Title

護理人員臨床工作所面臨的倫理困擾及其相關因素探討

Translated Titles

An exploration of the ethical distress and related factors that nurses encounter in their clinical practices

DOI

10.6830/CMU.2012.00163

Authors

劉寶珠

Key Words

護理人員 ; 倫理困擾 ; Nurse ; Ethical distress

PublicationName

中國醫藥大學護理學系碩士班學位論文

Volume or Term/Year and Month of Publication

2012年

Academic Degree Category

碩士

Advisor

辛幸珍

Content Language

繁體中文

Chinese Abstract

本研究目的在探討護理人員臨床工作中所面臨的倫理困擾及其相關因素。採敘述性調查研究,以中部某家醫學中心845位護理人員為研究對象,利用結構式問卷來收集資料,問卷內容包含「病人權利的維護」、「行善助人」、「協助醫院及專業利益」、「行使公平正義原則」、「醫病關係」、「人道立場」、「醫護合作」等七大範疇,共有46項倫理困擾。所得資料以SPSS 14.0建檔,並將資料分別進行描述性、推論性統計分析,描述性統計包含次數分配、百分比、平均值、標準差,而推論性統計則以皮爾森積差相關、單因子變異數分析及獨立樣本T檢定等統計方法。 本研究結果發現護理人員臨床工作面臨倫理困擾之程度與頻次皆以「病患權利的維護」及「行善助人」兩大範疇為最高,尤其是病人有需求卻連絡不到醫生、護理人力不足、病人消費者心態,護理工作熱忱受挫、新進人員過多,影響照護品質、評鑑準備所帶來之工作量與實際工作落差之倫理困擾最高。而護理人員之工作科別、年齡、工作年資及參加護理倫理課程與否皆與其倫理困擾有顯著相關。倫理困擾總分最高者為急診單位,其次為加護病房,開刀房則最低。護理人員年齡層在26-35歲之倫理困擾最高,在51-55歲之倫理困擾最低;工作年資5-15年者其倫理困擾最高,工作年資少於一年及大於20年者其倫理困擾最低;而有無參加護理倫理相關研習會或課程,對護理人員整體之倫理困擾有顯著上的影響。 經由本研究理解護理人員臨床工作中所面臨之倫理困擾,未來希望能改善醫療體系中醫護人力不足與醫病關係等問題,並提供更多倫理諮詢及倫理關懷管道,裨益有效紓解倫理困擾之壓力,讓護理人員能持續提供病人及家屬有品質的醫療照護。

English Abstract

The purpose of this study is to investigate the ethical distress and related factors that nurses encounter in their clinical practices. A descriptive survey design was used in this study. Nurses (845) were recruited from a medical center in central Taiwan. Data were collected by a structured questionnaire including seven core themes and fourty-six items. The seven core themes include (1) protecting patient's right, (2) beneficence to patients, (3) conflict in gathering professional interests, (4) difficulties in following the principle of justice, (5) the patient-health care professional relationship, (6) the attitude of humanism and (7) cooperation between nurses and doctors. Data were analyzed by descriptive statistics, Pearson correlation, One-way ANOVA and t-test using SPSS software, version 14. We found that the most common two core themes that nurses encounter in their clinical practices are difficulties to protect patient's right and the beneficence to patients. Especially, the ability for the patients to contact the doctors, the nursing manpower shortage, the patient’s consumer attitude causes discouragement in the workplace, too many insufficiently trained new personnel affect the quality of care and the medical service appraise brings the work loading. Other factors associated with the ethical distress that nurses encounter in their clinical practices are workplace, age, work period of service and participation in the ethical training. This study aims to enhance the understanding of ethical distress that nurses encounter in their clinical practices clinical work. In the future we hope to resolve the nursing manpower shortage in the health-care system improve physician-patient relationship and to provide ethical consultation and caring, thereby relieving pressure of the ethical distress and enabling the nursing staff to keep providing quality care to the patient and family.

Topic Category 醫藥衛生 > 社會醫學
健康照護學院 > 護理學系碩士班
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