Karabulut Seyhan Demir, Gül Şenay, Ateş Eylem Gül, Baykara Zehra Göçmen
Department of Medical History and Ethics, Faculty of Medicine, Baskent University, Ankara, Turkey.
Fundamentals of Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.
BMC Med Ethics. 2024 Dec 21;25(1):147. doi: 10.1186/s12910-024-01155-4.
Conscientious objection poses ethical dilemmas frequently encountered by nurses, allowing them to prioritize personal beliefs in caregiving. However, it may also be viewed as a stance jeopardizing patients' healthcare access. There is no measurement tool to measure conscientious objection in nurses. This study aimed to develop a measurement tool for nurses' conscientious objection attitudes.
This research is a methodological study conducted with a total of 261 nurses in Turkiye. Following content validity assessments by ten experts, a 29-item draft scale was developed. Exploratory and confirmatory factor analyses examined the factor structure, and reliability was assessed via the Spearman-Brown coefficient, intraclass correlation coefficient (ICC), and Bland Altman plot. Cronbach's alpha estimated internal consistency and discrimination, which were evaluated by comparing lower and upper 27% groups.
The Nurses' Conscientious Objection Attitude Scale (COAS-N) comprises 29 items and three sub-dimensions (prioritizing professional values, prioritizing personal values, and requesting the right to conscientious objection). Cronbach's alpha for the entire scale is 0.81.
Validity and reliability were established for the newly developed scale measuring nurses' conscientious objection attitudes.
道德拒绝对护士来说是经常遇到的伦理困境，这使他们能够在护理工作中优先考虑个人信仰。然而，它也可能被视为一种危及患者获得医疗服务的立场。目前尚无用于衡量护士道德拒绝的测量工具。本研究旨在开发一种测量护士道德拒绝态度的工具。
本研究是一项方法学研究，共纳入了土耳其的261名护士。在由十位专家进行内容效度评估后，编制了一个包含29个条目的量表初稿。通过探索性和验证性因素分析来检验因素结构，并通过斯皮尔曼-布朗系数、组内相关系数（ICC）和布兰德-奥特曼图评估信度。通过比较得分较低和较高的27%组来评估克朗巴哈系数估计的内部一致性和区分度。
护士道德拒绝态度量表（COAS-N）由29个条目和三个子维度（优先考虑专业价值观、优先考虑个人价值观以及要求道德拒绝权）组成。整个量表的克朗巴哈系数为0.81。
新开发的用于测量护士道德拒绝态度的量表已建立了效度和信度。
