{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:10:46Z","timestamp":1788667846166,"version":"build-2803163510"},"reference-count":83,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Ethics"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Symptoms of mental disorder that impair decision-making capacity in inpatient psychiatric units increase the ethical tension between patient autonomy and paternalistic responsibility. Practices such as involuntary admission, compulsory treatment, and physical restraint further intensify this tension, while nursing students are more vulnerable to these ethical dilemmas because of their limited clinical experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to describe nursing students\u2019 ethical experiences regarding the autonomy\u2013paternalism tension in inpatient psychiatric units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design<\/jats:title>\n                    <jats:p>A qualitative descriptive design was used. Data were collected through reflective journals kept during the clinical placement and semi-structured individual interviews conducted at the end of the placement. These data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and research context<\/jats:title>\n                    <jats:p>The study was conducted in the nursing department of a public university in T\u00fcrkiye. Thirty nursing students undertaking clinical practice in inpatient psychiatric units kept reflective journals, and 17 of them participated in individual interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical considerations<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Sakarya University Social and Human Sciences Ethics Committee, and written informed consent was obtained from all participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      The findings showed that students experienced the ethical tension between patient autonomy and paternalistic practices both explicitly and implicitly. Three main themes were identified:\n                      <jats:italic toggle=\"yes\">Experiencing Restrictions on Patient Autonomy<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Ethical Silence in Response to Ethical Conflict<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">Professional Ethical Development<\/jats:italic>\n                      . Students identified the lack of adequate information and insufficient consideration of patients\u2019 concerns as ethical problems that undermined patient autonomy. They also reported remaining silent, primarily because of hierarchical structures and their role as students.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The autonomy\u2013paternalism dilemma in inpatient psychiatric units constitutes a multidimensional experiential field for nursing students, intertwined with ethical silence, emotional burden, and processes of professional ethical development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09697330261483572","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:27:50Z","timestamp":1788442070000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethical experiences of nursing students in inpatient psychiatric units: The autonomy\u2013paternalism tension"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8060-9216","authenticated-orcid":false,"given":"Sevgi","family":"Koroglu Gokbel","sequence":"first","affiliation":[{"name":"Sakarya University"},{"name":"Sakarya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9889-3622","authenticated-orcid":false,"given":"Gulgun","family":"Durat","sequence":"additional","affiliation":[{"name":"Sakarya University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.790886"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13290"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00491"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-014-0500-x"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6939-15-82"},{"key":"e_1_3_6_7_2","volume-title":"Convention on the rights of persons with disabilities and optional protocol","author":"United Nations","year":"2006","unstructured":"United Nations. Convention on the rights of persons with disabilities and optional protocol. United Nations, 2006. https:\/\/www.un.org\/disabilities\/documents\/convention\/convoptprot-e.pdf (accessed 26 July 2026)."},{"key":"e_1_3_6_8_2","volume-title":"Guidance on community mental health services: promoting person-centred and rights-based approaches","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. Guidance on community mental health services: promoting person-centred and rights-based approaches. World Health Organization, 2021. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240025707 (accessed 26 July 2026)."},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2020.104389"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330211062981"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2023.105912"},{"key":"e_1_3_6_12_2","volume-title":"Principles of biomedical ethics","author":"Beauchamp TL","year":"2019","unstructured":"Beauchamp TL, Childress JF. Principles of biomedical ethics. 8th ed. Oxford University Press, 2019.","edition":"8"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12712"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000509119"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020952102"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12855"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.18662\/brain\/11.3Sup1\/129"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-019-4823-x"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2025.10808"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.699446"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.92301"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2006.019695"},{"issue":"1","key":"e_1_3_6_23_2","first-page":"121","article-title":"A human rights-based approach to psychiatry: is it possible?","volume":"22","author":"Broberg E","year":"2020","unstructured":"Broberg E, Persson A, Jacobson A, et al. A human rights-based approach to psychiatry: is it possible? Health Hum Rights 2020; 22(1): 121\u2013131.","journal-title":"Health Hum Rights"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01186-z"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0844562117731975"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-6861.2009.00223.x"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733019858711"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020911077"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2923.2003.01326.x"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare8030215"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/1078390319892311"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.profnurs.2021.07.013"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-01713-6"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733019877526"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330241238337"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/1744987119880234"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16481"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.5040\/9798216409625"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/0147-1767(85)90062-8"},{"issue":"5","key":"e_1_3_6_40_2","first-page":"1189","article-title":"Enhancing the quality and credibility of qualitative analysis","volume":"34","author":"Patton MQ","year":"1999","unstructured":"Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res 1999; 34(5 Pt 2): 1189\u20131208.","journal-title":"Health Serv Res"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.7475\/kjan.2025.0108"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330241262311"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2025.106671"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2021.103113"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21230"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.1339"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2022.1533"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12040445"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.968168"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.537379"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20922"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2023.2288181"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2023.546"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.1177\/21677026221133053"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1250856"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.55358\/atjmed.2022.11.017"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221140513"},{"key":"e_1_3_6_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15552"},{"key":"e_1_3_6_60_2","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep15090312"},{"key":"e_1_3_6_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221074013"},{"key":"e_1_3_6_62_2","doi-asserted-by":"publisher","DOI":"10.12681\/cjp.21763"},{"key":"e_1_3_6_63_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221140513"},{"key":"e_1_3_6_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nepr.2022.103391"},{"key":"e_1_3_6_65_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020956374"},{"key":"e_1_3_6_66_2","doi-asserted-by":"publisher","DOI":"10.1111\/nhs.70082"},{"key":"e_1_3_6_67_2","doi-asserted-by":"publisher","DOI":"10.1177\/2382120519899148"},{"key":"e_1_3_6_68_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330251366571"},{"key":"e_1_3_6_69_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2141"},{"key":"e_1_3_6_70_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12860"},{"key":"e_1_3_6_71_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733019881714"},{"key":"e_1_3_6_72_2","doi-asserted-by":"publisher","DOI":"10.1108\/MHRJ-11-2023-0065"},{"key":"e_1_3_6_73_2","doi-asserted-by":"publisher","DOI":"10.46483\/jnef.1372035"},{"key":"e_1_3_6_74_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17217748"},{"key":"e_1_3_6_75_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221143149"},{"key":"e_1_3_6_76_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733016654317"},{"key":"e_1_3_6_77_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733009106651"},{"key":"e_1_3_6_78_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2004.00764.x"},{"key":"e_1_3_6_79_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330241295369"},{"key":"e_1_3_6_80_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2004.03008.x"},{"key":"e_1_3_6_81_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01650-w"},{"key":"e_1_3_6_82_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330221140513"},{"key":"e_1_3_6_83_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppc.13106"},{"key":"e_1_3_6_84_2","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2023.1860"}],"container-title":["Nursing Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09697330261483572","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09697330261483572","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09697330261483572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:35:32Z","timestamp":1788665732000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09697330261483572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":83,"alternative-id":["10.1177\/09697330261483572"],"URL":"https:\/\/doi.org\/10.1177\/09697330261483572","relation":{},"ISSN":["0969-7330","1477-0989"],"issn-type":[{"value":"0969-7330","type":"print"},{"value":"1477-0989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"09697330261483572"}}