反刍思维和道德承诺在护士伦理弹性与伦理 行为间的链式中介效应
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女,硕士在读,学生

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湖南省中医药科研计划项目(B2024100);湖南省卫生健康高层次人才重大科研专项(R2023085)


The chain mediating effect of ruminative thinking and moral commitment on the relationship between nurses′ moral resilience and ethical behavior
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    目的 探讨护士的反刍思维、道德承诺在伦理弹性与伦理行为间的作用关系,为提升护士伦理行为提供参考。方法 采用便利抽样法选取湖南省9所三级甲等医院临床护士为调查对象。采用一般资料调查表、伦理行为量表、伦理弹性量表、反刍思维量表及道德承诺量表进行问卷调查。结果 回收有效问卷1 661份。护士伦理行为得分(66.99±6.96)分,与伦理弹性、道德承诺呈正相关,与反刍思维呈负相关(均P<0.05)。结构方程模型结果显示,伦理弹性对伦理行为具有直接效应,并通过反刍思维、道德承诺及其链式路径产生显著间接效应(均P<0.05)。结论 临床护士伦理行为处于中等偏上水平,反刍思维、道德承诺在护士伦理弹性与伦理行为间起链式中介作用。建议护理管理者通过伦理情境培训和心理支持增强护士伦理弹性,开展正念训练等减少反刍思维,并结合价值观教育强化道德承诺,促进伦理行为的持续改进。

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    Objective To explore the relationships among ruminative thinking, moral commitment, moral resilience, and ethical behavior in nurses, and to provide a reference for improving their ethical practices. Methods Clinical nurses from nine Grade A tertiary hospitals in Hunan Province were selected via convenience sampling. A questionnaire survey was conducted using a general information questionnaire, the Ethical Behavior Scale for Nurses-Revise, the Rushton Moral Resilience Scale, the Ruminative Responses Scale, and the Moral Commitment Scale for Nurses. Results A total of 1,661 valid questionnaires were collected. The nurses′ ethical behavior score was (66.99±6.96), which was positively correlated with moral resilience and moral commitment, and negatively correlated with ruminative thinking (all P<0.05). Structural equation model indicated that moral resilience had a direct effect on ethical behavior, and also produced significant indirect effects through ruminative thinking, moral commitment, and their chain pathway (all P<0.05). Conclusion Nurses′ ethical behavior is at a moderate to high level.Ruminative thinking and moral commitment play a chain mediating role between nurses′ moral resilience and ethical behavior. It is recommended that nursing managers strengthen scenario-based ethical training and psychological support to enhance nurses′ ethical resilience, implement mindfulness-based interventions to reduce ruminative thinking, and provide values-based education to promote moral commitment, resulting in boosting the improvement of ethical behavior of clinical nurses.

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刘宇菲,陈舟,黄娟,龚放华.反刍思维和道德承诺在护士伦理弹性与伦理 行为间的链式中介效应[J].护理学杂志,2025,41(24):116-119

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  • 收稿日期:2025-06-04
  • 最后修改日期:2025-08-23
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  • 在线发布日期: 2026-01-30