Crisham P
Nurs Res. 1981 Mar-Apr;30(2):104-10.
Based on cognitive theory of moral development, this research investigated the difference between nurses' responses to general, hypothetical moral dilemmas and their responses to real-life nursing dilemmas. The purpose of the research was to: identify recurrent moral dilemmas experienced by staff nurses; develop an instrument (Nursing Dilemma Test [NDT]) to measure nurses' responses to nursing dilemmas and the importance given to moral issues and practical considerations; relate staff nurses' responses to nursing dilemmas in the NDT and responses to hypothetical moral dilemmas in the Defining Issues Test to two subject variables (level of nursing education and length of clinical nursing experience); and compare moral judgments, both hypothetical general and nursing specific, of five subject groups (N = 225): staff nurses with associate degrees (57) and baccalaureate degrees (85) in nursing, nurses with masters degrees in nursing (10), college junior prenurses (36), and graduate level nonnurses (37). Findings verified the significance of formal education and previous involvement with similar dilemmas in enhancing principled thinking and raised questions about the relative strength of practical considerations in the hospital milieu.
基于道德发展的认知理论，本研究调查了护士对一般假设性道德困境的反应与对现实生活中护理困境的反应之间的差异。该研究的目的是：确定在职护士经常遇到的道德困境；开发一种工具（护理困境测试[NDT]），以衡量护士对护理困境的反应以及对道德问题和实际考量的重视程度；将在职护士在NDT中对护理困境的反应以及在界定问题测试中对假设性道德困境的反应与两个主题变量（护理教育水平和临床护理经验长度）联系起来；比较五个主题组（N = 225）的道德判断，包括一般假设性和护理特定性的道德判断：拥有护理学副学士学位（57人）和学士学位（85人）的在职护士、拥有护理学硕士学位的护士（10人）、大学三年级护理预科生（36人）以及研究生水平的非护士（37人）。研究结果证实了正规教育和先前处理类似困境的经历在增强原则性思维方面的重要性，并对医院环境中实际考量的相对强度提出了疑问。
