|
|
Nursing Science 2025
临床护士护理伦理决策能力的研究进展
|
Abstract:
在医疗护理服务需求日益多元化，患者的法律和伦理意识不断增强，医疗资源分配不均和护患矛盾冲突紧张的时代背景下，护理实践中的伦理问题日益凸显。临床护士正确理解和应用护理伦理知识，做出理性的伦理决策，对于开展高质量的护理服务至关重要。本文对护理伦理决策能力的概念、评估工具、现状、影响因素以及干预措施进行综述，旨在为护理伦理决策能力的相关研究提供参考，提升护理服务质量。
Against the backdrop of increasingly diverse demands for medical care services, growing legal and ethical awareness among patients, uneven distribution of medical resources, and escalating tensions between nurses and patients, ethical issues in nursing practice have become increasingly prominent. It is crucial for clinical nurses to correctly understand and apply ethical knowledge in nursing and make rational ethical decisions to provide high-quality nursing services. This article reviews the concept, assessment tools, current situation, influencing factors, and intervention measures of ethical decision-making ability in nursing, aiming to provide references for related research on ethical decision-making ability in nursing and improve the quality of nursing services.
| [1] | 杨丹, 施慧琳, 胡斌春, 等. 我国医院临床护士护理伦理认知和践行现状分析及对策研究[J]. 护理与康复, 2024, 23(10): 1-2. |
| [2] | 张耀丹, 杜爱平, 田永明. ICU护士道德勇气现状及影响因素分析[J]. 护理学杂志, 2023, 38(2): 51-54. |
| [3] | Dennis, V. (2022) The Challenges of Ethical Decision Making in Nursing. AORN Journal, 116, 1-2. https://doi.org/10.1002/aorn.13733 |
| [4] | Ulrich, C.M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., et al. (2010) Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66, 2510-2519. https://doi.org/10.1111/j.1365-2648.2010.05425.x |
| [5] | 徐艳玲, 张小曼. ICU护士道德困境、职业倦怠及伦理决策能力相关性分析[J]. 职业与健康, 2022, 38(9): 1172-1176. |
| [6] | 朱青波, 冯志仙. 护理伦理决策能力的影响因素与研究进展[J]. 护理与康复, 2023, 22(7): 87-90. |
| [7] | 邹颖, 刘俊荣, 刘春娟, 等. 护理伦理学课程思政教学指南[J]. 中国医学伦理学, 2024, 37(8): 988-994. |
| [8] | 刘健, 曹志平. 论护士护理伦理决策能力的培养[J]. 中国医学伦理学, 2005(1): 83-84. |
| [9] | 杨林玲, 陈丽萍, 刘俊荣. 临床护士伦理决策能力研究现状[J]. 医学与哲学, 2022, 43(7): 31-34. |
| [10] | 刘英为, 刘可风. 西方企业伦理决策研究的新动态[J]. 伦理学研究, 2014(4): 65-70. |
| [11] | 吴红梅, 刘洪. 西方伦理决策研究述评[J]. 外国经济与管理, 2006(12): 48-55. |
| [12] | Numminen, O.H. and Leino-Kilpi, H. (2007) Nursing Students’ Ethical Decision-Making: A Review of the Literature. Nurse Education Today, 27, 796-807. https://doi.org/10.1016/j.nedt.2006.10.013 |
| [13] | Ketefian, S. (1981) Moral Reasoning and Moral Behavior among Selected Groups of Practicing Nurses. Nursing Research, 30, 171-176. https://doi.org/10.1097/00006199-198105000-00011 |
| [14] | Crisham, P. (1981) Measuring Moral Judgment in Nursing Dilemmas. Nursing Research, 30, 104-110. https://doi.org/10.1097/00006199-198103000-00012 |
