Abstract
This study aimed to develop an ethical dilemma scale in nursing practice for end-of-life cancer patients and examine its reliability and validity. The investigation targeted nurses at hospitals with a palliative care unit and national cancer medical treatment base hospitals.
The questionnaires comprised 80 items gauging nurses' reactions to ethical dilemmas. These were sent to 4,500 of nurses of end-of-life cancer patients; 1,337 responses were received. Twenty-two items were eliminated by the item-analysis and 58 items were used for the factor analysis. Seven dilemmas related to the nursing process were developed: (1) lack of informed consent for the patient and their family; (2) lack of support for nurses' decision-making; (3) nurses being unable to provide care in accordance with the needs of the patient; (4) having a differing opinion from the physician; (5) treatment being prioritized over the situation of the patient; (6) treatment advancing while the patient is left behind; (7) the opinions of patients and their family differing.
Reliability was confirmed (by Cronbach's α coefficient: .861). The validity of the items was verified from the correlations between two criteria: a job satisfaction measurement scale for nurses and the ethical dilemma scale (Pearson's product-moment correlation coefficient: -.260, p < .01).
