Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: We recruited 500 nurses (...) from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40% ( n = 422). The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity ( p < 0.05). Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

There is considerable evidence that the experience of justice is associated with perceived legitimacy of authority, but there has been no research about this association when considering past rather than current fairness. Based on the fairness heuristic theory, we tested the hypothesis that interpersonal justice trajectories positively affect perceived legitimacy of the authority; we also tested whether social class moderated this effect. Community residents rated the authority's fairness on 16 consecutive weeks and rated perceived legitimacy on the 16th week. The (...) results of latent growth modeling showed that the trajectory of interpersonal justice scores leading up to the final week significantly predicted perceived legitimacy, regardless of the current experience of interpersonal fairness. Tests of moderation showed that the legitimacy perceptions of individuals of lower subjective social class were significantly affected by interpersonal justice trajectories, whereas this was not the case among individuals of higher subjective social class. The results are discussed in terms of their implications for research on perceived legitimacy and justice, as well as their implications for understanding social class. (shrink)

Background Nurses frequently experience ethical issues in their area of practice. In the challenging reality of today’s healthcare environment, nursing students need to be prepared to deal with ethical issues in their future roles. Nevertheless, Chinese nursing students’ ethical sensitivity status and the factors influencing it have not been described. Objective This study aims to explore the level of ethical sensitivity and its influencing factors among Chinese nursing students. Research design This was a cross-sectional study. We firstly cross-culturally adapted the (...) Japanese version of the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) into a Chinese version. Then, we administered the Chinese version of ESQ-NS, the Caring Ability Inventory (CAI), and general information questionnaire to nursing undergraduates. Participants and research context The invitations were sent to 600 nursing undergraduates from four universities in Hunan, China. Ethical considerations The study was supported by the Institutional Review Board (IRB) of the lead university. The Approval No. was E202092. Results A total of 489 undergraduate nursing students participated in the study. The mean score for ethical sensitivity of the samples was 36.34 ± 4.90, and 187.99 ± 22.64 for their humanistic care ability. Pearson’s correlation coefficient test indicated a meaningful and positive relationship between the ethical sensitivity and humanistic care ability (r = 0.576 and p <.01). And regression analysis showed that age, school year, experience in studying nursing ethics, how much you like nursing major, and humanistic care ability were of relevance to nursing students' ethical sensitivity. Discussion Our findings suggest that the mean ethical sensitivity score of Chinese nursing students is 36.34 (13–52). The humanistic caring ability of Chinese nursing students is still at a low level. Conclusion Future interventions for improving the ethical sensitivity of the nursing students should consider general information of participants and their humanistic care ability. (shrink)

Background: There is controversy concerning the use of physical restraint. Despite this controversy, some nurses still consider the application of physical restraint unavoidable for some of their clients. Aim: Identify the perceptions and practice of physical restraint in China. Research design: This was a descriptive study that combined qualitative interviews with a quantitative cross-sectional survey. Participants: A total of 18 nurses were interviewed and 330 nurses were surveyed. Ethical considerations: Approval of the study was obtained from the hospital ethics committee. (...) Permission to conduct the study was obtained from the director of nursing. Participants were assured that their participation is voluntary. Results: Physical restraint was commonly used to protect patients’ safety. Naturally, intensive care unit nurses used physical restraint much more frequently than general medical/surgical ward nurses ( p < 0.01). In addition, night shift nurses tended to use physical restraint more frequently. Conclusion: Nursing managers should be aware of the role nurses play in the use of physical restraint. In-service training regarding the proper use of physical restraint should be strengthened and nurse staffing levels should be improved in order to minimize the use of physical restraint in China. (shrink)

When humans are addressing multiple robots with informative speech acts, their cognitive resources are shared between all the participating robot agents. For each moment, the user’s behavior is not only determined by the actions of the robot that they are directly gazing at, but also shaped by the behaviors from all the other robots in the shared environment. We define cooperative behavior as the action performed by the robots that are not capturing the user’s direct attention. In this paper, we (...) are interested in how the human participants adjust and coordinate their own behavioral cues when the robot agents are performing different cooperative gaze behaviors. A novel gaze-contingent platform was designed and implemented. The robots’ behaviors were triggered by the participant’s attentional shifts in real time. Results showed that the human participants were highly sensitive when the robot agents were performing different cooperative gazing behaviors. Keywords: human-robot interaction; multi-robot interaction; multiparty interaction; eye gaze cue; embodied conversational agent. (shrink)

