关于被动安乐死的决策过程：计划行为理论框架
Decision-making process regarding passive euthanasia: Theory of planned behavior framework.
作者信息
Tsemach Ronit, Aharon Anat Amit
机构信息
Tel Aviv Sourasky Medical Center.
Tel Aviv University.
出版信息
Nurs Ethics. 2025 Mar;32(2):399-411. doi: 10.1177/09697330241238346. Epub 2024 Mar 7.
BACKGROUND
Nurses have an essential role in caring for end-of-life patients. Nevertheless, the nurse's involvement in the passive euthanasia decision-making process is insufficient and lower than expected.
OBJECTIVES
To explore factors associated with nurses' intention to be involved in non-treatment decisions (NTD) regarding passive euthanasia decision-making versus their involvement in the palliative care of patients requesting euthanasia, using the Theory of Planned Behavior (TPB) framework.
DESIGN
A cross-sectional study utilizing a random sample.
PARTICIPANTS AND RESEARCH CONTEXT
The study was conducted in one of the largest hospitals in Israel among 125 nurses employed in internal and surgical care wards. Data was collected through face-to-face interviews between March and April 2019.
METHOD
A closed structured questionnaire was developed according to TPB instructions. A paired sample test and two multiple hierarchical regressions were conducted. Variance explained (R) and the significance of F change were calculated for each regression. The study used the STROBE statement guideline.
ETHICAL CONSIDERATIONS
The study was approved by the hospital's Helsinki Committee (#20.11.2017).
FINDINGS
A paired sample test revealed that nurses' involvement in the palliative care of patients requesting passive euthanasia was significantly higher than in NTD regarding euthanasia. Regression analyses revealed that nurses' position and attitudes explain their intention to be involved in decision-making; attitudes and perceived behavioral control explain nurses' intention to be involved in the care of patients requesting euthanasia.
CONCLUSIONS
According to the TPB, nurses' attitudes explained their intention to participate in decision-making regarding passive euthanasia. It is recommended to enhance open discussion of this complex issue to encourage nurses' willingness to participate in NTD decision-making regarding euthanasia.
背景
护士在临终患者护理中发挥着重要作用。然而，护士在被动安乐死决策过程中的参与度不足，低于预期。
目的
运用计划行为理论（TPB）框架，探讨与护士参与被动安乐死决策中非治疗决策（NTD）的意愿相关的因素，以及他们参与请求安乐死患者的姑息治疗的意愿。
设计
一项采用随机抽样的横断面研究。
参与者和研究背景
该研究在以色列最大的医院之一进行，对象为内科和外科护理病房的125名护士。数据于2019年3月至4月通过面对面访谈收集。
方法
根据TPB指南编制了一份封闭式结构化问卷。进行了配对样本检验和两次多元层次回归分析。计算了每次回归的方差解释率（R）和F变化的显著性。该研究采用了STROBE声明指南。
伦理考量
该研究获得了医院赫尔辛基委员会的批准（#20.11.2017）。
研究结果
配对样本检验显示，护士对请求被动安乐死患者的姑息治疗参与度显著高于对安乐死NTD的参与度。回归分析表明，护士的职位和态度解释了他们参与决策的意愿；态度和感知行为控制解释了护士参与请求安乐死患者护理的意愿。
结论
根据TPB，护士的态度解释了他们参与被动安乐死决策的意愿。建议加强对这一复杂问题的公开讨论，以鼓励护士参与安乐死NTD决策的意愿。
Zotero 插件