Ulrich, C, M., Soeken, K, L., & Miller, N. (2003). Ethical conflict associated with managed care: views of nurse practitioners. Nursing Research, 52(3), 168-175.
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This article aims at determining nurse practitioners’ perceptions of ethical conflict in their practice. The targeted nurses have an affiliation to managed care systems. Further, the objective also includes identification of the relationship that exists between contextual factors in the society or market, organization or selected individuals, and ethical conflict found in the practice. This is quite a weighty objective because its findings may give an objective viewpoint of nurse practitioners’ perceptions of ethical conflict. On the other hand, it might not answer the question as to why the nurse practitioners have such perceptions despite how varied they may be. The objective might have included this question, with a need to know what can be done about the perceptions that the nurse practitioners have. The authors give a reason for nurse practitioners lying with regard to an illness or a diagnosis. The reason given is that the nurses can obtain insurance coverage for a patient. This shows that the authors’ objective is circumvented, or they digress from it while introducing their article.
Ulrich, Soeken, and Miller (2003) address four research questions. The first one looks at the relationships between demographics, ethical ideology, ethical concern and ethics education, and perceptions that practitioners have of ethical conflict in practice. Whereas it might be relevant to look at the relationship that exists between these perceptions and ethics education, ethical ideology, and ethical concern, it might not be worthwhile to look at the relationships existing with demographic characteristics as these might not have any causal effects on perceptions. The second question regards the perceptions’ relationship to organizational characteristics, including practice setting. It is opined that these relationships are also worth establishing, although one is rather likely to obtain equivocal results, which may not be relevant to the furtherance of knowledge.
The third question is to figure out the relationship that exists between the said perceptions and contextual characteristics of the society or the market including the attitude towards governmental regulation. This is also considered a relevant question as there can be an influence on one’s perception of ethical conflict depending on one’s ethical environment or the percentage of the population that has been enrolled in managed care. Preemptively, the greater the number of people enrolled, the higher the chances of being influenced negatively. The final research question appears to be the most prominent and reliant on the previous three; that is if there are characteristics that can be used to predict the perceptions of a nurse practitioner. If indeed these are exposed, then this information could be used to structure the organization in such a way that it provides an environment for the nurse practitioner to have the best possible perceptions. The structure of the society might not be easily manipulated, but the characteristics of the individual can be used to determine the best possible individuals for a given market.
Although the article presents no hypotheses for the study, the analysis of the results obtained from the collected data suggests that a hypothesis had to be tested since they used a one-way analysis of variance. Any analysis of variance has to have hypothesis testing, but the authors were not succinct about which hypotheses were being tested in the study. They only mention that they wanted to investigate differences that were related to the practice setting.