Sensibilidade moral das enfermeiras dos serviços de atenção às urgências

Abstract

Moral sensitivity is highlighted as an individual ability of nurses to recognize the moral dimension of situations that involve caring for a person, as well as the ethical consequences of actions. This study aims to understand how moral sensitivity is experienced by nurses who work in the context of emergency. This is a mixed methods study initially using a quantitative approach with the participation of 422 nurses from emergency care services, with the analysis being performed based on a psychometric, cross-sectional study, and followed by a qualitative study with the participation of 15 nurses from emergency care services with a descriptive comprehensive approach. A sequential explanatory strategy was chosen to integrate the methods, with integration of quantitative and qualitative data in the interpretation of results. The study was approved by the Research Ethics Committee. The results are presented in manuscript formats to be submitted to a scientific journal: “Moral sensitivity in nursing and interactions with care: integrative review”, which presents evidence on the use of the Moral Sensitivity Questionnaire instrument to deepen the study on moral sensitivity in nursing, in which the instrument was evaluated, with an assessment of moral sensitivity and its interactions with other phenomena; “Validity evidence of the moral sensitivity questionnaire for emergency nurses”, in which the instrument applied to nurses in the emergency context was evaluated in terms of Item Response Theory and also in terms of Confirmatory Factor Analysis, with emphasis on the use of the briefest instrument with 19 items; “Moral sensitivity and profile of emergency care nurses: A cross-sectional study”, highlights some characteristics which are related to moral sensitivity dimensions; “Moral sensitivity experienced by emergency care nurses: A mixed methods study” presents how moral sensitivity is experienced by emergency service nurses, with emphasis on: recognizing guiding principles of the care relationship; the moral significance of actions related to care quality; patient improvement, in which they seek to adopt behaviors that they judge to be best for the person; experience of conflicts which are internal or interpersonal; and relying on technical, scientific and ethical knowledge when dealing with morally sensitive situations. The results converge to understand moral sensitivity as an important component of moral competence to deal with the complexities inherent to care, particularly evidenced by: issues that reflect vulnerabilities for the person under care; the concept of sensitivity, which can be observed from the description of nurses’ experiences when recognizing limits, vulnerabilities and the need to provide knowledge and feelings in care. The novelty of the study of the moral sensitivity phenomenon in the context of Brazilian emergencies stands out. It presents contributions for nursing by deepening the moral sensitivity knowledge in emergency services. For research, it presents the Moral Sensitivity Questionnaire to evaluate moral sensitivity attitudes in the relationship between nurses and patients. Finally, for society, as nurses’ moral sensitivity can be related to a willingness to qualify care.