Background: Patients with a traumatic injury often require intensive care for life-saving treatments. Physical suffering and emotional stress during critical care can be alleviated by ethical caring provided by nurses. The relationship between body and self are fundamentally inseparable. Nurses need to understand the impacts of traumatic injury on a patient’s body and self. Aim: To understand the meaning of traumatic injury for body and self for patients receiving intensive care. Research design: A qualitative descriptive study using Giorgi’s phenomenological approach. (...) Participants and research context: Patients receiving intensive care for physical trauma were selected by purposive sampling (N = 15) from a medical center in Taiwan. Individual in-depth, face-to-face audiotaped interviews, guided by semi-structured questions, were used to collect data. Each interview lasted 30–60 min. Audiotaped interviews were transcribed and analyzed. Ethical considerations: This study was approved by the Institutional Review Board of the medical center. Findings: The impact of the experience of traumatic injury on participants’ body and self was described by three main themes: (1) Searching for the meaning of the injured body, (2) Feeling trapped in the bed, and (3) The carer and the cared-for. Discussion and conclusion: The implications of the three themes described in the findings are as follows: Trauma as a source of meaning; Body and self are mutually limiting or mutually enabling; and Ethical relationships. The experience of needing intensive care following a traumatic injury on the body and self was dynamic and mutual. The experience of the injury changed the relationship between body and self, and gave new meaning to life. Nurses play a crucial role in continuity of care by understanding the meaning of a traumatic injury for patient’s body and self that facilitates ethical care and recovery from injury. (shrink)

Biological pacemakers can be achieved by various gene‐based and cell‐based approaches. Embryonic stem cells (ESCs)‐derived pacemaker cells might be the most promising way to form biological pacemakers, but there are challenges as to how to control the differentiation of ESCs and to overcome the neoplasia, proarrhythmia, or immunogenicity resulting from the use of ESCs. As a potential approach to solve these difficult problems, tissue‐engineering techniques may provide a precise control on the different cell components of multicellular aggregates and the forming (...) of a construct with‐defined architectures and functional properties. The combined interactions between ESC‐derived pacemaker cells, supporting cells, and matrices may completely reproduce pacemaker properties and result in a steady functional unit to induce rhythmic electrical and contractile activities. As ESCs have a high capability for self‐renewal, proliferation, and potential differentiation, we hypothesize that ESCs can be used as a source of pacemaker cells for tissue‐engineering applications and the ambitious goal of biological cardiac pacemakers may ultimately be achieved with ESCs via tissue‐engineering technology. -/- . (shrink)

Ethical culture construction is beneficial to maximize policy following behavior and avoid accidents of coal miners in an economic downturn. This paper examines the congruence between coal mine ethical culture values and miners’ moral values and the relationship with PFB. To shed light on this relationship, supervisor moral values act as a key moderator. We build on the initial structure of values to measure ECVs, MVs, and SMVs. At the same time, available congruence was defined to describe the relationship between (...) the two values. Drawing upon a survey of 267 miners in Chinese large state-owned coal mining enterprises, results revealed that ECVs–MVs congruence had a linear relationship with intrinsic PFB and a non-linear relationship with extrinsic PFB. These findings demonstrate that SMVs had a moderating effect on the relationship between ECVs–MVs congruence and extrinsic PFB. Thus, we continued to calculate the available congruence scope in tested enterprises. Furthermore, this study gives relative management proposals and suggestions to improve miners’ moral standards and to reduce coal mine accidents. (shrink)

In this paper, we propose a method to design the pseudorandom number generator using three kinds of four-wing memristive hyperchaotic systems with different dimensions as multientropy sources. The principle of this method is to obtain pseudorandom numbers with good randomness by coupling XOR operation on the three kinds of FWMHSs with different dimensions. In order to prove its potential application in secure communication, the security of PRNG based on this scheme is analyzed from the perspective of cryptography. In addition, PRNG (...) has passed the NIST 800.22 and ENT test, which shows that PRNG has good statistical characteristics. Finally, an image encryption algorithm based on PRNG is adopted. In the encryption algorithm, the optimized Arnold matrix scrambling method and the diffusion processing based on XOR are used to obtain the final encrypted image. Through the evaluation of encryption performance, it is concluded that there is no direct relationship between the pristine image and encrypted image. The results show that the proposed image encryption scheme has good statistical output characteristics and security performance in line with cryptography. (shrink)

