Ethical Issues With Nurse Practitioner /Physician Assist

执业护士/医师协助的道德问题

• 批准号: 7005893
• 负责人: Christine P Grady
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7005893
• 关键词: allied health personnel; behavioral /social science research tag; clinical research; conflict; ethics; health care professional practice; health care quality; health economics; human subject; interview; managed care; nurse practitioners; patient care management; perception; population survey; questionnaires; statistics /biometry

This protocol is a descriptive, cross-sectional, nationally representative study to investigate nonphysician practitioners' (NPs and PAs) perceptions of ethical issues associated with primary care practice. NPs in primary care have expressed ethical conflicts in clinical practice centering on issues of justice, rights, responsibility, nonmaleficence, and beneficence. Other ethical conflicts identified for NPs include arrangements with managed care organizations, professional accountability, pressure to see an increasing volume of patients, and bonus and billing practices to lower costs. With the projected trends for NPs and PAs substantially increasing, knowledge of factors that influence ethical practice will be relevant in shaping the future role of the NP and PA for the provision of quality cost-effective health care. Additionally, to evaluate the effectiveness of monetary incentives to increase response rates to a mailed self-administered questionnaire, subjects were randomly assigned to one of three incentive groups. Data will be analyzed using descriptive statistics and measures of central tendency (frequencies, mean, standard deviation) as well as bivariate correlations. Multivariate regression will be utilized to determine factors that predict ethical conflict in practice and perceived delivery of quality care. Surveys were mailed, beginning in November 2002 to 3900 Nonphysician clinicians in the U.S. Data on ethical conflicts and impact on practice are currently being analyzed. Manuscripts are under review.

本方案是一项描述性、横断面、全国代表性研究，旨在调查非医师从业者（NP和PA）对初级保健实践相关伦理问题的看法。初级保健中的NPs表达了临床实践中围绕正义、权利、责任、无害和有益等问题的伦理冲突。确定的NP的其他伦理冲突包括与管理式护理组织的安排、专业责任、看到患者数量增加的压力以及降低成本的奖金和计费做法。随着NP和PA的预测趋势大幅增加，影响伦理实践的因素的知识将在塑造NP和PA的未来作用，提供高质量的成本效益的医疗保健相关。此外，为了评估金钱激励措施对提高邮寄自填问卷的应答率的有效性，受试者被随机分配到三个激励组中的一个。将使用描述性统计量和集中趋势（频率、平均值、标准差）以及双变量相关性指标分析数据。多元回归将被用来确定预测实践中的道德冲突和感知提供优质护理的因素。从2002年11月开始，向美国3900名非医生临床医生邮寄了调查。目前正在分析有关伦理冲突和对实践影响的数据。目前正在审查强制令。