Relationships between frequency of ethical issues and experiences among Japanese public health nurses

Objectives This study identified differences in the frequency of encountering ethical issues based on the experiences of Japanese public health nurses (PHNs). Method A questionnaire seeking the frequency of encountering ethical issues and the experiences in PHNs education and practice was sent to all Japanese local public health units. . Return of the anonymous questionnaire was considered consent to participate. Results Usable data were drawn from 3,409 questionnaires (31.1% return rate). Item analysis and exploratory factor analysis revealed three factors: (1) discrepancy of intention between client and his/her family about treatment or care, (2) differences in views between PHNs and administrators regarding providing services, and (3) discrepancy of view between PHNs and related professionals/organizations regarding care. Relationships between each factor score frequency of ethical issues and experiences and demographic data were analyzed using stepwise multiple regression analysis. Two items related to the experiences were significantly related to all three factor scores: 1) experiences caring for difficult cases, and 2) experiences in situations where the individual's wishes were not respected. Conclusions It was presumed that through accumulating experiences such as dealing with difficult and complex cases in their practice, PHNs came to recognize ethical issues and their sensitivity to ethical nuances increased. Establishing an ethical foundation to their practice might enhance their earlier understanding of ethical issues.