Objective: Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon whi...Objective: Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality.Methods: In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13.Results: Investigating moral distress domains(ignoring patient, decision-making power, and professional competence) and care quality domains(psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain(P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical(bodily), and communication domains of care quality.Conclusions: Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decisionmaking domains, improve the professional competence, and pay attention to patients.展开更多
Background: Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their prof...Background: Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their profession. While managing their daily relationships with their patients, nurses must also be able to control their actions to feel that they are from a social unit and feel their competence in association with others.Objective: This study aimed to investigate the relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Methods: This descriptive/comparative cross-sectional study was conducted in 2015 using 120 nurses as subjects. Subjects were selected using the census method. The research tools used to gain measurable data were the Pankratznursing questionnaire(PNQ) and Corley'sMoral distress scale (MDS). In order to analyze the collected data, descriptive statistic tests such as the relative frequency distribution, mean, standard deviation and the Pearson correlation test, T-test, ANOVA, and regression were used. The SPSSv.20 software was also used to analyze the data obtained. Results: The relationship between professional autonomy and moral distress revealed that there was a significant positive relationship between professional autonomy and moral distress in the intensity (r=0.39;P<0.001) and the iteration (r=0.41;P<0.001). In addition, professional autonomy predicted 18% of changes in intensity of moral distress in total(MR = 0.42, R2 = 0.18) and also professional au-tonomy predicted 25% of iteration in moral distress in total(MR = 0.507, R2= 0.25). Conclusions: The results of this study revealed that there was a direct positive relationship between professional autonomy and moral distress.展开更多
Background:Moral distress is characterized by biopsychosocial,cognitive,and behavioral effects experienced by clinicians when their values are compromised by internal or external constraints,which results in the inabi...Background:Moral distress is characterized by biopsychosocial,cognitive,and behavioral effects experienced by clinicians when their values are compromised by internal or external constraints,which results in the inability to give the desired care to patients.Objective:To assess predictors of moral distress among nurses working in Jimma University Medical Center,South West Ethiopia.Methods:An institution-based cross-sectional study design was used.A simple random sampling technique was applied to select a total of 248 study participants.Data were collected using a structured self-administered questionnaire,which contains sociodemographic characteristics,Moral Distress Scale-Revised,personal factors,and organizational factors.The data were entered into Epi-data version 3.1 and analyzed by SPSS software version 20.Descriptive statistics,bivariate analysis,and multivariable logistic regression analysis were performed.Finally,P-value<0.05 was used to declare and include variables with statistically significant in predicting the outcome variable.Results:More than two-thirds of the study participants 170(68.5%)were females.The mean age of the respondents is 29 years.Among the study participants,174(70.16%)nurses had experienced a high level of moral distress.Sex,working hours,professional commitment,autonomy,and working environment were statistically significant predictors of moral distress.Conclusions:More than two-thirds of the nurses were experiencing a high level of moral distress.This will affect the nursing service quality,nurses,the nursing profession,and the organization as a whole.This finding is critical for the study since the problem is happening in the presence of low nurse to patient ratio and low nursing care quality.Sex,working hours per week,professional commitment,autonomy,and working environment were identified as predictors of moral distress.展开更多
Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nu...Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 CRNAs.Results:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed important.Conclusion:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral distress.Findings indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.展开更多
Background: As medical technology has advanced, it has also made it possible to maintain end-stage life support for longer periods of time, but it has also been accompanied by a debate about ineffective care, nursing ...Background: As medical technology has advanced, it has also made it possible to maintain end-stage life support for longer periods of time, but it has also been accompanied by a debate about ineffective care, nursing is considered to be an ethically important profession, and nurses aim to achieve ethical goals such as providing the best possible care to patients, achieving high quality outcomes, but it is common when there are insufficient numbers of staff, inadequately trained staff, and organizational policies and procedures that make it difficult, or even impossible, for nurses to meet the needs of patients and their families. This conflict results in moral distress for nurses, yet limited attention has been paid to this phenomenon. Objective: To explore the current phenomenon of moral distress and its triggering factors in nurses in tertiary grade A hospitals in Wuhan, by targeting root causes and understanding the interplay between nurses and settings where moral distress occurs, interventions can be tailored to minimize moral distress with the ultimate goal of enhancing patient care. Method: Totally 384 nurses from clinical departments in 2 tertiary Grade A hospitals in Wuhan were investigated with the Chinese version Moral Distress Scale-Revised (MDS-R). Result: The total score of moral distress was 47.41 ± 27.14, and the mean scores of moral distress frequency and intensity were 1.01 ± 0.53 and 1.19 ± 0.61, which were at a lower level. The main source of moral distress for nurses is related to end-of-life care and medical decision communication;Nurses’ moral distress scores were statistically significant (P Conclusion: Hospital facility leaders and nursing managers need to train nurses to develop competency development such as reflection, empathy, communication, positive thinking, and emotional intelligence to practice ethical dilemma response, and facilitate collaborative communication among healthcare members, so as to alleviate moral distress in nurses.展开更多
目的系统评价和整合有关ICU护士道德困境体验的质性研究,为临床制定减轻道德困境的干预策略提供参考。方法检索Web of Science、Embase、PubMed、EBSCOhost、中国知网、万方、维普、中国生物医学文献数据库中与ICU护士道德困境相关的质...目的系统评价和整合有关ICU护士道德困境体验的质性研究,为临床制定减轻道德困境的干预策略提供参考。方法检索Web of Science、Embase、PubMed、EBSCOhost、中国知网、万方、维普、中国生物医学文献数据库中与ICU护士道德困境相关的质性研究,检索时限为建库至2023年7月,采用澳大利亚循证卫生保健中心质性研究质量评价标准评价纳入的文献,采用汇集性整合方法进行Meta整合。结果共纳入9篇研究,提炼出39个研究结果,归纳形成8个新类别,综合得出3个整合结果:造成ICU护士道德困境的因素、道德困境的感受、道德困境的应对方式。结论ICU护士道德困境的产生常与多种因素相关,道德困境会对ICU护士身心产生伤害,威胁护理安全。建议积极关注ICU护士的道德困境问题,并建立有针对性的支持系统,帮助护士积极应对道德困境。展开更多
目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用...目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用CiteSpace可视化分析软件对检索到的文献进行国家合作、发文机构、关键词共现、文献共被引等分析。结果共筛选出630篇文献,1995—2022年,有关护理领域道德困扰的发文量总体呈上升的趋势,其中美国、加拿大等发达国家及其机构在护理领域道德困扰方面的研究成果较多。工作满意度、伦理氛围、生命维持治疗、重症监护护士等12个方向是该领域的研究热点,新生儿学、沟通、伦理决策、量表研制等11个方向是该领域的研究前沿。结论美国、加拿大等发达国家在护理领域道德困扰方面的研究成果较多,我国目前仍处于探索与发展的初始阶段,研究成果相对较少,今后应结合我国文化与医疗背景,加强国际间的交流与合作,促进我国有关护理领域道德困扰研究的发展。展开更多
基金part of research project, which has been approved by Tabriz University of Medical Sciencesdeputy officials in Tabriz University of Medical Sciences for their financial support, contribution
文摘Objective: Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality.Methods: In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13.Results: Investigating moral distress domains(ignoring patient, decision-making power, and professional competence) and care quality domains(psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain(P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical(bodily), and communication domains of care quality.Conclusions: Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decisionmaking domains, improve the professional competence, and pay attention to patients.
文摘Background: Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their profession. While managing their daily relationships with their patients, nurses must also be able to control their actions to feel that they are from a social unit and feel their competence in association with others.Objective: This study aimed to investigate the relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Methods: This descriptive/comparative cross-sectional study was conducted in 2015 using 120 nurses as subjects. Subjects were selected using the census method. The research tools used to gain measurable data were the Pankratznursing questionnaire(PNQ) and Corley'sMoral distress scale (MDS). In order to analyze the collected data, descriptive statistic tests such as the relative frequency distribution, mean, standard deviation and the Pearson correlation test, T-test, ANOVA, and regression were used. The SPSSv.20 software was also used to analyze the data obtained. Results: The relationship between professional autonomy and moral distress revealed that there was a significant positive relationship between professional autonomy and moral distress in the intensity (r=0.39;P<0.001) and the iteration (r=0.41;P<0.001). In addition, professional autonomy predicted 18% of changes in intensity of moral distress in total(MR = 0.42, R2 = 0.18) and also professional au-tonomy predicted 25% of iteration in moral distress in total(MR = 0.507, R2= 0.25). Conclusions: The results of this study revealed that there was a direct positive relationship between professional autonomy and moral distress.
