ASSESSMENT OF THE FACTORS AFFECTING NURSES' COMPLIANCE WITH PROFESSIONAL ETHICS IN THE CAMEROONIAN HEALTH SECTOR

CHAPTER ONE

INTRODUCTION

Background of the Study

The primary objective of nursing is to deliver exceptional healthcare services while simultaneously upholding and enhancing the overall well-being of the community (Joolaee et al., 2020). However, ethics is seen as a fundamental component of all healthcare disciplines, including nursing. Therefore, it plays a crucial role in shaping the ethical conduct of nurses towards patients, so significantly impacting the enhancement of patients' health (Sanjari, Zahedi & Larijani, 2018). Professional ethics are the established rules or standards that regulate the conduct of professionals, including both clients and non-clients (Koehn, 2018). Professional ethics is an essential component of nursing that provides significance and guidance to the personal lives of nurses (Mahmoodi et al., 2019). An individual's ethical upbringing influences their overall inclinations in life and has an impact on their ability to make important decisions (Shakeriniya, 2021). Nursing ethics is a subdivision of medical ethics that has been shaped by advancements in the medical field (Borhani et al., 2019). Professional ethics pertains to the responsibilities that a profession has towards the individuals it serves (Liaschenko & Peter, 2020). 

Respecting human values, rights, and dignity is an essential aspect of nursing. From a clinical perspective, nursing encompasses three fundamental principles of caring: ethics, clinical judgement, and care (Jormsri et al., 2019). In his 2019 publication, Vinson identifies five key factors that are epistemological and foundational to the field of nursing. These elements encompass knowledge of nursing, the art of nursing, individual knowledge, ethics of nursing, and sociopolitical knowledge. Nursing ethics is the application of critical thinking and logical reasoning in clinical practice, guided by moral and philosophical principles. 

Nursing ethics can be viewed as a different skill set possessed by nurses that does not directly affect their clinical tasks or practical responsibilities in nursing. Nevertheless, these ethical principles are closely intertwined with therapeutic procedures and cannot be separated from them (Nasae & Chowalit, 2018). Lemonidou et al. (2019) propose that the ethical dedication to providing care is a fundamental aspect of nursing practice within the nurse-patient relationship. Currently, healthcare settings are undergoing fast transformations. Consequently, nurses encounter ethical dilemmas in the healthcare field that expose them to the possibility of ethical discord (Turkoski, 2018). While it is crucial to meet the criteria of professional ethics in patient care, research have shown that nursing practices often fail to adhere to these ethical norms. Professional ethics guidelines and criteria do not take into account patients' preferences and culture (Saharkhiz, 2018). Therefore, this study seeks to assess the factors affecting nurses compliance with professional ethics in  the Cameroonian health sector.

Statement of the Problem

Currently, healthcare settings are undergoing fast transformations. Consequently, nurses encounter ethical dilemmas in the healthcare field that expose them to potential ethical discord (Turkoski, 2020). While it is crucial to meet the criteria of professional ethics in patient care, research has shown that nursing practices often fail to adhere to these ethical norms. Professional ethics guidelines and criteria do not take into account patients' preferences and cultural factors (Saharkhiz, 2020). Previous research indicate that nurses exhibited a deficient connection to professional ethics. Sokhanvar (2019) found that the level of nurse awareness and implementation of ethical principles in patient care and clinical decision-making was unsatisfactory in Fars, Iran. In addition, nurses displayed a lack of interest in utilising ethical knowledge in their professional duties. Tefagh et al. (2018) discovered that Iranian nurses exhibited a major deficiency in their ability to administer medication safely, and they did not adhere to professional ethics. Furthermore, a comparative analysis of nurses' perspectives on ethical dilemmas in China and Switzerland demonstrated variations in several ethical principles, such as culture and religious beliefs. Chinese nurses exhibited higher levels of anxiety, sadness, and dissatisfaction both during and after their employment in comparison to their Swiss counterparts. Nevertheless, both factions encountered ethical dilemmas stemming from inadequate patient communication resulting from an overwhelming workload (Silen et al, 2018; Price, 2018). A separate study indicated that nurses may encounter a multitude of challenges in the course of their professional duties. Therefore, ethical concerns must be treated with utmost seriousness as a fundamental necessity. Conversely, the most thorough and exhaustive method for adhering to ethical standards is the qualitative approach, where participants openly discuss their own experiences (Ahmadi, 2018; Skulmosk et al., 2019). This information assists administrators in fostering professional ethics. Hence, it is in the light of these challenges, the study seeks to assess the factors affecting nurses compliance with professional ethics in the Cameroonian health sector.

 1.3  Objectives of the Study

The main purpose of this study is to assess the factors affecting nurses compliance with professional ethics in  the Cameroonian health sector. Specifically, the study will;

Determine whether the availability of resources influence nurses' ability to comply with ethical standards in Cameroon.

Assess the extent to which education and training in ethics influence nurses' compliance with professional standards in the Cameroonian health sector.

Assess the level at which stress and workload experienced by nurses affects their ability to adhere to ethical standards in Cameroon.

1.4  Research Questions

The following questions have been prepared for the study:

Does the availability of resources influence nurses' ability to comply with ethical standards in Cameroon?

To what extent does education and training in ethics influence nurses' compliance with professional standards in the Cameroonian health sector?

How does the level of stress and workload experienced by nurses affect their ability to adhere to ethical standards in Cameroon?

1.5 Research Hypotheses

H0: There are no significant factors affecting nurses compliance with professional ethics in  the Cameroonian health sector.

Ha: There are significant factors affecting nurses compliance with professional ethics in  the Cameroonian health sector.

1.6 Significance of the Study

This study will explore the various elements that influence how nurses uphold ethical standards, such as organizational culture, educational background, regulatory frameworks, and socio-economic conditions. Additionally, the study will provide insights into how contextual challenges impact ethical compliance, contributing to a more comprehensive understanding of the dynamics at play in different healthcare settings.Furthermore, the findings will highlight areas where improvements are needed, such as in the provision of ethical training, support systems, and regulatory oversight. Policymakers will also use the insights to shape policies that address the identified challenges and promote a culture of ethical compliance. Moreover, the study will aid nursing schools in tailoring their curricula to better prepare students for the ethical demands of the profession.

1.7 Scope of the study   

The scope of this study is boarded on the factors affecting nurses compliance with professional ethics in  the Cameroonian health sector. Geographically, the study will be delimited to nurses in Cameroon.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

 1.9 Definition of Terms

Nurses: Healthcare professionals who are trained to provide medical care, support, and education to patients. 

Compliance: refers to following protocols, regulations, and ethical standards to ensure proper conduct and high-quality care.

Professional Ethics: a set of principles and standards that guide the behavior and decision-making of professionals in a particular field.