三级综合医院成人ICU护士伦理冲突现状及影响因素研究

doi:10.3761/j.issn.0254-1769.2023.08.003

摘要/Abstract

摘要：

目的调查三级综合医院成人ICU护士的伦理冲突现状，并分析影响因素，为改善其伦理冲突水平提供依据。方法采用多阶段抽样的方法，于2021年12月—2022年4月应用一般资料调查问卷、护理伦理冲突问卷-重症监护版对28所三级综合医院的1 608名成人ICU护士进行调查，采用单因素分析及二元Logistic回归分析影响因素。结果共回收1 516份有效问卷，有效问卷回收率为94.28%。三级综合医院成人ICU护士的护理伦理冲突问卷-重症监护版得分为[75.5（35.0，125.0）]分。Logistic回归分析结果显示，地区、ICU类型、年龄、文化程度、职称、家庭人均月收入和是否接受过伦理培训是成人ICU护士伦理冲突的影响因素（P<0.05）。结论成人ICU护士的伦理冲突有待缓解，护理管理者应关注并识别伦理冲突风险人群，注重疏导与心理支持，制订个性化干预措施，缓解成人ICU护士的伦理冲突。

关键词: 重症监护病房, 伦理冲突, 横断面研究, 护理管理研究

Abstract:

Objective To investigate the current situation of ethical conflict among ICU nurses in tertiary general hospitals in China，and to analyze the influencing factors to provide evidence for the mitigation of ethical conflict. Methods A multi-stage sampling method was used to investigate 1608 ICU nurses from 28 tertiary general hospitals in 7 geographical regions in China from December 2021 to April 2022. The Chinese version of nursing ethics conflict questionnaire-intensive care version was adopted. The univariate analysis and multiple logistic regression were used to analyze the influencing factors. Results A total of 1 516 valid questionnaires were collected. The score of ethical conflict among ICU nurses in tertiary hospitals in China was 75.5（35.0，125.0）. Logistic regression analysis showed that region，ICU type，age，education level，position and whether they had received ethical training were the influencing factors of ICU nurses’ ethical conflict（P<0.05）. Conclusion The ethical conflict of ICU nurses in China is expected to be alleviated. Nursing managers should identify the population at risk of ethical conflict，pay attention to counseling and psychological support，and develop personalized strategies to abate the ethical conflict of ICU nurses.

Key words: Intensive Care Units, Ethical Conflict, Cross-Sectional Study, Nursing Administration Research

刘苑菲, 徐语同, 马亚君, 刘永刚, 崔念奇, 张玉萍, 马伟光, 金静芬. 三级综合医院成人ICU护士伦理冲突现状及影响因素研究[J]. 中华护理杂志, 2023, 58(8): 915-920.

LIU Yuanfei, XU Yutong, MA Yajun, LIU Yonggang, CUI Nianqi, ZHANG Yuping, MA Weiguang, JIN Jingfen. Investigation and influencing factors of ethical conflict among ICU nurses in tertiary general hospitals in China[J]. Chinese Journal of Nursing, 2023, 58(8): 915-920.

图/表 3

表1 调查对象的一般资料及伦理冲突的单因素分析结果（n=1 516）

Table 1 The general data of subjects and results of univariate analysis of ethical conflict（n=1 516）

表2 成人ICU护士伦理冲突问卷-重症监护版得分最高的5个条目[n=1 516，分，M（P25，P75）]

Table 2 The 5 items with the highest scores of ethical conflict in ICU nurses[n=1 516，scores，M（P25，P75）]

表3 成人ICU护士伦理冲突影响因素的二元Logistic回归分析

Table 3 Binomial logistic regression analysis of ethical conflict in ICU nurses

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