بررسي ارتباط شجاعت اخلاقي و مشاركت در تصميم گيري باليني پرستاران

Relationship between moral courage of nurses and their participation in clinical decision-making

ﻣﻴﻨﻪ و ﻫﺪف: ﺗﺼﻤﻴﻢﮔﻴﺮي ﺑﺎﻟﻴﻨﻲ ﺑﺨﺶ اﺳﺎﺳﻲ ﺣﺮﻓﻪ ﭘﺮﺳﺘﺎري اﺳﺖ. ﭘﺮﺳﺘﺎري ﺑـﺮ ﭘﺎﻳـﻪ اﺧـﻼق اﺳـﺘﻮار اﺳﺖ. ﭘﺮﺳﺘﺎراﻧﻲ ﻛﻪ داراي ﻋﻤﻠﻜﺮد اﺧﻼﻗﻲ ﺷـﺠﺎﻋﺎﻧﻪ ﻫﺴـﺘﻨﺪ ﺗﻌﻬـﺪ ﺑـﻪ ﺑﻴﻤـﺎران، از ﭘﻴﺎﻣـﺪﻫﺎي اﺣﺘﻤـﺎﻟﻲ و ﻧﮕﺮاﻧﻲﻫﺎي ﻣﺮﺑﻮط ﺑﻪ ﺧﻮدﺷﺎن ﺑﺮاﻳﺸﺎن ﻣﻬﻢ ﺗﺮ اﺳﺖ. ﻫﺪف اﻳﻦ ﭘﮋوﻫﺶ ﺗﻌﻴﻴﻦ ارﺗﺒﺎط ﺷﺠﺎﻋﺖ اﺧﻼﻗـﻲ و ﻣﺸﺎرﻛﺖ در ﺗﺼﻤﻴﻢﮔﻴﺮي ﺑﺎﻟﻴﻨﻲ ﭘﺮﺳﺘﺎران ﺑﻮده اﺳﺖ. روش ﺑﺮرﺳﻲ: اﻳﻦ ﭘﮋوﻫﺶ ﺗﻮﺻﻴﻔﻲ- ﻣﻘﻄﻌﻲ در ﺳﺎل 1398 اﻧﺠﺎم ﻳﺎﻓﺖ. ﺟﺎﻣﻌﻪ ﻣﻮرد ﻣﻄﺎﻟﻌـﻪ ﭘﺮﺳـﺘﺎران ﺷﺎﻏﻞ در CCU و ICU ﻣﺮﻛﺰ آﻣﻮزﺷﻲ، ﺗﺤﻘﻴﻘﺎﺗﻲ و درﻣﺎﻧﻲ ﻗﻠﺐ و ﻋﺮوق ﺷﻬﻴﺪ رﺟﺎﻳﻲ ﺑﻮد. ﻧﻤﻮﻧﻪ ﻣـﻮرد ﻣﻄﺎﻟﻌﻪ 195 ﻧﻔﺮ ﺑﻮد. ﺟﻬﺖ ﺟﻤﻊآوري دادهﻫﺎ از دو ﭘﺮﺳﺸـﻨﺎﻣﻪ اﺳـﺘﺎﻧﺪارد ﺷـﺠﺎﻋﺖ اﺧﻼﻗـﻲ Sekerka و ﻫﻤﻜﺎران )2009( و ﻣﺸﺎرﻛﺖ در ﺗﺼﻤﻴﻢﮔﻴﺮي ﺑﺎﻟﻴﻨﻲ )PDAQ ( اﺳﺘﻔﺎده ﺷـﺪ . داده ﻫـﺎ ﺑـﺎ اﺳـﺘﻔﺎده از آﻣـﺎر ﺗﻮﺻﻴﻔﻲ، ﺗﻲ ﻣﺴﺘﻘﻞ و ﺿﺮﻳﺐ ﻫﻤﺒﺴﺘﮕﻲ ﭘﻴﺮﺳﻮن در ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ 19 ﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ ﺷﺪ.يافته ها: ميانگين نمره كل شجاعت اخلاقي پرستاران مورد مطالعه 48 90 (دامنه قابل كسب 105 /38±11/ ( ﺑﻮد. ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮه ﻛﻞ ﺗﺼﻤﻴﻢﮔﻴﺮي ﺑﺎﻟﻴﻨﻲ در ﻣﻴﺎن ﭘﺮﺳـﺘﺎران ﻣـﻮرد ﻣﻄﺎﻟﻌـﻪ117/24 ±39/42 )داﻣﻨـﻪ ﻗﺎﺑﻞ ﻛﺴﺐ 0-180( ﺑﻪ دﺳﺖ آﻣﺪ. ﺷﺠﺎﻋﺖ اﺧﻼﻗﻲ ﺑﺎ ﻣﺸﺎرﻛﺖ در ﺗﺼـﻤﻴﻢ ﮔﻴـﺮي ﺑـﺎﻟﻴﻨﻲ ﻫﻤﺒﺴـﺘﮕﻲ ﻣﺜﺒـﺖ )0/397=r ( و ﻣﻌﻨﺎدار )0/001˂p ( داﺷﺖ. ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ ﻧﺸﺎن داد ﻛﻪ ﺷﺠﺎﻋﺖ اﺧﻼﻗﻲ از ﺟﺎﻳﮕﺎه وﻳﮋهاي در ﭘﺮﺳﺘﺎري ﺑﺮﺧـﻮردار اﺳـﺖ ﻛﻪ ﻣﻲﺗﻮاﻧﺪ ﭘﺮﺳﺘﺎر را ﺑﻪ ﺳﻤﺖ ﻣﺸﺎرﻛﺖ ﻓﻌﺎل در ﺗﺼﻤﻴﻢﮔﻴﺮي ﺑﺎﻟﻴﻨﻲ ﺳﻮق دﻫﺪ. ﺑـﺮاﻳﻦ اﺳـﺎس ﭘﻴﺸـﻨﻬﺎد ﻣﻲﺷﻮد دورهﻫﺎي ﻛﺎرﺑﺮدي ارﺗﻘﺎي اﺧﻼق ﺣﺮﻓﻪاي ﺟﻬﺖ ارﺗﻘﺎي ﺗﺼﻤﻴﻢﮔﻴﺮي و ﻋﻤﻠﻜﺮد اﺧﻼﻗﻲ در ﺑـﺎﻟﻴﻦ، ﺑﺮاي داﻧﺸﺠﻮﻳﺎن ﭘﺮﺳﺘﺎري و ﭘﺮﺳﺘﺎران ﺑﺮﮔﺰار ﮔﺮدد

Background & Aim: Clinical decision-making is an essential part of the nursing profession. The nursing profession is based on ethical principles. Due to their commitment to patients, morally courageous nurses ignore occupational risks threatening their own lives. The aim of this study was to investigate the relationship between moral courage of nurses and their participation in clinical decision-making. Methods & Materials: This descriptive, cross-sectional study was conducted in 2019. The study population was nurses working in the CCU and ICU of Shahid Rajaie Cardiovascular Medical and Research Center. The sample size was 195 people. The data was collected using the Sekerka’s Moral Courage Scale, and the Participation in Decision Activities Questionnaire (PDAQ). Data was analyzed using descriptive statistics, independent t-test and Pearson correlation coefficient through the SPSS software version 19. Results: The mean scores of moral courage and PDAQ in nurses were 90.38 ± 11.48 and 117.24±39.42, respectively. A positive correlation was found between moral courage and participation in clinical decision-makings (r=0.397, P<0.001). Conclusion: The results showed that moral courage has pride of place in the nursing profession that can encourage nurses to actively participate in clinical decision making. Therefore, professional ethics courses are suggested to be organized to improve decision-making and clinical ethical performance of nursing students and nurses.