Lee Myung Kyung, Oh Jihyun
College of Nursing, Research Institute of Nursing Innovation, Kyungpook National University, Daegu, South Korea.
Department of Nursing, Nursing Convergence Research Center, College of Nursing and Health, Kongju National University, Kongju, South Korea.
Medicine (Baltimore). 2024 Dec 13;103(50):e40927. doi: 10.1097/MD.0000000000040927.
During clinical placement, nursing students may experience unease and moral distress, which negatively impacts their professional values and vocational choices. However, no instrument exists to measure moral distress in nursing students. Thus, this study constructs measurement items for moral distress and explores the factors that influence the vocational choices of nursing students. The participants were recruited from three universities in South Korea Between September and October 2021. This study was adopted with a convenience sample of 270 Korean fourth-year nursing students who completed their clinical practice at tertiary general hospitals in three provinces in the North, Middle, and South areas of South Korea. Data were collected through a self-administered structured questionnaire. The study developed the items and subscales of the Moral Distress Scale using multistep methods following the recommendations of the Consensus-Based Standards for the Selection of Health Status Measurement Instrument. The study constructed 22 items of the three factors of Moral Distress Scale. The three factors of the Moral Distress Scale were "moral distress by low quality of care," "moral distress by a heavy workload and an insufficient workforce," and "unfair and distrust." The factors influencing the vocational choice of the nursing students were high professional values, intention not to choose nursing as a future career, lacking vision for choosing nursing, democratic family climate, and having at least one parent who was a medical professional. Moral distress in undergraduate nursing students may not influence their intention to choose the nursing profession. Fostering the professionalism and professional values of nursing students through university education curricula may help maintain their professional identity.
在临床实习期间,护理专业学生可能会经历不安和道德困扰,这会对他们的职业价值观和职业选择产生负面影响。然而,目前尚无用于测量护理专业学生道德困扰的工具。因此,本研究构建了道德困扰的测量项目,并探讨了影响护理专业学生职业选择的因素。研究对象于2021年9月至10月从韩国三所大学招募。本研究采用便利抽样法,选取了270名韩国四年级护理专业学生,他们在韩国北部、中部和南部地区三个省份的三级综合医院完成了临床实习。数据通过自行填写的结构化问卷收集。本研究按照基于共识的健康状况测量工具选择标准的建议,采用多步骤方法开发了道德困扰量表的项目和子量表。本研究构建了包含道德困扰量表三个因素的22个项目。道德困扰量表的三个因素分别是“护理质量低下导致的道德困扰”、“工作量大及劳动力不足导致的道德困扰”以及“不公平和不信任”。影响护理专业学生职业选择的因素包括较高的职业价值观、未来不打算选择护理职业、缺乏选择护理专业的愿景、民主的家庭氛围以及至少有一位父母是医学专业人员。本科护理专业学生的道德困扰可能不会影响他们选择护理职业的意愿。通过大学教育课程培养护理专业学生的专业素养和职业价值观,可能有助于维持他们的职业认同感。