J Korean Acad Psychiatr Ment Health Nurs.  2016 Dec;25(4):418-429. 10.12934/jkpmhn.2016.25.4.418.

Ethical Problems Experienced by Community Mental Health Nurses in Korea

Affiliations
  • 1Department of Nursing, Gachon University, Seongnam, Korea. illine@paran.com

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.

Keyword

Ethics; Nursing; Community; Mental health services; Qualitative research

MeSH Terms

Administrative Personnel
Budgets
Community Mental Health Centers
Education
Ethics
Focus Groups
Humans
Information Dissemination
Korea*
Mental Health Services
Mental Health*
Nursing
Qualitative Research
Statistics as Topic

Reference

1. Deady R, McCarthy J. A Study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspect Psychiatr Care. 2010; 46(3):209–220. DOI: 10.1111/j.1744-6163.2010.00260.x.
Article
2. Jameton A. Nursing practice, the ethical issues. Englewood Cliffs, New Jersey: Prentice Hall;1984. p. 343.
3. Corley MC. Nurse moral distress: a proposed theory and research agenda. Nurs Ethics. 2002; 9(6):636–650. DOI: 10.1191/0969733002ne557oa.
Article
4. Bigwood S, Crowe M. It's part of the job, but it spoils the job': a phenomenological study of physical restraint. Int J Ment Health Nurs. 2008; 17(3):215–222. DOI: 10.1111/j.1447-0349.2008.00526.x.
Article
5. Molewijk B, Hem MH, Pedersen R. Dealing with ethical challenges: a focus group study with professionals in mental health care. BMC Med Ethics. 2015; 16:4. DOI: 10.1186/1472-6939-16-4.
Article
6. Liegeois A, Van Audenhove C. Ethical dilemmas in community mental health care. J Med Ethics. 2005; 31(8):452–456. DOI: 10.1136/jme.2003.006999.
Article
7. Magnusson A, Lützén K. Intrusion into patient pivacy: a moral concern in the home care of persons with chronic mental illness. Nurs Ethics. 1999; 6(5):399–410. DOI: 10.1177/096973309900600506.
Article
8. Williamson T. Ethics of assertive outreach (assertive community treatment teams). Curr Opin Psychiatry. 2002; 15(5):543–547.
Article
9. Roberts LW, Battaqlia J, Epstein RS. Frontier ethics: mental health care needs and ethical dilemmas in rural communities. Psychiatr Serv. 1999; 50(4):497–503. DOI: 10.1176/ps.50.4.497.
Article
10. Morgan DL, Krueger RA. Focus group kit 2 (six book set). Thousand Oaks, California: Sage;1998. p. 139.
11. Downe-Wamboldt B. Content analysis: method, application, and issues. Health Care Women Int. 1992; 13(3):313–321. DOI: 10.1080/07399339209516006.
12. Atlas. ti 6.0 program (2011). Atlas. ti 6.0 scientific software (Version 6) (The qualitative data analysis software) [CD]. Berlin: ATLAS.ti.
13. Guba EG. Criteria for assessing the trustworthiness of naturalistic inquiries. ECTJ. 1981; 29(2):75–91. DOI: 10.1007/BF02766777.
Article
14. Shin WB, Kim TH, Kim JU. Research on protection statement and improvement of personal information. Crisisonomy. 2013; 9(6):111–140.
15. Usher KJ, Arthur D. Process consent: a model for enhancing informed consent in mental health nursing. J Adv Nurs. 1998; 27(4):692–697. DOI: 10.1046/j.1365-2648.1998.00589.x.
Article
16. Carpenter WT Jr, Gold JM, Lahti AC, Queern CA, Conley RR, Bartko JJ, et al. Decisional capacity for informed consent in schizophrenia research. Arch Gen Psychiatry. 2000; 57(6):533–538.
Article
17. Johnstone M. Bioethics: a nursing perspective 5th ed. Chatswood, NSW: Chuchill Livingstone;2009. p. 472.
18. Unwin N. Relativism and moral complacency. Philosophy. 1985; 60(232):205–214. DOI: 10.1017/s0031819100051093.
Article
19. Eren N. Nurses' attitudes toward ethical issues in psychiatric inpatient settings. Nurs Ethics. 2014; 21(3):359–373. DOI: 10.1177/0969733013500161.
Article
20. Choe K, Song E, Jung C. Ethical problems experienced by psychiatric nurses in Korea. Arch Psychiatr Nurs. 2012; 26(6):495–502. DOI: 10.1016/j.apnu.2012.04.002.
Article
21. Ohnishi K, Ohgushi Y, Nakano M, Fujii H, Tanaka H, Kitaoka K, et al. Moral distress experienced by psychiatric nurses in Japan. Nurs Ethics. 2010; 17(6):726–740. DOI: 10.1177/0969733010379178.
Article
22. Lawrence DJ. The four principles of biomedical ethics: a foundation for current bioethical debate. J Chiropr Humanit. 2007; 14:34–40. DOI: 10.1016/s1556-3499(13)60161-8.
Article
23. Preshaw DH, Brazil K, McLaughlin D, Frolic A. Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nurs Ethics. 2016; 23(5):490–506. DOI: 10.1177/0969733015576357.
Article
24. Hem MH, Pedersen R, Norvoll R, Molewijk B. Evaluating clinical ethics support in mental healthcare: a systematic literature review. Nurs Ethics. 2015; 22(4):452–466. DOI: 10.1177/0969733014539783.
Article
25. Magnusson A, Lützén K. Intrusion into patient privacy: a moral concern in the home care of persons with chronic mental illness. Nurs Ethics. 1999; 6(5):399–410. DOI: 10.1177/096973309900600506.
Article
26. Barker PJ. Ethical issues in mental health. London: Chapman & Hall;1991. p. 87.
27. Hong SM, Kim HJ, Lee GY, Lee JG, Choi YK. Development for the mental health performance indicators in Gyeonggi-do. Suwon, Gyeonggi Welfare Foundation. 2009. 12. Report No.2009-15.
28. Kim MH, Kim HN, Shin YM, Oh HM, Lee JS. Violence experiences of community mental health nurse. J Korea Acad Ind Coop Soc. 2015; 16(12):8626–8636. DOI: 10.5762/KAIS.2015.16.12.8626.
Article
29. Yang CI, Hsieh WP, Lee LH, Chen SL. Assault experiences: Lessons learned from mental health nurses in Taiwan. Int J Ment Health Nurs. 2016; 25(3):225–233. DOI: 10.1111/inm.12203.
Article
30. Redman BK, Fry ST. Nurses' ethical conflicts: what is really known about them? Nurs Ethics. 2000; 7(4):360–366. DOI: 10.1177/096973300000700409.
Article
Full Text Links
  • JKAPMHN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr