Ethical issues experienced by nurses during COVID-19 in university hospitals

Yasin, Janaína Cassana Mello; Barlem, Edison Luiz Devos; Silveira, Rosemary Silva da; Ruivo, Évilin Diniz Gutierres; Longaray, André Andrade; Brehmer, Laura Cavalcanti Farias

doi:10.1590/1980-220X-REEUSP-2023-0117en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0117en copy

Ethical issues experienced by nurses during COVID-19 in university hospitals^* * Extracted from the doctoral thesis: “Problemas éticos no cotidiano de trabalho da enfermagem no cuidado a pacientes com Covid-19 em Hospitais Universitários”. Universidade Federal do Rio Grande, 2023.

Problemas éticos vividos por enfermeros durante la COVID-19 en hospitales universitarios

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the ethical issues experienced by nurses in the care for patients with COVID-19 and the factors that influence their occurrence.

Method:

This is a cross-sectional, quantitative study, carried out between February and May 2022 with 101 nurses from two university hospitals, through the socio-occupational Ethical issues Experienced by Nurses in Emergency Questionnaire, adapted and validated for Brazilians. Descriptive statistical analysis, Pearson’s correlation test and linear regression were performed, adopting p-value.

Results:

Ethical issues related to concern and stress in caring for infected patients were evidenced, being influenced by perception of social stigmatization (p = .003) and perception of hospital measures (p = .000). Agreement with infection control measures (4.46) and perception of hospital measures against COVID-19 (3.26) were factors with the highest mean between the constructs.

Conclusion:

Nurses are faced with ethical issues in the face of concern and stress in caring for patients with COVID-19, who are affected by social issues and assistance. It is essential to support them, promoting their mental and social well-being to deal with new emergency situations.

DESCRIPTORS
Nursing; Coronavirus; Ethics, Nursing; Adult Health; Nursing, Team

Variables	Categories	N	%
Age	24 – 29 years	7	6.9
	30 – 39 years	51	50.5
	40 – 49 years	31	30.7
	50 – 59 years	9	8.9
	60 years or older	3	3
Sex	Female	85	84.2
Sex	Male	16	15.8
Marital status	Single	31	30.7
	Married	42	41.6
	Stable union	30	19.8
	Divorced	8	7.9
Have children	Yes	69	68.3
Have children	No	32	31.7
Length of professional experience	01 – 5 years	10	9.9
	06 – 10 years	20	19.8
	11 – 15 years	37	36.6
	16 – 20 years	10	9.9
	21 – 25 years	17	16.8
	26 years or older	7	6.9
Acting hospital	H1	79	78.2
Acting hospital	H2	22	21.8
Maximum title	Undergraduate degree	06	5.9
	Specialization	49	48.5
	Residence	06	5.9
	Master’s degree	30	29.7
	Doctoral degree	10	9.9
Tested positive for COVID-19	Yes	56	55.4
Tested positive for COVID-19	No	45	44.6
I received the COVID-19 vaccine	1 dose	1	1
	2 doses	3	3
	3 doses	96	95
	Did not vaccinate	1	1
I worry about being infected with COVID-19	Yes	98	97
I worry about being infected with COVID-19	No	3	3

