Daeyang University, Malawi.
Malawi University of Science and Technology, Malawi.
Nurs Ethics. 2022 Feb;29(1):181-193. doi: 10.1177/09697330211010259. Epub 2021 Aug 4.
Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.
The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.
A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.
The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.
The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p < 0.05) of nurses 57% (n = 135) with low ethical competence. There was no significant association between respondents' demographic variables and level of ethical competence (p > 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.
The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence.
护理实践中的伦理能力有助于临床护士批判性地思考、分析问题、做出伦理决策、解决伦理问题并在日常工作中表现出合乎道德的行为。因此，伦理能力有助于促进高质量的护理。然而，马拉维的伦理能力研究很少。
本研究旨在探讨马拉维选定医院临床护士的伦理能力。
在马拉维的四家选定医院进行了横断面调查，样本量为 271 名临床护士。使用自我管理问卷收集数据，问卷包括家庭护理护士道德能力量表。使用 STATA 版本 12.0 计算数据集的描述性统计数据和逻辑回归。
研究方案符合所有伦理要求，并获得马拉维大学医学院研究伦理委员会的批准。
马拉维的临床护士具有伦理能力。然而，有相当多的护士（57%，n=135）伦理能力较低，这一点具有统计学意义（p<0.05）。受访者的人口统计学变量与伦理能力水平之间没有显著关联（p>0.05）。通过逐步逻辑回归分析后的简化模型，确定了三个高水平伦理能力的决定因素（坚定的意志、判断技能和识别意图差异）。此外，结果表明伦理能力的指标包括关怀、保密和遵守护士着装规范。该研究还证实，家庭护理护士道德能力量表是评估资源匮乏环境中伦理能力的可靠工具。
完成调查的护士大多数伦理能力较低。然而，需要具备高水平伦理能力的临床护士来胜任医疗机构中复杂的伦理挑战。建议采取增强伦理能力的策略，如持续伦理教育、设立伦理委员会和提供支持性监督，以使马拉维的护士达到高水平的伦理能力。
