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Abstract
The paper
reports results of an assessment of knowledge and practice of medical ethics among nurses in a public hospital before and
after an intervention which consisted of a training workshop on medical ethics and provision of reading material on ethics.
The results of the study were to be used to formulate policies on ethical training for healthcare workers. The questionnaire
used had been employed previously in research on ethics [1]. Respondents were presented with case scenarios. They were asked
to choose the best among 3-4 approaches to resolving the ethical problem(s) in each scenario. The questionnaire was administered
a few hours before the workshop on ethics. The participants were asked to complete the same questionnaire within 1 month of
the ethics workshop. To make sure that responders gave honest answers, no personal identifiers were included on the questionnaires.
They were however asked to invent a code of their own and write that code on the pre and post-intervention questionnaires
to enable linkage between the pre and post questionnaires. The investigators would not know to whom the codes belonged. Data
was key-punched and analyzed using the SPSS program. Data analysis focused on estimating the proportion of participants who
changed responses to the scenarios after the ethics training workshop. There was no interest in studying whether the responses
were correct or not. Pre- and post intervention responses were compared and coded as ‘change’ or ‘no change’.
The frequencies, proportions (percentages), and binomial 95% confidence intervals were calculated using Stata/IC 10.0. The
degree of change for each question was graded as ‘little’ for changes in <10% of respondents, ‘some’
for 10 to <30%, ‘moderate’ for 30 to <50% and ‘great’ for 50% and above. Eighty two out of the
83 nurses who attended the workshop returned both the pre- and post-intervention questionnaires. The percentage of respondents
who changed their responses to questions after the intervention ranged from 15.5% to 56.5%. On average of 37.4% and 29.2%
of respondents changed in Islamic questions and general questions respectively. The most changed five questions are Islamic
questions in the aspects of ‘animal research’ (56.5%), ‘life support’ (43.2%), ‘euthanasia’
(42.2%), ‘halal medicine’ (40%), and ‘needles to addicts’ (39.1%). The conclusion from the study is
that there were considerable changes in response to questions after the intervention and greater changes were observed in
the Islamic questions than in the general questions. It is recommended, after further studies to corroborate this finding,
that teaching of medical ethics should consider the religious medium because it seems to have a bigger impact on the trainees.
Key words:
nurses ethics training
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1. Naznin Muhammad et al. The impact of the teaching of medical ethics in the medical
and allied health sciences curriculum in International Islamic University Malaysia. Paper being submitted to the
International Medical Journal (personal communication)
Table 1: Respondents change in response after the intervention
|
Question |
n |
Freq.a |
% |
(95% CI)b |
Change |
|
Q1 |
46 |
18 |
39.1 |
(25.1, |
54.6) |
Moderate |
|
Q2 |
45 |
8 |
17.8 |
( 8.0, |
32.1) |
Some |
|
Q3 |
46 |
18 |
39.1 |
(25.1, |
54.6) |
Moderate |
|
Q4 |
45 |
21 |
46.7 |
(31.7, |
62.1) |
Moderate |
|
Q5 |
46 |
11 |
23.9 |
(12.6, |
38.8) |
Some |
|
Q6 |
45 |
7 |
15.6 |
( 6.5, |
29.5) |
Some |
|
Q7 |
46 |
8 |
17.4 |
( 7.8, |
31.4) |
Some |
|
Q8 |
44 |
9 |
20.5 |
( 9.8, |
35.3) |
Some |
|
Q9 |
45 |
12 |
26.7 |
(14.6, |
41.9) |
Some |
|
Q10 |
46 |
15 |
32.6 |
(19.5, |
48.0) |
Moderate |
|
Q11 |
45 |
11 |
24.4 |
(12.9, |
39.5) |
Some |
|
Q12 |
46 |
16 |
34.8 |
(21.4, |
50.2) |
Moderate |
|
Q13 |
45 |
13 |
28.9 |
(16.4, |
44.3) |
Some |
|
Q14 |
45 |
16 |
35.6 |
(21.9, |
51.2) |
Moderate |
|
Q15 |
44 |
15 |
34.1 |
(20.5, |
49.9) |
Moderate |
|
Q16 |
45 |
13 |
28.9 |
(16.4, |
44.3) |
Some |
|
Q17 |
45 |
12 |
26.7 |
(14.6, |
41.9) |
Some |
|
Q18 |
45 |
10 |
22.2 |
(11.2, |
37.1) |
Some |
|
Q19 |
40 |
16 |
40.0 |
(24.9, |
56.7) |
Moderate |
|
Q20 |
46 |
21 |
45.7 |
(30.9, |
61.0) |
Moderate |
|
Q21 |
46 |
21 |
45.7 |
(30.9, |
61.0) |
Moderate |
|
Q22 |
42 |
22 |
52.4 |
(36.4, |
68.0) |
Great |
|
Q23 |
46 |
26 |
56.5 |
(41.1, |
71.1) |
Great |
|
Q24 |
45 |
15 |
33.3 |
(20.0, |
49.0) |
Moderate |
|
Q25 |
46 |
10 |
21.7 |
(10.9, |
36.4) |
Some |
|
Q26 |
46 |
13 |
28.3 |
(16.0, |
43.5) |
Some |
|
Q27 |
45 |
15 |
33.3 |
(20.0, |
49.0) |
Moderate |
|
Q28 |
46 |
22 |
47.8 |
(32.9, |
63.1) |
Moderate |
|
Q29 |
46 |
12 |
26.1 |
(14.3, |
41.1) |
Some |
|
Q30 |
45 |
14 |
31.1 |
(18.2, |
46.6) |
Moderate |
|
Q31 |
44 |
20 |
45.5 |
(30.4, |
61.2) |
Moderate |
|
Q32 |
44 |
11 |
25.0 |
(13.2, |
40.3) |
Some |
|
Q33 |
45 |
21 |
46.7 |
(31.7, |
62.1) |
Moderate |
|
Q34 |
45 |
22 |
48.9 |
(33.7, |
64.2) |
Moderate |
|
Q35 |
44 |
19 |
43.2 |
(28.3, |
59.0) |
Moderate |
|
Q36 |
45 |
11 |
24.4 |
(12.9, |
39.5) |
Some |
|
Q37 |
45 |
8 |
17.8 |
( 8.0, |
32.1) |
Some |
|
Q38 |
44 |
16 |
36.4 |
(22.4, |
52.2) |
Moderate |
|
Q39 |
45 |
19 |
42.2 |
(27.7, |
57.8) |
Moderate |
|
Q40 |
43 |
14 |
32.6 |
(19.1, |
48.5) |
Moderate |
a Number of participants change in their response after the intervention
b Binomial exact confidence interval
Note: <10%=Little change; 10% to <30%=Some change;
30% to <50%=Moderate change; 50% & above =Great change;
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