| Objectives1.To provide a reliable tool for evaluating undergraduate nursing students’ ethical behavior,we introduce the Ethical Behavior Test and test its reliability and validity.2.Taking undergraduate nursing students as the research object,the Chinese version of the Ethical Behavior Test is applied to investigate the current situation of ethical behavior and professional values among undergraduate nursing students,analyze the relevant influencing factors and explore the relevant strategies to improve the ethical behavior of undergraduate nursing students.Methods1.The source questionnaire of the Ethical Behavior Test developed by Belgian professor Bernadette Dierckx de Casterle was revised in strict accordance with the steps of translation,back translation,and cultural adaptation to make it more in line with Chinese language expression habits and cultural background.Based on the preliminary survey,509 undergraduate nursing students,from first-year students to senior students in Shandong University of Traditional Chinese Medicine,were selected to test the reliability and validity of the Chinese version of the Ethical Behavior Test.Cronbach’ s αcoefficient,half-fold reliability,and retest reliability were used to evaluate the reliability.In terms of validity,content validity,structure validity,and criterion correlation validity were used to evaluate the Ethical Behavior Test.2.The Chinese version of the Ethical Behavior Test and Nursing Profession Values Scale were applied to 921 undergraduate nursing students from first-year students to senior students in the School of Nursing,Shandong University of Traditional Chinese Medicine.The questionnaire data were analyzed using SPSS 21.0 and SAS 9.4,and general demographic data were used for descriptive statistical analysis.Independent sample T-test and one-way ANOVA were used to determine the influencing factors of the total score and the score of each dimension of the Chinese version of the Ethical Behavior Test.Multiple linear regression analysis was used to analyze the multifactor correlation between the general demographic data,the score of the Nursing Professional Values Scale,and the score of the Chinese version of the Ethical Behavior Test.Results1.The Chinese version of the Ethical Behavior Test contains five dilemmas,each of which includes three dimensions:ethical reasoning,ethical practice,and ethical self-efficacy.In the project analysis stage,the correlation coefficient between the scores of ethical reasoning,ethical practice,and ethical self-efficacy and the total score of the questionnaire under each dilemma was 0.402-0.538(P<0.01),and the difference between the scores of the high group and the low group under each dilemma was statistically significant(P<0.01).In terms of validity,the content validity index of each item of this questionnaire is ≥0.78.In the process of exploratory factor analysis,three factors were extracted,and the cumulative variance contribution rate of the three factors was 48.505%.And the total content validity index of the questionnaire is 0.93.In the process of confirmatory factor analysis,each fitting index in the preset model reached the ideal value:χ2/df=2.71,GFI=0.94,RMSEA=0.06,NFI=0.88,IFI=0.92,RFI=0.95,and the correlation coefficient of the efficacy criterion was 0.705(P<0.01),and the validity criterion was good.In terms of reliability analysis,Cronbach’s alpha coefficient was 0.918～0.931,and the split-half reliability coefficient was 0.785.The questionnaire was reinvestigated on 87 undergraduate nursing students at 21-day intervals,and the test-retest reliability of the questionnaire was 0.947-0.979.2.The total score of the Chinese version of the Ethical Behavior Test for undergraduate nursing students was(95.14±11.37),the ethical reasoning dimension was(35.11±6.08),the ethical practice was(13.21±3.56),and the ethical self-efficacy was(46.82±7.23).The results of the univariate analysis showed significant differences in the scores of the Ethical Behavior Test among undergraduate nursing students in terms of gender,grade,degree of professional preference,and whether they had studied nursing ethics.3.Undergraduate nursing students scored(94.92±22.28)points on the Nursing Professional Values Scale,(3.68±0.87)points for care provision,(3.60±0.85)points for activism,(3.60±0.87)points for freedom of responsibility and safety,and(3.71±0.91)points for trust dimension.4.There was a significant positive correlation between the scores of the Chinese version of the Ethical Behavior Test and the Nursing Professional Values Scale(P<0.01).5.The multiple linear stepwise regression analysis results showed that gender and nursing professional values had a significant positive predictive effect on the score of the Chinese version of the Ethical Behavior Test,and grade could negatively predict the score of the Chinese version of the Ethical Behavior Test.Conclusion1.The Chinese version of the Ethical Behavior Test has good reliability and validity,a reliable tool to evaluate the ethical reasoning ability,ethical practice,and ethical self-efficacy among undergraduate nursing students.2.The level of ethical behavior of undergraduate nursing students is at the medium level,which needs further improvement.Male nursing students,senior nursing students,students who dislike nursing,and students who have not studied nursing ethics have relatively low ethical behavior scores.Nursing educators should focus on the above groups in future ethics education,innovate ethics education,form a continuous ethics education system,help undergraduate nursing students improve their ability to solve ethical problems and cultivate positive ethical behavior.3.There is a significant positive correlation between the scores of nursing professional values of undergraduate nursing students and the scores of the Chinese version of the Ethical Behavior Test,suggesting that nursing educators can cultivate the ethical behavior of undergraduate nursing students by guiding undergraduate nursing students to establish positive and correct professional values. |
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