Barriers to compliance with principles of nursing ethics and their relationship with caring behaviors: perspectives of intensive care unit nurses in Tabriz University of Medical Sciences
,
Abstract
This study examined the barriers to complying with nursing ethics principles in adult intensive care units at teaching hospitals affiliated with Tabriz University of Medical Sciences and their relationship with caring behaviors in 2024. Using a descriptive-analytical design, 300 ICU nurses were surveyed through proportional random sampling. Data were collected via demographic forms, an ethical barriers questionnaire, and the Caring Behaviors Inventory (CBI-42). Results showed that the "individual and caring" domain had the highest ethical barrier score (52.36 ± 9.43), while the "workspace" domain had the lowest (20.56 ± 3.44). Most nurses (75.3%) perceived ethical barriers to be serious. Among the caregiving behaviors, "respect for others" had the highest score (56.93 ± 10.69), and "attention to others' experiences" had the lowest (20.02 ± 3.68). No significant correlation was found between ethical barriers and caregiving behaviors (P = 0.072, r = 0.104).Despite serious ethical challenges, the nurses in this study maintained acceptable standards of care. It is recommended to conduct further research into the specific ethical barriers subscales to better understand their influence on care quality and to develop strategies to improve nurses’ working conditions.
Salar A, Ghaljaei F. Effect of professional empowerment Model on ethical codes implementation from nurse’s and Mother’s viewpoint. Journal of Pediatric Nursing. 2021;7(3):29-35.
Haahr A, Norlyk A, Martinsen B, Dreyer P. Nurses experiences of ethical dilemmas: A review. Nursing ethics. 2020;27(1):258-72.
Hoseini M, Ebadi M, Farsi Z. The effect of ethical motivational program on nursesâ moral courage in Mashhadâ s military hospitals. Journal of Military Medicine. 2022;21(4):410-7.
Salimi S, Tarbiat S. Predictors and priority of caring behaviours in intensive care units. Nursing in Critical Care. 2021;26(6):523-30.
Hajibabaee F, Salisu WJ, Akhlaghi E, Farahani MA, Dehi MMN, Haghani S. The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic. BMC nursing. 2022;21(1):58.
Gholami A, Soltanian A, Khalili A. The survey of professional ethics observance from nurses' perspective and its related factors in hamadan medical education centers. 2020.
Ilkafah I, Mei Tyas AP, Haryanto J. Factors related to implementation of nursing care ethical principles in Indonesia. Journal of public health research. 2021;10(2):jphr. 2021.211.
Azadian M, Rahimi A, Mohebbi M, Iloonkashkooli R, Maleki M, Mardani A. The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints. Clinical Ethics. 2021;16(2):114-21.
Taylan S, Özkan İ, Şahin G. Caring behaviors, moral sensitivity, and emotional intelligence in intensive care nurses: A descriptive study. Perspectives in psychiatric care. 2021;57(2):734-46.
Heydari N, Torkaman M, Torabizadeh C. The Relationship Between Nurses' Perceptions of Caring Behaviors based on Watson's Theory and of Professional Ethics: A Cross-Sectional Study. Research Square. 2020.
Mohammadi MM, Parandin S, Bahrehmand P. Barriers to apply the principles of professional ethics in the practice from Viewpoints of Nurses and Nursing Instructors of Medical Sciences at Kermanshah University (2015). Journal of Ethics and Culture in nursing and midwifery. 2014;1(2):1-8.
Wolf ZR, Colahan M, Costello A, Warwick F. Relationship between nurse caring and patient satisfaction. Medsurg Nursing. 1998;7(2):99.
Hajinezhad ME AP, Rafii F, Ramezaniyan N, Tariqat M. Comparis on of patients and nurses views on nurse caring behaviors. Hayat Magazine. 2011;4:36- 45. (Persian).
Sharifi S, Ebrahimi H, Elyaszadeh S, Latifi A, Khodayari MT, Alizadeh M. Inhibitors and facilitators of compliance with professional ethics standards: nurses’ perspective. BMC Nursing. 2024;23(1):158.
Blackwood S, Chiarella M. Barriers to uptake and use of codes of ethics by nurses. Collegian. 2020;27(4):443-9.
Tayebi N, Omidi A, Chahkhoei M, Aliravari H, Haghshenas A. Barriers standards of professional ethics in clinical care from the perspective of nurses. Revista Latinoamericana de Hipertension. 2019;14(3).
Asadi F, Donyaei M, Karimzadeh M, HEYDARI M. Survey of nurses' awareness about the principles of professional ethics and barriers to its observance in public hospitals in South Khorasan Province in 2019. 2021.
Shafaat A, Alimohammadi N, Shahriari M. ٍEthical Care to Patients with Decreased Levels of Consciousness and its Relationship with Demographic Characteristics of Nurses in Intensive Care Units. Journal of Critical Care Nursing. 2020;13(4):1-10.
Elcelik UE, Ozcelik H, Muz G. The Effect on the Care Behaviors of Nurses Working in Intensive Care Clinics of Moral Distress Experienced During End of Life Patient Care. OMEGA-Journal of Death and Dying. 2024;90(1):388-403.
Salehi T, Haqqani H, Soltani M. Relationship between Leadership style of nursing managers and caring behaviors of nurses in selected hospitals in Tehran, Iran. Iran Journal of Nursing. 2022;35(136):218-31.
Düzalan ÖB, Coşar AA, Şahin E. The impact of nurses' ethical perceptions and sensitivities on care behaviors in internal medicine services. KONTAKT-Journal of Nursing & Social Sciences related to Health & Illness. 2025;27(1).
Ahmed FR, Saifan AR, Dias JM, Subu MA, Masadeh R, AbuRuz ME. Level and predictors of caring behaviours of critical care nurses. BMC nursing. 2022;21(1):341.
| Files | ||
| Issue | Vol 18 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Barrier; Ethical principles; Caring behaviors; Nurses; Intensive care unit. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
