Pinch W J
J Nurs Educ. 1985 Nov;24(9):372-6. doi: 10.3928/0148-4834-19851101-08.
This study investigated decision making in ethical dilemmas and attitudes toward professional autonomy. It was based on Murphy's identification of three nurse-patient relationship models. The model identification was the result of Murphy's investigation of the levels of moral reasoning of nurse practitioners, from Kohlberg's theory of moral development. Autonomy is necessary for patient advocacy in Murphy's highest order model of nurse-patient relationship. 109 freshmen, 103 seniors, and 82 graduates (baccalaureate nursing) were examined for model selection, risk-taking, restrictions, and anxiety in the decision-making process in specific situations. Autonomy was measured independently. The most significant results indicated that freshmen were less likely to select the autonomous model of relationship, had lower attitudes toward professional nursing autonomy, and were less willing to take risks. Graduates were lower than either student group in their perceptions of restrictions and anxiety. The responses to each dilemma itself varied by situation in relation to the model preferred.
本研究调查了伦理困境中的决策制定以及对职业自主性的态度。它基于墨菲对三种护患关系模式的识别。模式识别是墨菲根据科尔伯格道德发展理论对执业护士道德推理水平进行调查的结果。在墨菲的最高层级护患关系模式中，自主性对于患者维权而言是必要的。研究对109名大一新生、103名大四学生和82名本科毕业生（护理学专业）在特定情况下决策过程中的模式选择、冒险倾向、限制因素和焦虑状况进行了考察。自主性是独立测量的。最显著的结果表明，大一新生选择自主性关系模式的可能性较小，对职业护理自主性的态度较低，且不太愿意冒险。毕业生在对限制因素和焦虑的认知方面低于任何一个学生群体。针对每个困境本身的反应因与偏好模式相关的情境而异。
