Moral distress in undergraduate nursing students

Abstract

Background: Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints. Objectives: To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil. Method: Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models. Ethical considerations: Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande. Findings: The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000). Conclusion: The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician.

Frequency, Severity, Rate, and Causes of Moral Distress among Nursing Students: A Cross-Sectional Study

“…is finding is consistent with the results of Bordignon et al, Baghdadi et al,and Kamali [19,24,37]. However, some studies have indicated no significant relationship between work experience and MD [22,26].…”

“…Moreover, it might generate some indifference and pessimism about nurses and decrease interests in nursing [14][15][16][17][18][19][20][21][22][23]. Regarding MD, several studies have been performed on nurses and nursing students, accompanied by different results [3,[24][25][26].…”

“…Moreover, based on another study on nurses in the United States (2015), the mean rate of MD was described as mild, and the weak health provision was reported as the main cause of MD [30]. Based on different reports of MD level [8,24,29,31,32] and limited studies on Iranian nursing students in this area, we intended to perform this study. e purpose of this study was to determine the frequency, severity, rate, and causes of MD in nursing students.…”

A journey through roses and thorns: becoming a physician by learning from patients with life-threatening illnesses. A qualitative study with international medical students

“…2,19 Moreover, the students interviewed reported difficulties in following practices and rules that are not in line with their own values. 16,31 This internal conflict, leading to a decline in wellbeing, is known in literature as moral distress and it affects many healthcare professionals, particularly so when dealing with bioethical and moral issues. 1,2,32 In this regard, senior clinicians may support the medical students towards the understanding and the adoption of a taking care approach in accordance with local habits and customs, to adequately take care of their patients and caregivers.…”

Estratégias para o desenvolvimento da sensibilidade moral: perspectiva dos enfermeiros de unidades de terapia intensiva

“…17 The development of moral sensitivity and consequent dealing with ethical problems, however, may be weakened in the different care settings because the teaching of ethics is fragmented and out of context, while the working hours available to address this subject in most undergraduate nursing programs is insuficient. 18 In this sense, a study intending to identify the perception of students in regard to their professional preparedness highlights the importance of students in showing interest to filling in gaps in their education, especially through extracurricular activities so they may more fully visualize that reality is full of conflicts that are seldom addressed in classes or even during practical activities. 19 Additionally, there is a need to promote in future nursing workers their ability to deal with ethical conflicts in their inter-relationships with the team, between patients and nurses, so they can act in a morally mature manner, which is a process that leads to moral sensitivity.…”