Moral distress and the contributing factors among nurses in different work environments

Abstract

Background and Purpose: Considering the obstacles against the implementation of ethical decisions by nurses, experiencing moraldistress is one of the major issues in this profession. Moral distress could have negative effects on the physical and mental health ofnurses, quality of patient care and performance of health organizations. Given the importance of addressing moral distress in workingenvironment of nurses, this descriptive study aimed to evaluate the level of moral distress and the contributing factors among nurses indifferent hospitals affiliated to Shahroud University of Medical Sciences in 2014.Methods: This descriptive study was conducted on 122 nurses engaged in intensive care units (ICUs), internal medicine wards, surgicalwards and emergency sections of different hospitals affiliated to Shahroud University of Medical Sciences. Survey sampling was themethod of choice, and all the subjects met the inclusion criteria. Data collection was performed using demographic questionnairesand Corley’s Moral Distress Scale-Revised (MDS-R). Data analysis was performed using descriptive statistics, including independentT-test, Pearson's correlation coefficient and one-way ANOVA.Results: In this study, means of frequency and intensity of moral distress were relatively high among the subjects. Considering thesignificant difference between moral distress in nurses engaged in different wards (P=0.01), the highest and lowest rates of intensitywere observed in nurses of ICUs with a mean of 3.29±1.49, and those in surgical wards with a mean of 1.81±0.66. Among professionaland demographic variables, feeling supported by the head nurse (P=0.03) and the age of nurses (P=0.001) had a significant correlationwith the level of moral distress.Conclusion: According to the results of this study, identification of clinical environments involving high moral distress, as well as themain causes of moral distress in nursing managements, could contribute to the prevention of this problem among the nursing staff.