The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

A surprisingly large number of lottery prizes go unclaimed every year. This leads us to suspect that what people bet on is not only money, but also good mood. We conducted three studies to explain, from an emotional perspective, why people play lottery games. We first conducted two survey studies to assess mood state reported by online (Study 1a) and offline lottery buyers (Study 1b) at different stages of lottery play. The results revealed that participants’ highest mood appeared before knowing (...) whether they had won. In Study 2, we manipulated the means of reward (lottery tickets vs. cash) and compared participants’ mood changes at different stages of a rewards game in the laboratory. We found the following: first, lottery group participants were generally in a better mood; second, 42% of lottery group participants did not come to the laboratory to collect scratch cards; and third, lottery group participants took more time to return to the laboratory to check their tickets than participants in the cash group. In Study 3, we examined whether priming good or bad mood could influence participants’ preferences for cash versus lottery tickets. The results revealed that participants who were primed for poor mood had a higher preference for lottery tickets compared with their good mood counterparts. These findings suggest that what our participants sought in lottery play was not only money, but improved mood. (shrink)

Action understanding of children develops from simple associative learning to mentalizing. With the rise of embodied cognition, the role of interoception in action observation and action understanding has received more attention. From a developmental perspective, this study proposes a novel developmental model that explores how interoception promotes action understanding of children across ages. In early infancy, most actions observed in infants come from interactions with their caregivers. Babies learn about action effects through automatic interoceptive processing and interoceptive feedback. Interoception in (...) early infancy is not fully developed, such as the not fully developed gastrointestinal tract and intestinal nervous system. Therefore, in early infancy, action understanding is based on low-level and original interoceptive information. At this stage, after observing the actions of others, infants can create mental representations or even imitate actions without external visual feedback, which requires interoception to provide internal reference information. By early childhood, children begin to infer action intentions of other people by integrating various types of information to reach the mentalizing level. Interoception processing requires the integration of multiple internal signals, which promotes the information integration ability of children. Interoception also provides inner information for reasoning about action intention. This review also discussed the neural mechanisms of interoception and possible ways by which it could promote action understanding of children. In early infancy, the central autonomic neural network (CAN) automatically processes and responds to the actions of caregivers on infants, providing interoceptive information for action understanding of infants. In infancy, the growth of the somatomotor system provides important internal reference information for observing and imitating the actions of infants. In early childhood, the development of interoception of children facilitates the integration of internal and external information, which promotes the mentalization of action understanding of children. According to the proposed developmental model of action understanding of children promoted by interoception, there are multilevel and stage-dependent characteristics that impact the role of interoception in action understanding of children. (shrink)

Based on social cognitive theory, we studied the relationship between coaches’ paternalistic leadership and youth athletes’ organizational citizenship behavior and the mediation effect of athletes’ trust in coaches, in China. This age-specific research was conducted among more than 2,000 Chinese youth soccer players. Overall, 758 youth soccer players, aged 13–18 years, completed a self-report questionnaire. The results showed that the three dimensions of the coaches’ PL have different relationships with OCB, and the differences were due to differences in athletes’ ages. (...) Additionally, we verified the mediation role of trust. Our research conclusions are of great significance to the study of Chinese youth soccer as in-depth research can provide a deeper and more precise understanding of the relationship between PL and the OCB of Chinese youth soccer players. This study expands the literature on social cognitive theory and sheds light on the relationship between coach leadership and athlete OCB by providing extensive evidence. (shrink)

本书运用哲学诠释学之基本原理,对法律诠释现象作出了富有学理性的新诠释。全书从当代西方法学家的法律诠释观念入手,较为系统地总结和论述了法律诠释学的哲学基础、法律诠释学的性质与作用、法律诠释的方法等问题。 .

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)

Pseudo-clefts are the building blocks of coherent discourse progression and serve as a rhetorical toolkit to construct an authorial stance in the academic discourse. Despite an increasing interest in grammatical constructions in the academic discourse, researchers have not treated pseudo-clefts in much detail. This paper explores the features of pseudo-clefts in the corpus of academic discourse in the field of applied linguistics. Here, we take the textual and the interpersonal perspectives, focusing on the use of pseudo-clefts in terms of their (...) distribution in generic structure, discourse functions with reference to clefted constituents, and evaluative meaning. The results show that pseudo-clefts were more frequently used in “Results and Discussion” and Literature Review, performing the functions such as the specification of key terms, generalization of the literature, the description and explanation of findings, etc. They are facilitative in creating information gaps and establishing a logic-semantic expansive relationship between the clauses. The findings also suggest that the pseudo-clefts are evaluative devices and are involved in the construction of authorial identities. (shrink)

