Öz
Amaç: Ahlaki duyarlılığın gerçek hayattaki ahlaki karar verme sürecinde ilk adımı oluşturduğu düşünülmektedir. Etik anlamda yüklü bir uygulama olarak görülen sağlık alanında, hizmet sunucuların ahlaki duyarlılığının izlenmesi gerek hizmet kalitesi gerekse etik uygulama açısından önem arz etmektedir. Bu çalışmanın amacı intörn doktorlarda ahlaki duyarlılığın ve ahlaki duyarlılık ile ilişkili olabilecek faktörlerin saptanmasıdır.
Gereç ve Yöntem: Örneklem yöntemi kullanılmamış, araştırmaya katılmayı kabul eden 116 intörn doktor araştırmaya alınmıştır. Verilerin toplanması amacıyla, intörnlerin sosyodemografik özelliklerini içeren 12 soru ve 30 soru içeren Ahlaki Duyarlılık Anketi’nden oluşan veri toplama formu uygulanmıştır. Normal dağılım gösteren ölçek sonuçları için istatistiksel analiz Student t test testi ve ANOVA Testi ile yapıldı.
Bulgular: Çalışmaya katılan gönüllülerin Ahlaki Duyarlılık Anketi toplam puan ortalaması 89,14 olarak tespit edildi. Toplam puan, yarar sağlama ve oryantasyon alt ölçek puanlarına göre ahlaki duyarlılık düzeyi kadınlarda daha yüksek bulundu (p<0,05). Toplam puan, otonomi, bütüncül yaklaşım, uygulama ve oryantasyon alt ölçek puanlarına göre gelir algısı yüksek kişilerin ahlaki duyarlılık düzeyleri daha yüksek bulundu (p<0,05). Araştırmanın bağımsız değişkenleri olan “fakülteye girmeden önce yaşanan yer”, “mezun olunan okul türü”, “anne ve baba eğitim durumu”, “hekim olma hayali”, “tıp fakültesini seçme nedeni”, “ailede sağlık çalışanı olma durumu”, “ailede sakatlık olma durumu”, “afet yaşama” ve “afete şahit olma” ile Ahlaki Duyarlılık Anketi ortalama puanı arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır (p>0.05).
Sonuç: Bulgular, Ahlaki Duyarlılık Anketi ortalama puanları dikkate alındığında intörn doktorların ahlaki duyarlılıklarının üst orta düzeyde olduğunu göstermektedir. İntörnlerin ahlaki duyarlılığını kadın cinsiyet ve yüksek gelir düzeyi algısı olumlu yönde etkilemektedir. Bu etkinin sebeplerini aydınlatmak için izlem çalışmaları ve nitel araştırmalar planlanabilir.
Anahtar Kelimeler
Kaynakça
- 1. Lützén K, Dahlqvist V, Eriksson S, Norberg A. Developing the concept of moral sensitivity in health care practice. Nurs Ethics. 2006;13(2):187-96
- 2. Tymieniecka AT. The moral sense in the communal significance of life: Investigations in phenomenological praxeology: psychiatric therapeutics, medical ethics und social praxis within the life and communal world. Dordrecht: Reidel; 1986. 4–44 p.
- 3. Rest JR, Narvaez D. Moral Development in the Professions Psychology and Applied Ethics. 1st Editio. New York: Psychology Press; 1994.
