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重症监护病房护士的道德困扰、对死亡的态度及姑息治疗核心能力:一项横断面研究。

Moral distress, attitude toward death, and palliative care core competencies among ICU nurses: a cross-sectional study.

作者信息

Peng Mengyun, Guan Qin, Zhu Xiaoling

机构信息

School of Nursing, Suzhou Medical College, Soochow University, Suzhou, 215006, China.

Faculty of Nursing, Dali University, Dali, 671007, China.

出版信息

BMC Palliat Care. 2025 Jan 16;24(1):16. doi: 10.1186/s12904-025-01655-z.

Abstract

BACKGROUND

Palliative care is becoming more widely acknowledged as a crucial part of intensive care for all patients with life-threatening illnesses. Intensive care unit (ICU) nurses regard as a lead role to facilitate this integration, which require nurses to possess professional and comprehensive core competencies. However, there is little knowledge about the palliative care core competencies among ICU nurses.

AIMS

To explore the association of moral distress, attitude toward death, and palliative care core competencies of ICU nurses, and explore the mediating role of attitude toward death.

METHODS

This is a quantitative, cross-sectional study. Random cluster sampling method was used. 342 ICU nurses were selected from 5 hospitals across 4 provinces in China. Participants were evaluated using the Moral Distress Scale-revised (MDS-R), the Attitude toward Death Profile-Revised (DAP-R), and the Palliative Care Nurses' Core Competencies Scale (PCNCC). This study followed the STROBE statement.

RESULTS

The level of palliative care core competencies among ICU nurses is moderate. Moral distress and negative attitude toward death are negatively associated while positive attitude toward death is positively associated with core competencies in palliative care among ICU nurses. Attitude toward death partially mediates the relationship between moral distress and core competencies.

CONCLUSION

Link between moral distress, attitude toward death, and palliative care core competencies among ICU nurses was found in this study.

摘要

背景

姑息治疗作为对所有患有危及生命疾病患者的重症监护的关键部分,正得到越来越广泛的认可。重症监护病房(ICU)护士被视为促进这种整合的主导角色,这要求护士具备专业且全面的核心能力。然而,关于ICU护士的姑息治疗核心能力的了解却很少。

目的

探讨ICU护士的道德困扰、对死亡的态度与姑息治疗核心能力之间的关联,并探讨对死亡态度的中介作用。

方法

这是一项定量的横断面研究。采用随机整群抽样方法。从中国4个省份的5家医院选取了342名ICU护士。使用修订后的道德困扰量表(MDS-R)、修订后的死亡态度量表(DAP-R)和姑息治疗护士核心能力量表(PCNCC)对参与者进行评估。本研究遵循STROBE声明。

结果

ICU护士的姑息治疗核心能力水平中等。道德困扰与对死亡的消极态度呈负相关,而对死亡的积极态度与ICU护士的姑息治疗核心能力呈正相关。对死亡的态度部分中介了道德困扰与核心能力之间的关系。

结论

本研究发现了ICU护士的道德困扰、对死亡的态度与姑息治疗核心能力之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5369/11740462/ce6c36052adb/12904_2025_1655_Fig1_HTML.jpg

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