目的 探讨急诊情境下护士道德困境的体验.方法 2023年8-11月,采用现象学研究法对某三级甲等综合性医院急诊科的15名护士进行半结构式访谈,并对访谈资料进行分析.结果 急诊情景下护士道德困境体验可归纳为3个主题、8 个亚主题,即急诊护士面临的道德挑战(生命救治与优质护理的权衡、医患间价值观的冲突、医护关系的不平衡、组织约束和公平护理的抉择)、遭遇道德困境时的情感体验及应对方式.结论 护理管理者应寻求急诊情境下护士道德困境的根源,帮助其提升伦理专业素养、增强其道德韧性及营造良好的伦理氛围,以缓解护士的道德困境,促进其积极的道德行为.

Objective To explore nurses’ experience of moral distress in emergency settings.Methods A phenomenological approach was used to conduct semi-structured interviews with 15 emergency nurses from a tertiary A general hospital from August to November 2023.The interview data were analyzed. Results The experiences of moral distress among emergency nurses could be categorized into three themes and eight sub-themes:the moral challenges faced by emergency nurses（balancing life-saving and quality care,conflicts in values between medical staff and patients,imbalanced nurse-physician relationship,choices concerning organizational constraints and equitable care),emotional experiences when encountering moral distress,and coping strategies.Conclusions Nursing administrators should identify the root causes of moral distress in emergency settings,help nurses enhance their ethical competence and moral resilience,and foster a positive ethical climate to alleviate moral distress and promote ethical behavior.

R47-05

国家自然科学基金（82371336）；江苏省人兽共患病学重点实验室“护馨基金”（HX2104）