Ham Kathy
Department of Nursing, Southeast Missouri State University, One University Plaza-MS 8300, Cape Girardeau, MO 63701, USA.
J Contin Educ Nurs. 2004 Mar-Apr;35(2):66-73. doi: 10.3928/0022-0124-20040301-08.
A descriptive study was used to compare ethical reasoning abilities in senior baccalaureate nursing students and experienced registered nurses. The effects of environmental factors and previous experience with ethical dilemmas in regard to nursing principled thinking were also examined.
Findings on the Nursing Dilemma Test indicated a significant difference in the level of nursing principled thinking in the two groups, with nursing students scoring higher than experienced nurses. There was a significant negative correlation between years of experience and level of nursing principled thinking. The level of nursing education (e.g., associate degree of nursing, diploma, bachelor of science in nursing, masters degree, or doctorate) did not appear to have an effect on nursing principled thinking. In addition, subjects who were most affected by practical considerations demonstrated less use of higher level moral reasoning. The effect of previous experience with ethical dilemmas on nursing principled thinking was found to be nonsignificant.
Ethical dilemmas continue to create much confusion and uncertainty for practicing nurses. Suggestions are made regarding individual analysis of personal and professional values in nurses. In addition, recommendations include ongoing educational offerings and nursing administration support to assist nurses during times of moral distress.
采用描述性研究比较本科高年级护理专业学生和经验丰富的注册护士的伦理推理能力。还考察了环境因素以及以往处理伦理困境的经验对护理原则性思维的影响。
护理困境测试的结果表明，两组在护理原则性思维水平上存在显著差异，护理专业学生的得分高于经验丰富的护士。工作年限与护理原则性思维水平之间存在显著负相关。护理教育水平（如护理学副学士学位、文凭、护理学理学学士、硕士学位或博士学位）似乎对护理原则性思维没有影响。此外，受实际考虑因素影响最大的受试者较少运用高层次的道德推理。以往处理伦理困境的经验对护理原则性思维的影响不显著。
伦理困境继续给执业护士带来诸多困惑和不确定性。针对护士个人和职业价值观的个体分析提出了建议。此外，建议包括持续提供教育课程以及护理管理部门的支持，以在护士面临道德困扰时提供帮助。
