医院伦理氛围在伦理支持体系与急诊分诊护士道德勇气关系中的中介作用  

The mediating role of hospital ethical climate in the relationship between ethical support system and emergency triage nurses' moral courage

作　　者：康云 邵艳 彭贵海 李龙倜 马菊华[3] KANG Yun;SHAO Yan;PENG Guihai;MA Juhua;LI Longti

机构地区：[1]十堰市太和医院/湖北医药学院附属医院门诊服务中心,湖北省十堰市442000 [2]十堰市太和医院/湖北医药学院附属医院护理部,湖北省十堰市442000 [3]湖北医药学院医学伦理学教研室

出　　处：《中华急危重症护理杂志》2024年第9期799-805,共7页Chinese Journal of Emergency and Critical Care Nursing

基　　金：2022年十堰市科学技术研究与开发立项项目(22Y25)。

摘　　要：目的 探讨医院伦理氛围在伦理支持体系与急诊分诊护士道德勇气之间的中介作用,并为临床实践提供依据,以提升急诊分诊护士的伦理标准和决策能力。方法 于2023年10月-12月,通过便利抽样方法,在湖北省十堰市3所三级甲等综合医院中选取396名急诊分诊护士作为研究对象。基于社会支持理论,假设医院伦理氛围在伦理支持体系对急诊分诊护士道德勇气的影响中起中介作用。采用一般资料调查表、急诊分诊护士伦理支持体系感受调查问卷、医院伦理氛围量表及护士道德勇气量表进行数据收集,并使用结构方程模型进行数据分析和假设验证。结果 描述性分析显示,急诊分诊护士的伦理支持体系感受、医院伦理氛围及道德勇气的评分分别为(83.35±10.01)分、(100.64±13.49)分、(81.52±10.56)分。相关性分析表示,伦理支持体系得分与医院伦理氛围得分(r=0.833,P<0.01)及道德勇气得分(r=0.820,P<0.01)之间均呈强正相关,医院伦理氛围得分与道德勇气得分(r=0.887,P<0.01)也显示出强正相关性。结构方程模型分析表明,各项拟合指标优良,医院伦理氛围在伦理支持体系感受与道德勇气之间具有显著的中介作用,间接效应值为0.492,95%CI为0.489~0.685,相对效应值为51.52%。结论 医院伦理氛围显著地中介了伦理支持体系与急诊分诊护士道德勇气之间的关系,强调了医院伦理氛围在提升护理职业道德标准中的关键作用。Objective To explore the mediating role of hospital ethical climate in the relationship between ethical support system and the moral courage of emergency triage nurses,and to provide practical insights for clinical practice to enhance the ethical standards and decision-making abilities of emergency triage nurses.Methods From October to December 2023,396 emergency triage nurses were selected from three tertiary hospitals in Shiyan City through convenience sampling.Based on the theory of social support,it was hypothesized that the hospital ethical climate mediated the impact of ethical support systems on the moral courage of emergency triage nurses.Data were collected using a general information questionnaire,Emergency Triage Nurses'Ethical Support System Perception Questionnaire,Hospital Ethical Climate Scale,and Moral Courage Scale for Nurses.Structural Equation Modeling(SEM)was utilized for data analysis and hypothesis testing.Results Descriptive analysis indicated that the scores for emergency triage nurses'perceptions of the ethical support system,hospital ethical climate,and moral courage were(83.35±10.01),(100.64±13.49),and(81.52±10.56),respectively.Correlation analysis showed strong positive correlations between scores of the ethical support system and hospital ethical climate(r=0.833,P<0.01),and moral courage(r=0.820,P<0.01).The hospital ethical climate also had a strong positive correlation with moral courage scores(r=0.887,P<0.01).SEM analysis indicated excellent fit indices,the hospital ethical climate significantly mediated the relationship between perceptions of the ethical support system and moral courage,with an indirect effect value of 0.492,95%CI of 0.489-0.685,and a relative effect of 51.52%.Conclusion The hospital ethical climate significantly mediates the relationship between ethical support system and the moral courage of emergency triage nurses,underscoring the critical role of the hospital ethical climate in enhancing professional ethical standards in nursing.

关 键 词：急诊分诊护士 伦理支持体系 医院伦理氛围 道德勇气 中介作用 护理管理研究 

分 类 号：R47[医药卫生—护理学]