fa تبیین تجارب پرستاران بخش مراقبت ویژه از دیسترس اخلاقی در همه‌گیری کوید-19 اخلاق پزشکی Medical Ethics پژوهشي-کامل Research(Original) <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span b="" koodak="" style="font-family:"><span style="color:black">&nbsp;</span></span></span><span new="" roman="" style="font-family:" times=""><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span> <span b="" style="font-family:" zar=""><span style="color:black">پرستاران به</span></span>‌<span b="" style="font-family:" zar=""><span style="color:black">عنوان ارائه</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">دهنده مستقیم و مداوم خدمت به&nbsp; بیمار، بیش از سایر گروه</span></span>‌<span b="" style="font-family:" zar=""><span style="color:black">ها در محیط کاری با انواع گوناگونی از تنش</span></span>‌<span b="" style="font-family:" zar=""><span style="color:black">های روانی رو به رو هستند. در این بین حضور دیسترس اخلاقی در بخش</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">های مراقبت ویژه بسیار چشمگیرتر است.</span></span> <span b="" style="font-family:" zar=""><span style="color:black">لذا این مطالعه با هدف تبیین تجارب دیسترس اخلاقی پرستارانی که در مراکز مراقبت ویژه از بیماران کوید</span></span><span b="" style="font-family:" zar=""><span style="color:black">-</span></span><span b="" style="font-family:" zar=""><span style="color:black">19 مراقبت می‌کردند، طراحی شد.</span></span><span b="" style="font-family:" zar=""><span style="color:#0e101a"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span> <span b="" style="font-family:" zar=""><span style="color:black">پژوهش حاضر یک پژوهش کیفی و از نوع تحلیل محتوا قراردادی است</span></span> <span b="" style="font-family:" zar=""><span style="color:black">که در سال 1400-1399 انجام شد. جامعه پژوهش، پرستاران بخش</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">های مراقبت</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">های ویژه کرونا بودند</span></span> <span b="" style="font-family:" zar=""><span style="color:black">که ﺑﻪ</span></span>‌<span b="" style="font-family:" zar=""><span style="color:black">ﺻﻮﺭﺕ ﻣﺒﺘﻨﻲ ﺑﺮ ﻫﺪﻑ از بیمارستان</span></span>‌<span b="" style="font-family:" zar=""><span style="color:black">های آموزشی استان مازندران انتخاب شدند. ابزار جمع</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">آوری ﺩﺍﺩﻩ</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">ﻫﺎ، ﻣﺼﺎﺣﺒﻪ‌ ﻋﻤﻴﻖ با سوالات نیمه ساختاریافته بود. جهت تحلیل داده</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">ها از رویکرد کیفی گرانهیم و لوندمن استفاده شد. صحت و استحکام مطالعه توسط معیارهای پیشنهادی گوبا و لینکلن بررسی شد.</span></span><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">یافته</span></span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span> <span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">در این مطالعه با 14 پرستار(4 مرد و 10 زن) با محدوده سنی 25 تا 48 سال مصاحبه شد. یافته</span></span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">های مطالعه شامل سه ﻃﺒﻘﻪ اﺻﻠﯽ و هشت زیﺮ ﻃﺒﻘﻪ شامل آزردگی متعدد (تنش</span></span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">های روانی جسمی پرستار، اثرات منفی بر روابط خانوادگی و دوستان، اثرات منفی بر کار حرفه</span></span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">ای)، فشارکاری پرستاری (شرایط سخت بیمار و همراه، سختی و تنش</span></span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">کاری، ضعف مدیریت در اداره شرایط) و ماندگاری و انطباق (خودحفاظتی پرستار، کنارآمدن پرستار با شرایط سخت) بود.</span></span></span><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span> <span b="" style="font-family:" zar=""><span style="color:black">براساس یافته</span></span><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span><span b="" style="font-family:" zar=""><span style="color:black">های مطالعه پرستاران باید تشویق به بیان احساسات خود شوند، تا از طریق آن بتوانند بین دشواری تصمیمات اخلاقی و برآوردن نیاز بیمار و مدیریت احساسات خود تعادلی برقرار کنند.<span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span> <div id="ftn2"></div> &nbsp;<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">As direct and continuous care providers to patients, nurses face various types of psychological stress in the work environment more than other groups.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">Meanwhile, moral distress in special care units is much more impressive.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">This study aimed to explain the moral distress experienced by nurses that provided care to patients with COVID-19 patients in special care units.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:150%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">We performed a conventional qualitative content analysis in 2020-2021.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">The study population included nurses caring for COVID-19 patients in special care units selected by purposive sampling in educational hospitals affiliated with Mazandaran University of Medical Sciences. In-depth, semi-structured interviews were carried out for data collection.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">Graneheim and Lundman qualitative approach was used to analyze the data.</span></span><span style="font-size:10.0pt"><span style="line-height:150%"> The trustworthiness of the study was assessed by </span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">Guba and Lincoln&#39;s stringent criteria.</span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Results:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">In this study, 14 nurses (25-48 yeas of age) were interviewed.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">We found three main layers and eight sub-layers, including multiple annoyances (mental and physical stress, negative effects on family and friends relationships, negative effects on professional work), work pressure (hard conditions of the patient and companion, difficulty and work stress, weak management), and persistence and adaptation (self-protection, coping with difficult conditions).</span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Conclusion:</span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:150%">Based on this study, nurses should be encouraged to express their feelings so that they can establish a balance between the difficulty of ethical decisions and meeting the patient&#39;s needs and managing their emotions.</span></span><i><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></i></span></span></span></span><br> &nbsp; پرستار, مراقبت ویژه, دیسترس اخلاقی, کوید-19 nurse, intensive care, moral distress, COVID-19 124 134 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-3185-11&slc_lang=fa&sid=1 Fereshteh Araghian Mojarad فرشته عراقیان مجرد fereshteharaghian@yahoo.com 1003194753284600156096 1003194753284600156096 No Assistant Professor, Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran استادیار، مرکز تحقیقات طب سنتی و مکمل ، انستیتوی اعتیاد ، دانشگاه علوم پزشکی مازندران ، ساری ، ایران Vida Shafipour ویدا شفیع پور vidashafipour@yahoo.com 1003194753284600156097 1003194753284600156097 Yes Associate Professor, Department of Nursing, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran دانشیار، گروه پرستاری، دانشکده پرستاری و مامایی نسیبه، دانشگاه علوم پزشکی مازندران، ساری، ایران