Abbasi Mahmoud, Nejadsarvari Nasrin, Kiani Mehrzad, Borhani Fariba, Bazmi Shabnam, Nazari Tavaokkoli Saeid, Rasouli Hamidreza
Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Department of Medical Ethics, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2014 Oct 5;16(10):e18797. doi: 10.5812/ircmj.18797. eCollection 2014 Oct.
Researchers have regarded moral distress as a major concern in the health care system. Symptoms associated with moral distress may manifest as frustration, dissatisfaction, and anxiety and may lead to burnout, job leaving, and finally, failure to provide safe and competent care to patients. Proper management of this phenomenon can be fulfilled through study of its causes at different levels of health services and taking necessary measures to solve them.
This study aimed to determine the status of moral distress in physicians practicing in hospitals affiliated to Medical Sciences Universities in Tehran.
This cross-sectional study was carried out using the Standard Hamric Scale to collect data after modification and evaluation of its reliability and validity. A total of 399 physicians responded to the scale. Data analysis was performed using descriptive and correlation statistics with respect to the variables.
Results showed that the frequency of moral distress of physicians was 1.24 ± 0.63 and the intensity of moral distress and composite score of moral distress were 2.14 ± 0.80 and 2.94 ± 2.38, respectively. A significant negative correlation existed between age and frequency and composite score (r = -0.15, P < 0.01 and r = -0.16, P < 0.01, respectively) as well as years of experience and composite score (r = -0.11, P = 0.04). Moral distress composite score in adults specialists was higher than pediatricians (P = 0.002), but lower in physicians participated in medical ethics training courses compared to those not participated.
Physicians may encounter moral distress during their practice; therefore, the common causes of distress should be identified in order to prevent its occurrence.
研究人员已将道德困扰视为医疗保健系统中的一个主要问题。与道德困扰相关的症状可能表现为沮丧、不满和焦虑，并可能导致职业倦怠、离职，最终无法为患者提供安全和称职的护理。通过在不同层面的卫生服务中研究其原因并采取必要措施加以解决，可以对这一现象进行妥善管理。
本研究旨在确定在德黑兰医科大学附属医院执业的医生中道德困扰的状况。
本横断面研究采用标准哈姆里克量表收集数据，该量表在修改并评估其信效度后使用。共有399名医生对该量表做出了回应。针对变量进行描述性和相关性统计分析。
结果显示，医生道德困扰的频率为1.24±0.63，道德困扰强度和道德困扰综合评分为分别为2.14±0.80和2.94±2.38。年龄与频率和综合评分之间存在显著负相关（r=-0.15，P<0.01和r=-0.16，P<0.01），工作年限与综合评分之间也存在显著负相关（r=-0.11，P=0.04）。成人专科医生的道德困扰综合评分高于儿科医生（P=0.002），但参加医学伦理培训课程的医生的道德困扰综合评分低于未参加者。
医生在执业过程中可能会遇到道德困扰；因此，应确定困扰的常见原因以预防其发生。
