Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 14, 2025
Date Accepted: Aug 11, 2026
Ethics of Care in Nursing: Protocol for a Qualitative Systematic Review and Best-Fit Framework Synthesis
ABSTRACT
Background:
The nursing profession is guided by ethical principles, nursing ethics is a core attribute of the nursing profession, reflecting its values and professional image. The essence of nursing care aligns more closely with ethics of care frameworks. existing research remains fragmented and limited in scope, particularly regarding contemporary applications of Gilligan's and Tronto's theoretical frameworks in nursing practice
Objective:
To explore the components and indicators of ethics of care in the nursing profession based on the theoretical perspectives of Gilligan (1982) and Tronto (2013), with the goal of developing a conceptual framework of ethics of care that can be applied in nursing contexts
Methods:
The study has been registered with PROSPERO (CRD420251032024) and will be conducted following the PRISMA guidelines (Page et al., 2021) and will use the Joanna Briggs Institute (JBI) Critical Appraisal Tools to assess the quality of selected studies. The analysis will focus on indicators aligned with five key elements of the ethics of care framework: attentiveness, ethical responsibility, ethical competence, ethical responsiveness, and mutual ethical care. This review will include research published between 2020 and 2024. Articles written in English will be sourced from the following electronic databases: CINAHL Complete, EBSCO Discovery Service (EDS) plus Full Text, JSTOR, ScienceDirect, SpringerLink Journal, and Scopus. Qualitative data will be analyzed using thematic synthesis based on the framework by Thomas & Harden (2008), while quantitative data will be analyzed using meta-analysis techniques.
Results:
Preliminary search conducted in April 2025 yielded 68 articles, with 65 unique articles after duplicate removal. Following title and abstract screening, 43 articles progressed to full-text assessment, resulting in 7 articles meeting inclusion criteria. Data extraction and synthesis are scheduled for May 2025, with expected completion by June 2025.
Conclusions:
The findings will be producing a robust conceptual framework with operational definitions, conceptual diagrams illustrating the relationships among components and indicators, and contextual and factor-based analyses. The results of this review can inform the development of assessment tools for ethics of care in nursing, support nursing education, and contribute to policy and practice guideline development in the nursing profession. Clinical Trial: PROSPERO database (Registration Number: CRD420251032024)
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