The inner struggle of nurses, exploring moral distress among hospital nurses: A cross-sectional study

IF 7.5 1区 医学 Q1 NURSING
Wendy H. Oldenmenger , Elke Berger , Arianne Stoppelenburg
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引用次数: 0

Abstract

Background

As frontline caregivers, nurses often find themselves at the crossroads of complex ethical decisions that can significantly impact patient outcomes and their own well-being. Identifying the areas of experienced moral dilemmas in the workplace and gaining insight into the prevalence of moral distress can lead to a healthier workplace environment.

Objective

This study aims to examine the frequency, intensity and level of moral distress among nurses who work in a hospital, and to identify the variables associated with the level of moral distress.

Design

Cross-sectional study.

Setting

One university hospital and six general hospitals.

Participants

654 of the 1095 nurses working on inpatient units filled out the questionnaire (response rate 60 %).

Methods

The intensity and frequency of moral distress was assessed using the Moral Distress Scale-Revised (MDS-R). We also asked two additional questions about considering leaving their job, and if they could describe a distressing case and how moral distress was discussed. Multivariable regression analysis was conducted to identify the variables associated with the level of moral distress.

Results

The overall mean MDS-R score of the 654 included nurses was low at 36.4 (SD 26). Nurses reported to have frequent dilemmas regarding organizational aspects and aspects of end-of-life care. The multivariable analyses showed that higher levels of moral distress were experienced by registered nurses, nurses working on a medical ward, and nurses who had ever left or considered leaving their job, or considering leaving their job at the moment.

Conclusions

Although nurses in our study experiences low levels of moral distress, they do experience moral dilemmas related to organizational topics and end of life care. We all need to pay attention to these dilemmas and how to discuss them in order to achieve a resilient nursing profession at a time of major nursing shortages.

Tweetable abstract

Caring for increasingly complex patients in a dynamic healthcare system is likely to continue to produce morally challenging scenarios.

护士的内心挣扎,探究医院护士的道德困扰:横断面研究
作为一线护理人员,护士经常会发现自己处于复杂的道德抉择的十字路口,而这些抉择会对患者的治疗效果和自身福祉产生重大影响。确定工作场所中出现道德困境的领域并深入了解道德困扰的普遍程度,可以营造一个更健康的工作环境。本研究旨在调查在医院工作的护士中出现道德困扰的频率、强度和程度,并确定与道德困扰程度相关的变量。横断面研究。一家大学医院和六家综合医院。在住院部工作的 1095 名护士中有 654 人填写了调查问卷(回复率为 60%)。我们使用道德压力量表修订版(MDS-R)对道德压力的强度和频率进行了评估。我们还额外询问了两个问题:是否考虑离职;是否能描述一个令人痛苦的病例以及如何讨论道德困扰。我们进行了多变量回归分析,以确定与道德困扰程度相关的变量。654 名护士的 MDS-R 总平均得分较低,为 36.4 分(标准差为 26 分)。据报告,护士经常在组织方面和临终关怀方面遇到困境。多变量分析表明,注册护士、在医疗病房工作的护士、曾经离职或考虑离职或正在考虑离职的护士的道德困扰程度较高。虽然在我们的研究中,护士的道德困扰程度较低,但他们确实经历过与组织主题和临终关怀相关的道德困境。我们都需要关注这些两难问题以及如何讨论这些问题,以便在护理人员严重短缺的情况下实现护理行业的可持续发展。在充满活力的医疗保健系统中护理日益复杂的病人很可能会继续产生具有道德挑战性的情景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
15.00
自引率
2.50%
发文量
181
审稿时长
21 days
期刊介绍: The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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