Abstract
BackgroundEthical conflicts are common in the critical care setting, and have compromised job satisfaction and nursing care quality. Using reliable and valid instruments to measure the ethical conflict is essential. This study aimed to translate the Ethical Conflict in Nursing Questionnaire — Critical Care Version into Chinese and determine the reliability and validity in the population of Chinese nurses.MethodsResearchers obtained permission and followed the translation-backward method to develop the Chinese version of the Ethical Conflict in Nursing Questionnaire — Critical Care Version (ECNQ-CCV-C). Relevant psychometric properties were selected according to the Consensus-based standards for the selection of health status measurement instruments checklist. Critical care nurses were recruited from two tertiary public hospitals in Hangzhou, Zhejiang Province, and Kunming, Yunnan Province. Of the 264 nurses we approached, 248 gave their consent and completed the study.ResultsThe ECNQ-CCV-C achieved Cronbach’s alphas 0.902 and McDonald’s omega coefficient 0.903. The test-retest reliability was satisfactory within a 2-week interval (intraclass correlation coefficient = 0.757). A unidimensional structure of the ECNQ-CCV-C was determined. Confirmatory factor analysis supported acceptable structure validity. Concurrent validity was confirmed by a moderate relation with a measure for hospital ethical climate (r = − 0.33, p < 0.01). The model structure was invariant across different gender groups, with no floor/ceiling effect.ConclusionsThe ECNQ-CCV-C demonstrated acceptable reliability and validity among Chinese nurses and had great clinical utility in critical care nursing.
Highlights
Ethical conflicts are common in the critical care setting, and have compromised job satisfaction and nursing care quality
A high turnover rate would compromise the quality of nursing care, and poor staffing pattern would in turn aggravate the experience of ethical conflict [9]
The departments covered a wide variety of nursing critical care units, including the Emergency Intensive Care Unit (EICU), Surgical Intensive Care Unit (SICU), Cardiac Surgical Intensive Care Unit (CSICU), Neurosurgery Intensive Care Unit (NICU) and General Intensive Care Unit for a representative data
Summary
Ethical conflicts are common in the critical care setting, and have compromised job satisfaction and nursing care quality. Examples include taking care of a patient who should in a general ward rather than an intensive care unit, implementing a treatment that is too aggressive for the patient and causes additional suffering, or making the best use of available techniques and resources for critically ill patients without significantly improving their outcomes [4, 5] These experiences can lead to subsequent deleterious effects both personally and organizationally. Critical care nurses who experience ethical conflicts would be involved in depression, anxiety, anger, powerlessness and even emotional exhaustion combined with physical symptoms [6]. These experiences render them more prone to burnout, compassion fatigue, job dissatisfaction, and leaving the profession of nursing [7, 8]. A high turnover rate would compromise the quality of nursing care, and poor staffing pattern would in turn aggravate the experience of ethical conflict [9]
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