- 4. Rest JR, Narvaez D, Thoma SJ, Bebeau MJ. A Neo-Kohlbergian approach to morality research. J Moral Educ. 2000;29(4):381-95
- 5. Kohlberg L, Hersh RH. Moral Development: A Review of the Theory. Theory Into Practice. 1977;16(2):53-9
- 6. Lützén K. Moral Sensing and Ideological Conflict: Aspects of the Therapeutic Relationship in Psychiatric Nursing. Scand J Caring Sci. 1990;4(2):69-76
- 7. Gastmans C. A fundamental ethical approach to nursing: Some proposals for ethics education. Nurs Ethics. 2002;9(5):494-507
- 8. Söderberg A, Gilje F, Norberg A. Transforming desolation into consolation: The meaning of being in situations of ethical difficulty in intensive care. Nurs Ethics. 1999;6(5):357-73
- 9. Sørlie V, Jansson L, Norberg A. The meaning of being in ethically difficult care situations in paediatric care as narrated by female Registered Nurses. Scand J Caring Sci. 2003;17(3):285-92
- 10. Sørlie V, Kihlgren AL, Kihlgren M. Meeting ethical challenges in acute care work as narrated by enrolled nurses. Nursing Ethics. 2004;11(2):179-88
- 11. Cronqvist A, Theorell T, Burns T, Lützén K. Caring about - Caring for: Moral obligations and work responsibilities in intensive care nursing. Nurs Ethics. 2004;11(1):63-76
- 12. Lowe M, Kerridge I, Bore M, Munro D, Powis D. It is possible to assess the “ethics” of medical school applicants? J Med Ethics. 2001;27(6):404-8
- 13. Lützén K, Evertzon M, Nordin C. Moral sensitivity in psychiatric practice. Nurs Ethics. 1997;4(6):472-81
- 14. Çetin M, Cimen M. Assessing a group of physicians’ ethical sensitivity in Turkey. Iran J Public Health. 2011;40(3):89–97.
- 15. Aydın Y, Dikmen Y, Kalkan SC. Ebelik Öğrencilerinin Hasta Bakim Uygulamalarinda Etik Duyarliliklarinin İncelenmesi. J Contemp Med. 2017;7(2):168–168.
- 16. Yılmaz D, Düzgün F, Uzelli Yılmaz D, Akın Korhan E, Dikmen Y. Examination of Ethical Sensitivity and Related Factors of Nurses in Internal Clinics: An Example of University Hospital. DEUHFED. 2018;11(2):157–63.
- 17. Mezuniyet Öncesi Tıp Eğitimi Ulusal Çekirdek Eğitim Programı‐2014.
- 18. Lützén K, Johansson A, Nordström G. Moral sensitivity: Some differences between nurses and physicians. Nurs Ethics. 2000;7(6):520-30
- 19. Tosun H. Ahlaki Duyarlılık Anketi (ADA): Geçerlik ve güvenirlik çalışması. J Contemp Med. 2018;8(4):316-21
- 20. Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses’ moral sensitivity. Nurs Ethics. 2017;24(6):732-43
- 21. Park M, Kjervik D, Crandell J, Oermann MH. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nurs Ethics. 2012;19(4):568-80
- 22. Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics. 2017;24(4):474-82
- 23. Yeom HA, Ahn SH, Kim SJ. Effects of ethics education on moral sensitivity of nursing students. Nurs Ethics. 2017; 24(6):644-52
- 24. Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nurs Ethics. 2015; 22(6):661-75
- 25. Üzar Özçetin YS, Hiçdurmaz D. The Related Factors of Moral Sensitivity in Nursing Students. DEUHFED. 2018;11(3):209–17.
- 26. Tazegün A, Çelebioğlu A. Ethical Sensitivity Levels of Pediatric Nurses and The Factors Affecting This Sensitivity. J Dr Behcet Uz Child s Hosp. 2016;6(2):97-102
- 27. Tuvesson H, Lützén K. Demographic factors associated with moral sensitivity among nursing students. Nurs Ethics. 2017;24(7):847-55
- 28. Kohlberg L, Kramer R. Continuities and discontinuities in childhood and adult moral development. Hum Dev. 1969;12(2):93-120
- 29. Gilligan C. In a Different Voice: Psychological Theory and Women’s Development. Cambridge, MA: Harvard University Press; 1982.
