Ethical Decision-Making Model by Hospital Nurses Providing Nursing Care to COVID-19 Patients

Abstract

Nurses often experience ethical dilemmas in decision-making while providing nursing care to clients, especially COVID-19 patients. This study aimed to identify an ethical decision-making model used by hospital nurses in East Nusa Tenggara (ENT) Province, Indonesia, in providing nursing care to COVID-19 patients. This article is based on a research and development cross-sectional study. The population comprised 330 hospital nurses who provided nursing care to COVID-19 patients in ENT. The sample was derived via two-stage cluster sampling and consisted of 175 respondents. The research was conducted from January to June 2022. The independent variables were consequences of actions, deontological ethics, intuition, and the stigma towards COVID-19 patients. Furthermore, the sub-variables of deontological ethics were generosity, justice, autonomy, honesty, and obedience. Meanwhile, the dependent variable was ethical decision-making. Data was collected using questionnaires as instruments. The authors analyed the data partially with chi-square and simultaneously with multiple logistic regression tests. There were correlations between the consequences of action and ethical decision-making (p=0.003). In addition, there were correlations between generosity, justice, autonomy, honesty, and obedience and ethical decision-making (p=0.001). Furthermore, there was a correlation between intuition and ethical decision-making (p=0.0001). Moreover, there was a correlation between the stigma towards COVID-19 patients and ethical decision-making (p=0.0001). Multiple logistic linear test results showed that the significant variables in the ethical decision-making model were generosity (p=0.0001), autonomy (p=0.0001), justice (p=0.001), and honesty (p=0.0001). In conclusion, generosity, autonomy, justice, and honesty have a 40% influence on ethical decision-making by hospital nurses in East Nusa Tenggara in providing nursing care to COVID-19 patients.