Swisher Laura Lee
School of Physical Therapy & Rehabilitation Sciences and College of Medicine, University of South Florida, Tampa, FL 33612-4766, USA.
Physiother Res Int. 2010 Jun;15(2):69-79. doi: 10.1002/pri.482.
Although there is extensive literature in other health care fields about the ability to make ethical judgements (moral reasoning), there is a paucity of research addressing the moral reasoning of practising physical therapists. The purposes of this research were to 1) identify the types of moral reasoning used by practising physical therapists as measured by the Defining Issues Test; 2) identify differences in moral reasoning among physical therapists based on educational background, demographic variables, clinical experience, practice setting or expertise in ethics; and 3) compare the moral reasoning of physical therapists with that of other professional groups.
The Defining Issues Test of James Rest was used to evaluate moral reasoning. Five hundred thirty-seven physical therapists responded to a mail survey sent to a random sample of 2,000 American Physical Therapy Association members. Twelve physical therapists with expertise in ethics or professionalism completed the same survey.
The mean postconventional score for the random sample was 41.93. This score was lower than the mean scores of physicians, nurses, medical students, nursing students and dental students established in previous research. Females, ethics experts and those in academic settings had higher postconventional scores.
Physical therapists scored lower in postconventional moral reasoning than some other professional groups with similar educational background. Factors that may inhibit or enhance the development of moral reasoning among physical therapists and possible consequences of high or low moral reasoning scores in physical therapy require further research. These findings may raise concerns about the entry-level educational curriculum and professional development opportunities in the area of ethics and moral reasoning. Results of this research may also highlight the challenges of evaluation, scholarship and research in physical therapy ethics. Further research and theory development is needed to address the relationships between moral theory and descriptive or empirical research within physical therapy.
尽管在其他医疗保健领域有大量关于做出伦理判断（道德推理）能力的文献，但针对执业物理治疗师道德推理的研究却很少。本研究的目的是：1）通过界定问题测试确定执业物理治疗师所使用的道德推理类型；2）根据教育背景、人口统计学变量、临床经验、执业环境或伦理专业知识，确定物理治疗师在道德推理方面的差异；3）将物理治疗师的道德推理与其他专业群体进行比较。
采用詹姆斯·雷斯特的界定问题测试来评估道德推理。向随机抽取的2000名美国物理治疗协会会员发送邮件调查问卷，537名物理治疗师进行了回复。12名具有伦理或专业精神专业知识的物理治疗师完成了相同的调查。
随机样本的后习俗水平平均得分是41.93。该得分低于先前研究中医生、护士、医学生、护理学生和牙科学生的平均得分。女性、伦理专家和学术环境中的人员后习俗水平得分较高。
物理治疗师在后习俗道德推理方面的得分低于一些具有相似教育背景的其他专业群体。可能抑制或促进物理治疗师道德推理发展的因素以及物理治疗中道德推理得分高或低的可能后果需要进一步研究。这些发现可能引发对伦理和道德推理领域的入门级教育课程及专业发展机会的关注。本研究结果也可能凸显物理治疗伦理中评估、学术研究和研究的挑战。需要进一步的研究和理论发展来解决物理治疗中道德理论与描述性或实证研究之间的关系。
