The relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards

Abstract

Background Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their profession. While managing their daily relationships with their patients, nurses must also be able to control their actions to feel that they are from a social unit and feel their competence in association with others. Objective This study aimed to investigate the relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Methods This descriptive/comparative cross-sectional study was conducted in 2015 using 120 nurses as subjects. Subjects were selected using the census method. The research tools used to gain measurable data were the Pankratznursing questionnaire(PNQ) and Corley'sMoral distress scale (MDS). In order to analyze the collected data, descriptive statistic tests such as the relative frequency distribution, mean, standard deviation and the Pearson correlation test, T-test, ANOVA, and regression were used. The SPSSv.20 software was also used to analyze the data obtained. Results The relationship between professional autonomy and moral distress revealed that there was a significant positive relationship between professional autonomy and moral distress in the intensity (r = 0.39; P < 0.001) and the iteration (r = 0.41; P < 0.001). In addition, professional autonomy predicted 18% of changes in intensity of moral distress in total(MR = 0.42, R 2 = 0.18) and also professional autonomy predicted 25% of iteration in moral distress in total(MR = 0.507, R 2 = 0.25). Conclusions The results of this study revealed that there was a direct positive relationship between professional autonomy and moral distress.

Predictors and outcomes of nurse professional autonomy: A cross‐sectional study

“…Nevertheless, this study's findings are consistent with previous studies (Amini et al, 2015;Iranmanesh et al, 2014;Karanikola et al, 2014;Mrayyan, 2005) and were significantly higher when compared with that of Sarkoohijabalbarezi et al (2017) and Papathanassoglou et al (2012).…”

“…This result is not surprising considering that the majority of the respondents in the current study were new in the profession, had less clinical experiences, and were still adjusting to their role as nurses, whereas in the study of Lapena et al, (), the respondents were head nurses who held supervisory and administrative functions and were expected to have higher authority as compared with staff nurses. Nevertheless, this study's findings are consistent with previous studies (Amini et al, ; Iranmanesh et al, ; Karanikola et al, ; Mrayyan, ) and were significantly higher when compared with that of Sarkoohijabalbarezi et al () and Papathanassoglou et al ().…”

“…Among nurses, higher levels of autonomy has been regarded as an essential determinant of work satisfaction (AllahBakhshian et al, 2017), safety performance (Ko, Jeong, & Yu, 2018), and staff nurse retention (Papathanassoglou et al, 2012). Other studies reported negative consequences of low autonomy levels in nurses such as burnout (Adebayo & Ezeanya, 2011), depression, job strain, absenteeism (Enns, Currie, & Wang, 2015), and moral distress (Papathanassoglou et al, 2012;Sarkoohijabalbarezi, Ghodousi, & Davaridolatabadi, 2017). A better outcome through an enhanced sense of personal accomplishment were observed in nurses who experienced positive nursephysician relations and support from nursing management at the unit level appears and those who had higher clinical autonomy (Karanikola et al, 2014).…”

The relationship between professional autonomy and moral distress in ICU nurses of Guilan University of Medical Sciences in 2017

“…Consistent with the findings of this study, Karanikola et.al (2014) study conducted in Italy reported high professional autonomy of ICU nurses (7). However, in Sarkoohi Jebalarzi et.al (2017) study in Iran on PICU nurses, and in another study in Europe, professional autonomy of ICU nurses was low (5,18). In the current study, sampling was done typically of adults ICU which is another reason for different results.…”

“…Despite of the fact that professional autonomy of nurses is influenced by the environment and organizational culture governing the clinical environments (16), and the ethical stressors that lead to moral distress in ICU nurses could be different under the effect of organizational behaviors and diversity of clinical environments 12,few research is conducted about the professional autonomy and moral distress of ICU nurses in different countries which some of them have reported negative and significant relationship and some others, positive and significant relationship (17). Only one study in Iran has reported the significant relationship between professional autonomy and moral distress in Pediatric Intensive Care Units (PICU) nurses (18). Regarding what has been said and since there is no study in our country which deals with the relationship between professional autonomy and moral distress in ICUs nurses, this study was conducted to determine the relationship between professional autonomy and moral distress of ICU nurses in medicaleducational hospitals of Guilan University of Medical Sciences.…”