Factors	N	$\bar{X}$	SD
*F1 – ETHICAL ISSUES IN PATIENT CARE*	101	3.38	1.023
Q01. I AM CONCERNED ABOUT PROVIDING CARE TO PATIENTS WITH COVID-19.	101	3.83	1.217
Q02. IF I HAVE TO CHOOSE BETWEEN COVID-19 PATIENTS AND OTHER TYPES OF PATIENTS, I WILL CARE FOR OTHER TYPES OF PATIENTS.	101	2.73	1.288
Q03. IT WILL BE STRESSFUL FOR ME TO CARE FOR PATIENTS WITH COVID-19.	101	3.52	1.154
*F2 – PERCEIVED RISK OF INFECTION AND WILLINGNESS TO WORK*	101	1.57	.650
Q04. IF NOT REQUESTED BY COVID-19 PATIENTS, I WILL NOT PROVIDE ADDITIONAL CARE MYSELF.	101	1.86	1.059
Q05. THERE IS A NEED TO REDUCE THE HOLISTIC CARE PROVIDED TO PATIENTS WITH COVID-19.	101	1.49	.743
Q07. IF I HAVE TO TAKE CARE OF COVID-19 PATIENTS EVERY DAY, I WILL QUIT MY JOB.	101	1.56	.888
Q08. I WOULD LIKE TO CHANGE PROFESSIONS BECAUSE OF COVID-19.	101	1.29	.589
*F3 – PERCEPTION OF SOCIAL STIGMATIZATION*	101	2.45	1.050
Q10. IF PEOPLE WERE AWARE OF THE FACT THAT I AM PROVIDING CARE TO PATIENTS WITH COVID-19, I MIGHT HAVE DISADVANTAGES.	101	3.15	1.299
Q11. I AM AFRAID OF BEING ISOLATED IF MY NEIGHBORS FIND OUT THAT I CARE FOR COVID-19 PATIENTS.	101	2.10	1.136
Q12. I AM CONCERNED THAT MY FAMILY WILL BE ISOLATED IF MY NEIGHBORS FIND OUT THAT I CARE FOR COVID-19 PATIENTS.	101	2.12	1.160
*F4 – AGREEMENT WITH INFECTION CONTROL MEASURES*	101	4.46	.500
Q13. WHEN I SEE A PATIENT WITH RESPIRATORY ILLNESSES ACCOMPANIED BY FEVER, I CHECK WHETHER PATIENTS HAVE COME FROM A HOSPITAL WITH SUSPECTED COVID-19 INFECTION, HAVE HAD CONTACT WITH A PATIENT WITH COVID-19, OR HAVE RECENTLY TRAVELED.	101	4.10	1.118
Q14. I WASH MY HANDS BEFORE AND AFTER HAVING CONTACT WITH A PATIENT WITH COVID-19 OR AN INFECTIOUS SUBSTANCE AND BEFORE AFTER PUTTING ON MY PERSONAL PROTECTIVE EQUIPMENT.	101	4.85	.410
Q17. WHEN COUGHING, I COVER MY MOUTH AND NOSE WITH A TISSUE, AND DISCARD IT IN AN APPROPRIATE PLACE.	101	4.22	1.035
Q18. I WASH MY HANDS IF I COVER MY MOUTH WITH MY HANDS WHEN I COUGH.	101	4.66	.637
*F5 – PERCEPTION OF HOSPITAL MEASURES AGAINST COVID-19*	101	3.26	.974
Q19. MY HOSPITAL IS EQUIPPED WITH SUFFICIENT FACILITIES TO PREVENT THE SPREAD OF COVID-19.	101	3.14	1.158
Q20. MY HOSPITAL FOLLOWS THE BEST INFECTION CONTROL GUIDELINES TO PREVENT THE SPREAD OF COVID-19.	101	3.49	1.128
Q21. MY HOSPITAL REGULARLY DISCUSSES HOW TO PREVENT COVID-19.	101	3.15	1.152

Variables	Beta (β)	T	p
F2 – Perceived risk of infection and willingness to work	.178	2.653	.009^* * Significance level p < 0.05.
F3 – Perception of social stigmatization	.376	5.778	.003^* * Significance level p < 0.05.
F4 – Agreement with hospital infection control measures	.172	2.760	.007^* * Significance level p < 0.05.
F5 – Perception of hospital measures	.373	5.792	.000^* * Significance level p < 0.05.

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Janaína Cassana Mello Yasin, Rua Augusto Duprat, 369, 96211-050 – Rio Grande, RS, Brazil, janinhacm@gmail.com

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Ethical issues experienced by nurses during COVID-19 in university hospitals* * Extracted from the doctoral thesis: “Problemas éticos no cotidiano de trabalho da enfermagem no cuidado a pacientes com Covid-19 em Hospitais Universitários”. Universidade Federal do Rio Grande, 2023.

Problemas éticos vividos por enfermeros durante la COVID-19 en hospitales universitarios

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Ethical issues experienced by nurses during COVID-19 in university hospitals^* * Extracted from the doctoral thesis: “Problemas éticos no cotidiano de trabalho da enfermagem no cuidado a pacientes com Covid-19 em Hospitais Universitários”. Universidade Federal do Rio Grande, 2023.