Nurses’ Ethical Dilemmas and Ethical Decision Making in Providing Care for Psychiatric Patients with Violent Behavior in Psychiatric Hospitals, Southern Thailand

Abstract

This descriptive research aimed to study nurses’ ethical dilemmas and ethical decision making in providing care for psychiatric patients with violent behavior in psychiatric hospitals, Southern Thailand regarding to the dilemma between doing good care and violating clients’ autonomy. One hundred and fourty four nurses were included in the study. The instrument was a questionnaire covering 3 areas: (1) demographic data, (2) the frequency and severity of ethical dilemmas, and (3) ethical decision making and reasons. Content validity was examined by three experts. The reliability of the questionnaire was tested with 30 subjects and yielded a Cronbach’s alpha coefficient for the ‘frequency part’ as 0.84 and for the ‘severity part’ as 0.78. Data were analyzed using descriptive statistics. The results were as follows:

Nurses faced with the dilemma as moderate level (M=3.34, SD=1.05). They also reported the severity of this dilemma as a moderate level (M=2.95, SD=0.87). 74.3% of subjects had faced the ethical dilemma of “uncomfortable to choose between isolating the patient in the seclusion room and letting them stay with others” from moderate to high level. A majority of these nurses (65.9%) dealt with this dilemma by taking the patient into a seclusion room in order to protect the patient from harm.