Emotions and feelings in critical and emergency caring situations: a qualitative study

  1. Llauradó-Serra, Mireia
  2. Acebedo-Urdiales, Sagrario
  3. Bazo-Hernández, Leticia
  4. Jiménez-Herrera, María F.
  5. Font-Jiménez, Isabel
  6. Axelsson, Christer
  1. 1 Universitat Rovira i Virgili
    info

    Universitat Rovira i Virgili

    Tarragona, España

    ROR https://ror.org/00g5sqv46

  2. 2 Universitat Internacional de Catalunya
    info

    Universitat Internacional de Catalunya

    Barcelona, España

    ROR https://ror.org/00tse2b39

  3. 3 University of Borås
    info

    University of Borås

    Borås, Suecia

    ROR https://ror.org/01fdxwh83

Mostrar afiliaciones +
Revista:
BMC Nursing

ISSN: 1472-6955

Año de publicación: 2020

Volumen: 19

Número: 1

Tipo: Artículo

DOI: 10.1186/S12912-020-00438-6 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: BMC Nursing

Resumen

BackgroundMoral emotions are a key element of our human morals. Emotions play an important role in the caring process. Decision-making and assessment in emergency situations are complex and they frequently result in different emotions and feelings among health-care professionals.MethodsThe study had qualitative deductive design based on content analysis. Individual interviews and focus groups were conducted with sixteen participants.ResultsThe emerging category “emotions and feelings in caring” has been analysed according to Haidt, considering that moral emotions include the subcategories of “Condemning emotions”, “Self-conscious emotions”, “Suffering emotions” and “Praising emotions”. Within these subcategories, we found that the feelings that nurses experienced when ethical conflicts arose in emergency situations were related to caring and decisions associated with it, even when they had experienced situations in which they believed they could have helped the patient differently, but the conditions at the time did not permit it and they felt that the ethical conflicts in clinical practice created a large degree of anxiety and moral stress. The nurses felt that caring, as seen from a nursing perspective, has a sensitive dimension that goes beyond the patient’s own healing and, when this dimension is in conflict with the environment, it has a dehumanising effect. Positive feelings and satisfaction are created when nurses feel that care has met its objectives and that there has been an appropriate response to the needs.ConclusionsMoral emotions can help nurses to recognise situations that allow them to promote changes in the care of patients in extreme situations. They can also be the starting point for personal and professional growth and an evolution towards person-centred care.

Referencias bibliográficas

  • Mulligan K, Scherer KR. Toward a working definition of emotion. Emot Rev. 2012;4(4):345–57.
  • Scherer KR. Toward a dynamic theory of emotion: the component process model of affective states. Geneva Stud Emotion Commun. 1987;1:1–98.
  • Scherer, K.R, Johnstone, J. Appraisal considered as a process of multi-level sequential checking. In Scherer K.R., Appraisal processes in emotion: theory, methods, research. New York: Oxford University Press; 2001: 92–120.
  • Ratner C. A cultural-psychological analysis of emotions. Cult Psychol. 2000;6:5–39.
  • Mesquita B, Frijda NH. Cultural variations in emotions: a review. Psychol Bull. 1992;112(2):179–204.
  • Haidt J. Elevation and the positive psychology of morality. In: Keyes CLHJ, editor. Positive psychology and the life well-lived. Washington, DC: Flourishing; 2003. p. 275–89.
  • Kroll J, Egan E. Psychiatry, moral worry, and the moral emotions. J Psychiatr Pract. 2004;10(6):352–60.
  • Tangney JP, Stuewig J, Mashek DJ. Moral emotions and moral behavior. Annu Rev Psychol. 2007;58:345–72.
  • Haidt J. The moral emotions. In: Davidson RJ, editor. Handbook of affective sciences. Oxford: Oxford University Press; 2003. p. 852–70.
  • Peil KT. Emotion: the self-regulatory sense. Glob Adv Health Med. 2014;3(2):80–108.
  • Edwards SD. Three versions of an ethics of care. Nurs Philos. 2009;10(4):231–40.
  • Gastmans C. The care perspective in healthcare ethics. In: Davis A, Tschudin V, De Raeve T, editors. Essentials of Teaching and Learning in Nursing Ethics. Perspectives and Methods. Philadelphia: Churchill Livinsgtone Elsevier; 2006. p. 135–48.
  • Little MO. Care: from theory to orientation and back. J Med Philos. 1998;23(2):190–209.
  • Tronto JC. An ethic of care. Generations. 1998;22(3):15–20.
  • Monin JK, Schulz R. Interpersonal effects of suffering in older adult caregiving relationships. Psychol Aging. 2009;24(3):681–95.
  • Storch JL, Kenny N. Shared moral work of nurses and physicians. Nurs Ethics. 2007;14(4):478–91.
  • Fields SK, Hojat M, Gonnella JS, Mangione S, Kane G, Magee M. Comparisons of nurses and physicians on an operational measure of empathy. Eval Health Prof. 2004;27(1):80–94.
  • Hartrick Doane GA. Am I still ethical? The socially-mediated process of nurses' moral identity. Nurs Ethics. 2002;9(6):623–35.
  • James I, Andershed B, Gustavsson B, Ternestedt BM. Emotional knowing in nursing practice: in the encounter between life and death. Int J Qual Stud Health Well-being. 2010;5(2). https://doi.org/10.3402/qhw.v5i2.5367. Published 13 Jul 2010.
  • Jimenez-Herrera MF, Axelsson C. Some ethical conflicts in emergency care. Nurs Ethics. 2015;22(5):548–60.
  • Kvale S, Brinkmann S. InterViews: Learning the craft of qualitative research interviewing. 2nd ed. Los Angeles: Sage; 2009.
  • Ivanoff SD, Hultberg J. Understanding the multiple realities of everyday life: basic assumptions in focus-group methodology. Scand J Occup Ther. 2006;13(2):125–32.
  • Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995;311(7000):299–302.
  • Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15.
  • Papastavrou E, Andreou P, Vryonides S. The hidden ethical element of nursing care rationing. Nurs Ethics. 2014;21(5):583–93.
  • Hartog CS, Benbenishty J. Understanding nurse-physician conflicts in the ICU. Intensive Care Med. 2015;41(2):331–3.
  • Wujtewicz M, Wujtewicz MA, Owczuk R. Conflicts in the intensive care unit. Anaesthesiol Intensive Ther. 2015;47(4):360–2.
  • Lutzen K, Cronqvist A, Magnusson A, Andersson L. Moral stress: synthesis of a concept. Nurs Ethics. 2003;10(3):312–22.
  • Oberle K, Hughes D. Doctors' and nurses' perceptions of ethical problems in end-of-life decisions. J Adv Nurs. 2001;33(6):707–15.
  • Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. Clin Issues Perinat Womens Health Nurs. 1993;4(4):542–51.
  • Meltzer LS, Huckabay LM. Critical care nurses' perceptions of futile care and its effect on burnout. Am J Crit Care. 2004;13(3):202–8.
  • Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;131(6):803–55.
  • Hunsaker S, Chen HC, Maughan D, Heaston S. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J Nurs Scholarsh. 2015;47(2):186–94.
  • McCullough ME, Kilpatrick SD, Emmons RA, Larson DB. Is gratitude a moral affect? Psychol Bull. 2001;127(2):249–66.
  • McCullough ME, Emmons RA, Tsang JA. The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol. 2002;82(1):112–27.
  • Fredrickson BL, Tugade MM, Waugh CE, Larkin GR. What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003;84(2):365–76.