护理学生伦理敏感性问卷的编制与验证。
The development and validation of the Ethical Sensitivity Questionnaire for Nursing Students.
机构信息
Department of Fundamental Nursing, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192, Japan.
Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 4313192, Japan.
出版信息
BMC Med Educ. 2019 Jun 17;19(1):215. doi: 10.1186/s12909-019-1625-8.
BACKGROUND
Recent advances in medicine and an increasingly demanding healthcare environment are causing various complicated ethical problems. Nursing students need to prepare to deal with ethical issues in their future roles. Ethical sensitivity is a key aspect of the ethical decision-making process; however, there is no scale to measure nursing students' ethical sensitivity. Therefore, we developed a scale and verified its reliability and validity.
METHODS
The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) was developed in three phases. First, questionnaire items were formulated after a literature review and interviews with nursing students. Next, its face and content validity were examined by an expert panel and piloted among nursing university graduates. Then, a final draft questionnaire survey was administered to nursing university students from 10 Japanese universities in 2015 and an exploratory factor analysis was performed. Criteria-related relevance was examined to compare established scales (i.e. the Japanese version of the Moral Sensitivity Test (JMST) and the Japanese version of the revised Moral Sensitivity Questionnaire (JMSQ)) using single regression analysis. A second questionnaire survey was conducted in one of the 10 universities to examine reliability.
RESULTS
Initially, 48 items including ethical conflict in clinical nursing practice were formulated, and 47 items were approved by the expert panel. Five-hundred and twenty-eight nursing students responded to the final draft questionnaire. Participants' mean age was 20.4 (standard deviation = 3.1) years. The questionnaire was reduced to 13 items and three factor structures were determined by exploratory factor analysis: 'respect for individuals', 'distributive justice', and 'maintaining patients' confidentiality'. The Cronbach's alpha values for items in each domain ranged from 0.77-0.81, and the Cronbach's alpha for the entire ESQ-NS was 0.82. The ESQ-NS was significantly associated with specific domains: ‛Judgment of the care conflict' from the JMST and 'Sense of Moral Burden' from the JMSQ. Pearson's correlation coefficient of the ESQ-NS between the first and second survey was 0.42 (p < .01).
CONCLUSIONS
The EAQ-NS, which was developed to evaluate the ethical susceptibility of nursing students, showed good validity, internal consistency, and reliability. This questionnaire can be used to evaluate nursing students' ethics education by self-evaluation.
背景
医学的进步和日益增长的医疗保健需求带来了各种复杂的伦理问题。护理专业的学生需要为未来的角色做好处理伦理问题的准备。伦理敏感性是伦理决策过程的一个关键方面；然而，目前没有衡量护理学生伦理敏感性的量表。因此，我们开发了一个量表，并验证了其信度和效度。
方法
护理学生伦理敏感性问卷（ESQ-NS）是分三个阶段开发的。首先，通过文献回顾和对护理专业学生的访谈，制定了问卷条目。接下来，通过专家小组的评审和护理专业毕业生的预试验对其进行了内容和表面效度检验。然后，于 2015 年在日本的 10 所大学向护理专业大学生发放最终版问卷进行调查，并进行探索性因子分析。通过单回归分析，用已建立的量表（即日本版道德敏感性测试（JMST）和日本版修订道德敏感性问卷（JMSQ））来检验标准相关的相关性。在其中一所大学进行了第二次问卷调查，以检验信度。
结果
最初制定了 48 个条目，包括临床护理实践中的伦理冲突，其中 47 个条目得到了专家小组的认可。共有 528 名护理专业学生对最终版问卷做出了回应。参与者的平均年龄为 20.4（标准差=3.1）岁。问卷被简化为 13 个条目，通过探索性因子分析确定了三个因子结构：“尊重个人”、“分配公正”和“保护患者隐私”。每个领域的克朗巴赫 α 值在 0.77-0.81 之间，ESQ-NS 的整体克朗巴赫 α 值为 0.82。ESQ-NS 与特定领域显著相关：JMST 的“护理冲突判断”和 JMSQ 的“道德负担感”。ESQ-NS 在第一次和第二次调查之间的皮尔逊相关系数为 0.42（p<.01）。
结论
EAQ-NS 是为评估护理专业学生的伦理敏感性而开发的，具有良好的效度、内部一致性和信度。该问卷可用于通过自我评价评估护理学生的伦理教育。
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