Butz A M, Redman B K, Fry S T, Kolodner K
Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Md. 21287-3144, USA.
J Pediatr Health Care. 1998 Jul-Aug;12(4):183-90.
The purpose of this descriptive study was to (a) identify the types of ethical conflicts and their resolutions reported by a group of certified pediatric nurse practitioners (CPNPs) in their ambulatory practice and (b) to examine demographic, educational, and practice-setting factors associated with these conflicts.
Five hundred fifty-nine CPNPs, identified by the National Association of Pediatric Nurse Associates and Practitioners, received survey questionnaires in the mail and were asked to participate by describing an ethical conflict in their practice. Questionnaires were completed by 118 CPNPs. Each ethical conflict was analyzed according to a four content analysis classification system to capture multiple relevant meanings. The relationship between types of ethical conflicts and demographic, educational, and practice-setting variables was examined.
One third (34%) of the perceived ethical conflicts fell in the child/parent/practitioner relationship category. Most conflicts (31%) were experienced as a moral dilemma where 2 or more clear moral principles apply but they support mutually inconsistent courses of action. Most ethical conflicts (22%) were unresolved.
Understanding the nature of ethical conflicts that CPNPs are experiencing in ambulatory settings is important. Professional and institutions/agencies need to collaborate on how to initiate appropriate ethics education and consultation for professional staff to recognize, discuss, and resolve ethical conflicts in the workplace.
本描述性研究的目的是：（a）确定一组认证儿科执业护士（CPNP）在门诊实践中报告的伦理冲突类型及其解决方案；（b）研究与这些冲突相关的人口统计学、教育和实践环境因素。
由全国儿科护士协会和执业者协会确定的559名CPNP通过邮件收到调查问卷，并被要求通过描述其实践中的伦理冲突来参与调查。118名CPNP完成了问卷。根据一个四分内容分析分类系统对每一个伦理冲突进行分析，以捕捉多种相关含义。研究了伦理冲突类型与人口统计学、教育和实践环境变量之间的关系。
三分之一（34%）的感知伦理冲突属于儿童/父母/执业者关系类别。大多数冲突（31%）被体验为一种道德困境，即适用两条或更多明确的道德原则，但它们支持相互矛盾的行动方针。大多数伦理冲突（22%）未得到解决。
了解CPNP在门诊环境中所经历的伦理冲突的性质很重要。专业人员和机构/机构需要就如何为专业人员开展适当的伦理教育和咨询进行合作，以便在工作场所识别、讨论和解决伦理冲突。
