정신보건간호사가 지역사회 정신간호 현장에서 경험하는 윤리적 문제

Abstract

Purpose: The purpose of this study was to explore ethical problems that cause moral distress in nurses and affects the quality of care provided by community mental health nurses working in community mental health settings. Methods: Three focus group interviews were held with 14 nurses working in 3 community mental health centers in Korea. Qualitative descriptive methods and qualitative content analysis were used. Results: Data analysis found 5 domains (decision making, communication, resources, safety, advocacy), 9 categories (personal information sharing issues, ethical insensibility, collisions between principles and practice, institutions unprepared in ethical problems, ethical dilemma in interactions with clients, problems with the evaluation system, problems with the budget structure, problems with the lack of safety measure, and problems with role limitation as a professional) and 11 subcategories. Conclusion: Results of this study suggest a) a need for further research on identifying ethical conflicts arising in community mental health fields, and b) on what nurses actually do when they deal with ethical conflicts, c) efforts to develop ethics support programs such as ethics education, training and reflection meetings to enhance nurses’ ethical sensitivity, d) consideration of a supportive environment and culture that prioritizes ethical concerns in practitioners as well as administrators.