Conscience among care professionals in hospital setting

The fundamental changes have made health care more complex and ethics has increasingly become a required component of clinical practice. Considering this the objectives of Lithuanians Health Care System emphasize the necessity to create and implement health care policy that will ensure public health care, high quality of health care services. Health care ethics could be considered one of the most important factors having influenced the development of the principles for the patients’ right and the protection of persons’ dignity in the 21st century. The need to explore and explain conscience within the caring context among health care professionals is an important task. The overall aim for the thesis was to describe the essence of the concept of Conscience reflected by care professionals and to adapt the questionnaire of Conscience in Lithuania hospital setting, with its psychometric evaluation. The thesis was designed as two part study. Part I the literature study was performed. Through PubMed and ELIN navigator which contains 17 data bases, covering the period from 1996 to 2005, June. Studies were included if they concerned perceptions of conscience exploration among care professionals in hospital setting. Methanalysis was carried out and model of Conscience was performed. The aim of study part 2 was to adapt the Lithuanian version of questionnaire Conscience to Lithuanian conditions and to test its reliability and validity. The adaptation procedure consisted of translation, expert panel checking relevancy of questions and examining psychometric properties of Lithuanian version of questionnaire Conscience. A pilot study was performed at two Lithuanian hospitals. Study subjects n = 99. Reliability was estimated by testing internal consistency. Correlation coefficient Cronbach’s alpha r = 0,788, split half analysis correlation coefficients: Cronbach’s alpha r = 0,575, Spearmans – Brown r = 0,73, Guttman – Split half coefficient r = 0,73. Validity was performed by testing face validity, content validity and construct validity. Face validity was confirmed by expert panel. Content validity was estimated by Cronbach’s Alpha if item deleted confirmed relevant data. An orthogonal principal components factor analysis with varimax rotation was conducted on the 16 items. Data adequacy KMO criterion on sphericity 0,695 confirms that data fits to factor analysis. The six factors with factorial weight L ≤ 0,4 explained 69% dispersion of the data. Factorial weight L ranged from 0,443 to 0,872. The instrument seems to be reliable and valid to assess the conscience among care professionals in hospital setting in Lithuania