การสำรวจระดับประเทศด้านระบบและกลไกจริยธรรมขององค์กรพยาบาลตามการรับรู้ของหัวหน้าพยาบาล

บทคัดย่อ

    Objective: To explore components of the ethics system and mechanisms in nursing organisations in Thailand, with a focus on activities promoting nurses’ ethical behaviours and enhancing ethical decision-making skills, and to compare supporting factors, inhibiting factors, and need of support for the development of nursing ethics system and mechanisms in nursing organisations.
    Design: National survey
    Methodology: The sample comprised 480 nursing directors/representatives from university hospitals, medical centers, general hospitals, community hospitals, and private hospitals in Thailand. Data were collected by the Ethics System and Mechanisms Survey which was developed by the researchers. Descriptive statistics and independent t-test were used for data analysis.
    Results: Less than half of the nursing organisations had nursing ethics committee in place, whilst slightly more than half of the organisations (52.5%), and only a few (8.1 %) had their ethics-related duties conducted by other committees in the hospitals and by individually assigned nurses, respectively. Nearly all of the nursing organisations (90.8%) had ethics policies, 73.3% had annual ethics operation plans, and 67.1% had strategic ethics plans. Almost all of nursing organisations with ethics committee in place (92.4 %) exercised promotion of ethical behaviours and conducted ethical decision-making skills development for their nurses, through implementation of ethical practice guidelines. Administrators of the nursing organisations equipped with nursing ethics committee and of those equipped with other committees had no differences in perceived supporting factors regarding policy, organisation, and personnel, and the need to be supported by the Nursing and Midwifery Council. Administrators of the nursing organisations with nursing ethics committees in place displayed significantly less perception of inhibiting factors regarding policy, organisation, and personnel, as well as significantly less need for the hospitals’ support than those with other committees. Nonetheless, both these groups of organisations were considerably highly in need of support from hospitals and Nursing and Midwifery Council.

     Recommendations: A reflected in the study, the development of nursing ethics system and mechanisms in Thailand is at an early stage. Support from their own hospitals and Thailand Nursing and Midwifery Council would be vital to achieving the goals of advancing nurses’ ethical behaviours and ethical decision-making skills.