Dierckx de Casterlé B, Grypdonck M, Vuylsteke-Wauters M
University of Leuven, Belgium.
J Nurs Meas. 1997 Summer;5(1):87-112.
The need for reliable and valid measures for ethical behavior of nurses has encouraged the authors to develop a new instrument to measure students' ethical behavior in daily nursing dilemmas. Characteristic of the instrument presented is the inclusion of two fundamental components of ethical behavior: (1) ethical reasoning (and the resulting decision), and (2) the actual implementation of the ethical decision. As for many instruments, Kohlberg's theory of moral development has been used as the conceptual framework. However, Kohlberg's abstract justice orientation was refined by a care perspective and representative nursing dilemmas were used to make the instrument conceptually more appropriate for measuring nurses' ethical behavior. The analysis of the psychometric properties of the instrument has provided several relevant indications for the reliability and validity of the ethical reasoning and implementation scores. The revealed inconsistencies in the Ethical Behavior Test could be satisfactorily interpreted in terms of Kohlberg's theory and related empirical research findings, supporting the reliability of the ethical behavior scores. The content validity rests upon the careful development of the instrument resulting in an optimal mix of dilemmas, arguments and care situations to reveal nurses' ethical behavior and in a substantial degree of correspondence between the concept and operationalization. The congruency between the patterns of ethical behavior and Kohlberg's theoretical insights about ethical reasoning and practice support the construct validity of the instrument.
对衡量护士道德行为的可靠且有效的方法的需求促使作者开发一种新工具，以测量学生在日常护理困境中的道德行为。所呈现工具的特点是纳入了道德行为的两个基本组成部分：（1）道德推理（以及由此产生的决策），以及（2）道德决策的实际执行。与许多工具一样，科尔伯格的道德发展理论被用作概念框架。然而，科尔伯格的抽象正义取向通过关怀视角得到了完善，并使用具有代表性的护理困境使该工具在概念上更适合衡量护士的道德行为。对该工具心理测量特性的分析为道德推理和执行得分的可靠性和有效性提供了若干相关指标。在《道德行为测试》中揭示的不一致之处可以根据科尔伯格的理论和相关实证研究结果得到令人满意的解释，这支持了道德行为得分的可靠性。内容效度取决于该工具的精心开发，从而产生困境、论据和关怀情境的最佳组合，以揭示护士的道德行为，并在很大程度上使概念与操作化之间保持一致。道德行为模式与科尔伯格关于道德推理和实践的理论见解之间的一致性支持了该工具的结构效度。
