Moral Sensitivity and Moral Distress in Critical Care Unit Nurses

Abstract

Background and Aim: The present study was carried out aiming to determine the relationship between moral distress and moral sensitivity among nurses. Materials and Methods: This descriptive analytical study was conducted on 257 nurses employed in teaching hospitals affiliated to Birjand University of Medical Sciences (South Khorasan) in 2015. Available sampling was done among the nurses working in intensive care units (ICU, CCU, NICU and dialysis) in the whole province meeting the inclusion criteria. The data collection tool was a three-part questionnaire consisting of the demographic information questionnaire, Corly moral distress questionnaire, and the Korean version of the Hun moral sensitivity questionnaire. The collected data were analyzed running SPSS statistical software version 16. Ethical Considerations: Written consent was obtained from all participants. Additionally, all of them were assured of anonymity of the questionnaires and confidentiality of the information. Findings: There was no significant relationship between moral distress and the nurses' moral sensitivity (P=0.2). The mean scores (out of 5) were 3.5±0.66 for the total moral distress, 3.5±0.75 for the intensity of moral distress, and 3.54±0.66 for the frequency of moral distress, respectively. The mean for moral sensitivity (out of 4) was 3.1±0.45. There was a statistically significant relationship between moral sensitivity and moral distress with age and years of work experience, and also between moral distress and the type of the ward (P<0.05). Conclusion:The findings indicates that nurses who do not have sufficient executive power for moral performance will experience moral distress, despite their high and low levels of moral sensitivity. Thus, it is necessary hospital administrators to take some specific measures to carry out periodic evaluation of this phenomenon, and hold some codified trainings in this regard.

Factors Associated with Moral Distress and Caring Behavior of Nurses Working in Emergency Departments of Mazandaran University of Medical Sciences During COVID-19 Pandemic

“…According to the correlational results, there was no significant relation between moral distress and caring behavior in emergency nurse (r=0/025). The results of the descriptive study named as "the correlation between moral distress and caring behavior of ICU nurse" stated that there was a significant, negative relation between moral distress and caring behavior (r=0/15), i.e., when nurses encounter increase in moral distress, they would have fewer caring behaviors (10), which was not consistent in its result with the present study; probably one of its reasons can be the significant relation between moral distress and the working unit (32), and the second reason can be the sampling type in that study in which individuals were included in the study through census, which forces a problem on generalization of results. While in our study, individuals were randomly selected.…”

Moral Distress in Nursing and Its Contributors in the Context of Iran

“…Lack of fulfillment of these objectives can lead to moral distress, which is in fact a common phenomenon in the nursing profession (3). As a huge group of caregivers, nurses are constantly faced with ethical issues that can play a significant role in their quality of care (5). Therefore, moral distress can have different effects on nurses, patients, and the health system and can result in significant consequences (6).…”

“…Therefore, moral distress can have different effects on nurses, patients, and the health system and can result in significant consequences (6). It has been shown in various studies that moral distress in a nurse can lead to job withdrawal, stress, burnout, job dissatisfaction, poor quality of work, incidence of physical symptoms such as headache and nightmare, reduced nursing confidence, and even prolonged patient hospitalization (5)(6)(7)(8). Several contributors to moral distress have been enumerated in studies conducted in different countries, including labor pressure, workforce shortage, working atmosphere, futile care, unnecessary tests on the patient, and incompetency of physicians and treatment team in fulfilling demands of patients and their families and making decisions for end-stage patients (7,(9)(10)(11).…”

The Relationship Between Ethical Awareness in Nursing Profession, and Moral Sensitivity in Nurses of Hamadan University of Medical Sciences, Iran.

“…Contrary to our ndings, a number of studies have shown that formal employees had a higher level of awareness (38,44). Also, in the study of Mohammadi et al (2017), there was a signi cant relationship between ethics and \employment status. Ethical awareness was higher in people with contractual and formal employment status (1).…”

“…Moral sensitivity is an individual characteristic (23) and a basic need for nurses to recognize, interpret and answer ethical issues about the patient and to understand the potential impact of their actions on patients' health (24,25). Moral sensitivity is the core of moral literacy and is the most important and rst prerequisite for ethical practice in nursing care (26-31).…”