Silvia M. G. Caldeira

Background Moral distress contributes to serious consequences, and cultivating individual moral resilience has been proposed as a promising approach to mitigating the detrimental impact of moral distress, despite its varying definitions. Methods A scoping review of the literature was conducted to analyse the concept of moral resilience in health, following the principles recommended by the Joanna Briggs Institute and the Walker and Avant conceptual analysis method. Results From the 39 articles included in this review, six key attributes, nine antecedents and six consequences were identified. A definition of moral resilience is described based on the literature. Conclusion Moral resilience is the inherent ability or process to sustain, restore, or deepen one's moral integrity when confronted with moral adversity situations and moral distress. This ability can be challenged or degraded but not extinguished. Understanding the antecedents of moral resilience is crucial for developing effective strategies to promote it. Identifying the consequences of moral resilience can emphasise its importance.

Aim: To explore healthcare chaplains’ experience of providing spiritual support to individuals and families from minority religious and non-religious faiths and to identify key elements of the role. Background: Currently, there is limited research uncovering the essential elements of healthcare chaplaincy, specifically with reference to religious and/or spiritual diversity, and as interprofessional collaborators with nurses and midwives in healthcare. Research design and participants: Using phenomenology, we interviewed eight healthcare chaplains from a variety of healthcare settings in the Republic of Ireland. Data were analysed using a seven-step framework comprising Moustakas’ (1994) modification of the Van Kaam method of data analysis. Ethical considerations: Ethical approval was granted by the university and the principles of informed consent applied. Findings: Three main themes emerged: what the chaplain brings; components of ritual, minority faith or no faith; and practising chaplaincy. Subthemes included ‘offering’, ‘awareness and insight’, ‘acceptance and empathy’, ‘skilled companionship’, ‘presence’, ‘a confidant and holder of hope’ and ‘a vital resource’. Discussion and conclusions: The healthcare chaplain is a key collaborator in facilitating holistic person-centred care and in supporting healthcare professionals. Chaplaincy services are an essential but largely unrecognised and potentially cost-effective component of interprofessional team working. Relevance to clinical practice: This study has illuminated key aspects of the healthcare chaplain’s role as interprofessional collaborator in person-centred care, in navigating diversity and ensuring respect and dignity for the person irrespective of religious or spiritual care needs.

Occupational Health Nursing (OHN) has followed a complex path to build and strengthen its theoretical basis. Starting with Public Health core principles, theories were shaped by the dualism of person worker and working environment, where sometimes the centre of the thought was given to the latter and other times to the former. The problem was not much on such conflict but on the definition of the correct OHN focus and whether genuine nursing knowledge was being applied. We are worried that other disciplines radically influenced the theoretical path taken by OHN theorists. To approach this problem, a unitary‐transformative perspective can help us describe and analyse this phenomenon and engage scholars to reflect upon the accurate epistemological focus of OHN. We aimed to deepen this reflection and uncover a new OHN theoretical focus.

Background The learning process about dignity and how undergraduate nursing students experience and use this ethical knowledge is an under-represented field in nursing research. To overcome the lack of conceptual clarity, it is important to understand what processes and dimensions students develop to support this learning outcome. Objective This study aimed to explain the process of learning about dignity by undergraduate nursing students. Research design and methods A qualitative study was conducted using the grounded theory method. Participants and research context Data was collected through free reports and in-depth semi-structured interviews with 20 participants. A focus group was held for the selective coding. Sampling began purposefully and evolved into theoretical. Reflective and theoretical memos were generated from the data collection and constant comparison. Data analysis was performed using qualitative data analysis software using Corbin and Strauss’ method. Ethical considerations The research was approved by a specialized research ethics committee from a Health School. Findings The process of learning about dignity by undergraduate nursing students revealed ‘recognition of dignity’ as the core category, supported by five main categories: ‘proto-conscience of dignity’, ‘pathway to nursing’, ‘consciousness of dignity’, ‘ways of learning’, and ‘becoming capable’. These categories illustrate the processes and dimensions involved in nursing students’ concept translation of dignity learning, allowing a theory to emerge. Conclusions The ‘Recognition of Dignity’ theory aims to contribute to developing educational, training, and supervision processes for nursing programs. It seeks to enhance the ethical and moral development of undergraduate nursing students by helping them understand the concept of dignity and its fundamental importance in nursing.

This article describes how nurses can use the Q methodology to include head and neck cancer patients in research. These patients are often excluded from participating in research based on temporary or permanent voiceless, disfigurement, or impaired communication. Q methodology is defined as the method for the study of subjectivity and related procedures seem to facilitate the participation of head and neck cancer patients. As so, this inclusive dimension should be taken into consideration in research project design also as an ethical aspect of the study, in particular when involving these patients or others in similar conditions.

Nursing research using concept analysis plays a critical role for knowledge development, particularly when concerning to broad and foundational concepts for nursing practice, such as dignity. This study aimed to synthesize research concerning concept analysis of dignity in nursing care. Based on a literature review, electronic databases were searched (MEDLINE, CINAHL, COCHRANE, SCOPUS, EBSCOhost, and PubMed) using the terms “dignity,” “human dignity,” “concept analysis,” and nurs*. Papers in Portuguese or English were included. The research synthesis was conducted independently by two reviewers. A total of 35 citations were identified and seven papers were included. Six studies were elected using Walker and Avant concept analysis methodology while one applied the Beth Rodgers evolutionary model. The concept of dignity has been studied by nurses, and its attributes, antecedents, consequences, and similar concepts were synthesized into a definition. Dignity emerged as a fundamental concept in nursing ethics and the main attributes synthesized were personhood (intrinsic), sociability (relational/behavioral), respect, and autonomy. The antecedents identified were: facilitators—patient focus care, recognition (of the attributes of dignity), education, and ethical competence; threats—vulnerability and organizational environment. The consequences were positive coping, empowerment, and dignity preservation. The synthesis of these seven studies using concept analysis provided a clear definition of dignity. These findings challenge future research and education, particularly for the study of undergraduate and postgraduate nursing education programs to enhance skills for preserving patient dignity in clinical practice.