ﺑﺮرﺳﯽ ﺳﻄﺢ ﺗﺼﻤﯿﻢﮔﯿﺮ ي اﺧﻼﻗﯽ ﭘﺮﺳﺘﺎران و ارﺗﺒﺎط آن ﺑﺎ ﻧﮕﺮش آﻧﺎن ﺑﻪ ﻣﺮاﻗﺒﺖﻫﺎي ﭘﺎﯾﺎن زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﮐﻮوﯾﺪ 19

Evaluating the Level of Ethical Decision Making of Nurses and Its Relationship with the Attitudes of End-Of-Life Care of Patients with COVID-19

ﭘﺮﺳﺘﺎران ازﺟﻤﻠﻪ اﻋﻀﺎي ﺗﯿﻢ درﻣﺎن ﻫﺴﺘﻨﺪ ﮐﻪ ﺑﯿﺸﺘﺮﯾﻦ ارﺗﺒﺎط را ﺑﺎ ﺑﯿﻤﺎران ﮐﻮوﯾﺪ 19 دارﻧﺪ و از ﺗﺼﻤﯿﻢﮔ ﯿﺮي اﺧﻼﻗﯽ، در ﻣﺮاﻗﺒﺖ از آنﻫﺎ ﻧﺎﮔﺰﯾﺮﻧﺪ. از ﺳﻮ ي دﯾﮕﺮ، اﻧﮕﯿﺰهي ﭘﺮﺳـــﺘﺎران در اﺟﺮاي ﻣﺮاﻗﺒﺖ ﭘﺎﯾﺎن زﻧﺪﮔ ﯽ، ﺗﺤﺖ ﺗﺄﺛﯿﺮ ﻧﮕﺮش و آﮔﺎﻫﯽ و اﺳـــﺘﺪﻻل اﺧﻼﻗﯽ آنﻫﺎﺳــﺖ . ﭘﮋوﻫﺶ ﺣﺎﺿــﺮ، ﺑﺎ ﻫﺪف ﺑﺮرﺳــ ﯽ ﺳــﻄﺢ ﺗﺼــﻤﯿﻢﮔ ﯿﺮي اﺧﻼﻗﯽ ﭘﺮﺳـــﺘـﺎران و ارﺗﺒـﺎط آن ـﺑﺎ ﻧﮕﺮش آـﻧﺎن ـﺑﻪ ﻣﺮاﻗﺒـﺖ ﻫـﺎي ﭘـﺎﯾـ ﺎن زـﻧﺪﮔ ﯽ ﺑﯿﻤـﺎران ﻣﺒﺘﻼ ـﺑﻪ ﮐﻮوﯾﺪ 19 در ﺑﯿﻤﺎرﺳـﺘﺎنﻫﺎي ﻣﻨﺘﺨﺐ واﺑﺴـﺘﻪ ﺑﻪ داﻧﺸـﮕﺎه ﻋﻠﻮم ﭘﺰﺷـﮑﯽ اﺳـﺘﺎن ﻫﻤﺪان، در ﺳﺎل 1399 اﻧﺠﺎم ﮔﺮﻓﺖ. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ، 180 ﻧﻔﺮ از ﭘﺮﺳﺘﺎران ﺷﺎﻏﻞ در ﺑﯿﻤﺎرﺳﺘﺎن ، ﺑﺎ روش ﻧﻤﻮﻧﻪﮔ ﯿﺮي در دﺳــﺘﺮس، اﻧﺘﺨﺎب ﺷــﺪﻧﺪ. اﺑﺰارﻫﺎي ﮔﺮدآوري دادهﻫﺎ ﺷــﺎﻣﻞ ﭘﺮﺳــﺶﻧﺎﻣﻪي اﻃﻼﻋﺎت دﻣﻮﮔﺮاﻓﯿﮏ، ﭘﺮﺳــﺶﻧﺎﻣﻪي آزﻣﻮن ﻣﻌﻤﺎي اﺧﻼﻗﯽ ﭘﺮﺳــﺘﺎري )Nursing Dilemma Test( و ﭘﺮﺳـﺶﻧﺎﻣﻪي ﻧﮕﺮش ﭘﺮﺳـﺘﺎران ﻧﺴـﺒﺖ ﺑﻪ ﻣﺮاﻗﺒﺖ ﻫﺎ ي ﭘﺎﯾﺎن زﻧﺪﮔ ﯽ ﺑﻮد. ﻣﻄﺎﺑﻖ ﺑﺎ ﻧﺘﺎﯾﺞ، ﺑﯿﻦ ﺗﺼـﻤﯿﻢﮔ ﯿﺮي اﺧﻼﻗﯽ ﭘﺮﺳـﺘﺎران و ﻧﮕﺮش آﻧﺎن ﺑﻪ ﻣﺮاﻗﺒـﺖ ﻫـﺎي ـﭘﺎﯾـ ﺎن زـﻧﺪﮔ ﯽ، راﺑﻄـﻪاي ﻣﺜﺒـﺖ و ﻣﻌﻨـﺎدار وﺟﻮد دارد )05 /0

Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards Endof- Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.