NICU护士道德困境、医院伦理氛围与工作满意度的现状及相关性研究

Study on the current situation and correlation of NICU nurses’ moral dilemma,hospital ethical climate and job satisfaction

目的:调查新生儿重症监护病房(NICU)护士道德困境、医院伦理氛围、工作满意度现状,探讨三者之间的关系。方法:便利抽样法选取郑州市4家三级甲等医院NICU护士248例为研究对象,采用一般资料调查表、护士道德困境量表、医院伦理氛围量表、工作满意度量表进行问卷调查。结果:NICU护士道德困境得分为(92.40±50.65)分,医院伦理氛围得分为(100.31±18.28)分,工作满意度得分为(49.60±14.36)分;一般人口学特征中是否为独生子女或不同学历、职称、人事关系、工作压力、与病人家属沟通能力及对护理专业有不同看法的NICU护士其工作满意度得分差异有统计学意义(P<0.05);道德困境与工作满意度呈负相关,医院伦理氛围与工作满意度呈正相关,差异均有统计学意义(P<0.01);医院伦理氛围总分、道德困境总分是NICU护士工作满意度的主要预测变量(R2=0.534)。结论:NICU护士的道德困境处于较高水平、医院伦理氛围处于中等水平、工作满意度处于较低水平,减少NICU护士的道德困境,改善医院伦理氛围可有效提高NICU护士的工作满意度。

Objective:To investigate the current situation of nurses’ moral dilemma,hospital ethical climate and job satisfaction in neonatal intensive care unit(NICU).Methods:From March to April 2020,a sample of 248 NICU nurses from 4 third-class hospitals in Zhengzhou were selected as the research object by the convenience sampling method,and the general data questionnaire,nurse moral distress scale,hospital ethical climate scale,and job satisfaction scale were used for questionnaire survey.Results:The NICU nurse’s moral distress score was(92.40 ±50.65),the hospital ethical climate score was(100.31 ± 18.28),and the job satisfaction score was(49.60 ± 14.36).There were statistically significant differences in job satisfaction scores among NICU nurses with general demographic characteristics,such as whether they were only children,with different educational background,professional title,personnel relationship,work pressure,communication ability with patients’ family members,and different views on nursing specialty(P<0.05).Moral distress is negatively correlated with job satisfaction,hospitals ethical climate is positively correlated with job satisfaction,and the differences are statistically significant(P<0.01).The main predictors of NICU nurses’ job satisfaction are the the total score of hospital ethical climate and moral distress(R2=0.534).Conclusion:The moral distress of NICU nurses at a high level,the hospital ethical climate is at a medium level,and the job satisfaction is at a low level,to reduce the moral distress of NICU nurses and improve the hospital ethical climate can effectively improve the job satisfaction of NICU nurses.