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关爱明日的劳动力:道德韧性与医疗保健伦理教育。

Caring for tomorrow's workforce: Moral resilience and healthcare ethics education.

作者信息

Monteverde Settimio

机构信息

University of Zurich, Switzerland

出版信息

Nurs Ethics. 2016 Feb;23(1):104-16. doi: 10.1177/0969733014557140. Epub 2014 Dec 10.

Abstract

BACKGROUND

Preparing tomorrow's healthcare workforce for managing the growing complexity of care places high demands on students, educators, and faculties. In the light of worrying data about study-related stress and burnout, understanding how students manage stressors and develop resilience has been identified as a priority topic of research. In addition to study-related stressors, also moral stressors are known to characterize the students' first clinical experiences.

OBJECTIVES

However, current debates show that it remains unclear how healthcare ethics education should address them. In order to clarify this issue, this study first develops the notion of moral resilience as a response to moral stressors involving both situations of moral complexity and moral wrongness. Second, it explores the potential of healthcare ethics education in fostering moral resilience. For this purpose, it defines moral resilience operationally as a reduction of moral distress in a given axis of time measured by a validated tool.

RESEARCH DESIGN, PARTICIPANTS, AND CONTEXT: The educational transferability was assessed within an explorative, quantitative pre-post interventional study with a purposive sample of 166 nursing students. The educational intervention comprised a lecture introducing the typology of moral stressors. Before and after the lecture, students were presented vignettes depicting morally stressful situations.

ETHICAL CONSIDERATIONS

The competent research ethics committee confirmed that no ethical approval was needed. Informed consent was obtained from participants.

FINDINGS

Three of four vignettes showed a modest but statistically significant reduction in measured levels of distress after the lecture (p < 0.05, α = 5%).

DISCUSSION

The study shows the potential of healthcare ethics education in providing students with transformative knowledge that fosters moral resilience.

CONCLUSION

In times of global scarcity of educational resources, healthcare ethics education has an important contribution to offer in the promotion of students' mental and physical health by strengthening the knowledge base of moral resilience. This legitimates its costs for societies, faculties, and professional bodies.

摘要

背景

为明天的医疗保健劳动力做好准备,以应对日益复杂的护理工作,这对学生、教育工作者和教职员工提出了很高的要求。鉴于有关学习相关压力和倦怠的令人担忧的数据,了解学生如何应对压力源并培养适应力已被确定为一个优先研究课题。除了与学习相关的压力源外,道德压力源也是学生首次临床经历的特征。

目的

然而,当前的辩论表明,医疗保健伦理教育应如何应对这些压力源仍不明确。为了澄清这一问题,本研究首先提出了道德适应力的概念,作为对涉及道德复杂性和道德错误情况的道德压力源的一种应对。其次,它探讨了医疗保健伦理教育在培养道德适应力方面的潜力。为此,它将道德适应力操作性地定义为在给定时间轴上通过经过验证的工具测量的道德困扰的减少。

研究设计、参与者和背景:在一项探索性、定量的前后干预研究中,对166名护理专业学生的目的样本进行了教育可转移性评估。教育干预包括一次介绍道德压力源类型学的讲座。在讲座前后,向学生展示描绘道德压力情境的小品。

伦理考量

主管研究伦理委员会确认无需伦理批准。已获得参与者的知情同意。

研究结果

四个小品中有三个在讲座后显示出测量的困扰水平有适度但具有统计学意义的降低(p < 0.05,α = 5%)。

讨论

该研究表明了医疗保健伦理教育在为学生提供促进道德适应力的变革性知识方面的潜力。

结论

在全球教育资源稀缺的时代,医疗保健伦理教育通过加强道德适应力的知识基础,在促进学生的身心健康方面可做出重要贡献。这使其对社会、教职员工和专业团体的成本具有合理性。

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