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医疗保健中的伦理困境:医生和护士之间的比较。

Ethical difficulties in healthcare: A comparison between physicians and nurses.

机构信息

University of L'Aquila, Italy.

Civilian Hospital, Avezzano, Italy.

出版信息

Nurs Ethics. 2018 Dec;25(8):1064-1074. doi: 10.1177/0969733016687158. Epub 2017 Jan 18.

Abstract

BACKGROUND

: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity.

OBJECTIVE

: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians.

METHODS

: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals. For data collection, a semi-structured questionnaire was used, consisting of 21 items divided into four sections exploring (1) demographic and occupational characteristics, (2) knowledge in the ethics field, (3) experience with ethical issues and (4) the propensity to use ethics consultation.

ETHICAL CONSIDERATIONS

: Research ethics approval was obtained from the Italian Nurses Professional Board.

RESULTS

: The results show that both nurses and physicians are faced with ethically sensitive situations. Nurses were found to have better judgement concerning their own knowledge than physicians, but more physicians were found to have a deeper level of specific training in ethics issues. The propensity to ask for ethics consultations to address ethical issues was found to be significantly associated with the degree to which ethical issues have deepened (and the level of experience acquired in this field).

CONCLUSION

: The presence of a consulting service that can lead to shared choices may represent, together with basic and continuing education, a valid support for professional growth in the ethical field for both physicians and nurses.

摘要

背景

生物医学科学、技术和护理实践的进步导致了伦理问题的增加,以及卫生工作者在其专业活动中遇到的困难相应增加。

目的

本研究的主要目的是分析护士和医生在伦理领域的知识、伦理问题的经验以及使用伦理咨询的倾向。

方法

2014 年 3 月至 6 月,在意大利中部的四家医院对 351 名护士和 128 名医生进行了横断面观察性研究。为了收集数据,使用了半结构化问卷,共 21 个项目分为四个部分,分别探讨(1)人口统计学和职业特征、(2)伦理领域的知识、(3)伦理问题的经验以及(4)使用伦理咨询的倾向。

伦理考虑

意大利护士专业委员会批准了该研究的伦理审查。

结果

结果表明,护士和医生都面临着涉及伦理的敏感情况。与医生相比,护士在判断自己的知识方面表现更好,但在伦理问题的特定培训方面,医生的水平更深。寻求伦理咨询以解决伦理问题的倾向与伦理问题的深入程度(以及在该领域获得的经验水平)显著相关。

结论

咨询服务的存在,加上基础和继续教育,可能共同为医生和护士在伦理领域的专业成长提供有效的支持。

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