A comparative study of selected ethical issues at the patient's end of life : International and Japanese nurses' perceptions

这个国际比较研究检查的观念或经验的护士关于出现在临终病人的护理伦理问题。目的是探索在这些伦理问题中发现的社会和文化因素，并发现不同文化之间的异同。编制了一份英文问卷，其中包括人口统计部分和数据收集部分。在发给150名国际参与者之前，对问卷进行了内容效度测试。调查问卷随后被翻译成日语，并发给200名日本护士。日本护士的回应率为73.5%，国际护士的回应率为66%。对数据进行内容分析。日本护士临终伦理关注的频率依次为：1)不向重病患者披露信息（59），2)在没有考虑患者的情况下做出决定（54），3)护理环境不适合晚期患者（34），4)不适当的医疗命令，如对高龄或晚期患者采用积极的治疗技术（32），5)缺乏死亡选择（11）。国际护士关注的问题是：1)安乐死、预先指示、协助自杀等权利死亡（25），2)何时应该停止治疗（20），3)器官捐赠(9),4)谁来决定？(9)、(5)资源分配(5)、(5)信息披露，如对儿童/跨文化患者的信息披露，以及海量的信息。

This international comparative study examined the perceptions or experiences of nurses regarding the ethical issues that arise in the care of the dying patient. The aim was to explore the social and cultural factors found in these ethical issues and discover similarities and differences across cultures. A questionnaire in English was developed that included a demographic sections and a data gathering section. The questionnaire was tested for content validity prior to sending to 150 international participants. The questionnaire was then translated into Japanese and administrated to a sample of 200 Japanese nurses. The response rate was 73.5% for Japanese nurses and 66% for international nurses. Content analysis of the data was undertaken. The Japanese nurses' end-of-life ethical concerns in rank order of frequency were : 1) Non disclosure of information to seriously ill patients(59), 2)Decisions made without including the patient(54), 3)Care environment which does not fit with terminally ill patients(34), 4)Inappropriate medical orders such as aggressive cure technology to very old or terminally ill patients(32), 5)Lack of choices of where to die(11). The international nurses' concerns were : 1)Right do die such as euthanasia, advance directive, and assisted suicide(25), 2)Time when treatment should be withdrawn(20), 3)Organ donation(9), 4)Who decides? (9), 5)Resource allocation(5), 5)Information disclosure such as to children/trans-cultural patients, and overwhelming amount of information.