护理管理中的伦理问题：问题的频率和难度。

Ethical problems in nursing management: Frequency and difficulty of the problems.

机构信息

Elina Aitamaa, MNSc, RN, is Doctoral Candidate, Department of Nursing Science, University of Turku, Finland. E-mail:

出版信息

Health Care Manage Rev. 2021 Jan/Mar;46(1):25-34. doi: 10.1097/HMR.0000000000000236.

DOI:10.1097/HMR.0000000000000236

PMID:30724758

Abstract

BACKGROUND

Nurse managers (NMs) lead the biggest personnel group in health care-nurses. They have various responsibilities in clarifying an organization's values to their staff and overseeing and supporting continuous upholding of ethical standards and nurses' ethical competence.

PURPOSE

The purpose of the study was to investigate the frequency and difficulty of the ethical problems NMs encounter in their work and to determine the background factors correlating with the problems.

METHODOLOGY

Cross-sectional survey design was used. Ethical problems were approached by five categories related to patients, nursing staff, other professional groups, the organization, and the NMs themselves. The data collected with questionnaires from NMs in ward, middle, and strategic management (n = 214) in Finland from November 2014 to May 2015 were statistically analyzed.

RESULTS

The most frequently encountered ethical problems were related to nursing staff and organization: About half of NMs encountered those problems at least weekly. The most difficult ethical problems were related to the organization-the mean value of the sum score being significantly higher compared to the four other sum scores (p < .0001). When combining information on the frequency and difficulty of the encountered ethical problems, organization-related problems were the most significant. The more positively NMs assessed their work-related background factors, the fewer ethical problems they encountered and the easier they considered them.

CONCLUSION

Awareness of the frequency and difficulty of ethical problems in nursing, especially those related to organization, needs to be increased in health care organizations to find solutions for dealing with them.

PRACTICE IMPLICATIONS

Strengthening resources for ethics, like ethics experts and multiprofessional committees, may be helpful. Ethical consideration and discussion of prioritization should be routinely used in administrative decision-making. Ethics education and instructions for repetitive situations could increase NMs' ability to manage with ethical problems. Support mechanisms are needed for situations where difficult value clashes appear.

摘要

背景

护士长（NM）领导着医疗保健领域中最大的人员群体——护士。他们有各种责任，包括向员工阐明组织的价值观，监督和支持对道德标准和护士道德能力的持续坚持。

目的

本研究旨在调查 NM 在工作中遇到的伦理问题的频率和难度，并确定与这些问题相关的背景因素。

方法

采用横断面调查设计。通过与患者、护理人员、其他专业人员、组织和 NM 自身相关的五个类别来探讨伦理问题。2014 年 11 月至 2015 年 5 月，从芬兰的病房、中层和战略管理（n=214）NM 中收集了问卷数据，并进行了统计分析。

结果

最常遇到的伦理问题与护理人员和组织有关：约一半的 NM 每周至少遇到一次这些问题。最困难的伦理问题与组织有关——总分的平均值明显高于其他四个总分（p<.0001）。当结合遇到的伦理问题的频率和难度信息时，与组织相关的问题最为显著。NM 对其工作背景因素的评价越积极，他们遇到的伦理问题就越少，他们认为这些问题就越容易处理。