School of Nursing, Yunnan University of Chinese Medicine, Kunming, China.
School of Medicine, Yunnan University of Chinese Medicine, Kunming, China.
Syst Rev. 2024 Nov 20;13(1):87. doi: 10.1186/s13643-024-02473-9.
Recognizing and appropriately responding to ethical considerations is a crucial element of ethical nursing practice. To mitigate instances of ethical incongruity in healthcare and to promote nurses' comprehension of their professional ethical responsibilities, it is imperative for researchers to accurately evaluate ethical sensitivity. Conducting a systematic review of the available instruments would enable practitioners to determine the most suitable instrument for implementation in the field of nursing.
This review aims to systematically assess the measurement properties of instruments used to measure ethical sensitivity in nursing.
A systematic literature search was conducted in July 2022 in the following electronic databases: Scopus, CINAHL, APAPsycINFO, Embase, Web of Science, and PubMed. Two reviewers independently screened and assessed the studies in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The updated criteria for good measurement properties are used to rate the result of measurement properties, and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the quality of the summarized evidence.
This review encompasses a total of 29 studies that describe 11 different instruments. Neither cross-cultural validity nor responsiveness was examined in any of the included studies. Whereas the majority of the instruments were conducted with at least some type of validity assessment, nearly all of the reliability results rated were indeterminate. Two instruments were recommended, the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units. It is recommended that new self-administration instruments for special nursing settings be developed in accordance with the item response theory (IRT)/Rasch model.
The selection of ethical sensitivity measurement instruments in nursing, and further research on the development, psychometric, and cross-cultural adaptation of these instruments, could be conducted in accordance with the findings and suggestions of this systematic review.
• This review was conducted to assess 11 instruments that were used to measure ethical sensitivity in nursing in 29 studies. • The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units can be recommended, but further reliability and cross-cultural validity testing are needed. • The IRT/Rasch model is also recommended to measure ethical sensitivity in nursing. • The potential limitation of utilizing the COSMIN checklist for assessing methodological quality is worth considering. • Test-retest was considered inappropriate; thus, the reliability testing of ethical sensitivity measurement instruments still needs to be explored.
识别和适当应对伦理问题是伦理护理实践的关键要素。为了减少医疗保健中伦理不一致的情况，并促进护士理解其专业伦理责任，研究人员必须准确评估伦理敏感性。对现有工具进行系统审查将使从业者能够确定最适合在护理领域实施的工具。
本研究旨在系统评估用于测量护理伦理敏感性的工具的测量特性。
于 2022 年 7 月在以下电子数据库中进行了系统文献检索：Scopus、CINAHL、APAPsycINFO、Embase、Web of Science 和 PubMed。两名审查员根据共识基础的健康测量仪器选择标准（COSMIN）检查表独立筛选和评估研究。使用更新的良好测量特性标准来评估测量特性的结果，并使用修改后的推荐评估、制定和评估（GRADE）方法对总结证据的质量进行分级。
本综述共纳入 29 项研究，描述了 11 种不同的工具。纳入的研究均未评估跨文化效度或反应度。虽然大多数工具都进行了至少某种类型的有效性评估，但几乎所有的可靠性结果都不确定。推荐使用 2 种工具，即护理学生伦理敏感性问卷（ESQ-NS）和重症监护病房护士伦理意识量表。建议根据项目反应理论（IRT）/Rasch 模型为特殊护理环境开发新的自我管理工具。
可以根据本系统综述的发现和建议，选择护理伦理敏感性测量工具，并进一步研究这些工具的开发、心理测量学和跨文化适应性。
本综述评估了用于测量护理伦理敏感性的 11 种工具，涉及 29 项研究。
推荐使用护理学生伦理敏感性问卷（ESQ-NS）和重症监护病房护士伦理意识量表，但需要进一步进行可靠性和跨文化有效性测试。
还建议使用 IRT/Rasch 模型测量护理伦理敏感性。
利用 COSMIN 清单评估方法学质量的潜在局限性值得考虑。
考虑到测试-再测试不合适，伦理敏感性测量工具的可靠性测试仍需进一步探讨。
