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基于实践环境,评估医疗保健专业人员对伦理委员会和医院在解决临床伦理困境中作用的观点。

Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment.

作者信息

Marcus Brian S, Carlson Jestin N, Hegde Gajanan G, Shang Jennifer, Venkat Arvind

机构信息

Yale University School of Medicine, New Haven, CT, USA.

Department of Emergency Medicine, Allegheny Health Network, Erie, PA, USA.

出版信息

HEC Forum. 2016 Mar;28(1):35-52. doi: 10.1007/s10730-014-9262-4.

Abstract

We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.

摘要

我们试图评估医疗保健专业人员对于伦理委员会和医院在基于执业地点解决临床伦理困境中所起作用的观点是否存在差异。我们于2013年12月21日至2014年3月15日对六家医院(一家三级学术医疗中心、三家大型社区医院和两家小型社区医院)的医疗保健专业人员进行了一项调查研究。该调查包括八个临床伦理案例,随后是关于伦理委员会或医院在解决这些案例中是否有作用、作用可能是什么以及针对具体案例的问题的陈述。受访者使用5分制李克特量表来表达他们对所提出前提的认同程度。我们使用方差分析测试来评估受访者的观点是否因执业地点而有显著差异。240名医疗保健专业人员(108名来自三级医疗中心、92名来自大型社区医院、40名来自小型社区医院)完成了调查(回复率:63.6%)。在32个单独问题中,只有3个显示出不同执业地点之间有任何显著的回答差异。总体而言,在伦理委员会或医院在案例解决中是否有作用、作用可能是什么以及针对具体案例的问题等问题类别中,不同执业地点的观点没有差异。在这项多中心调查研究中,医疗保健专业人员对于伦理委员会或医院在解决临床伦理案例中所起作用的观点因执业地点而异的情况很少。

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