Moral Sensitivity and Related Factors among Outpatient Nurses in Advanced Treatment Hospitals and Regional Medical Care Support Hospitals

Abstract

Objective: This study aimed to clarify moral sensitivity and related factors among outpatient nurses in advanced treatment hospitals and regional medical care support hospitals in Japan.
Methods: We conducted an anonymous self-administered questionnaire survey of 961 outpatient nurses at advanced treatment hospitals and regional medical care support hospitals. We calculated the scores of the subscales and items of responses to a moral sensitivity test (Japanese version). Of the subscales, “Understanding of a patient,” “Responsibility/safety,” and “Fidelity” had a Cronbach’s alpha of ≥0.5. Association between these subscales and individual and workplace characteristics was therefore analyzed using the Wilcoxon test or Spearman’s correlation coefficient.
Results: There were 560 responses and 443 valid responses (response rate, 58.3%; valid response rate, 46.1%). The surveyed nurses had an average 20.9 years of experience. “Understanding of a patient” yielded the highest score among the subscales. It was also found related to being married, family nursing experience, worries about ethical issues, being a certified nurse/certified nurse specialist, and the hospital having an ethics committee. “Responsibility/safety” was related to education, worries about ethical issues, and the hospital having an ethics committee. “Fidelity” was related to nurses’ sex, bereavement experience, job description, being a certified nurse/certified nurse specialist, nursing ethics training, need for ethics education, and the hospital having an ethics committee.
Conclusions: The results indicate that to enhance the moral sensitivity of outpatient nurses, it is necessary to systematically work on ethical issues, study sessions, and creating a system that facilitates consultation.