The current literature in artificial intelligence and robotics awareness focused on the dark side of AIRA. Accordingly, this study sheds light on the positive effect of AIRA on employee creativity by exploring how and when hotel employees may take proactive behavior facing the threat of AI and robotics to further stimulate creativity. Based on the work adjustment theory and the locus of control theory, this study constructs a moderating multiple mediation model to explain the influence of AIRA on employee creativity, (...) in which active learning and task crafting are used as mediating variables, and locus of control is used as moderating variable. Data collected from 264 employees in a Chinese hotel are used for empirical analysis. Results show that AIRA indirectly positively affects employee creativity via active learning and task crafting and Locus of control not only moderates the mediating effect of active learning between the relationship of AIRA and employee creativity but also moderates the mediating effect of task crafting between the relationship of AIRA and employee creativity. The theoretical and practical implications are discussed. (shrink)

Adopting Gilles Deleuze and Felix Guattari's formulations of the rhizome, this article will examine a dynamic that lies between the film Japón's (Carlos Reygadas, 2002) vernacular specificities, European modernist aesthetics and cosmopolitan spectatorship. The article aims to reveal that Japón, along with other contemporary slow films from around the world, has the potential to reify a deterritorialising and reterritorialising encounter that rethinks a Eurocentric genealogical reading of world cinema and challenges a capitalist code of filmmaking.

Background: Good nurses show concern for patients by caring for them effectively and attentively to foster their well-being. However, nurses cannot be taught didactically to be “good” or any trait that characterizes a good nurse. Nurses’ self-awareness of their role traits warrants further study. Objectives: This study aimed (a) to develop a strategy to elicit nurses’ self-exploration of the importance of good nurse traits and (b) to explore any discrepancies between such role traits perceived by nurses as ideally and actually (...) important. Research design: For this mixed-method study, we used good nurse trait card play to trigger nurses’ reflections based on clinical practice. Nurse participants appraised the ideal and actual importance of each trait using a Q-sort grid. The gap between the perceived ideal and actual importance of each trait was examined quantitatively, while trait-related clinical experiences were analyzed qualitatively. Participants and research context: Participants were 35 in-service nurses (mean age = 31.6 years (range = 23–49 years); 10.1 years of nursing experience (range = 1.5–20 years)) recruited from a teaching hospital in Taiwan. Ethical considerations: The study was approved by the Institutional Review Board of the study site. Findings: Good nurse trait card play with a Q-sort grid served as an icebreaker to help nurse participants talk about their experiences as embodied in good quality nursing care. Nurses’ perceived role–trait discrepancies were divided into three categories: over-performed, least discrepant, and under-performed. The top over-performed trait was “obedience.” Discussion: Patients’ most valued traits (“patient,” “responsible,” “cautious,” and “considerate”) were perceived by participants as ideally important but were under-performed, perhaps due to experienced nurses’ loss of idealism. Conclusion: Good nurse trait card play with Q-sort grid elicited nurses’ self-dialogue and revealed evidence of the incongruity between nurses’ perceived ideal and actual importance of traits. The top over-performed trait, “obedience,” deserves more study. (shrink)

Background: Ethical challenges are common in clinical nursing practice, and an infectious environment could put nurses under ethical challenges more easily, which may cause nurses to submit to negative emotions and psychological pressure, damaging their mental health. Purpose: To examine the ethical challenges encountered by nurses caring for patients with the novel coronavirus pneumonia (COVID-19) and to provide nurses with suggestions and support regarding promotion of their mental health. Research design and method: A qualitative study was carried out using a (...) qualitative content analysis. The participants were 18 nurses who agreed to attend an interview and describe their own experiences of providing care to COVID-19 patients in China. They were purposively sampled, and structured, in-depth interviews were performed. Data were iteratively collected and analyzed from February to March 2020. Ethical considerations: The proposal was approved by the Research Ethics Committee of the Second Hospital of Shandong University, China. Findings: The findings revealed three main themes and 10 categories. The themes were the following: (1) ethical challenges (people with COVID-19, inequality, professional ethics, and job competency); (2) coping styles (active control and planning, seeking support as well as catharsis, and staying focused); and (3) impacts on career (specialized nursing skills, scientific research ability, and management skills). Conclusion: Nurses faced ethical challenges on multiple fronts in caring for COVID-19 patients. The results may help nurses with more safety, ethics, and humanistic care in nursing practice. (shrink)

