基于《大医精诚》医学伦理思想的护生专业价值观研究

发布时间：2018-03-26 06:42

本文选题：大医精诚　切入点：专业价值观　出处：《北京中医药大学》2012年硕士论文

【摘要】：[目的] 本研究以《大医精诚》中蕴含的医学伦理思想为内涵来充实护理伦理学基本框架,并以此为基础构建符合我国文化背景和基本国情的护理专业价值观量表结构,进而编制符合中国文化特点的护生专业价值观量表,以便为我国护理教育者今后深入开展提升护生专业价值观的实证性研究提供适宜的评价工具。另一方面以本研究研制的护生专业价值观量表为测量工具进行调查,了解在校本科护生的专业价值观现状,并探讨可能存在的影响因素。 [方法] 本研究通过回顾国内外护理专业价值观的相关文献,探讨《大医精诚》中的医学伦理思想和护理伦理学相关理论,得出本研究的理论框架。再以《大医精诚》中的医学伦理思想内涵为依据编制访谈提纲对在校护生和在职护士进行深入访谈,从而获得编制量表的条目进而形成护生专业价值观初始问卷。最后采用探索性因子分析方法对数据进行分析,获得护生专业价值观最终量表,并对其进行信效度检验。以本研究研制的护生专业价值观量表为工具对北京、天津等地三所高等医学院校的894名护理本科生进行调查。采用SPSS统计软件对得到数据进行统计,进一步验证新编量表的结构拟合程度、并对护生专业价值观的基本情况和可能存在的影响因素进行分析。 [结果] 护生专业价值观初始问卷：在文献研究的基础上,探讨《大医精诚》中的医学伦理思想和护理伦理学相关理论,初步拟定护理专业价值观量表的内部结构,通过深入访谈的方法编制量表条目,最终形成由4个维度、56个条目组成的初始问卷。护生专业价值观正式量表：使用初始问卷对360名护生进行预测,通过统计分析,最终形成4个维度、27个条目的护生专业价值观正式量表。量表包括专业自我成长、利他主义、职业主动性和专业使命感四个维度,四个维度的累计贡献率为54.270%。护生专业价值观量表和各维度的Cronbach's a系数为0.745-0.939,重测信度系数为0.862(P0.01),证明此量表信效度良好。量表采用5级评分,分值越高表明被试对象的专业价值观水平越高。护生专业价值观总体现状：结果显示被调查的本科护生专业价值观认同度较高。量表各个条目的平均分值为3.09±0.87—4.03±0.79,护生专业价值观各个维度的均值为3.56±0.64—3.97±0.59,四个维度中“利他主义”的均值最高,“专业使命感”的均值最低。护生专业价值观的影响因素：以护生专业价值观量表调查得分为因变量,将调查结果中护生的一般资料(年级、家庭背景、政治面貌、是否独生子女)作为预测变量,采用逐步多元回归分析法进行数据分析,结果仅有年级和家庭背景进入回归方程,但是由于决定系数R2仅为2.3%和3.9%,由于对因变量解释率较低,所以不能确定两者就是护生专业价值观的影响因素。 [结论] 本研究编制的护生专业价值观量表具有良好的信效度,其内容符合我国文化背景和基本国情,可以用于测量我国护理专业本科学生的专业价值观。调查结果显示被调查的三所高校本科护生的专业价值观水平较高。《大医精诚》中所隐含的医学伦理思想与我国护理专业价值观内涵联系密切,可以在今后的护理教育中有意识地将其渗透到护生的人文教育中来,不断培养适合我国文化背景和基本国情且具有中国特色的优秀护理人才。
[Abstract]:[Objective]
In this study, "medical ethics embodied in the" big medicine sincere connotation to enrich the basic framework of nursing ethics, and on the basis of the construction of nursing in accordance with China's cultural background and the basic situation of the value structure of the scale, and then compiled in accordance with the characteristics of Chinese culture of nursing students professional values scale for nursing education in China in the future to carry out the study on improving the professional values of nursing students and provide appropriate evaluation tools. On the other hand, developed in the research of nursing students professional values scale as the measurement tool for investigation, the notion of the professional value of undergraduate nursing students at school to understand, and to explore the influencing factors may exist.
[method]
By reviewing the related literature at home and abroad of nursing professional values in this study, to explore the theory of medical ethics and "nursing ethics related big medicine sincere > in the theoretical framework of this research. Then in" big medicine sincere > in the connotation of medical ethics as the basis for preparing interviews conducted in-depth interviews of nursing students and the nurses, so as to obtain the item scale and the formation of professional values of nursing students at the end of the initial questionnaire. Exploratory factor analysis was used to analyze the data, get professional values of nursing students of the scale, reliability and validity were tested on it.
In this study the nursing students professional values scale as a tool for Beijing, 894 nursing undergraduates in three Tianjin and other advanced medical universities were investigated. The statistics of the data obtained by SPSS statistical software, to further verify the new structure of the fitting degree of the scale, and the factors that influence the basic situation of professional values of nursing students and there may be analyzed.
[results]
Professional values of nursing students: the initial questionnaire based on literature research, to explore the theory of medical ethics and "nursing ethics related big medicine sincere >, initial development of nursing professional values within the structure of the scale, through the preparation methods of in-depth interview scale items, finally formed by 4 dimensions, the initial questionnaire was 56 items.
Professional values of nursing students: a formal questionnaire using the initial questionnaire to 360 nursing students, through statistical analysis, the final form of 4 dimensions, 27 items of nursing students professional values of the formal scale. The scale includes professional self-development, altruism, initiative and professional occupation mission four dimensions. The cumulative contribution rate of 54.270%. of the four dimensions of nursing students professional values scale and each dimension of Cronbach's a coefficient is 0.745-0.939, the test-retest reliability coefficient was 0.862 (P0.01), proved that the scale had good reliability and validity scale. By 5 score, the higher the score showed that subjects professional level is the value of the object view high.
Professional values of nursing students overall situation: the survey shows that the professional value of undergraduate nursing students a high degree of recognition. The average score of each item is 3.09 + 0.87, 4.03 + 0.79, the average professional values of nursing students in each dimension is 3.56 + 0.64 and 3.97 + 0.59, four dimensions of "altruism" the highest average, the lowest average professional mission ".
Factors affecting the professional values of nursing students in nursing students professional values questionnaire score as the dependent variable, the result of investigation of nursing students in the general information (grade, family background, political affiliation, singleton) as predictor variables, using multiple regression analysis method for data analysis, and the results only grade family background into the regression equation, but due to the coefficient of determination R2 was only 2.3% and 3.9%, as the dependent variables explain the low rate, so we can not determine the influence factors of the two is the professional values of nursing students.
[Conclusion]
The establishment of the professional values of nursing students scale has good reliability and validity, its contents accord with China's cultural background and basic conditions, can be used for measuring the professional value of undergraduate nursing students in China. The survey results show that the medical ethics surveyed three universities of undergraduate nursing students professional values of higher level implied. < > in the doctors and nursing professional values of our country closely, can be in nursing education in the future will consciously penetrate into the humanistic education of nursing students to develop suitable for China's cultural background and basic conditions and excellent nursing talents with China characteristics.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R47-4;G641

【参考文献】