Investigation On Nursing Ethical Decision-Making Of Clinical Nurses

[Objective] The study was to investigate the level of clinical nurses’competence of ethical decision-making ability and relevant factors of this ability and analyse current problems. Besides, by analysing nurses’ethical decision making progress, some training programs are expected to proposed.[Method] Take samples of quota sampling method to choose 450 clinical nurses from four grade A class three hospitals. The Chinese Version Nursing Dilemma Test Questionnair was used to investigate nurses’ethical decision-making ability, and this questionnair uses Principled Thinking as its index to explore nurses’ethical decision-making ability and Practical Thinking as disturbance variable. The Statistical Methods of one-way ANOVA and multiple linear step wise regression were used for analysing the collected data. Besides, semi-structured interview was used to interview some nurses who gained higher principled thinking scores. By analysing these nurses’ ethical principles and attitudes, some suggestions were made to improve nurses’ ethical decision-making ability. These suggestions are based on "MORAL model" which is invented by professor Crisham, the inventor of NDT.[Result]1、The average scores of Principled Thinking and Practical Thinking of clinical nurses were (47.71±7.13)and (20.49±4.08); In six dilemma stories, the percentage of nurses who selected Practical Thinking as the most important were 3.89%,47.67%, 13.47%,17.62%,1.55% and 2.85% respectively. A negative correlationship has been found between principled thinking and Practical Thinking, r=-0.402, (P<0.05).2、There were significant difference in ethical decision-making ability among nurses who were in the different nursing professional attitudes, ethical knowledge, ethical decision-making knowledge, ethical training, decision-making training (P<0.05). Besides, there were significant difference in ethical decision-making ability among three ethical dilemma stories. Multiple linear regression analysis showed that ethical training and nursing professional attitudes make the greatest contribution to the scores of ethical decision-making.3、Critical nurses’basic principle of ethical decision-making:patients’life is preferred, laws and principles above individual requirements, decision orientation comply with families, humanities concern.[Conclusion]1、The ability of ethical decision-making of clinical nurses are in middle level. Higher scores of principled thinking stands for stronger ability of ethical decision-making. There was a negative correlation between nurses’Principled Thinking and Practical Thinking.2、In the influence factors:nurses who hold positive attitudes towards nursing science and have gained courses or training about ethical knowledge and ethical decision-making knowledge got higher scores than counterparts. Different action awareness can also affect nurses’ethical decision-making ability.3、Both Chinese and American nurses are confronted with similar nursing dilemmas which are related to institution restrain, human rights, values conflict, etc.