The relationship between moral distress and perception of futile care in the critical care unit.
The relationship between moral distress and perception of futile care in the critical care unit.
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DOI：
10.1016/j.iccn.2007.03.011
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发表时间：
2007-10-01
影响因子：
5.3
通讯作者：
Larson, Joel S
中科院分区：
文献类型：
--
作者：
Mobley, Melinda J;Rady, Mohamed Y;Larson, Joel S
目得：研究道德困扰（MD）和无效护理在重症监护室（CCU）的关系。对象和方法：一个横断面调查，包括38个临床情况与MD相关的6类：医生的做法，护理实践，制度因素，无效护理，欺骗和安乐死被分配到100名护士在一个单一的CCU。采用Likert量表对MD的强度和频率进行评分：0-最低，6-最高。中位年龄为33岁，80%为女性。MD的中位强度在六个类别中均较高，与年龄、在CCU的时间或护理实践无关。无效护理的MD发生率最高，且与年龄>33岁（p=0.03）、在CCU时间>4年（p=0.04）和护理工作年限>7年（p=0.01）显著相关。未来的干预措施，需要尽量减少暴露于徒劳的护理情况，并制定机制，以减轻疾病的影响，在CCU。
PURPOSE: Study the relationship between moral distress (MD) and futile care in the critical care unit (CCU).SUBJECTS AND METHODS: A cross-sectional survey consisting of 38 clinical situations associated with MD related to 6 categories: physician practice, nursing practice, institutional factors, futile care, deception and euthanasia was distributed to 100 nurses at a single CCU. The intensity and frequency of MD were scored with Likert scale: 0-lowest and 6-highest.RESULTS: The survey was completed by 44 (44%) nurses. Median age was 33 years, 80% females. Median intensity of MD was high for the six categories and had no relationship with age, time in CCU or nursing practice. The encounter frequency of MD for futile care was the highest and was significantly related to age >33 years (p=0.03), time in CCU >4 years (p=0.04) and nursing practice >7 years (p=0.01).CONCLUSION: MD associated with clinical situations representing futile care increased with time in CCU. Future interventions are required to minimize the exposure to futile care situations and develop mechanisms to mitigate the effects of MD in the CCU.