Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Palyatif Bakım Ünitelerindeki Etik Sorunlar ve Etik Dışı Davranışlar: Hemşireler Üzerinde Kalitatif Bir Araştırma
Ethical Issues and Unethical Behaviors in Palliative Care Units: A Qualitative Study on Nurses
Güzin AYANa , Oya ÇELEBİ ÇAKIROĞLUb
aKütahya Sağlık Bilimleri Üniversitesi Gediz Sağlık Hizmetleri Meslek Yüksekokulu, Tıbbi Hizmetler ve Teknikler Bölümü, İlk ve Acil Yardım Programı, Kütahya, Türkiye
bİstanbul Medeniyet Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Hemşirelikte Yönetim AD, İstanbul, Türkiye
Turkiye Klinikleri J Nurs Sci. 2025;17(2):546-56
doi: 10.5336/nurses.2024-105785
Article Language: TR
Full Text
ÖZET
 Amaç: Bu araştırma, palyatif bakım ünitelerinde çalışan hemşirelerin deneyimlediği etik sorunları ve etik dışı davranışları derinlemesine keşfetmek amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Bu kalitatif araştırma, tanımlayıcı fenomenolojik tasarım tipindedir. Kartopu örnekleme yöntemi kullanılarak belirlenmiş olan örneklem grubunu kamu hastanelerinin palyatif birimlerinde çalışan 10 hemşire oluşturmuştur. Araştırmacılar tarafından literatür doğrultusunda oluşturulan görüşme rehberi veri toplama aracı olarak kullanılmıştır. Araştırmanı verileri çevrim içi, yarı yapılandırılmış, bireysel derinlemesine görüşme yöntemi ile Eylül-Aralık 2023 tarihleri arasında toplanmıştır. Görüşmelerin tamamı, araştırmanın birinci yazarı tarafından gerçekleştirilmiş olup ses kayıt cihazı ile kayıt altına alınmıştır. Araştırmadan elde edilen veriler, MAXQDA 2020 programında Colaizzi tarafından önerilen 7 adımlı yöntem kullanılarak analiz edilmiştir. Bulgular: Bu araştırmadan elde edilen bulgulara dayalı olarak, palyatif bakım ünitesinde çalışan hemşirelerin etik olmayan davranış deneyimleri; ''bakım hizmetlerinde etik dışı davranışlar'', ''yönetsel ve örgütsel etik dışı davranışlar'' ve ''etik dışı davranışlara karşı duygusal yansımalar'' olmak üzere 3 ana temada toplanmıştır. Sonuç: Bu araştırma, palyatif bakım ünitelerinde çalışan hemşirelerin sağlık bakım hizmeti sunumunda etik dışı davranışlar deneyimleyebildiklerini ortaya koymaktadır. Ek olarak, hemşireler palyatif birimlerde etik iklime sahip bir iş ortamı oluşturmaya engel olan bir yönetim yaklaşımı sergilenebildiğini bildirmektedir. Son olarak, hemşireler tarafından deneyimlenen etik dışı davranışların duygusal açıdan olumsuz yansımaları olduğu görülmektedir.

Anahtar Kelimeler: Palyatif bakım; etik; kalitatif araştırma; hemşireler
ABSTRACT
 Objective: This research was conducted to explore in depth the ethical problems and unethical behaviors experienced by nurses working in palliative care units. Material and Methods: This qualitative study is a descriptive phenomenological design type. The sample group, which was determined using the snowball sampling method, consisted of 10 nurses working in palliative units of public hospitals. The interview guide created by the researchers in line with the literature was used as a data collection tool. The research data were collected between September-December 2023 with an online, semi-structured, individual in-depth interview method. All interviews were conducted by the first author of the study and recorded with a voice recorder. The data obtained from the study were analyzed using the 7- step method suggested by Colaizzi in the MAXQDA 2020 program. Results: Based on the findings of this study, the unethical behavior experiences of nurses working in palliative care units were grouped under 3 main themes: ''unethical behaviors in care services'', ''managerial and organizational unethical behaviors'' and ''emotional reflections on unethical behaviors''. Conclusion: This study reveals that nurses working in palliative care units may experience unethical behaviors in the provision of health care services. In addition, nurses report that a management approach that prevents creating a work environment with an ethical climate in palliative units may be exhibited. Finally, unethical behaviors experienced by nurses appear to have negative emotional repercussions.

Keywords: Palliative care; ethics; qualitative research; nurses
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