Moral Distress among Nurses Working in a Teaching Hospital

Amita Ale, Ramesh Subba, Amrit Ghimire, Sarita Nepal
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Abstract

INTRODUCTION: Distress is a serious problem to nurses, the deepest source of distress that nurse’s experience has been arisen because of the variation between nurse’s values and reality of daily nursing practice. Moral distress referred to the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress has a deleterious effect on patients, nurses, and organizations which results in decreased job satisfaction, increased turnover, and withdrawal from a job, and developing physical and psychological symptoms. The aim of this study is to assess the moral distress among the nurses in Chitwan Medical College Teaching Hospital. MATERIALS AND METHODS: A descriptive, cross-sectional research design was conducted among 114 nurses of Chitwan Medical College Teaching Hospital by use probability, stratified random sampling technique. Data was collected by using Standard Hamric Modified Distress Scale-Revised (MDS-R). RESULTS: The study finding revealed that majority of nurses (82.5%) had mild moral distress and 17.5% had severe moral distress. The father’s occupation was significantly associated with moral distress (p=0.035). Interestingly, a statically significant association was observed between moral distress and respondents who were utilizing facilities of government health insurance (p=0.013). CONCLUSIONS: Nearly one fifth of the nurses have severe moral distress which is less in count but its effects may be severe. Hence special program needs to be organized by hospital admission for nurses to minimize the moral distress.  
教学医院护士的道德困境
导读:困扰是困扰护士的一个严重问题,护士的痛苦最深的根源是护士的价值观与日常护理实践的现实之间的差异。道德困境指的是当一个人感到被迫违背自己的道德要求时产生的认知-情感失调。道德困境对病人、护士和组织都有有害的影响,导致工作满意度下降,人员流失率增加,退出工作,并出现身体和心理症状。本研究的目的是评估奇旺医学院附属医院护士的道德困境。材料与方法:采用概率、分层随机抽样方法对奇旺医学院附属医院114名护士进行描述性、横断面调查设计。采用标准Hamric修正痛苦量表(MDS-R)收集数据。结果:研究发现,大多数护士(82.5%)存在轻度道德困境,17.5%存在重度道德困境。父亲的职业与道德困扰显著相关(p=0.035)。有趣的是,在道德困扰与使用政府医疗保险设施的受访者之间观察到统计学上显著的关联(p=0.013)。结论:近五分之一的护士存在严重的道德困扰,虽然数量较少,但影响可能比较严重。因此,需要医院为护士组织特殊的方案,以尽量减少道德困境。
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