- 30. You D, Maeda Y, Bebeau MJ. Gender differences in moral sensitivity: A meta-analysis. Ethics Behav. 2011;21(4):263–82
- 31. Lützén K, Blom T, Ewalds-Kvist B, Winch S. Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nurs Ethics. 2010;17(2):213-24
- 32. Başak T, Uzun Ş, Arslan F. Investigation of the moral sensibility of intensive care nurses. Gulhane Med J. 2010; 52(2):76-81
- 33. Oguzhan G, Aydın GZ, Bölükbaşı FB. Determination of nursing moral sensitivity: A state hospital example. Sağlık Akad Derg. 2019;6(2):91–9.
Öz
Background: Moral sensitivity is thought to be the first step in real-life moral decision-making. In the field of health, which is seen as an ethically loaded practice, monitoring the ethical sensitivity of service providers is essential both in terms of service quality and ethical practice. This study aimed to determine the moral sensitivity and the factors that may be related to the moral sensitivity of interns.
Methods: A total of 116 intern doctors who accepted to participate were included in the study without using a sampling method. In order to collect the data, a data collection form consisting of sociodemographic characteristics of the interns and Moral Sensitivity Questionaire (MSQ) was used. As the scores obtained from the scale showed normal distribution, Student's t-test was used for the comparison of two groups, and the ANOVA test was used for the comparison of three groups.
Results: The mean MSQ total score of the volunteers participating in the study was 89.14. The moral sensitivity level was higher in women in total score, benevolence, and orientation subscale scores (p <0.05). According to the total score, autonomy, meaning, rules, and orientation subscale scores, the moral sensitivity levels of individuals with high-income perception were higher (p <0.05).
Conclusion: The findings show that the interns’ moral sensitivity level is high-intermediate when the average Moral Sensitivity Questionaire scores are taken into consideration. The female gender and the perception of the high-income level positively affects the moral sensitivity of interns. Follow-up studies and qualitative research can be planned to clarify the reasons for this effect.
Anahtar Kelimeler
Kaynakça
- 1. Lützén K, Dahlqvist V, Eriksson S, Norberg A. Developing the concept of moral sensitivity in health care practice. Nurs Ethics. 2006;13(2):187-96
- 2. Tymieniecka AT. The moral sense in the communal significance of life: Investigations in phenomenological praxeology: psychiatric therapeutics, medical ethics und social praxis within the life and communal world. Dordrecht: Reidel; 1986. 4–44 p.
- 3. Rest JR, Narvaez D. Moral Development in the Professions Psychology and Applied Ethics. 1st Editio. New York: Psychology Press; 1994.
- 4. Rest JR, Narvaez D, Thoma SJ, Bebeau MJ. A Neo-Kohlbergian approach to morality research. J Moral Educ. 2000;29(4):381-95
- 5. Kohlberg L, Hersh RH. Moral Development: A Review of the Theory. Theory Into Practice. 1977;16(2):53-9
- 6. Lützén K. Moral Sensing and Ideological Conflict: Aspects of the Therapeutic Relationship in Psychiatric Nursing. Scand J Caring Sci. 1990;4(2):69-76
- 7. Gastmans C. A fundamental ethical approach to nursing: Some proposals for ethics education. Nurs Ethics. 2002;9(5):494-507
- 8. Söderberg A, Gilje F, Norberg A. Transforming desolation into consolation: The meaning of being in situations of ethical difficulty in intensive care. Nurs Ethics. 1999;6(5):357-73
- 9. Sørlie V, Jansson L, Norberg A. The meaning of being in ethically difficult care situations in paediatric care as narrated by female Registered Nurses. Scand J Caring Sci. 2003;17(3):285-92
- 10. Sørlie V, Kihlgren AL, Kihlgren M. Meeting ethical challenges in acute care work as narrated by enrolled nurses. Nursing Ethics. 2004;11(2):179-88
- 11. Cronqvist A, Theorell T, Burns T, Lützén K. Caring about - Caring for: Moral obligations and work responsibilities in intensive care nursing. Nurs Ethics. 2004;11(1):63-76
- 12. Lowe M, Kerridge I, Bore M, Munro D, Powis D. It is possible to assess the “ethics” of medical school applicants? J Med Ethics. 2001;27(6):404-8
- 13. Lützén K, Evertzon M, Nordin C. Moral sensitivity in psychiatric practice. Nurs Ethics. 1997;4(6):472-81
- 14. Çetin M, Cimen M. Assessing a group of physicians’ ethical sensitivity in Turkey. Iran J Public Health. 2011;40(3):89–97.
