title: Unmet Needs for Clinical Ethics Support Services in Nurse: Based on focus group interviews.
abstract: BACKGROUND
  As nurses' ethical competence in their own fields is essential, clinical ethics support services help nurses improve ethical competence.
  
  
  OBJECTIVE
  The purpose of this study was to identify the unmet needs of ethical support for nurses in clinical settings and explore the differences by nursing units.
  
  
  METHODS
  Focus group interview design was applied. Participants and research context: Data were collected via four rounds of focus group interviews with 37 nurses at intensive care units, medical-surgical units, emergency departments and oncology units. Major questions were as follows: 'What is nurses' experience of ethical difficulties while working as a clinical nurse?' and 'What kinds of clinical ethics support services do nurses require in different clinical settings?' Inductive content analysis was performed to analyse the data. Ethical considerations: Ethical approval was obtained from the institutional review of board at the College of Nursing.
  
  
  RESULTS
  Five categories (with 14 subcategories) were identified: difficulty providing evidence-based care, lack of support in maintaining patients' and family members' dignity, insufficient education regarding clinical ethics, loss of professional self-esteem and expectations concerning organizational support. Nurses' desire for ethical support varied according to department.
  
  
  CONCLUSIONS
  Nurses face both practical and existential ethical issues that require rapid solution each day. There is a need for ethical counselling to prevent compassion fatigue and identify means via which nurses reflect on their daily lives in their own fields. In-house training should be provided for each unit, to improve ethical competence and facilitate the development of pragmatic, sensible solutions.
authors.affiliation: Yonsei University, Mo-Im Kim Nursing Research Institute, Seoul, Korea.
authors.forename: Sanghee
authors.initials: S
authors.lastname: Kim
authors.affiliation: Gyeongsang University, South Korea.
authors.forename: Minjeong
authors.initials: M
authors.lastname: Seo
authors.affiliation: Konyang University, South Korea.
authors.forename: Doo Ree
authors.initials: DR
authors.lastname: Kim
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004993:Ethics, Nursing; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006757:Hospital Units; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D012944:Social Support
keywords: Content analysis; clinical ethics support; ethical competency; focus group