Background Recent advances in medicine and an increasingly demanding healthcare environment are causing various complicated ethical problems. Nursing students need to prepare to deal with ethical issues in their future roles. Ethical sensitivity is a key aspect of the ethical decision-making process; however, there is no scale to measure nursing students’ ethical sensitivity. Therefore, we developed a scale and verified its reliability and validity. Methods The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) was developed in three phases. First, questionnaire items were formulated after a literature review and interviews with nursing students. Next, its face and content validity were examined by an expert panel and piloted among nursing university graduates. Then, a final draft questionnaire survey was administered to nursing university students from 10 Japanese universities in 2015 and an exploratory factor analysis was performed. Criteria-related relevance was examined to compare established scales (i.e. the Japanese version of the Moral Sensitivity Test (JMST) and the Japanese version of the revised Moral Sensitivity Questionnaire (JMSQ)) using single regression analysis. A second questionnaire survey was conducted in one of the 10 universities to examine reliability. Results Initially, 48 items including ethical conflict in clinical nursing practice were formulated, and 47 items were approved by the expert panel. Five-hundred and twenty-eight nursing students responded to the final draft questionnaire. Participants’ mean age was 20.4 (standard deviation = 3.1) years. The questionnaire was reduced to 13 items and three factor structures were determined by exploratory factor analysis: ‘respect for individuals’, ‘distributive justice’, and ‘maintaining patients’ confidentiality’. The Cronbach’s alpha values for items in each domain ranged from 0.77–0.81, and the Cronbach’s alpha for the entire ESQ-NS was 0.82. The ESQ-NS was significantly associated with specific domains: ‛Judgment of the care conflict’ from the JMST and ‘Sense of Moral Burden’ from the JMSQ. Pearson’s correlation coefficient of the ESQ-NS between the first and second survey was 0.42 ( p < .01). Conclusions The EAQ-NS, which was developed to evaluate the ethical susceptibility of nursing students, showed good validity, internal consistency, and reliability. This questionnaire can be used to evaluate nursing students’ ethics education by self-evaluation.
The aspects of "suppressed expression," "deep adjustment," and "surface adjustment" of emotional labor seem to be the major occupational stressors for nurses, as well as job-related stressors measured by BSQ. Working in an inpatient department appears to be a potent stressor for nurses.
Objective: The purpose of this study was to develop a draft Clinical Interpersonal Reactivity Index to evaluate empathy, sympathy and "perspective taking" in nurses. Creating a Clinical Interpersonal Reactivity Index is expected to contribute to improving the mental health of nurses. Participants were five nurses who were able to talk about empathy and who were recommended by a facility administrator. Research data were collected in semi-structured interviews. The rigor of the items was verified by comparing the items with two existing theories, a nursing theory by Travelbee and a psychological theory by Rogers. Results: All participants were female and aged between 34 and 64 years (average 47.4 years). As a result of the interviews, 27 items were developed. The dependability of all items was confirmed since they conformed to Travelbee's and Rogers' theories, and the credibility was confirmed by discussion between eight nursing researchers, including the authors. Twenty-seven items were developed to evaluate the empathy, sympathy and "perspective taking" required for nurses providing patient care and were considered appropriate for the draft Clinical Interpersonal Reactivity Index. Statistical verification of the items is necessary for use of the Clinical Interpersonal Reactivity Index in the future. <Keywords> empathy, interpersonal relations, nurse-patient relations, mental health, nurses
Background An ethical competence list for nurses could guide educators and managers in the field of health care to both support the development of ethical conduct and improve the assessment of ethical competence in health care. Aim This study aimed to verify the reliability and validity of the Ethical Caring Competency Scale (ECCS) and to obtain suggestions for its use as an evaluation form in rubric format among a sample of Japanese nurses. Research design This research employed a descriptive and cross-sectional design. Participants and research context A self-administered questionnaire was distributed to 1157 nurses working in two hospitals in Japan. The contents of the survey were demographic data, a draft of the ECCS consisting of 22 competencies from four core competencies, questions regarding experience in learning about medical/nursing ethics, and the Work Motivation Measurement Scale for Nurses. Three levels of difficulty for the 22 items were established using relative comparisons of the mean scores within the four core competencies. Three groups, namely, an expert group, a middle group, and a beginner group, were categorized according to the quartiles of the total ECCS score. Ethical considerations This study was approved by the Clinical Research Ethics Committee of Hamamatsu University School of Medicine (Decision no. 18-267). The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings A total of 962 valid responses were analyzed. The ECCS scores for the three levels of difficulty were significantly different from each other. Stability was confirmed by the test-retest of the total ECCS scores (r = .900, p < .0001). The total ECCS scores for the three groups showed significant differences in all pairs. The Cronbach’s α coefficient ranged from .72 to .89 for each core competency, and internal consistency was confirmed. Conclusion The reliability and validity of the ECCS as a scale were statistically verified, and we were able to obtain suggestions for its application as a form of evaluation in rubric format.
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