Samaan M C, Cuttini M, Casotto V, Ryan C A
Hospital for Sick Children, Toronto, 555 University Avenue, Ontario M5G 1X8, Canada.
Arch Dis Child Fetal Neonatal Ed. 2008 May;93(3):F217-21. doi: 10.1136/adc.2006.113597. Epub 2007 Aug 17.
To explore the clinical staff attitudes towards ethical decision making in neonatal intensive care units (NICUs) in Ireland, to establish differences between doctors and nurses and to compare attitudes in Ireland with those in Europe.
Cross-sectional study by means of an anonymous questionnaire. 64 doctors and 228 nurses in seven NICUs participated (response rates 74% and 81%, respectively). Through factor analysis the staff answers to 12 attitude statements were used to build a score whose range varied from 0 (preservation of life in any case) to 10, indicating a more individualised approach according to the patient's best interests.
Staff attitudes to ethical decision making in NICU.
Mean values of attitude scores were 5.8 (95% CI 5.3 to 6.2) for doctors, and 6.0 (95% CI 5.5 to 6.5) for nurses. Respondents with experience in follow-up of NICU graduates had significantly higher scores (6.7 vs 5.4, p = 0.018), while the opposite was true among more religious staff (5.8 vs 6.9, p = 0.026) and particularly for minority religions such as Muslim (4.1, 95% CI 3.1 to 5.2). Scores were higher after age 30 for nurses, and after age 40 for doctors, suggesting the adoption of a less vitalistic viewpoint as respondents grow older and more experienced. Among doctors, a relationship was found between the attitude score and their self-reported non-treatment practices.
In Ireland, NICU doctors and nurses hold similar attitudes towards ethical decision making. Personal and professional factors have a statistically significant impact on attitude score. Compared with the rest of Europe, attitudes in Ireland appear more similar to those of southern rather than northern European countries.
探讨爱尔兰新生儿重症监护病房（NICU）临床工作人员对伦理决策的态度，确定医生和护士之间的差异，并将爱尔兰的态度与欧洲其他地区进行比较。
采用匿名问卷进行横断面研究。七个NICU的64名医生和228名护士参与调查（回复率分别为74%和81%）。通过因子分析，工作人员对12条态度陈述的回答被用来构建一个分数，分数范围从0（在任何情况下都要维持生命）到10，表示根据患者的最大利益采取更个性化的方法。
NICU工作人员对伦理决策的态度。
医生的态度得分平均值为5.8（95%可信区间5.3至6.2），护士为6.0（95%可信区间5.5至6.5）。有NICU毕业生随访经验的受访者得分显著更高（6.7对5.4，p = 0.018），而宗教信仰较强的工作人员得分则相反（5.8对6.9，p = 0.026），尤其是穆斯林等少数宗教信仰者（4.1，95%可信区间3.1至5.2）。护士在30岁以后得分较高，医生在40岁以后得分较高，这表明随着受访者年龄增长和经验增加，他们采取的生命主义观点有所减少。在医生中，态度得分与他们自我报告的不治疗做法之间存在关联。
在爱尔兰，NICU医生和护士对伦理决策持相似态度。个人和职业因素对态度得分有统计学上的显著影响。与欧洲其他地区相比，爱尔兰的态度似乎更类似于南欧国家而非北欧国家。
