Abstract
Objective: To map the ethical problems experienced by nurses in Mobile Pre-hospital Care in the literature. Method: A scoping review was conducted following the Joanna Briggs Institute recommendations, from October to November 2021, with searches in Latin American and Caribbean Health Sciences (LILACS), Web of Science, SAGE Journal, Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: Nine studies comprised the final sample. Ethical problems experienced in the clinical practice of Pre-hospital Mobile Care nurses were presented in four thematic categories: Team/user/family relationship ethics, Inter-team relationship ethics, Organizational structure and management ethics, and External factors and mobile pre-hospital care ethics. Conclusion: The evidence pointed to the need for attention to the ethical dimension, to the values and duties involved in morally inappropriate situations experienced by nurses in the pre-hospital setting.
References
O’Dwyer G, Konder MT, Reciputti LP, Macedo C, Lopes MGM. O processo de implantação do Serviço de Atendimento Móvel de Urgência no Brasil: estratégias de ação e dimensões estruturais. Cad Saúde Pública. 2017;33(7):e00043716. http://doi.org/10.1590/0102-311X00043716.
Wihlborg J, Edgren G, Johansson A, Sivberg B. Reflective and collaborative skills enhance Ambulance nurses' competence - A study based on qualitative analysis of professional experiences. Int Emerg Nurs. 2017;32:20-27. http://doi.org/10.1016/j.ienj.2016.06.002.
Jafari M, Ebadi A, Khankeh HR, Maddah SSB, Hosseini MA. Development and validation of moral distress scale in pre-hospital emergency service providers. Int J Emerg Serv. 2022;11(2):263-276. https://doi.org/10.1108/IJES-05-2021-0028.
Ribeiro SCC, Ferreira GI, Sallas J, Novaes MRCG, Guilhem DB. Ethical-professional decision-making in exceptional situations given the Covid-19 pandemic: a scoping review. Online Braz J Nurs. 2022;21(suppl 2):e20226557. https://doi.org/10.17665/1676-4285.2022.6557.
Zoboli ELCP, Santos DV. Deliberação: sistematização da tomada de decisão ética. In: Ética e bioética: desafios para a enfermagem e a saúde. Barueri: Manole; 2017.
Gracia D. Problemas con la deliberación. Folia Human. 2019;(3):1-16. https://doi.org/10.30860/0013.
Sandman L, Nordmark A. Ethical conflicts in prehospital emergency care. Nurs Ethics. 2006;13(6):592-607. https://doi.org/10.1177/0969733006069694 [included in the review].
Oliveira SS, Lima AB, Santa Rosa DO, Freitas GF, Ferraz MOA. Experiences of the moral deliberation of nurses in mobile pre-hospital care. Rev Baiana Enferm. 2021;35:e38733. https://doi.org/10.18471/rbe.v35.38733.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews. In: Aromataris E, Munn Z (Eds.). JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; 2020 [cited 2022 Jul 15]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL/4687342/Chapter+11%3A+Scoping+reviews.
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-473. https://doi.org/10.7326/M18-0850.
Santana JCB, Silva RCL, Souza VAG, Graças APRM, Oliveira MM, Tálamo CP. Ethics and humanization of service in a pre-hospital care: what do you think health care professionals. R Pesq Cuid Fundam Online. 2012 [cited 2022 Jul 12];4(4):2744-2745. Available from: http://seer.unirio.br/cuidadofundamental/article/view/1746/pdf_598 [included in the review].
Erbay H, Alan S, Kadioglu S. Attitudes of prehospital emergency care professionals toward refusal of treatment: A regional survey in Turkey. Nurs Ethics. 2014;21(5):530-539. https://doi.org/10.1177/0969733013505311 [included in the review].
Oliveira SS. Deliberação moral da enfermeira no cuidado pré-hospitalar à luz da fenomenologia social [Internet]. Dissertação [Mestrado em Enfermagem]. Salvador: Escola de Enfermagem da Universidade Federal da Bahia, Universidade Federal da Bahia; 2014 [cited 2022 Jul 24]. Available from: https://repositorio.ufba.br/bitstream/ri/16833/1/Oliveira%2c%20Simone_da_Silva_Disserta%c3%a7%c3%a3o.pdf [included in the review].
Torabi M, Borhani F, Abbaszadeh A, Atashzadeh-Shoorideh F. Ethical decision-making based on field assessment: The experiences of prehospital personnel. Nurs Ethics. 2017;26(4):1075-1086. https://doi.org/10.1177/0969733017736925 [included in the review].
Karlsson M, Karlsson N, Hilli Y. Ethical dilemmas during cardiac arrest incidents in the patient's home. Nurs Ethics. 2017;26(2):625-637. https://doi.org/10.1177/0969733017709337 [included in the review].
Torabi M, Borhani F, Abbaszadeh A, Atashzadeh-Shoorideh F. Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study. BMC Med Ethics. 2018;19(1):95. https://doi.org/10.1186/s12910-018-0334-x [included in the review].
Torabi M, Borhani F, Abbaszadeh A, Atashzadeh-Shoorideh F. Barriers to ethical decision-making for pre-hospital care professionals. Nurs Ethics. 2020;27(2):407-418. https://doi.org/10.1177/0969733019848044 [included in the review].
Bremer A, Holmberg M. Ethical conflicts in patient relationships: Experiences of ambulance nursing students. Nurs Ethics. 2020;27(4):946-959. https://doi.org/10.1177/0969733020911077 [included in the review].
Sundström BW, Bremer A, Lindström V, Vicente V. Caring science research in the ambulance services: an integrative systematic review. Scand J Caring Sci. 2018;33(1):3-33. https://doi.org/10.1111/scs.12607.
Bremer A, Sandman L. Futile cardiopulmonary resuscitation for the benefit of others: an ethical analysis. Nurs Ethics. 2011;18(4):495-504. https://doi.org/10.1177/0969733011404339.
Nobre TC, Heliodoro EA, Rosa DO. Valores pessoais e profissionais de enfermeiros. Enferm Foco. 2021;12(1):132-138. https://doi.org/10.21675/2357-707X.2021.v12.n1.3487.
Dourado JVL, Aguiar FAR, Lopes RE, Silva MAM, Ferreira Júnior AR. Ethical problems experienced by nurses in the Family Health Strategy. Rev Bioét. (Impr.). 2020;28(2):356-364. https://doi.org/10.1590/1983-80422020282397.
Yasin JCM, Barlem ELD, Barlem JGT, Silveira RS, Dalmolin GL, Andrade GB. The ethical dimension of problems faced in general medicine: relationship with moral sensitivity. Rev. Latino-Am. Enfermagem. 2020;28:e3309. http://dx.doi.org/10.1590/1518-8345.4033.3309.
Taveira RPC, Silva JLL, Souza RD, Rego VTSM, Lima VF, Soares RS. Nurse's role in emergency pre-hospital care. Glob Acad Nurs. 2021;2(3):e156. https://dx.doi.org/10.5935/2675-5602.20200156.
Cabral CCO, Bampi LNS, Queiroz RS, Araújo AF, Calasans LHB, Vaz TS. Quality of life of nurses from the mobile emergency care service. Texto Contexto Enferm. 2020;29:e20180100. http://dx.doi.org/10.1590/1980-265X-TCE-2018-0100.
Bijani M, Abedi S, Karimi S, Tehranineshat B. Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis. BMC Emerg Med. 2021;21(1):11. https://doi.org/10.1186/s12873-021-00408-4
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