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ICU护士道德脱离现状及影响因素分析

Analysis of the current situation of ICU nurses' moral disengagement and influencing factors.

作者信息

He Juanfeng, Zhang Yalin, Zhang Fang, Yang Xue, Zhang Xi

机构信息

Renmin Hospital of Wuhan University, Wuhan, China.

The First Affiliated Hospital of Xinxiang Medical University, China, Xinxiang, China.

出版信息

BMC Med Ethics. 2025 Jul 3;26(1):80. doi: 10.1186/s12910-025-01245-x.

Abstract

PURPOSE

Moral disengagement can lead to anti-social behaviour by employees in business. In the healthcare field, moral disengagement can lead nurses to make unethical decisions and behaviours that can harm patient well-being. Therefore, this paper will examine the factors influencing moral disengagement among ICU nurses with the aim of contributing to the reduction of the level of moral disengagement among nurses.

METHODS

Between January 2024 and January 2025, ICU nurses from second-level and above general hospitals in Henan and Hubei, China, were selected as survey respondents. The questionnaire survey was conducted using a general information questionnaire, a moral disengagement scale, a moral resilience scale, and a moral disengagement energy scale, and multiple linear stepwise regression was used to analyze the influencing factors of ICU nurses' moral disengagement.

RESULTS

305 ICU nurses scored (91.40 ± 34.37) on the Moral Disengagement Scale. The multiple linear stepwise regression analysis results showed that years of working experience, whether or not they had received ethics training(16.219 p < 0.001), ears of experience (-7.673, p = 0.018), moral resilience(-18.452,p < 0.001), and moral distress (5.523,p < 0.001) were the influencing factors of moral disengagement among ICU nurses (p < 0.05). The adjusted R2 = 0.499,which explains 49.9% of the total variation, suggests that the model explains the influences of moral disengagement well.

CONCLUSION

The moral disengagement of ICU nurses is moderately high, and individualized interventions can be carried out for high-risk groups to reduce this level and improve ethical decision-making to protect patient's rights and interests.

摘要

目的

道德推脱会导致企业员工出现反社会行为。在医疗领域,道德推脱会致使护士做出不道德的决策和行为,进而损害患者的福祉。因此,本文将探讨影响重症监护病房(ICU)护士道德推脱的因素,以期有助于降低护士群体的道德推脱程度。

方法

在2024年1月至2025年1月期间,选取中国河南和湖北二级及以上综合医院的ICU护士作为调查对象。采用一般信息问卷、道德推脱量表、道德复原力量表和道德推脱能量量表进行问卷调查,并运用多元线性逐步回归分析ICU护士道德推脱的影响因素。

结果

305名ICU护士在道德推脱量表上的得分为(91.40±34.37)分。多元线性逐步回归分析结果显示,工作年限、是否接受过伦理培训(16.219,p<0.001)、工作年限(-7.673,p=0.018)、道德复原力(-18.452,p<0.001)和道德困扰(5.523,p<0.001)是ICU护士道德推脱的影响因素(p<0.05)。调整后的R2=0.499,解释了总变异的49.9%,表明该模型对道德推脱的影响解释良好。

结论

ICU护士的道德推脱程度处于中等偏高水平,可针对高危群体开展个性化干预,以降低这一水平,提高伦理决策能力,保护患者权益。

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