医院伦理氛围调查——该量表的选定心理测量特性及波兰护士和助产士的调查结果
Hospital ethical climate survey - selected psychometric properties of the scale and results among polish nurses and midwives.
作者信息
Dziurka Magdalena, Ozdoba Patrycja, Olson Linda, Jedynak Anna, Ozga Dorota, Jurek Krzysztof, Dobrowolska Beata
机构信息
Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland.
Consultants and previous Professor and Dean at North Park University, Chicago, IL, USA.
出版信息
BMC Nurs. 2022 Nov 2;21(1):295. doi: 10.1186/s12912-022-01067-x.
BACKGROUND
The hospital ethical climate affects the quality of nursing care. A positive ethical climate is likely to reduce the proportion of those who consider leaving the profession, so it is necessary to develop tools which will enable assessment and analysis of the hospital ethical climate. The aim of this study was to examine selected psychometric properties of the Polish version of the Hospital Ethical Climate Survey, assess the hospital ethical climate perceived by nurses and midwives from Polish hospitals, and to determine its correlations with job-related variables.
METHODS
A cross-sectional study among 558 nurses and midwives working in hospitals in Poland.
RESULTS
The 21-item model showed acceptable model fitness between the hypothetical model of ethical climate and the data in the study. Five items with low factor loadings were removed from the study. The internal consistency was satisfactory (0.93). The mean score for the overall hospital ethical climate was 3.62. The highest mean score of hospital ethical climate in the present study was found in the "peers" subscale and the lowest in the "physicians" subscale. A positive correlation was found between overall hospital ethical climate and respondents' satisfaction with work, salary, and working time. The hospital ethical climate was associated with problems found in nurses and midwives' work, such as: limited time for direct face-to-face care, the lack of equipment and resources to provide high-quality health care, strained relations with hospital managers and other health care professionals, limitations to one's own competences or those of other medical professionals, moral dilemmas related to patient care, the low prestige of nurses'/midwives' work, physical and mental burden, and the risk of making a mistake.
CONCLUSION
The Polish 21-item version of the Hospital Ethical Climate Survey is a reliable tool. Correlations revealed that relationships with managers and physicians, and working conditions should be improved in order for the hospital ethical climate to improve.
背景
医院伦理氛围影响护理质量。积极的伦理氛围可能会降低考虑离职的人员比例，因此有必要开发能够对医院伦理氛围进行评估和分析的工具。本研究的目的是检验波兰语版医院伦理氛围调查问卷的选定心理测量学特性，评估波兰医院护士和助产士所感知的医院伦理氛围，并确定其与工作相关变量的相关性。
方法
对波兰医院工作的558名护士和助产士进行横断面研究。
结果
21项模型显示伦理氛围假设模型与研究数据之间具有可接受的模型适配度。从研究中剔除了5个因子载荷较低的项目。内部一致性令人满意（0.93）。医院整体伦理氛围的平均得分为3.62。本研究中医院伦理氛围平均得分最高的是“同事”子量表，最低的是“医生”子量表。发现医院整体伦理氛围与受访者对工作、薪资和工作时间的满意度之间存在正相关。医院伦理氛围与护士和助产士工作中发现的问题相关，例如：直接面对面护理的时间有限、缺乏提供高质量医疗保健的设备和资源、与医院管理人员及其他医疗专业人员关系紧张、自身或其他医疗专业人员能力受限、与患者护理相关的道德困境、护士/助产士工作的声望较低、身心负担以及犯错风险。
结论
波兰语版21项医院伦理氛围调查问卷是一个可靠的工具。相关性表明，为改善医院伦理氛围，应改善与管理人员和医生的关系以及工作条件。
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