加護病房護理人員倫理困境及其相關因素之探討

The Ethic Dilemma and its Related Factors among Nursing Staff at Intensive Care Unit

本研究目的是探討加護病房護理人員與倫理困境及其相關因素。研究設計為敘述性探索調查，採立意取樣，以南部某醫學中心加護病房年資滿3個月以上之護理人員為研究對象，收案期間自2003年8月1日至8月15日，研究工具使用「倫理困境量表」，問卷內容包含32種情境，將倫理困境引發痛苦程度及發生頻率，採Likert-type7點計分法，分數越高表示痛苦程度及發生頻率越高，共發問卷286份，回收有效問卷243份，有效回收率達84.96％。研究結果如下：引發加護病房護理人員，痛苦程度、發生頻率最高之情境為「在一個護理人力不足，照顧品質不良的環境工作」；加護病房護理人員產生痛苦程度屬中、重度且經常發生；單位科別以心臟胸腔外科與小兒科加護病房護理人員，面對倫理困境痛苦程度最高；教育程度顯示高職畢業者比五專畢業者痛苦程度高；法律課程上課時數、與倫理困境發生頻率與痛苦程度呈現正相關。本研究結果期能幫助加護病房護理人員，瞭解倫理困境之情境，提供護理教育相關倫理、法律等課程設計、臨床實務及行政管理之參考。

The aim of this research was to study the ethic dilemma and its related factors for nursing staff at intensive care unit. The descriptive study purposively sampled 243 nursing staff working in the intensive care unit in a medical center in southern Taiwan. Data were collected by “Ethic Dilemma Evaluation Scale” from August 1 to 15 in 2003. The study results showed that “a working environment with shortage of nursing manpower and low nursing quality” was the most frequent source of suffering among nursing staff in intensive care units. The suffering ranged between moderate and severe level. The departments that caused the nursing staff to suffer most from ethic dilemmas were the cardiology, thoracic surgeries, and pediatrics. In addition, the staff with five-year college nursing education usually suffered less than those with three-year senior high school vocational education. Legal training experience was positively associated with the occurrence of the ethic dilemmas. The study results contributed in understanding the ethic dilemma faced by nursing staff working in intensive care units and emphasized the needs to offer nursing staff with relevant ethical and legal training.