Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well (...) as Google Scholar search engine using keywords such as moral distress, intensive care unit, ICU, nurses, and critical care nurses from 1984, when the concept of MD was first introduced in the nursing literature, up to 29 October 2020. Studies focusing on the interventions for managing MD in critical care nurse were evaluated. The quality of eligible papers was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 8 studies fulfilled the eligibility criteria. Three studies had RCT design and five studies had quasi-experimental design. All studies were conducted in the United States or Iran. Educational workshop, moral empowerment program, social work intervention, nursing ethics huddles, and multifaceted resiliency bundle intervention were effective interventions for managing of MD among critical care nurses. There is limited but promising research evidence evaluating the efficacy of educational interventions for managing of MD among critical care nurses. Although some positive results have been reported, there is limited generalizable evidence due to the variability of interventions. These findings highlight the need for further studies to validate the efficacy of these interventions or develop more potent and efficient interventions for reducing MD in critical care nurses. (shrink)

Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, (...) constraints, consequences, and interventions about moral distress in nurses, from the earliest records up to 26 December 2020. The required data were extracted from 61 relevant studies by two independent reviewers. Results Resources and constraints in the occurrence of moral distress among nurses can be divided into three general categories including internal factors, clinical factors, and external factors. The consequences of moral distress on nurses and the medical system reduced moral sensitivity, development of psychological and physical health problems, and the intention to leave the profession. The potential effective interventions were the implementation of integrated communication programs, strengthening physician–nurse collaboration, nursing involvement in clinical decision-making and end-of-life issues, social support, using a resiliency bundle, interdisciplinary discussion, and promoting nurses’ ethical and communication skills. Conclusion There are a wide range of resources and constraints impacting moral distress in nurses that could lead to negative consequences. Further studies are necessary to identify, evaluate, and implement a range of potential effective interventions for the management of moral distress in nurses. (shrink)

Günümüze kadar süregelen bir mezhep olarak Zeydiliğin Yemen bölgesinde geçirdiği süreçlerden birisi de 16. yy.’da imametini ilan eden Mansûr-Billâh Kâsım b. Muhammed ile başlayan ve Cumhuriyetin ilanına kadar iktidarın soyundan gelenlerin devam ettirdiği dönem bulunmaktadır. Ancak Kâsımîler dönemi olarak bilinen bu sürece dair literatürde yeterli bilgi bulunmamaktadır. Mansûr-Billâh Kâsım b. Muhammed’in akaid, fıkıh, usul gibi alanlarda kıymetli eserlerinin yanı sıra kaleme aldığı ufak bir risalesi de bulunmaktadır. Bu çalışmada ise Kâsımî Hanedanlığının kurucusu olarak bilinen Mansûr-Billâh Kâsım b. Muhammed’in oğlu Müeyyed-Billâh (...) Muhammed b. Kâsım için kaleme aldığı vasiyet metninin literatüre kazandırılması amaçlanmaktadır. (shrink)

Bu makale, insanın delil ve kanıt aramaksızın bir görüşe ya da gruba bağlanması anlamıyla taklidin, bilgi ve inanç ile olan bağıntısı ve insanın düşünmesine imkân tanımadan zihninde hazır bulduğu bilgi olarak ilhamın Mu’tezilî yaklaşımla tetkikine odaklanmaktadır. Bu doğrultuda makalede öncelikle, Mu’tezile’nin taklit ve ilhama yaklaşımları tespit edilecek, sonrasında bilgi ediminde insanın düşünsel çabasıyla çelişen her iki eğilimin analizi yapılacaktır. Her iki kavramın bilgi kaynakları arasında yer almamasının mantıksal gerekçeleri ortaya konularak aynı zamanda bireysel ve sosyal bir soruna da işaret edilecektir. (...) Makalenin esas hedefi ve özgünlüğü ise süregelen bir problemin eleştirisi bağlamında meseleye yaklaşması olacaktır. Bu itibarla makalede ana temayı oluşturan kavramların kısa lügavî tahlili yapıldıktan sonra tartışma konusu iki başlık altında ele alınacaktır. Makalenin planı gereği taklit ve ilhamın iman ile doğrudan bağıntısı kurulmayacak tamamıyla epistemik değeri üzerinden konu tartışılacaktır. Karşılaştırma türünde bir çalışma olmadığı için de konu Mu’tezile merkezinde değerlendirilecek, tematik bağlamın sınırları içerisinde tasvir edilmeye gayret edilecektir. Mu’tezilî bilginlere özgü klasik kaynakların yanında Zeydî-Mu’tezilî âlimlerin eserleri bununla birlikte günümüzde kaleme alınan benzeri çalışmalar makalenin bilimsel literatürünü oluşturacaktır. Genel hatlarıyla bir mezhebin yaklaşımı merkeze alındığından tasvirî bir yöntem üzerinden fikrî değerlendirmeler yapılacaktır. Sonuç olarak bilinçsiz itaatin ve özel bilgi arayışının bilgi değeri taşımadığı, doğru olan yöntemin akıl yürütme ve düşünme olduğu, gerçek itaatin bilgiye olması gerektiği vurgulanacaktır. (shrink)

