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重症监护病房护士的伦理冲突。

Ethical conflict among nurses working in the intensive care units.

机构信息

AJA University of Medical Sciences, Tehran, Iran.

Yazd Branch, Islamic Azad University, Yazd, Iran.

出版信息

Nurs Ethics. 2019 Nov-Dec;26(7-8):2225-2238. doi: 10.1177/0969733018796686. Epub 2018 Oct 18.

Abstract

BACKGROUND

Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it.

OBJECTIVES

This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units.

RESEARCH DESIGN

This was a descriptive cross-sectional research.

PARTICIPANTS AND RESEARCH CONTEXT

In total, 382 nurses working in the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version).

ETHICAL CONSIDERATIONS

This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed.

FINDINGS

The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to "using resources despite believing in its futility," with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of "working with incompetent staff." The most frequently observed type of conflict was moral dilemma.

CONCLUSION

The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment.

摘要

背景

伦理冲突是决策过程的障碍,也是护士在护理工作中承担伦理责任所产生的问题。重症监护病房的护士可能会面临这种现象。深入研究这一现象有助于预防和治疗它。

目的

本研究旨在确定重症监护病房护士的伦理冲突频率、程度、暴露水平和类型。

研究设计

这是一项描述性的横断面研究。

参与者和研究背景

共有 382 名在伊朗医院重症监护病房工作的护士采用随机抽样法入选。使用护理伦理冲突问卷-重症监护版(波斯语版)收集数据。

伦理考虑

本研究得到了医学研究伦理委员会的批准。在研究过程中,我们遵守了完成知情同意书、确保信息保密和自愿参与等伦理原则。

结果

结果表明,伦理冲突的平均暴露水平为 164.39±79.06。最常见的冲突与“尽管认为资源无效但仍使用资源”有关,每周或每月至少发生一次(68.6%,n=262)。最具冲突性的情况是侵犯隐私(76.9%,n=294)。然而,根据理论模型,伦理冲突的暴露水平遵循“与不称职的员工一起工作”的情况。最常观察到的冲突类型是道德困境。

结论

护士中度暴露于伦理冲突与之前的研究结果一致。然而,与其他研究的结果相比,伦理冲突的频率、程度和类型有所不同。识别重症监护病房护士的伦理冲突有助于巩固那些有利于降低伦理冲突水平的措施,设计适当的策略来预防伦理冲突,并改善护理工作环境。

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