病棟看護師が経験する倫理的問題の特徴と経験や対処の実態及びそれらに関連する要因 The characteristics of ethical problems experienced by ward nurses in nursing practice, their experiences and responses to these problems, and the associated underlying factors

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病棟看護師が経験する倫理的問題の特徴と経験や対処の実態及びそれらに関連する要因を検討することを目的に、日本の病棟看護師1,746名に自記式質問紙調査を2007年10〜11月に実施し、1,144名から回答(回収率:65.5%)を得た。その結果、病棟看護師は、倫理をめぐる問題を1ヶ月に1〜3回経験することが多く、経験した倫理的問題を解決した割合は平均40%と低かった。経験した問題の頻度の上位には、「身体抑制や薬剤による沈静をするか、しないか」、「患者に十分な看護ケアを提供できていない看護師の充足状況」、「看護師と医師(他の専門家)の関係における対立」があったが、多くの問題は未解決であった。性別、施設規模、所属病棟、倫理的問題を検討する機会などが倫理的問題の経験の頻度や解決の割合の関連要因として示され、道徳的感性と倫理的問題の経験の頻度にも相関が認められた。以上より、倫理的問題の解決能力の向上に向けた倫理教育や組織的な体制を整備する必要性への示唆を得た。

The purpose of this study is to clarify the characteristics of ethical problems experienced by ward nurses in nursing practice, their experiences and responses to these problems, and associated underlying factors. In this study, a self-administered questionnaire survey was issued to 1,746 ward nurses in October and November 2007 in Japan. Responses were obtained from 1,144 ward nurses (recovery rate: 65.5%). The results show that they often experienced ethical problems one to three times a month. The average resolution rate of the ethical problems reported by them was low at 40%. The most frequent problems they experienced were "Use / nonuse of physical / chemical restraints", "Staffing patterns that limit patient access to nursing care", and "Conflict in nurse / doctor relationships (or other professional relationships)", but most of the problems were not solved. Variables such as the nurses' sex, size of institutions, wards the nurses worked on, and chances for the nurses to study ethical problems were indicated as the associated underlying factors which affect both experiences of ethical problems and the resolution rate of ethical problems. The occurrence rate of experiencing problems was correlated with moral sensitivity to the associated underlying factors. This study suggests that it is necessary for nurses to have opportunities to study ethics for nursing in order to develop greater ability to solve the ethical problems and improve organizational systems in the hospitals.

収録刊行物

  • 生命倫理

    生命倫理 19(1), 87-97, 2009

    日本生命倫理学会

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各種コード

  • NII論文ID(NAID)
    110007659920
  • NII書誌ID(NCID)
    AN10355291
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    13434063
  • データ提供元
    CJP書誌  CJP引用  NII-ELS  IR  J-STAGE 
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