文摘Background:Moral distress is characterized by biopsychosocial,cognitive,and behavioral effects experienced by clinicians when their values are compromised by internal or external constraints,which results in the inability to give the desired care to patients.Objective:To assess predictors of moral distress among nurses working in Jimma University Medical Center,South West Ethiopia.Methods:An institution-based cross-sectional study design was used.A simple random sampling technique was applied to select a total of 248 study participants.Data were collected using a structured self-administered questionnaire,which contains sociodemographic characteristics,Moral Distress Scale-Revised,personal factors,and organizational factors.The data were entered into Epi-data version 3.1 and analyzed by SPSS software version 20.Descriptive statistics,bivariate analysis,and multivariable logistic regression analysis were performed.Finally,P-value<0.05 was used to declare and include variables with statistically significant in predicting the outcome variable.Results:More than two-thirds of the study participants 170(68.5%)were females.The mean age of the respondents is 29 years.Among the study participants,174(70.16%)nurses had experienced a high level of moral distress.Sex,working hours,professional commitment,autonomy,and working environment were statistically significant predictors of moral distress.Conclusions:More than two-thirds of the nurses were experiencing a high level of moral distress.This will affect the nursing service quality,nurses,the nursing profession,and the organization as a whole.This finding is critical for the study since the problem is happening in the presence of low nurse to patient ratio and low nursing care quality.Sex,working hours per week,professional commitment,autonomy,and working environment were identified as predictors of moral distress.
文摘Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 CRNAs.Results:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed important.Conclusion:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral distress.Findings indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.
文摘Background: As medical technology has advanced, it has also made it possible to maintain end-stage life support for longer periods of time, but it has also been accompanied by a debate about ineffective care, nursing is considered to be an ethically important profession, and nurses aim to achieve ethical goals such as providing the best possible care to patients, achieving high quality outcomes, but it is common when there are insufficient numbers of staff, inadequately trained staff, and organizational policies and procedures that make it difficult, or even impossible, for nurses to meet the needs of patients and their families. This conflict results in moral distress for nurses, yet limited attention has been paid to this phenomenon. Objective: To explore the current phenomenon of moral distress and its triggering factors in nurses in tertiary grade A hospitals in Wuhan, by targeting root causes and understanding the interplay between nurses and settings where moral distress occurs, interventions can be tailored to minimize moral distress with the ultimate goal of enhancing patient care. Method: Totally 384 nurses from clinical departments in 2 tertiary Grade A hospitals in Wuhan were investigated with the Chinese version Moral Distress Scale-Revised (MDS-R). Result: The total score of moral distress was 47.41 ± 27.14, and the mean scores of moral distress frequency and intensity were 1.01 ± 0.53 and 1.19 ± 0.61, which were at a lower level. The main source of moral distress for nurses is related to end-of-life care and medical decision communication;Nurses’ moral distress scores were statistically significant (P Conclusion: Hospital facility leaders and nursing managers need to train nurses to develop competency development such as reflection, empathy, communication, positive thinking, and emotional intelligence to practice ethical dilemma response, and facilitate collaborative communication among healthcare members, so as to alleviate moral distress in nurses.
文摘目的系统评价和整合有关ICU护士道德困境体验的质性研究,为临床制定减轻道德困境的干预策略提供参考。方法检索Web of Science、Embase、PubMed、EBSCOhost、中国知网、万方、维普、中国生物医学文献数据库中与ICU护士道德困境相关的质性研究,检索时限为建库至2023年7月,采用澳大利亚循证卫生保健中心质性研究质量评价标准评价纳入的文献,采用汇集性整合方法进行Meta整合。结果共纳入9篇研究,提炼出39个研究结果,归纳形成8个新类别,综合得出3个整合结果:造成ICU护士道德困境的因素、道德困境的感受、道德困境的应对方式。结论ICU护士道德困境的产生常与多种因素相关,道德困境会对ICU护士身心产生伤害,威胁护理安全。建议积极关注ICU护士的道德困境问题,并建立有针对性的支持系统,帮助护士积极应对道德困境。
文摘目的基于Web of Science,采用文献计量学方法分析护理领域道德困扰的研究现状、研究热点及研究前沿。方法在Web of Science核心合集数据库社会科学引文索引中,以“nurse”和“moral distress”为检索词,检索建库至2022年的文献,然后运用CiteSpace可视化分析软件对检索到的文献进行国家合作、发文机构、关键词共现、文献共被引等分析。结果共筛选出630篇文献,1995—2022年,有关护理领域道德困扰的发文量总体呈上升的趋势,其中美国、加拿大等发达国家及其机构在护理领域道德困扰方面的研究成果较多。工作满意度、伦理氛围、生命维持治疗、重症监护护士等12个方向是该领域的研究热点,新生儿学、沟通、伦理决策、量表研制等11个方向是该领域的研究前沿。结论美国、加拿大等发达国家在护理领域道德困扰方面的研究成果较多,我国目前仍处于探索与发展的初始阶段,研究成果相对较少,今后应结合我国文化与医疗背景,加强国际间的交流与合作,促进我国有关护理领域道德困扰研究的发展。
