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Cited by 18Ethics in medical practiceEthics in Business and EducationEthics and bioethics in healthcare

Exploring Ethical Dilemmas and Coping Strategies in Nursing: A Focus Group Study of Nurses and Nursing Students

Open access
Hwu, Lien‐Jen, Pai, Hsiang‐Chu·2025·Nursing & Health Sciences
DOI 10.1111/nhs.70082PMC PMC12021456
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Abstract

This study explored the ethical dilemmas and coping behaviors of nurses and students in clinical settings and analyzed their differences. Using separate focus group interviews, 12 nurses and 18 fourth‐year nursing students who had completed internships shared their experiences. The results identified two major themes related to ethical dilemmas: Powerlessness and diversity in ethical decision‐making. Nurses and students often experienced powerlessness due to the hierarchical structure of healthcare or their lack of experience, making it difficult to navigate complex clinical situations. Coping strategies included demonstrating empathy and patient companionship, enhancing professional literacy, and seeking support from available resources. Participants emphasized the need to strengthen nursing ethics education by focusing on ethical awareness, understanding personal values, and improving communication skills. Strengthening these areas could enhance ethical decision‐making, improve professional competence, and support best clinical care practices.

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  • Existing research methodologies in this area primarily rely on qualitative interviews, often feature small sample sizes, and include few randomized controlled trials; small overall sample sizes limit generalizability and statistical power.

    “Existing research methodologies present several limitations: on one hand, mainstream studies primarily rely on qualitative interviews, often feature small sample sizes, and include few randomized controlled trials (RCTs). The generally small overall sample sizes limit the generalizability and statistical power of the conclusions [33–37].”

    From Exploring the integration of AI and national quality courses in China: a study on teaching practices in nursing smart education (2025) · cites this paper as [34]

    Methods > Participants reports 30 participants, and Methods > Study Design describes three qualitative focus-group interviews. Limitations says the findings may not generalize to different contexts because of cultural and healthcare-system factors. The paper does not establish that studies in the field generally use small qualitative samples, that RCTs are rare, or that small samples limit statistical power. (LLM, conf=0.85)

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Authors
Hwu, L., & Pai, H.
Affiliations
Chung Shan Medical University Hospital (TW)
Corresponding author
Hwu, Lien‐Jen
ORCID
Venue
Nursing & Health Sciences
Publisher
Wiley
Published
2025-04-24
Volume
27
Issue
2
Pages
e70082-e70082
ISSN
  • 1441-0745 (ISSN-L)
  • 1442-2018
DOI
10.1111/nhs.70082
PMC
PMC12021456
OpenAlex
W4409741656
Cited by
18
References
41
Citations by year
2026: 14 · 2025: 4
FWCI
22.71
Type
journal article
Language
en
Open access
Licence
Locations
  • Nursing and Health Sciences (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
National Science and Technology Council
Topics
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
  • Social Sciences › Decision Sciences › Information Systems and Management › Ethics in Business and Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
nursing ethics, ethical dilemmas, ethical decision-making, coping strategies, nurses, nursing students, powerlessness, empathy, professional literacy, nursing ethics education, clinical practice
MeSH terms
Coping Skills, Ethical Dilemmas, Adaptation, Psychological, Adult, Ethics, Nursing, Female, Humans, Male, Middle Aged, Nurses, Students, Nursing, Focus Groups, Qualitative Research

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