| [15] | 吴敏娟, 张邢炜, 冯国和, 等. 伦理决策测量工具及其应用和护理启示[J]. 护理学报, 2015, 22(18): 18-21. |
| [16] | 郁晓路, 袁长蓉, 仇瑶琴, 等. 护理伦理决策能力的评价方法及启示[J]. 护理管理杂志, 2013, 13(7): 494-496. |
| [17] | 张静, 杨韶刚. 道德判断测验在中国的研究综述[J]. 电子科技大学学报(社科版), 2011, 13(6): 91-95. |
| [18] | Bužgová, R. and Sikorová, L. (2013) Moral Judgment Competence of Nursing Students in the Czech Republic. Nurse Education Today, 33, 1201-1206. https://doi.org/10.1016/j.nedt.2012.06.016 |
| [19] | 朱磊. 实习护生伦理决策能力及相关因素的研究[D]: [硕士学位论文]. 蚌埠: 蚌埠医学院, 2011. |
| [20] | 吴晨曦. 临床护士评判性思维态度倾向性与护理伦理决策能力的相关性研究[D]: [硕士学位论文]. 成都: 中医药大学, 2013. |
| [21] | 吴敏娟. 临床护士护理伦理决策能力的现状调查和相关因素分析[D]: [硕士学位论文]. 杭州: 杭州师范大学, 2016. |
| [22] | 陈昕羽. 护理伦理决策能力评估量表的研制与评价[D]: [硕士学位论文]. 成都: 成都中医药大学, 2023. |
| [23] | Maluwa, V.M., Maluwa, A.O., Mwalabu, G. and Msiska, G. (2021) Assessment of Ethical Competence among Clinical Nurses in Health Facilities. Nursing Ethics, 29, 181-193. https://doi.org/10.1177/09697330211010259 |
| [24] | Poikkeus, T., Suhonen, R., Katajisto, J. and Leino-Kilpi, H. (2016) Organisational and Individual Support for Nurses’ Ethical Competence: A Cross-Sectional Survey. Nursing Ethics, 25, 376-392. https://doi.org/10.1177/0969733016642627 |
| [25] | Aitamaa, E., Suhonen, R., Iltanen, S., Puukka, P. and Leino-Kilpi, H. (2019) Ethical Problems in Nursing Management: Frequency and Difficulty of the Problems. Health Care Management Review, 46, 25-34. https://doi.org/10.1097/hmr.0000000000000236 |
| [26] | Baysal, E., Sari, D. and Erdem, H. (2018) Ethical Decision-Making Levels of Oncology Nurses. Nursing Ethics, 26, 2204-2212. https://doi.org/10.1177/0969733018803662 |
| [27] | 张亚卓. 临床护士护理伦理决策能力现状及影响因素研究[J]. 世界最新医学信息文摘, 2019, 19(13): 189-192. |
| [28] | 许馨元. 临床护理人员的护理伦理素养调查研究[D]: [硕士学位论文]. 大连: 大连医科大学, 2021. |
| [29] | 罗思意, 吴龙, 黄光梅, 等. 重症监护室护士伦理敏感性研究进展[J]. 医学与哲学, 2024, 45(9): 35-38. |
| [30] | 何青云, 黄春美. ICU护士的伦理冲突研究进展[J]. 护理学报, 2024, 31(20): 33-38. |
| [31] | 刘聪慧, 张梦桐, 赵翠翠, 等. 肿瘤科护士道德困境研究进展[J]. 医学与哲学, 2023, 44(7): 52-55. |
| [32] | 张霄, 吕仕杰, 陈迎新, 等. 基于VOSviewer的护理伦理决策国际研究热点分析[J]. 医学与哲学, 2021, 42(12): 27-31. |
| [33] | 邵渝, 史红健, 李东雅, 等. 中医医院护士伦理决策能力调查及相关因素分析[J]. 中医药导报, 2022, 28(11): 210-213. |
| [34] | 赵丽, 柏玲, 王丽娜, 等. ICU护理人员伦理认知影响因素分析[J]. 中国医学伦理学, 2023, 36(8): 904-908. |
| [35] | 高静, 吴晨曦, 杨翔宇, 等. 临床护士护理伦理决策能力现状及影响因素研究[J]. 中华护理杂志, 2013, 48(6): 488-491. |
| [36] | 张艺博, 王冬华. 护士道德困境对护理的影响及应对策略研究进展[J]. 职业与健康, 2019, 35(3): 422-425. |
| [37] | 王明丽. 护士护理伦理决策能力的影响因素[J]. 管理观察, 2018(31): 173-174. |
| [38] | 罗梦丹, 武文文, 刘成媛, 等. 国内护理伦理困境及其决策研究的文献计量学分析[J]. 现代临床护理, 2019, 18(5): 62-68. |
| [39] | 张晓飞, 孙玫, 任璐, 等. 精神科护士的伦理决策能力现状及影响因素分析[J]. 护理学杂志, 2018, 33(23): 47-49. |
