ZG, Gabay EM, Rana MS, Rutter MJ, Reilly BK. (2020). Novel use of lip balm under tracheostomy ties to prevent skin irritation in the pediatric patient. International Journal of Pediatric Otorhinolaryngology, 138, 110280. https://doi.org/ 10.1016/j.ijporl.2020.110280
• Kalisch BJ, Landstrom G, Williams RA. (2009). Missed nursing care: Errors of omission. Nursing Outlook, 57(1), 3–9. https://doi.org/10.1016/j.outlook.2008. 05.007
• Kalisch BJ, Williams RA. (2009). Development and psychometric testing of a tool to measure missed nursing care. The Journal of Nursing Administration, 39(5), 211–219. https://doi.org/10.1097/NNA. 0b013e3181a23cf5
• Lake ET, Staiger DO, Cramer E, Hatfield LA, Smith JG, Kalisch BJ, ve ark. (2020). Association of patient acuity and missed nursing care in u.s. neonatal ıntensive care units. Medical Care Research and Review: MCRR, 77(5), 451–460. https://doi.org/ 10.1177/1077558718806743
• Lamb C, Evans M, Babenko-Mould Y, Wong CA, Kirkwood KW. (2019). Conscience, conscientious objection, and nursing: A concept analysis. Nursing Ethics, 26(1), 37–49. https://doi.org/10.1177/ 0969733017700236
• Mohammadi A, Hanifi N, Varjoshani NJ. (2020). The relationship amongst nurses’ perceived organizational justice, work consciousness, and responsibility. Nursing Ethics, 27(3), 701–713. https://doi.org/10.1177/0969733019897768
• Mojarad FA, Jouybari L, Sanagoo A. (2018). Rocky road ahead of nursing presence in the oncology care unit: a qualitative study. Open Access Macedonian Journal of Medical Sciences, 6(11), 2221–2227. https://doi.org/10.3889/oamjms.2018.426
• Orique SB, Patty CM, Woods E. (2016). Missed nursing care and unit-level nurse workload in the acute and post-acute settings. Journal of Nursing Care Quality, 31(1), 84–89. https://doi.org/10.1097/NCQ.000000 0000000140
• Ozcan S. (2022). The relationship between nurses’ conscientious intelligence levels and care behaviors: A cross-sectional study. Clinical Ethics, 17(2), 136–143. https://doi.org/10.1177/1477750921994286
• Özdemi̇r S, Çömezoğlu E, Sayi̇ner F. (2021). Ebelerin kültürlerarası duyarlılıklarının vicdan algılarına etkisi. Ebelik ve Sağlık Bilimleri Dergisi, 4(1), 1–11. https://dergipark.org.tr/tr/pub/esbder/issue/62134/870504
• Purdy IB, Craig JW, Zeanah P. (2015). NICU discharge planning and beyond: Recommendations for parent psychosocial support. Journal of Perinatology, 35(1), S24–S28. https://doi.org/10.1038/jp.2015.146
• Shaw J, Downie J. (2014). Welcome to the wild, wild north: Conscientious objection policies governing Canada’s medical, nursing, pharmacy, and dental professions. Bioethics, 28(1), 33–46. https://doi.org/10.1111/bioe.12057
• Shenton AK. (2004). Strategies for ensuring trustworthiness in qualitative research projects. Education for Information, 22(2), 63–75. https://doi.org/10.3233/EFI-2004-22201
• Sulmasy DP. (2019). Conscience, tolerance, and pluralism in health care. Theoretical Medicine and Bioethics, 40(6), 507–521. https://doi.org/10.1007/ s11017-019-09509-5
• Tong A, Sainsbury P, Craig J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Journal of the International Society for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093 /intqhc/mzm042
• Tubbs-Cooley HL, Mara CA, Carle AC, Mark BA, Pickler RH. (2019). Association of nurse workload with missed nursing care in the neonatal ıntensive care unit. JAMA Pediatrics, 173(1), 44–51. https://doi.org/ 10.1001 /jamapediatrics.2018.3619
• Tubbs-Cooley HL, Pickler RH, Meinzen-Derr JK. (2015). Missed oral feeding opportunities and preterm infants’ time to achieve full oral feedings and neonatal intensive care unit discharge. American Journal of Perinatology, 32(1), 1–8. https://doi.org/10.1055/s-0034-1372426
• Yi L. (2021). Erratum to “research on china academic social sciences and humanities library” [Voice of the Publisher 3 (2020) 110-115]. Voice of the Publisher, 07(04), 117–122. https://doi.org/10.4236/vp.2021. 74010
• Yıldız A, Karadağ A, Yıldız A, Çakar V. (2021). Determination of the effect of prophylactic dressing on the prevention of skin injuries associated with personal protective equipments in health care workers during COVID-19 pandemic. Journal of Tissue Viability, 30(1), 21–27. https://doi.org/10.1016/ j.jtv.2020.10.005
• Yilmaz EÇ, Ozdemir S. (2022). Baby crying analyzing and solution using matlab graphical user interface; interdisciplinary collaboration between engineering and nursing. Biomedical and Biotechnology Research Journal, 6(3), 410. https://doi.org/10.4103/ bbrj.bbrj_173_22