Moral distress in correctional nurses: A national survey

Abstract

Background: Moral distress is an increasingly documented problem in nursing and might foster nurses’ intention to leave their workplace. It has been studied in different settings, but no specific research has been conducted in Italian correctional facilities. A recent Italian study produced a preliminary validation of the Moral Distress Scale for Correctional Nurses, which needs to be completed. Objectives: To investigate the level of moral distress of nurses working in the Italian correctional setting, by completing the validation process of the Moral Distress Scale for Correctional Nurses. Methodology: Multicenter questionnaire survey. All correctional nurses (461) affiliated with the Italian Society of Medicine and Penitentiary Health (also called “Simspe-onlus”) were invited to participate and 238 responded. The survey was conducted between April and November 2017 through SurveyMonkey®. Analysis of covariance was conducted to investigate the relationship between moral distress and the other variables under study. Exploratory factor analysis was conducted on the scale to confirm its dimensions. Ethical considerations: The study was approved by the Italian Society of Medicine and Penitentiary Health (Simspe-onlus). The questionnaire included informed consent, pursuant to the law in force. The software could not accept questionnaires without explicit consent. Data were analyzed anonymously. Findings: The median score was 46.5, indicating moderate moral distress. The only variable affecting moral distress was work experience in correctional facilities. Longer experience was correlated to higher levels of moral distress and intention to leave. Incompetent colleagues and short staffing were related to higher levels of moral distress. The scale confirmed the one-dimensional structure suggested by the original authors. Discussion: This is the first study investigating moral distress among Correctional Nurses. The prison context is a high-risk environment for nurses, increasing the intention to leave the workplace. Conclusion: Corrective and protective measures, such as specific education, are needed to prevent moral distress development and to reduce nurses’ shortage in this area.

The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review

“…This health emergency is trigging an intense, international healthcare response, with thousands of healthcare workers (HCWs) at the frontline caring for those affected by the virus (Lai et al 2020 ; Tan et al 2020 ; The Lancet 2020 ) and is expected to cause enduring substantial physical, personal and emotional distress to healthcare providers providing direct care to COVID-19 patients (Lamiani et al 2012 ; Falcó-Pegueroles et al 2016 ; Lusignani et al 2017 ; Delfrate et al 2018 ; Lazzari et al 2020 ).…”

The role of prison nursing: an integrative review

“…Entre ellos, el estudio de Sánchez-Roig et al 26 muestra la complejidad de los cuidados que deben recibir los presos, tanto para enfermedades transmisibles y drogodependencias como para enfermedades mentales, además de otros problemas de salud, para los cuales es necesario que la enfermera reciba una formación especializada en el ámbito penitenciario. Del mismo modo, Lazzari et al 27 y Carnevale et al 25 llegan a la conclusión de que el trabajo en el entorno carcelario requiere una formación específica, actualizada y continua por parte de las enfermeras, con el objetivo de que la población reclusa reciba unos cuidados de calidad.…”

“…Finalmente, en consonancia con el estudio anteriormente comentado, Lazzari et al 27 evidencian la angustia moral que sufre la enfermera en el ámbito penitenciario por incompetencias entre las/los propias/os trabajadoras/es a la hora de realizar sus labores como enfermeras, basándose en los problemas éticos, así como en la fragilidad por parte del sistema penitenciario a la hora de gestionar las competencias sanitarias de una prisión.…”

Addressing Moral Distress in Correctional Nursing: A Call to Action

“…Recently, the authors reviewed EBSCO Medical and Health Databases and CINAHL and conducted a hand search of the Journal of Correctional Health Care, searching for any literature that explored the concept of moral distress among CNs. Only three articles that directly addressed moral distress among CNs were located and all three of these studies were conducted in Italy (Carnevale, Delogu, Bagnasco, & Sasso, 2018;Lazzari et al, 2020;Sasso, Delogu, Corrozino, Aleo, & Bagnasco, 2018). The authors were unable to locate studies of this nature that were conducted in the United States.…”