Grosek Štefan, Kučan Rok, Grošelj Jon, Oražem Miha, Grošelj Urh, Erčulj Vanja, Lajovic Jaro, Borovečki Ana, Ivanc Blaž
Division of Surgery, Department of Paediatric Surgery and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Chair of Paediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
PLoS One. 2020 Jul 14;15(7):e0235509. doi: 10.1371/journal.pone.0235509. eCollection 2020.
Healthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations.
The primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them.
We conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016.
The final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more frequently encountered ethical dilemmas with respect to preserving patients' dignity, protecting patients' information, and relations between HCPs and patients. In terms of solutions, all HCPs most frequently discussed ethical dilemmas with co-workers (colleagues), and with the head of the department. According to HCPs, the most important role of HECs is staff education, followed by improving communication, and reviewing difficult ethical cases.
Waiting periods for diagnostics and treatment and suboptimal working conditions due to poor interpersonal relations are considered to be among the most important ethical issues by HCPs in Slovenian hospitals. The most important role of HECs is staff education, improving communication, and reviewing difficult ethical cases.
医疗保健专业人员（HCPs）、患者及其家属经常面临伦理困境。医疗保健伦理委员会（HECs）的作用是在这些情况下提供支持。
主要目标是研究HCPs遇到伦理困境的频率。次要目标是确定遇到的主要伦理困境类型以及HCPs如何解决这些困境。
我们在斯洛文尼亚的14家医院对HCPs进行了一项基于调查的横断面研究。通过按比例分层抽样选择的HCPs设计并验证了一份问卷。数据收集于2015年4月至2016年4月期间进行。
最终样本量为n = 485（385名或79.4%为女性）。在二级和三级医疗机构工作的HCPs的回复率分别为45%和51%。485名HCPs中有340名（70.4%）（非常）频繁遇到伦理困境。常见的伦理困境包括诊断或治疗的等待期、由于病房人际关系不佳导致的工作条件不理想、维护患者尊严以及HCPs与患者之间的关系。与在三级医疗机构工作的同事相比，在二级医疗机构工作的医生和护士在维护患者尊严、保护患者信息以及HCPs与患者之间的关系方面更频繁地遇到伦理困境。在解决方法方面，所有HCPs最常与同事和科室主任讨论伦理困境。据HCPs称，HECs最重要的作用是员工教育，其次是改善沟通和审查困难的伦理案例。
在斯洛文尼亚医院，HCPs认为诊断和治疗的等待期以及由于人际关系不佳导致的工作条件不理想是最重要的伦理问题之一。HECs最重要的作用是员工教育、改善沟通和审查困难的伦理案例。
