伦理敏感性理论培训前后NICU安宁疗护护士伦理冲突应对能力变化的质性研究 [中文引用][英文引用]

目的  探究伦理敏感性理论培训前后新生儿重症监护病房（neonatal intensive care unit，NICU）安宁疗护护士伦理冲突应对能力的变化，以提升 NICU 安宁疗护工作质量。方法  采用描述现象学研究方法，通过目的抽样法，于 2025 年 1月— 3 月，选取本市某三级甲等综合医院接受过伦理敏感性理论培训的 16 名 NICU 护士作为研究对象，进行半结构式访谈，采用 Colazzi 7 步分析法分析资料。结果  16 名护士均完成访谈，提炼出 3 个主题 8 个副主题，培训前面临的伦理冲突现实困境（治疗决策判断与家属期望冲突、家属认知偏差引发信任危机）；培训后伦理冲突应对策略的改变（个体化应对策略、团队协作、外部资源引入与支持）；伦理敏感性理论培训提升护士应对能力（提升伦理问题识别能力、优化决策制定过程、促进有效沟通）。结论  NICU 安宁疗护护士面临较多伦理冲突，而伦理敏感性培训能培养与提升护士伦理冲突应对能力。

Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units（NI CU）before and after ethical sensitivity theory training. Methods A descriptive phenomenological research method was employed. Using purposive sampling，we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city. After ethical sensitivity theory training between January and March 2025，the nurses participated in a semi-structured interview. Data were analyzed using Colaizzi's seven-step analysis method. Results All participants completed the interview. The data were abstracted to three main themes encompassing eight sub-themes：experiences of ethical conflict dilemmas before ethical sensitivity theory training（conflicts between treatment decision-making and family expectations，trust crises triggered by family cognitive biases），the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training（individualized coping strategies，teamwork and communication， introduction and support of external resources），and the role of ethical sensitivity theory training in enhancing coping ability（improving the ability to identify ethical issues，optimizing the decision-making process，and promoting effective communication）. Conclusion Palliative care nurses in the NICU face various ethical conflicts，and ethical sensitivity training can enhance their ability to manage these conflicts