Suhonen Riitta, Stolt Minna, Gustafsson Marja-Liisa, Katajisto Jouko, Charalambous Andreas
Department of Nursing Science, University of Turku, Finland.
J Adv Nurs. 2014 Jun;70(6):1356-68. doi: 10.1111/jan.12297. Epub 2013 Nov 19.
To investigate the associations among the ethical climate, professional practice environment and individualized nursing care in care settings for older people.
The quality of care provision is affected by organizational environments, such as ethical climate and professional practice environment. Although, the association between professional practice environment and individualized nursing care has been pointed out, we know that little is known about how ethical climate is associated with the level of individualized nursing care delivery.
A cross-sectional explorative and correlational survey design.
The study was conducted in 62 units in the vicinity of a Finnish city using a sample of nurses (N = 874, response rate 58%) who worked clinically with older people in different care settings in 2012. Survey data were collected using the Hospital Ethical Climate Survey, Revised Professional Practice Environment scale and Individualised Care Scale-B. Data were analysed statistically using descriptive statistics, correlation coefficients (Pearson) and multiple stepwise regression analyses.
Statistically significant correlations were found among the variables, ethical climate and individualized care and between individualized care and all professional practice environment sub-scales. Multiple stepwise regression showed associations among individualized care, ethical climate and internal work motivation, control over practice and leadership and autonomy.
The study provided better understanding of the complex concept of individualized care by taking into consideration the ethical climate and the practice environment and their associations. To increase individualization in care provision, efforts need to be directed towards organizational aspects requiring the support of nursing leaders.
探讨老年人护理机构中的伦理氛围、专业实践环境与个性化护理之间的关联。
护理服务质量受组织环境影响，如伦理氛围和专业实践环境。虽然专业实践环境与个性化护理之间的关联已被指出，但我们所知甚少的是伦理氛围如何与个性化护理的提供水平相关联。
横断面探索性和相关性调查设计。
该研究在芬兰一个城市附近的62个单位进行，采用护士样本（N = 874，回复率58%），这些护士在2012年于不同护理机构为老年人提供临床护理。使用医院伦理氛围调查问卷、修订后的专业实践环境量表和个性化护理量表 - B收集调查数据。使用描述性统计、相关系数（皮尔逊）和多元逐步回归分析对数据进行统计分析。
在变量、伦理氛围与个性化护理之间以及个性化护理与所有专业实践环境子量表之间发现了具有统计学意义的相关性。多元逐步回归显示了个性化护理、伦理氛围与内部工作动机、实践控制权、领导能力和自主权之间的关联。
该研究通过考虑伦理氛围和实践环境及其关联，对个性化护理这一复杂概念有了更好的理解。为了提高护理服务的个性化程度，需要针对需要护理领导者支持的组织层面做出努力。
