Kulju Kati, Suhonen Riitta, Puukka Pauli, Tolvanen Anna, Leino-Kilpi Helena
Department of Nursing Science, University of Turku, FI-20014, Turku, Finland.
Department of Nursing Science/ Turku University Hospital and City of Turku, Welfare Division, University of Turku, Turku, Finland.
BMC Med Ethics. 2020 May 29;21(1):43. doi: 10.1186/s12910-020-00469-3.
Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff's behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists.
A self-evaluation instrument (Physiotherapist's Ethical Competence Evaluation Tool) based on an analysis of a concept "ethical competence" was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire.
Based on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct.
This was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients' viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient.
患者有权获得平等、尊重的治疗。如今,三分之一的患者投诉涉及医护人员对患者的行为。符合伦理道德的安全护理需要具备伦理能力,这已被视为物理治疗中的一项核心能力。它已根据性格优势、伦理意识、决策中的道德判断技能以及做好事的意愿来定义。本研究的目的是分析执业物理治疗师的伦理能力。
基于对“伦理能力”概念的分析,于2016年构建了一份自我评估工具(物理治疗师伦理能力评估工具),在公共卫生服务机构或私人诊所工作的物理治疗师(n = 839)对该问卷进行了回复。
根据结果,大多数物理治疗师在伦理能力的所有领域对自己的伦理能力评价很高,子量表包括优势、意识、技能和意愿。做好事的意愿被评价为最高,而性格优势,包括支持伦理流程和代表患者发声的优势,被评价为最低。物理治疗师在遇到伦理问题时最常咨询同事。其他解决问题的方法不太熟悉,国际或国家伦理行为准则也不熟悉。
这是首次尝试在物理治疗的临床环境中,使用一种新颖的自我评估工具,对伦理能力的各个方面进行实证评估。即使物理治疗师认为自己在伦理方面有能力,但在伦理意识方面仍需要进一步探索。此外,应该考虑患者对符合伦理道德护理的观点,以更好地确保患者的伦理安全。