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伦理氛围、道德困扰和道德敏感性对血液透析护士离职意愿的影响:一项横断面研究。

Impact of ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses: a cross-sectional study.

作者信息

Kim Haengsuk, Kim Hyunjung, Oh Younjae

机构信息

Graduate School of Nursing Science, Hallym University, Hallymdaehakgil 1, 24252, Chuncheon, Gangwon-do, Republic of Korea.

Kangdong Sacred Heart Hospital, Seongan-ro 150, Gangdong-gu, 05355, Seoul, Republic of Korea.

出版信息

BMC Nurs. 2023 Feb 27;22(1):55. doi: 10.1186/s12912-023-01212-0.

Abstract

BACKGROUND

While several studies have been performed on turnover intention among nurses, limited studies have considered the ethical perspectives on turnover intention among haemodialysis nurses. The purpose of this study was to clarify the impact of ethical factors, namely ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses.

METHODS

This cross-sectional research was conducted between July and August 2017. A total of 148 haemodialysis nurses were invited to participate in the study by convenience sampling from 11 general and university hospitals in South Korea. Data were analysed using SPSS for t-test, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression analysis.

RESULTS

In the final regression model, the adjusted R-squared significantly explained 34.6% of the variance in turnover intention (F = 22.534, p < .001) when moral distress related to physician practice (β = 0.310, p = .001) and ethical climate related to the hospital climate (β = - 0.253, p = .003) and manager (β = - 0.191, p = .024) were included. Following the stepwise multiple regression process, all subdomains related to moral sensitivity were excluded due to no statistical significance in the final regression model.

CONCLUSION

To reduce turnover intention among haemodialysis nurses, hospitals and managers should pay attention to haemodialysis nurses' moral distress originating from physicians' practice and improve their ethical climate. Additionally, it is required that the impact of moral sensitivity on turnover among nurses working in diverse care settings be examined further.

摘要

背景

虽然已经对护士的离职意愿进行了多项研究,但考虑血液透析护士离职意愿的伦理视角的研究却很有限。本研究的目的是阐明伦理因素,即伦理氛围、道德困扰和道德敏感性对血液透析护士离职意愿的影响。

方法

这项横断面研究于2017年7月至8月进行。通过便利抽样,邀请了韩国11家综合医院和大学医院的148名血液透析护士参与研究。使用SPSS进行数据分析,以进行t检验、单因素方差分析、Pearson相关系数分析和多元回归分析。

结果

在最终回归模型中,当纳入与医生行为相关的道德困扰(β = 0.310,p = 0.001)、与医院氛围相关的伦理氛围(β = -0.253,p = 0.003)和与管理者相关的伦理氛围(β = -0.191,p = 0.024)时,调整后的R平方显著解释了离职意愿方差的34.6%(F = 22.534,p < 0.001)。在逐步多元回归过程之后,由于在最终回归模型中无统计学意义,所有与道德敏感性相关的子领域均被排除。

结论

为降低血液透析护士的离职意愿,医院和管理者应关注血液透析护士因医生行为产生的道德困扰,并改善其伦理氛围。此外,需要进一步研究道德敏感性对不同护理环境中工作的护士离职率的影响。

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