บรรยากาศจริยธรรมตามการรับรู้ของพยาบาลโรงพยาบาลมหาราชนครเชียงใหม่

Abstract

The ethical climate is an organizational situation related to patient care which is related to ethics. The purposes of this study were to study the ethical climate as perceived by nurses and to make recommendations for enhancing the ethical climate for nurses at Maharaj Nakorn Chiang Mai Hospital. The study samples consisted of 319 staff nurses. The instrument was a questionnaire which was modified from Sukanya Chomsrisawad's questionnaire (2010) which, in turn, had been translated to Thai by the back-translation method, from Olson's (1995) Hospital Ethical Climate Survey (HECS). The content validity index and the reliability of the questionnaire were 0.88 and 0.95, respectively. The statistics used for data analysis were mean, standard deviation, and percentage. The results of the study revealed that:1. The overall score for ethical climate as perceived by nurses was at a high level (X = 4.15, SD = 0.46). As for each dimension, it was found that the mean score of the dimensions of peers, patients, managers, hospital, and physicians were at high levels (X = 4.35 + 0.52, 4.15 +0.46, 4.19 +0.50, 4.07 + 0.55 and 3.91 + 0.67, respectively). 2. The recommendations for enhancing the ethical climate regarding nurses' opinions for the 5 dimensions were as follows: 2.1 Peer dimension: Peers should 1) provide care using patient-centered care; and 2) have good interactions with each other, respect opinions, support and respect each other and communicate clearly with courtesy. 2.2 Patient dimension: Nurses should 1) confidently provide information, care and accurate nursing treatment; and 2) have good relationships with patients, provide time and opportunities for them to explain their needs, and ask about doubts regarding treatment and nursing care.2.3 Manager dimension: Managers should 1) adhere to the principles of good govemance while governing subordinates; 2) do performance appraisal with justice, give true feedback on the results of performance appraisal and show an appreciation or give rewards for nurses who have good performance; 3) have channels for listening to opinions and problems, as well as help nurses all the time; 4) provide clear solutions that do not unnecessarily increase workload; and 5) suggest ethical practice guidelines according to the hospital's policy and operation process to nurses. 2.4 Hospital dimension: The hospital should 1) specify the hospital's ethical policies which have clear standards and are consistent with work; and 2) arrange activities to promote good relationships between nurses and physicians in order to create unity and familiarity with each other. 2.5 Physician dimension: Physicians should provide information about treatment plans to the nursing team for cooperation in patient care. Nursing executives can use the results of this study as basic data for enhancing the ethical climate of nurses.