School of Health Sciences, Jönköping, Sweden.
J Clin Nurs. 2011 Dec;20(23-24):3483-93. doi: 10.1111/j.1365-2702.2011.03753.x. Epub 2011 Sep 2.
The aim was fivefold: to describe Swedish nurses' perceptions of moral distress and determine whether there were differences in perceptions depending on demographic characteristics and to describe the usability of the Moral Distress Scale in a Swedish context. Further, the aim was to describe Swedish nurses' perceptions of ethical climate and the relationship between moral distress and ethical climate.
Moral distress has been studied for more than two decades and the Moral Distress Scale is the most widely used instrument for measuring it. Moral distress has mainly been studied in relation to nurses' characteristics, but increasing attention has been paid to contextual aspects, such as ethical climate, that could be associated with moral distress.
Descriptive, with a quantitative approach.
The study used two questionnaires: the Moral Distress Scale and the Hospital Ethical Climate Survey. The study was carried out at two hospitals in Sweden and included 249 nurses.
Both level and frequency of moral distress were low, however level of moral distress was high in situations when the patient was not given safe and proper care. Generally, the frequency of moral distress was lower than the level. Of the situations on the Moral Distress Scale, 13 of the 32 were considered irrelevant by 10-50% of the participants. The more positive the ethical climate was perceived to be, the less frequently morally distressing situations were reported.
Since a positive ethical climate was associated with less frequent occurrences of moral distress, it should be investigated what contributes to a positive ethical climate. To be used in a Swedish context, the Moral Distress Scale needs further revision.
Open dialogues at wards are encouraged regarding what practices contribute to a positive ethical climate.
目的有五个方面：描述瑞典护士对道德困境的看法，确定对道德困境的看法是否因人口统计学特征而有所不同，并描述道德困境量表在瑞典背景下的可用性。此外，目的还在于描述瑞典护士对伦理气候的看法以及道德困境与伦理气候之间的关系。
道德困境已经研究了二十多年，道德困境量表是衡量道德困境最广泛使用的工具。道德困境主要与护士的特征有关，但越来越多的关注已经转向与道德困境相关的环境方面，例如伦理气候。
描述性，采用定量方法。
该研究使用了两种问卷：道德困境量表和医院伦理气候调查。该研究在瑞典的两家医院进行，共纳入 249 名护士。
尽管道德困境的水平和频率都很低，但在患者未得到安全和适当护理的情况下，道德困境的水平很高。总的来说，道德困境的频率低于水平。在道德困境量表上的 32 种情况中，有 13 种情况被 10-50%的参与者认为不相关。感知到的伦理气候越积极，报告的道德困境情况就越少。
由于积极的伦理气候与道德困境的发生频率较低有关，因此应调查是什么因素促成了积极的伦理气候。要在瑞典背景下使用，道德困境量表需要进一步修订。
鼓励在病房进行公开对话，讨论哪些实践有助于营造积极的伦理氛围。
