三级医院肿瘤科护士的医院伦理气氛感知现状及其影响因素研究

  目的  探讨三级医院肿瘤科护士的医院伦理气氛感知现状，并分析其影响因素，以期能为临床伦理问题的解决及肿瘤科护士的管理工作提供一定的参考和依据。  方法  使用便利抽样，于2019年6—12月调查浙江省5所三级医院291例肿瘤科护士。使用一般资料调查表、医院伦理气氛量表和中国大五人格量表进行问卷调查。采用单因素分析和多元线性回归方法分析肿瘤科护士医院伦理氛围感知的影响因素。  结果  肿瘤科护士的医院伦理气氛感知总分为(3.43±0.86)分，各维度从高到低依次为法律规范型[(3.92±0.77)分]、规则型[(3.51±0.73)分]、关怀型[(3.42±0.72)分]、功利型[(3.27±0.72)分]和独立判断型[(2.81±0.63)分]。多元线性回归结果显示，上班后医学伦理培训、责任心、宜人性、工作年限和合同制护士是肿瘤科护士医院伦理气氛感知的影响因素，且可解释总变异的51.4%(F=27.823，P < 0.001)。  结论  护理管理者应注重肿瘤科护士的伦理培训，尤其是工作年限较短的护士和合同制护士的伦理意识培养和伦理问题应对技巧的培训，并根据护士的人格特质，合理安排工作岗位，提高护士对医院伦理气氛的感知程度。 

Study on the current status of perception and influencing factors of hospital ethical climate in oncological nurses of tertiary hospital

  Objective  To explore the current status of hospital ethical climate perception in oncological nurses of tertiary hospitals, analyze its influencing factors, and provide some reference and basis for the solution of clinical ethical problems and the management of oncological nurses.  Methods  There were 291 oncological nurses recruited from 5 tertiary hospitals in Zhejiang Province from June to December 2019 by convenience sampling. The basic data questionnaire, Ethical Climate Questionnaire and Big-Five Factor Inventory were used in the investigation. Single factor analysis and multiple linear regression were used to analyze the influencing factors of hospital ethical climate perception in clinical oncology nurses.  Results  The score of hospital ethical climate in oncological nurses was (3.43±0.86) points. The subscale scores from high to low were legal normative style of (3.92±0.77) points, regular style of (3.51±0.73) points, caring style of (3.42±0.72) points, utilitarian style of (3.27±0.72) points and independent judgment style of (2.81±0.63) points. Multiple linear regression analysis showed that ethical training in the work, responsibility personality, pleasant personality, working years and contract nurses were the influencing factors of the perception of ethical climate, which could explain 51.4% of the total variation (F=27.823, P < 0.001).  Conclusion  Nursing managers should pay attention to the ethical training of oncological nurses, especially ethical consciousness and ethical problem-solving skill in nurses with short working years and contract nurses, arrange their jobs reasonably according to their personalities, and improve their perception of hospital ethical climate.