护生临床实习伦理困境的质性研究

Ethical dilemmas in clinical practice of nursing students: a qualitative research/

目的深入了解实习护生在临床实习过程中面临伦理困境的主观体验。方法运用现象学研究法,采用目的抽样法对13例实习护生深入访谈以获取资料。结果通过阅读、分析、反思、分类、归纳,提炼出以下3大主题:(1)操作规范性的伦理冲突;(2)自身能力不足的伦理冲突;(3)价值观差异的伦理冲突。对第1个主题的分析获得病人要求与规范操作之间的伦理冲突、临床实际工作与规范行为的伦理冲突2个次要概念;对第3个主题的分析获得保护性医疗与病人知情权的伦理冲突和安乐死的伦理冲突2个次要概念。结论学校及临床带教老师应为实习护生提供多方面的、持续的应对伦理冲突的教育,促进实习护生伦理素质的不断提高。

Objective To understand the experience of nursing students＇ ethical dilemmas during clinical practice. Method Qualitative descriptive research was adopted. The data of 13 nursing students were collected through deep interviews, and the phenomeno-logical analysis method was used. Result Applying readinganalysis-reflection-separa- tion and theme refining methods, four themes were drawn：（1）Ethical conflicts： Operation standard; （2）Ethical conflicts： Lack of ability; （3）Ethical conflicts.. Value differences. The first theme was showed as two aspects： Patient demand and standard operation,Practical clinical work and normative behavior; The third theme was showed as two aspects： Protective medical and patienfs right of informed consent,The ethics of euthanasia conflict. Conclusion To improve nursing students＇ ethical quality, the academic and clinical teachers should provide them continuous, multiple aspects education in responding to ethical conflicts.