IntroductionThe 2019–2020 pandemic COVID-19 has become a global health crisis. While many recent studies on COVID-19 pandemic have focused on disease epidemiology and psychological status of patients, few have explored the multi-facet influential factors or combined perspectives from both the patients and healthcare workers. The purposes of this study were to: analyze the influencing factors of psychological distress of COVID-19 patients; and describe the experience of healthcare workers relieving psychological distress.Materials and MethodsThis study uses a mixed-method cross-sectional design, including a (...) quantitative study and a qualitative study, targeting two populations: COVID-19 patient and health workers, respectively. In the quantitative part, we recruited a convenience sample of patients with COVID-19 from five hospitals in Wuhan, Hubei Province from 10 to 15 April, 2020. Besides, we collected data by using participants’ socio-demographic information sheet, the Connor-Davidson Resilience Scale-10, the Herth Hope Index, the Distress Thermometer, the Revised Chinese Version of Mishel Uncertainty in Illness Scale, and the Chinese Version of Wake Forest Physician Trust Scale. In the qualitative part, the participants were healthcare workers involved in medical aid missions in Hubei Province, China. Meanwhile, we used sampling with convenient and purposive, data collection with a semi-structured online video interview, and text transcription with Colaizzi’s phenomenological method.ResultsThe results reveal that 25.7% of patients reported higher level of psychological distress. After controlling the sociodemographic variables, only severity of COVID-19 and uncertainty in illness shown significant effect on psychological distress in the regression model. The experience of healthcare workers emerged five themes: Particularly needed psychological care, Manifestation of negative emotion, Manifestation of proactive adaptation, Strategies relieving psychological distress, and gains of healthcare workers after delivering effective psychological care.ConclusionThe 25.7% of patients with COVID-19 still suffered from psychological distress, which should receive timely attention from healthcare workers. And the severity of the disease and disease uncertainty have a significant impact on distress. It is critical to train the healthcare workers on detecting the different manifestation of psychological distress, offering timely disease related information, and applying communication strategies. (shrink)

Interactions with teachers and peers are critical for children’s social, behavioral, and academic development in the classroom context. However, these two types of interpersonal interactions in the classroom are usually pursued via separate lines of inquiries. The current study bridges these two areas of research to examine the way in which teachers influence child-perceived peer social support and peer victimization for 2,678 children within 183 classrooms in preschool through grade three. Two levels of teacher influence are considered, namely teacher-child closeness (...) and conflict relationships at the child-level, and teacher management of interpersonal interactions at the classroom-level. Results of multilevel regression models showed that teacher-child closeness was associated with the growth of child-perceived peer social support from fall to spring, whereas teacher-child conflict and teachers’ behavior management practices were associated with the change in child-perceived peer victimization across the academic year. These associations were unique and above and beyond the influence of children’s actual peer social interactions, including reciprocal friendships and the collective classroom reputation of peer victimization. Collectively, findings highlight the multi-faceted teacher roles in shaping children’s perceptions of their peer social experiences during the earliest years of schooling. (shrink)

This study examines the relationship among the employees–organization pro-environmental values fit, supervisors’ PEVs and employees’ pro-environmental behaviors. Informed by the PEB, organizational values and employee–organization fit literature, we propose and test hypotheses that under egoistic, altruistic and biosphere-value orientations, E–O PEVs fit versus non-fit have significant effects on employees’ private-sphere PEB and public-sphere PEB, identifying supervisors’ PEVs as a moderator. An empirical investigation indicates that the effect of E–O PEVs fit on employees’ private-sphere PEB and public-sphere PEB varies as the (...) value orientation differs. More specifically, under the context of altruistic and biosphere-value orientations, if the organizational PEVs do not match the employees’ PEVs, especially when the former exceeds the latter, employees’ PEB will rise as the organizational PEVs increase. As for egoistic value orientation, when organizational PEVs exceed employees’ PEVs, not only will public-sphere PEB stop decreasing and tend to stabilize, but also private-sphere PEB will rise to a slight degree. Furthermore, compared with altruistic and biospheric values dimensions, supervisors who promote egoistic PEVs will have a more significant effect on the relationship between global E–O PEVs fit and employees’ PEB. Finally, we suggest that the goals of an organization and its supervisors need to be combined within the actual situation of Chinese corporations to truly implement corporate green practices by balancing the profit goal and the environmental goal. (shrink)

Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to (...) interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress. (shrink)