School of Nursing, Sun Yat-sen University, Guangzhou, China.
Emergency Department, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Int Emerg Nurs. 2022 Jul;63:101186. doi: 10.1016/j.ienj.2022.101186. Epub 2022 Jun 21.
Emergency nurses are likely to experience serious ethical dilemmas and conflicts because of the dangerous and unpredictable care situations. Nursing ethical decision-making ability is therefore a core competence. Empathy and professional values may be the important variables that influence ethical decision-making. However, for emergency nurses, there is a lack of empirical evidence to support presently. This study aimed to explore the influence of empathy and professional values on nursing ethical decision-making of emergency nurses.
A convenience sample of 236 emergency nurses from 10 general hospitals in China were surveyed. Their ethical decision-making ability, empathy and professional values were measured using the Judgment About Nursing Decision scale, Jefferson Scale of Empathy-Health Professionals, and Nursing Professional Values Scale-Revised, respectively. Additionally, their sociodemographic data were collected. Univariate analysis, Pearson analysis, and multiple linear regression were performed.
The mean ethical decision-making score of emergency nurses was 295.06 ± 26.49, which was medium level. Their average ethical choice score was higher than that of ethical action (P < 0.001). The multiple linear regression results showed that professional values (Standardized coefficients (β) = 0.295, 95% confidence interval (CI): 0.618-1.618), empathy (β = 0.210, 95% CI: 0.620-1.613), job title (β = 0.253, 95% CI: 0.357-2.800) and number of forms of in-service training on ethical decision-making (β = 0.243, 95% CI: 0.254-3.942) were the independent factors significantly influencing the ethical decision-making ability. The multivariate linear regression model had an F statistic of 32.153 (P < 0.001) and an R = 0.588.
Strengthening nurses' empathy and professional values can help nurses make ethical decisions. More clinical experience and in-service training on ethical decision-making can help emergency nurses better handle ethical dilemmas and conflicts.
由于护理情况危险且不可预测，急诊护士可能会遇到严重的伦理困境和冲突。因此，护理伦理决策能力是一项核心能力。同理心和专业价值观可能是影响伦理决策的重要变量。然而，对于急诊护士来说，目前缺乏实证证据支持。本研究旨在探讨同理心和专业价值观对急诊护士护理伦理决策的影响。
采用便利抽样法，选取中国 10 家综合医院的 236 名急诊护士进行调查。采用护理决策判断量表、杰斐逊同理心量表-卫生专业人员版和护理专业价值观量表修订版分别测量护士的伦理决策能力、同理心和专业价值观。此外，还收集了他们的社会人口学数据。进行单因素分析、Pearson 分析和多元线性回归分析。
急诊护士的伦理决策平均得分为 295.06±26.49，处于中等水平。他们的平均伦理选择得分高于伦理行动得分（P<0.001）。多元线性回归结果显示，专业价值观（标准化系数β=0.295，95%置信区间：0.618-1.618）、同理心（β=0.210，95%置信区间：0.620-1.613）、职称（β=0.253，95%置信区间：0.357-2.800）和伦理决策形式的在职培训次数（β=0.243，95%置信区间：0.254-3.942）是影响伦理决策能力的独立因素。多元线性回归模型的 F 统计量为 32.153（P<0.001），R2=0.588。
加强护士的同理心和专业价值观有助于护士做出伦理决策。更多的临床经验和伦理决策在职培训可以帮助急诊护士更好地处理伦理困境和冲突。