- 15. Aydın Y, Dikmen Y, Kalkan SC. Ebelik Öğrencilerinin Hasta Bakim Uygulamalarinda Etik Duyarliliklarinin İncelenmesi. J Contemp Med. 2017;7(2):168–168.
- 16. Yılmaz D, Düzgün F, Uzelli Yılmaz D, Akın Korhan E, Dikmen Y. Examination of Ethical Sensitivity and Related Factors of Nurses in Internal Clinics: An Example of University Hospital. DEUHFED. 2018;11(2):157–63.
- 17. Mezuniyet Öncesi Tıp Eğitimi Ulusal Çekirdek Eğitim Programı‐2014.
- 18. Lützén K, Johansson A, Nordström G. Moral sensitivity: Some differences between nurses and physicians. Nurs Ethics. 2000;7(6):520-30
- 19. Tosun H. Ahlaki Duyarlılık Anketi (ADA): Geçerlik ve güvenirlik çalışması. J Contemp Med. 2018;8(4):316-21
- 20. Lee HL, Huang SH, Huang CM. Evaluating the effect of three teaching strategies on student nurses’ moral sensitivity. Nurs Ethics. 2017;24(6):732-43
- 21. Park M, Kjervik D, Crandell J, Oermann MH. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nurs Ethics. 2012;19(4):568-80
- 22. Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics. 2017;24(4):474-82
- 23. Yeom HA, Ahn SH, Kim SJ. Effects of ethics education on moral sensitivity of nursing students. Nurs Ethics. 2017; 24(6):644-52
- 24. Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nurs Ethics. 2015; 22(6):661-75
- 25. Üzar Özçetin YS, Hiçdurmaz D. The Related Factors of Moral Sensitivity in Nursing Students. DEUHFED. 2018;11(3):209–17.
- 26. Tazegün A, Çelebioğlu A. Ethical Sensitivity Levels of Pediatric Nurses and The Factors Affecting This Sensitivity. J Dr Behcet Uz Child s Hosp. 2016;6(2):97-102
- 27. Tuvesson H, Lützén K. Demographic factors associated with moral sensitivity among nursing students. Nurs Ethics. 2017;24(7):847-55
- 28. Kohlberg L, Kramer R. Continuities and discontinuities in childhood and adult moral development. Hum Dev. 1969;12(2):93-120
- 29. Gilligan C. In a Different Voice: Psychological Theory and Women’s Development. Cambridge, MA: Harvard University Press; 1982.
- 30. You D, Maeda Y, Bebeau MJ. Gender differences in moral sensitivity: A meta-analysis. Ethics Behav. 2011;21(4):263–82
- 31. Lützén K, Blom T, Ewalds-Kvist B, Winch S. Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nurs Ethics. 2010;17(2):213-24
- 32. Başak T, Uzun Ş, Arslan F. Investigation of the moral sensibility of intensive care nurses. Gulhane Med J. 2010; 52(2):76-81
- 33. Oguzhan G, Aydın GZ, Bölükbaşı FB. Determination of nursing moral sensitivity: A state hospital example. Sağlık Akad Derg. 2019;6(2):91–9.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2020 |
| Gönderilme Tarihi | 19 Ağustos 2019 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 19 Sayı: 57 |