The association between nurses' moral distress and sleep quality and their influencing factor in private and public hospitals in Iran

Abstract

BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress that is an underlying issue in the nursing profession, which can lead to problems such as reduced quality and quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, this study aimed to explore the association between nurses' moral distress and sleep quality and its comparison among nurses in private and public hospitals. MATERIALS AND METHODS: This was a descriptive-analytical study involving 150 nurses working in Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Data were collected through the questionnaire of sociodemographic characteristics, the Corley's Moral Distress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS software version 22. Descriptive statistics such as frequency, mean, ANOVA, independent t -test, multiple linear regression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated. RESULTS: The analysis revealed that moral distress was positively associated with sleep quality. Furthermore, the scores of nurses' moral distress and sleep quality were different in private and public hospitals, so that the level of moral distress in the public hospital and sleep quality in the private hospital was higher and lower, respectively, but the difference was not statistically significant. Moreover, sleep quality, and the type of employment was the most important predicting variables of moral stress ( B = 1.86) and sleep quality ( B = 2.39), respectively. CONCLUSION: According to the study results, a positive and significant association was found between moral distress and nurses' sleep quality. It is recommended that appropriate strategies and training program be formulated by the health-care system to increase nurses' ability to combat moral distress adverse effects.

Registered Nurses' and nursing students' perspectives on moral distress and its effects: A mixed‐methods systematic review and thematic synthesis

“…Physical manifestations of moral distress among RNs were reported in studies from Iran (Fard et al, 2020), Canada (Forozeiya et al, 2019), Norway (Jansen et al, 2020), USA (Prestia et al, 2017;Sauerland et al, 2014;Wilson et al, 2013;Wolf et al, 2016) and Uganda (Harrowing & Mill, 2010). Symptoms experienced included fatigue (Harrowing & Mill, 2010;Wolf et al, 2016), insomnia (Fard et al, 2020;Forozeiya et al, 2019;Jansen et al, 2020;Wilson et al, 2013;Wolf et al, 2016), hypertension (Jansen et al, 2020;Wolf et al, 2016) and appetite loss (Wolf et al, 2016). Moral residue, the enduring, cumulative effect of morally distressing situations (Stovall et al, 2020), manifested in insomnia, cardiovascular, gastrointestinal and menstrual problems (Pavlish et al, 2016), alopecia (Sauerland et al, 2014) and activated exacerbations of physical and psychological illnesses (Pavlish et al, 2016).…”

“…Physical manifestations of moral distress among RNs were reported in studies from Iran (Fard et al, 2020), Canada (Forozeiya et al, 2019), Norway (Jansen et al, 2020), USA (Prestia et al, 2017;Sauerland et al, 2014;Wilson et al, 2013;Wolf et al, 2016) and Uganda (Harrowing & Mill, 2010). Symptoms experienced included fatigue (Harrowing & Mill, 2010;Wolf et al, 2016), insomnia (Fard et al, 2020;Forozeiya et al, 2019;Jansen et al, 2020;Wilson et al, 2013;Wolf et al, 2016), hypertension (Jansen et al, 2020;Wolf et al, 2016) and appetite loss (Wolf et al, 2016).…”

Investigating the Relationship between Moral Distress and Coping in Pre-Hospital Emergency Medical Services Technicians of East Azerbaijan Province in 2021

“…The ability to coping can be affected and destroyed by exposure to many stressors, and in a vicious cycle, it can lead to other negative consequences. Accordingly, and given the complications caused by moral distress in the performance of EMS technicians and the fact that the level of exposure of ICU nurses and EMS technicians to moral distress has been reported to be high [18][19][20], and also to the best of our knowledge, no study was found to investigate moral distress in EMS technicians, this study was conducted to investigate the relationship between moral distress and coping in EMS technicians working in emergency medical service bases affiliated to East Azerbaijan University of Medical Sciences to provide basic information on the level of coping of technicians in these wards, identify one of the possible factors related to coping in them, and reveal the necessity of dealing with solutions to reduce and control moral distress and promote coping in EMS technicians.…”