Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10381898" target="_blank" >RIV/00216208:11110/18:10381898 - isvavai.cz</a>
Alternative codes found
RIV/00064165:_____/18:10381898
Result on the web
<a href="https://doi.org/10.1136/bmjqs-2017-007390" target="_blank" >https://doi.org/10.1136/bmjqs-2017-007390</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1136/bmjqs-2017-007390" target="_blank" >10.1136/bmjqs-2017-007390</a>
Alternative languages
Result language
angličtina
Original language name
Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool
Original language description
Background: Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). Objectives: To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates. Methods: Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups. Results: Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team; active involvement of nurses in end-of-life care and decision-making; active decision-making by physicians; and practice and culture of ethical awareness. Measurement invariance of the EDMCQ across occupational groups was shown, reflecting that nurses and physicians interpret the EDMCQ items in a similar manner. Conclusions: The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians' behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU team interventions.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30223 - Anaesthesiology
Result continuities
Project
—
Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2018
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
BMJ Quality and Safety
ISSN
2044-5415
e-ISSN
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Volume of the periodical
27
Issue of the periodical within the volume
10
Country of publishing house
GB - UNITED KINGDOM
Number of pages
9
Pages from-to
781-789
UT code for WoS article
000446082200004
EID of the result in the Scopus database
2-s2.0-85048121637