Sofrimento moral e clima ético entre enfermeiros hospitalares
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/24281 |
Resumo: | Hospital nurses are faced with ethical issues/conflicts in their care practice, which depending on their deliberation process, may or may not cause them moral distress. Its general objective was to analyze the association between moral distress and the perception of ethical climate among nurses in hospital environments. The study was developed in two stages: one with a quantitative approach and the other a qualitative one. The quantitative stage was carried out with 269 nurses of a university hospital in the South region of Brazil, through the access to the database of the matrix project entitled "Moral distress in hospital nurses: what is its relation with ethical climate and burnout?", using sociodemographic and work variables, the Brazilian Scale of Moral Distress in Nurses and the Hospital Ethical Climate Survey - Brazilian version. For data analysis, descriptive statistics, Mann-Whitney test, and Poisson regression were employed. Thus, it was found that the highest intensity and frequency of moral distress was related to the factor Working conditions, while the lowest was related to the factor Defense of values and rights. Furthermore, moral distress was associated with the variables general negative ethical climate, employment relationship, and intention to quit. In the qualitative stage, semi-structured interviews were conducted with 20 nurses working in the psychiatric units, emergency room, surgical clinic, and obstetric center of the same university hospital. Through textual discourse analysis, two categories emerged: Repercussions of the negative ethical climate and the occurrence of moral distress; and Facilitators for the positive ethical climate and moral acting. Thus, this study made it possible to analyze the main repercussions resulting from moral distress in nurses, which are more evident when the perception of the ethical climate is negative. It is also suggested that improving the ethical climate through implementations of interventions to reduce moral distress in nurses. This study is in accordance with the ethical precepts proposed by resolution 466/2012. |
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2022-05-05T13:58:46Z2022-05-05T13:58:46Z2022-01-20http://repositorio.ufsm.br/handle/1/24281Hospital nurses are faced with ethical issues/conflicts in their care practice, which depending on their deliberation process, may or may not cause them moral distress. Its general objective was to analyze the association between moral distress and the perception of ethical climate among nurses in hospital environments. The study was developed in two stages: one with a quantitative approach and the other a qualitative one. The quantitative stage was carried out with 269 nurses of a university hospital in the South region of Brazil, through the access to the database of the matrix project entitled "Moral distress in hospital nurses: what is its relation with ethical climate and burnout?", using sociodemographic and work variables, the Brazilian Scale of Moral Distress in Nurses and the Hospital Ethical Climate Survey - Brazilian version. For data analysis, descriptive statistics, Mann-Whitney test, and Poisson regression were employed. Thus, it was found that the highest intensity and frequency of moral distress was related to the factor Working conditions, while the lowest was related to the factor Defense of values and rights. Furthermore, moral distress was associated with the variables general negative ethical climate, employment relationship, and intention to quit. In the qualitative stage, semi-structured interviews were conducted with 20 nurses working in the psychiatric units, emergency room, surgical clinic, and obstetric center of the same university hospital. Through textual discourse analysis, two categories emerged: Repercussions of the negative ethical climate and the occurrence of moral distress; and Facilitators for the positive ethical climate and moral acting. Thus, this study made it possible to analyze the main repercussions resulting from moral distress in nurses, which are more evident when the perception of the ethical climate is negative. It is also suggested that improving the ethical climate through implementations of interventions to reduce moral distress in nurses. This study is in accordance with the ethical precepts proposed by resolution 466/2012.Os enfermeiros hospitalares se deparam com questões/conflitos éticos na sua prática assistencial, que a depender do seu processo de deliberação, podem provocar ou não sofrimento moral nos mesmos. Teve como objetivo geral: analisar a associação entre sofrimento moral e a percepção do clima ético em enfermeiros de ambientes hospitalares. O estudo desenvolveu-se em duas etapas: uma com abordagem quantitativa e outra qualitativa. A etapa quantitativa foi realizada com 269 enfermeiros de um hospital universitário da região Sul do Brasil, mediante o acesso ao banco de dados do projeto matricial intitulado “Sofrimento moral em enfermeiros hospitalares: qual sua relação com clima ético e burnout?’’, sendo utilizado as variáveis sociodemográficas e laborais, a Escala Brasileira de Distresse Moral em Enfermeiros e o Hospital Ethical Climate Survey - Versão Brasileira. Para a análise de dados, empregou-se a estatística descritiva, teste de Mann-Whitney e regressão de Poisson. Assim, verificou-se que a maior intensidade e frequência de sofrimento moral esteve relacionada ao fator Condições de trabalho, enquanto a menor ao fator Defesa de valores e direitos. Ainda, o sofrimento moral foi associado às variáveis clima ético geral negativo, vínculo empregatício, e a intenção de deixar o emprego. Na etapa qualitativa, realizou-se entrevistas semiestruturadas com 20 enfermeiros atuantes nas unidades da psiquiatria, pronto socorro, clínica cirúrgica e centro obstétrico do mesmo hospital universitário. Mediante análise textual discursiva, emergiram duas categorias: Repercussões do clima ético negativo e a ocorrência do sofrimento moral; e Facilitadores para o clima ético positivo e para atuação moral. Dessa forma, este estudo possibilitou analisar as principais repercussões em decorrência do sofrimento moral nos enfermeiros, as quais ficam mais evidentes quando a percepção do clima ético é negativa. Sugere-se ainda que melhorar o clima ético por meio de implementações de intervenções para reduzir o sofrimento moral nos enfermeiros. Este estudo está de acordo com os preceitos éticos propostos pela resolução 466/2012.