In this study, the classification of Zaydī fuqahā’ that emerged in the mutaaḫḫirūn period of Zaydī fiqh and related terms are examined. The book named Bulūgh al-arab wa-kunūz al-dhahab fī-maʿrifat al-madhhab, which has great importance among the studies aiming to present the Zaydī fiqh accumulation as a uniform doctrinal structure was taken as a basis in the processing of the subject. After an introduction in which Zaydī fiqh studies are evaluated in their relationship with the subject, the issue is handled (...) under three main headings. In the first title, the author and his work are introduced, and in the second and third titles, the methods and terms used in the classification of the Zaydī fukahâ are examined. The author of the work is ʿAlī b. ʿAbd Allāh al-Shaharī (d. 1190/1776) who lived during the period of the Qāsimī dynasty (al-dawla al-Qāsimiyya) in Yemen. The most important feature of the work, which was prepared using many sources that were attributed importance among the Zaydī literature, is that it was the most comprehensive of all that had written on madhhab doctrine until then. The first part of the work explains that the right madhhab to be followed is Zaydiyya. In the second part, the classes of the Zaydī fuqahā’, which is the subject of our study, are explained. The fuqahā’ classes are primarily divided into two parts: al-salaf al-ṣāliḥīn and al-ḫalaf al-ṣāliḥīn. The first dates back to the beginning of the 3rd/10th century. This class is divided into two parts, as al-sābiqūn and al-mutaaḫḫirūn. The sābiqūn starts with ʿAlī b. Abī Ṭālib, his two sons al-Ḥasan and Ḥusayn and ends with the sons of twelve imams who are their descendants. Zayd b. ʿAlī (d. 122/740) is one of the twelve imams. The most important of the faqīhs in the part of mutaaḫḫirūn, which started with al-Qāsim b. Ibrāhīm al-Rassī (d. 246/860), are the six imams called ahl-al-nuṣūṣ or aʾimma al-nuṣūṣ. The reason why they are named as such is that their words were taken as a basis in determining the views of the sect on the field of uṣūl and furūʿ l-fiqh. al-Qāsim al-Rassī is at a point where all the knowledge of the Prophet's family and the principles agreed upon by sābiqūn, reach him through many channels. al-Hādī Yaḥyā b. al-Ḥusayn (d. 298/911), grandson of al-Qāsim, is the most important imam in terms of his position in the madhhab. The ḫalaf al-ṣāliḥīn is also divided into two parts as ahl l-taḥṣīl and ahl l-naẓar. The first part also referred to as muḥaṣṣilūn or aʾimma al-taḥṣīl, has no subcategories. The second part is divided into two sub-sections as ahl l-taqrīr and mudhākirūn. The muḥaṣṣilūn class starts with those who catch up with the last class of ahl al-nuṣūṣ and ends with ʿAbd Allāh b. Ḥamza (d. 614/1217), one of the three important imams. Two other important imams of muḥaṣṣilūn are Aḥmad b. al-Huṣayn (d. 411/1020) and his brother Yahyā b. al-Husayn (d. 424/1032). It is the fiqh activity of the jurists of this class, called taḥṣīl l-madhhab, that brought Zaydī fiqh, which was fiqh of imams (madhāhib l-aʾimma) in its first period, into a single madhhab and to its classical form in the last period. Mudhākirūn jurists lived at the same time as the ahl-t-taqrīr. This period is about 700 years from the beginning of the 6th/12th century, which is the last century of the muḥaṣṣilūn class, to the end of the 12th/18th century, when Shaharī lived. The roles of the ahl al-taqrīr in the madhhab mostly consist of reviewing the works of the ahl-l tahṣīl, approving the correct ones, and correcting the wrong ones. That's why they are so named. The author of Kitāb l-Azhār, Aḥmad b. Yaḥyā l-Murtaḍā (d. 840/1437), is one of the prominent jurists among the ahl l-taqrīr. The majority of Zaydi fuqahā’ belong to the muẕākirūn class. These are the lowest class of the ahl-al-naẓar. As an important result reached in the study, it is possible to express the following: There is a difference between some of the knowledge and opinions in modern Zaydī studies, which include the same subject as Shaharī's work, in terms of the classification of Zaydī fuqahā’ and the terms used. Therefore, the findings and conclusions based on this work should be confirmed by new studies on other Zaydī classics, and existing opinions on Zaydī jurisprudence should be reviewed. (shrink)