This study aimed to clarify ethical care competency in practical nursing and to develop a draft evaluation scale. The Behavioral Event Interview was conducted with 15 nurses who were certified nurse specialist or highly experienced nurses nominated by the head of their workplace as high performers regarding efforts towards ethical issues in practical nursing. A total of 903 minutes of recorded interview data were analyzed qualitatively and descriptively, and 498 codes describing nurses’ experiences were abstracted through comparative examination of similarity and dissimilarity, and 22 subcategories and 4 core categories were extracted. The four core categories were as follows, “expressing sensitivity and values of good care,” “providing care while considering what is better care,” “bringing indirect effects to provide better care” and “acting toward learning better care.” The 22 subcategories were checked against the Spencer Competency Dictionary to verify their theoretical validity as competencies. Finally, a draft evaluation scale was developed using 22 competencies.

Ethical review of nursing research, which has different characteristics from medical research, has challenges for both researchers and reviewers. The purpose of this study is to clarify the thoughts of nursing researchers who have undergone the review in their research ethics committees. The research participants were 10 nursing researchers whose researches were reviewed after enforcement of “Ethical Guidelines for Medical and Health Research Involving Human Subjects.” Semi-structured interviews were conducted, and the verbatim record was inductively analyzed. Five core-categories were derived from the data; appreciation for benefit of the review, doubt about necessity of review, disaffectedness to research ethics committees, and suggestion for improvement of research ethics committees and its review process. The results revealed not only challenges to be addressed by institutions such as composition of research ethics committee members, but also challenges to research ethics committees and committee members who review including how to proceed with the review, as well as challenges to researchers with lack of understanding on reviewing. These results suggest the necessity of training seminar to both reviewers and nursing researchers.

This study aimed to development of the Nursing Students’ Ethical Behavior Self-Evaluation Scale in Nursing Practice. A self-administered questionnaire survey was conducted with 1,361 fourth-year nursing students in baccalaureate programs, and data from 302 students were analyzed. Using item analysis and exploratory factor analysis, 19 items and four factors of the Nursing Students’ Ethical Behavior Evaluation Scale in Nursing Practice were extracted: “seeking and giving dignified care that captures individuality,” “respect for human rights of patients,” “responsible execution through collaboration,” and “autonomous learning attitude.” Confirmatory factor analysis yielded GFI=0.904, AGFI=0.874, CFI=0.946, and RMSEA=0.061. Cronbach’s alpha for the subscales ranged from 0.825 to 0.886. The correlation of the Nursing Students’ Ethical Behavior Evaluation Scale in Nursing Practice with the Self-Efficacy Scale for Nursing Students during Clinical Training was 0.602. Using the test-retest method, the correlation for the subscales range from 0.503 to 0.709. The reliability and validity of the Nursing Students’ Ethical Behavior Self-Evaluation Scale in Nursing Practice were verified.

The purpose of this study was to examine the usefulness of nursing students’ ethical susceptibility questionnaire (ESQ-NS) by comparison using the Moral Sensitivity Test (MST). A four-year longitudinal survey was conducted from April 2015 to November 2018. As a result of repeated-measures one-way analysis of variance, the ESQ-NS showed a significant difference in the total score and two of the three sub-factors: “Respect for individuals”(p<0.001) and “Maintaining patients’ confidentiality”(p<0.001). Correlation analysis also showed a significant correlation between ESQ-NS and MST. This means that while the two measures measure similar concepts, it was suggested that they were independent of each other. ESQ-NS was significantly associated with grade, with higher grade students showing higher ethical sensitivity than grade students. Therefore, we believe that ESQ-NS has shown its usefulness as a tool for measuring student ethical sensitivity considered to be nurtured and improved in basic nursing education.

The purpose of this study was to clarify nursing students’ perceptions of ethical problems and explore related factors. We administered a questionnaire survey to students of a nursing baccalaureate program and obtained responses from 266 of them. Four factors (Factor I: How medical professionals treat patients; Factor II: Knowledge and skills of nurses; Factor III: Respect for patients’ autonomy; Factor IV: Ward rules and facilities) regarding their perceptions of ethical problems were extracted by explanatory factor analysis. The scores of 32 items on ethical problems were 2.6–4.3. Items that nursing students perceived as the most important ethical problems were shown to be related to Factor I. Exploration of the related factors showed significant differences in Factor IV by grades, clinical training experience, and attendance in ethics classes.

The purpose of this study is to understand the ethical issues experienced by nurse practitioners who provide medical care, such as “tokutei koui”(designated duties). The nurse practitioners in this study were designated as shinryo-kangoshi in Japan. A questionnaire survey was conducted on 249 nurse practitioners certified by the Japan NP Graduate School of Education Council, and 54 responses were analyzed. As a result, the nurse practitioner experienced many ethical issues such as “physical restraint: sedation or not,” “advocacy of patient rights,” and “staffing that could not provide adequate care.” And they were suffering from the ethical issue of “relationships with doctors and nurses.”

The ethical issues experienced by nurse practitioners are similar to those of clinical nurses, and their ethical sensibility as nurses might be reflected in the results. In addition, sedation is the important issue of participants’ experiences as nurse practitioners. Nurse practitioners have ethical problems with their relationships with doctors and nurses, suggesting differences in issues across the field of education. There is a need for further development of ethics education in the master’s program at the graduate school.

We held an ethics conference for students in undergraduate nursing programs during psychiatric nursing training. We then conducted semi-structured interviews to clarify the reflections and learning of ten students who participated in the conference. We generated 71 subcategories that fell into the following 9 categories: [difficulty in interpreting ethics conference methodology], [acquisition of ethical thought with an understanding of ethics principles], [acquisition of multifaceted thought through the acknowledgement of competing opinions within oneself], [understanding of ethical dilemmas existing in nursing practice], [affirmation of the ethics conference], [changes in ethical thinking after the ethics conference], [changes in ethical behavior during practical training in mental health nursing after the ethics conference], [application of lessons learned at the ethics conference to other field training and lectures in other subjects], and [distress about not being able to apply ethics conference to practice]. The students also learned about ethical dilemmas in nursing practice at the ethics conference. The students acquired multifaceted thought at the ethics conference and changed behaviors related to ethics in their own nursing interventions.