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em EnfermagemUFSMBrasilEnfermagemAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessSofrimento moralClima éticoÉticaSaúde do trabalhadorEnfermagemMoral distressEthical climateEthicsOccupational healthNursingCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMSofrimento moral e clima ético entre enfermeiros hospitalaresMoral distress and ethical climate between hospitals nursesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisDalmolin, Graziele de Limahttp://lattes.cnpq.br/7268927320407160Barlem, Jamila Geri TomaschewskiGreco, Patrícia Bitencourt ToscaniMagnago, Tania Solange Bosi de Souzahttp://lattes.cnpq.br/0711769623267526Bernardi, Camila Milene Soares400400000000600600600600600600a089c052-df21-46a2-9a0e-262db1f05381345b8909-6972-4406-a0fb-d65fd70fa23b4be968e7-77f3-4b78-b924-5204f73797d650a8948d-47b5-428d-b33b-e91d6884f213393d6a8d-988b-4beb-a31e-f1140deaeb4ereponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGENFERMAGEM_2022_BERNARDI_CAMILA.PDFDIS_PPGENFERMAGEM_2022_BERNARDI_CAMILA.PDFDissertação de mestradoapplication/pdf3264387http://repositorio.ufsm.br/bitstream/1/24281/1/DIS_PPGENFERMAGEM_2022_BERNARDI_CAMILA.PDF74a529afbe3ce0ca829739421eafb8fbMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81956http://repositorio.ufsm.br/bitstream/1/24281/3/license.txt2f0571ecee68693bd5cd3f17c1e075dfMD53CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/24281/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD521/242812022-05-05 10:58:46.639oai:repositorio.ufsm.br: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 Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2022-05-05T13:58:46Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
dc.title.alternative.eng.fl_str_mv |
Moral distress and ethical climate between hospitals nurses |
title |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
spellingShingle |
Sofrimento moral e clima ético entre enfermeiros hospitalares Bernardi, Camila Milene Soares Sofrimento moral Clima ético Ética Saúde do trabalhador Enfermagem Moral distress Ethical climate Ethics Occupational health Nursing CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
title_full |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
title_fullStr |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
title_full_unstemmed |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
title_sort |
Sofrimento moral e clima ético entre enfermeiros hospitalares |
author |
Bernardi, Camila Milene Soares |
author_facet |
Bernardi, Camila Milene Soares |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Dalmolin, Graziele de Lima |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7268927320407160 |
dc.contributor.referee1.fl_str_mv |
Barlem, Jamila Geri Tomaschewski |
dc.contributor.referee2.fl_str_mv |
Greco, Patrícia Bitencourt Toscani |
dc.contributor.referee3.fl_str_mv |
Magnago, Tania Solange Bosi de Souza |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0711769623267526 |
dc.contributor.author.fl_str_mv |
Bernardi, Camila Milene Soares |
contributor_str_mv |
Dalmolin, Graziele de Lima Barlem, Jamila Geri Tomaschewski Greco, Patrícia Bitencourt Toscani Magnago, Tania Solange Bosi de Souza |
dc.subject.por.fl_str_mv |
Sofrimento moral Clima ético Ética Saúde do trabalhador Enfermagem |
topic |
Sofrimento moral Clima ético Ética Saúde do trabalhador Enfermagem Moral distress Ethical climate Ethics Occupational health Nursing CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Moral distress Ethical climate Ethics Occupational health Nursing |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
description |
Hospital nurses are faced with ethical issues/conflicts in their care practice, which depending on their deliberation process, may or may not cause them moral distress. Its general objective was to analyze the association between moral distress and the perception of ethical climate among nurses in hospital environments. The study was developed in two stages: one with a quantitative approach and the other a qualitative one. The quantitative stage was carried out with 269 nurses of a university hospital in the South region of Brazil, through the access to the database of the matrix project entitled "Moral distress in hospital nurses: what is its relation with ethical climate and burnout?", using sociodemographic and work variables, the Brazilian Scale of Moral Distress in Nurses and the Hospital Ethical Climate Survey - Brazilian version. For data analysis, descriptive statistics, Mann-Whitney test, and Poisson regression were employed. Thus, it was found that the highest intensity and frequency of moral distress was related to the factor Working conditions, while the lowest was related to the factor Defense of values and rights. Furthermore, moral distress was associated with the variables general negative ethical climate, employment relationship, and intention to quit. In the qualitative stage, semi-structured interviews were conducted with 20 nurses working in the psychiatric units, emergency room, surgical clinic, and obstetric center of the same university hospital. Through textual discourse analysis, two categories emerged: Repercussions of the negative ethical climate and the occurrence of moral distress; and Facilitators for the positive ethical climate and moral acting. Thus, this study made it possible to analyze the main repercussions resulting from moral distress in nurses, which are more evident when the perception of the ethical climate is negative. It is also suggested that improving the ethical climate through implementations of interventions to reduce moral distress in nurses. This study is in accordance with the ethical precepts proposed by resolution 466/2012. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-05-05T13:58:46Z |
dc.date.available.fl_str_mv |
2022-05-05T13:58:46Z |
dc.date.issued.fl_str_mv |
2022-01-20 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/24281 |
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http://repositorio.ufsm.br/handle/1/24281 |
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por |
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400400000000 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Enfermagem |
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UFSM |
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Brasil |
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Enfermagem |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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