摘要
目的探讨护士道德困境的现状及其影响因素。方法采用立意取样法对济南市3所三级甲等医院的252名临床护士使用中文版护士道德困境量表（MDS－R）和工作诊断调查表（JOS）进行问卷调查，了解护士道德困境的现状及其影响因素。结果护士道德困境频率（MDF）平均得分（1．06±0．46）分，道德困境强度（MDI）平均得分（1．05±0．63）分，护士道德困境总分的均分为（38．86±26．26）分，无效护理是引起护士道德困境高频率和高强度的主要原因。不同年龄、工作年限、第一学历、职称、职务、科室、编制及收入的护士的道德困境得分比较差异有统计学意义。多元逐步回归分析得出影响护士道德困境的因素有：年龄、第一学历、科室、职称及工作特征中的任务重要性、工作自主性和合作性。结论提示护士应加强护理伦理知识的学习，提高自身伦理决策能力；护理管理者应重视科室管理，加强医护合作关系，提高护士工作自主性，营造良好的科室氛围，提高护士应对与决策能力，降低道德困境水平。
Objective To explore the current situation and influencing factors of moral distress among nurses. Methods 252 clinical registered nurses from 3 Grade-3 Level-A hospitals in Jinan were investigated by the Chinese version of Moral Distress Scale-Revised and Job Diagnostic Survey. Results The mean score of MDF was （1.06±0.46） points and the mean score of MDI was （1.05±0.63） points. The total score of MDS-R was （38.86±26.26） points. Futile care was the main source for the high frequency and high intensity of moral distress among nurses. There were significant differences in the level of moral distress among different groups of age, years of nursing experience, first education degree, professional title, position, department, staffing of government affiliated institutions and income. The result of multiple linear regression analysis showed that age, first education degree, department, professional title, and the importance of assignment, autonomy, collaboration of work were the influencing factors for moral distress of nurses. Conclusions It suggested that nurses should strengthen the study of knowledge about ethics to improve their capacity of ethical decision-making, and nurse managers should pay attention to department management,strengthen the medical cooperation, and improve nurses job autonomy to improve nurses capacity of coping and deci- sion-making and reduce the level of moral dilemmas.
出处
《中国实用护理杂志》
北大核心
2014年第1期55-59,共5页
Chinese Journal of Practical Nursing
关键词
护士
道德困境
影响因素
决策
Nurses
Moral distress
Influencing factors
Decision-making