| [40] | Alba, B. (2016) Factors That Impact on Emergency Nurses’ Ethical Decision-Making Ability. Nursing Ethics, 25, 855-866. https://doi.org/10.1177/0969733016674769 |
| [41] | 王密密, 杜志红, 龚晓玲, 等. 绵阳市公立综合医院临床护士护理伦理决策能力现状及影响因素[J]. 职业与健康, 2018, 34(22): 3071-3074. |
| [42] | 胡欣玥, 吴燕, 江小艳. 上海市基层医疗机构护士护理伦理决策能力现状及影响因素研究[J]. 全科护理, 2023, 21(22): 3041-3045. |
| [43] | Du, J., Huang, S., Lu, Q., Ma, L., Lai, K. and Li, K. (2022) Influence of Empathy and Professional Values on Ethical Decision-Making of Emergency Nurses: A Cross Sectional Study. International Emergency Nursing, 63, Article ID: 101186. https://doi.org/10.1016/j.ienj.2022.101186 |
| [44] | 贾秀丽, 张丽敏, 袁占心. ICU护士心理健康状况及对护理伦理决策能力的影响[J]. 护理学杂志, 2017, 32(9): 63-65. |
| [45] | 邹玲, 谢娟. 职业获益感在急危重症科室医务人员情绪智力与职业倦怠中的中介作用[J]. 职业与健康, 2022, 38(1): 84-88. |
| [46] | 黄永慧, 郭云飞, 姚溪, 等. 河南省三级甲等医院护士医院伦理氛围感知与组织公民行为的相关性研究[J]. 全科护理, 2023, 21(20): 2845-2847. |
| [47] | Esmaelzadeh, F., Abbaszadeh, A., Borhani, F. and Peyrovi, H. (2017) Strengthening Ethical Decision-Making: The Experience of Iranian Nurses. Nursing Management, 24, 33-39. https://doi.org/10.7748/nm.2017.e1610 |
| [48] | 李珍英, 陈琦慧, 徐晓霞, 等. 肿瘤科护士伦理行为现状及影响因素分析[J]. 护理学杂志, 2024, 39(7): 13-16. |
| [49] | 郝楠, 张昊, 许雅琼, 等. 肿瘤科护士的道德困境、工作投入与组织伦理氛围相关性研究[J]. 中国医学伦理学, 2019, 32(8): 1059-1064. |
| [50] | 王慧凤, 孟德敏, 赵阳阳. 遭受医疗暴力事件急诊ICU护士的护理伦理决策能力与创伤后应激障碍的相关性[J]. 临床研究, 2019, 27(12): 162-165. |
| [51] | 蒋莎莎, 蒋正辉. 工作场所暴力对护士护理伦理决策能力的影响[J]. 护理管理杂志, 2015, 15(2): 132-134. |
| [52] | Maddineshat, M., Yousufzadeh, M.R., Mohseni, M. and Maghsoudi, Z. (2019) Teaching Ethics Using Games: Impact on Iranian Nursing Students’ Moral Sensitivity. Indian Journal of Medical Ethics, IV, 14-20. https://doi.org/10.20529/ijme.2018.056 |
| [53] | 杨捷婷. 案例式教学对护生伦理决策能力的影响[J]. 中国高等医学教育, 2022(2): 73-74. |
| [54] | 朱磊, 张志斌, 牛倩. 情境模拟案例教学法对五年制高职护生护理伦理决策能力的影响[J]. 护理学报, 2020, 27(17): 10-14. |
| [55] | West, R.S., Axel-Adams, R.M. and Wocial, L.D. (2024) Embedding Nursing Ethics within Teaching Strategies in Nurse Residency Programs. Journal for Nurses in Professional Development, 40, 167-171. https://doi.org/10.1097/nnd.0000000000001055 |
| [56] | Smith, K.V. (1996) Ethical Decision-Making in Nursing: Implications for Continuing Education. The Journal of Continuing Education in Nursing, 27, 42-45. https://doi.org/10.3928/0022-0124-19960101-09 |
| [57] | 刘海霞. 临床护士伦理学继续教育必要性调查[J]. 河南医学研究, 2017, 26(9): 1591-1592. |
| [58] | 谢红珍, 袁长蓉, 沈园园, 等. 《中国护士伦理准则》内容解读[J]. 中国医学伦理学, 2020, 33(10): 1234-1242. |
| [59] | 潘绍山, 张金钟, 张新庆, 等. 《护士伦理准则》内容解读[J]. 中国医学伦理学, 2014, 27(4): 468-470. |
