Abstract
The purpose of this study is to investigate how participation in action research will change nursing activities in dealing with ethical issues experienced in daily nursing settings of organ transplantation. The action research here is comprised of four types of sessions: clarification of wishes (1st session), meetings to talk about matters experienced, study meetings, and reflections (final session). In the first and final sessions, group interviews about ethical practices were conducted. Recorded data from the interviews and 4th meeting to talk about experiences were analyzed using WordMiner1.5. Participants had the individual need, “wish to improve understanding of ethics in their own skills to promote ethical practices and ethical interests”. Then, they became aware of “ethical practice in placing importance on the relationship with patients/their families and ethics attitudes as nurses”. This awareness was connected to “sharing ideas and information with medical staff, awareness of and action suitable for ethics issues, and increased interest in ethics issues”. Like this, the awareness of ethical practices has expanded from individuals to the relationship with patients/their families and sharing ideas with medical staff, and this has developed into self-development. The findings suggest the importance of an organizational culture that addresses ethics to improve practical ethics skills. The findings also suggest that it would be necessary for an organization to take long-term actions to addresses ethical issues in wards or hospitals.
Highlights
Organ transplantations cannot be performed without a donor
The purpose of this study is to investigate how participation in action research will change nursing activities in dealing with ethical issues experienced in daily nursing settings of organ transplantation
The authors chose action research (AR) with a mutual approach so that the participating nurses can reflect on their own activities and can achieve their wishes for ethical practices related to the ethical issues arising in daily nursing settings
Summary
Organ transplantations cannot be performed without a donor. In Japan, there are fewer cases of brain death and heart death transplantations than in other countries, and this makes it necessary for many organ transplantations to rely on living donor transplantation. In living donor transplantation, ethical issues are important issues for nurses. This is because of the complicated emotions that arise between recipients and donors over family relationships and conflicts of interest concerning the donor candidates. There are increasing numbers of nursing studies on the ethics involved in organ transplantations in Japan and other countries. The role of advocators who defend patients and donors [2] [3], the importance of support for recipients and donors in the decision making [4] [5], and the importance of case studies by specialists of other fields [6] [7] have attracted attention. Meeting to talk about experiences (2), “Cases related to decision making support for living donor relatives of the second degree or closer”. Meeting to talk about experiences (4), “Cases choosing continuing the dialysis therapy due to decreased functioning of the transplanted kidney 1” May
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