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Review
. 2023 Aug;32(15-16):4408-4418.
doi: 10.1111/jocn.16563. Epub 2022 Nov 1.

Ethical conflict in nursing: A concept analysis

Yuanfei Liu  1 , Xueqing Wang  2 , Zhaochen Wang  3 , Yuping Zhang  1 , Jingfen Jin  1   4   5
Affiliations
Review

Ethical conflict in nursing: A concept analysis

Yuanfei Liu et al. J Clin Nurs. 2023 Aug.

Abstract

Aims and objectives: The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue.

Background: Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept.

Design: Concept analysis.

Methods: Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study.

Results: Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care.

Conclusions: A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education.

Relevance to clinical practice: A clearer understanding of such an important facet of nursing practice helps nurses raise awareness of ethical conflict and implement effective coping strategies to improve their well-being and patient care.

No patient or public contribution: This is a review article conducted by the researchers, so there is no patient or public contribution.

Keywords: concept analysis; ethical conflict; ethics; nursing.

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