Karagozoglu Serife, Yildirim Gulay, Ozden Dilek, Çınar Ziynet
Cumhuriyet University, Turkey.
Dokuz Eylül University, Turkey.
Nurs Ethics. 2017 Mar;24(2):209-224. doi: 10.1177/0969733015593408. Epub 2016 Aug 3.
Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue.
AIM/OBJECTIVE: The study aims to (a) validate the Turkish version of the Moral Distress Scale-Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses' moral distress level.
The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale-Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.
In parallel with the original scale, Turkish version of Moral Distress Scale-Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.
Turkish version of Moral Distress Scale-Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care.
道德困扰是医疗保健领域专业人员中常见的问题。道德困扰是指专业人员尽管知道正确的行为是什么,但由于多种障碍而无法实施该行为时所经历的困扰。在重症监护病房工作的护士所经历的道德困扰程度因国家/文化/机构而异。然而,在土耳其,既没有用于评估护士所遭受道德困扰的测量工具,也没有针对该问题进行的研究。
本研究旨在(a)验证用于重症监护病房的土耳其语版修订版道德困扰量表,并检验该量表土耳其语版的有效性和可靠性,以及(b)探究土耳其重症监护护士的道德困扰水平。
本方法学、描述性横断面设计研究的样本包括土耳其三个城市四家医院内科和外科重症监护病房的200名护士。数据通过社会人口学特征表和土耳其语版修订版道德困扰量表收集。伦理考量:研究方案经居米什尔大学医学院伦理委员会批准。所有参与研究的护士均提供了知情同意书,并被告知数据保密。
与原量表一致,土耳其语版修订版道德困扰量表由21个项目组成,并呈现单因素结构。确定参与研究的护士的道德困扰总分和项目平均分分别为70.81±48.23和3.36±4.50。
土耳其语版修订版道德困扰量表可作为评估土耳其重症监护病房护士所经历道德困扰的可靠有效测量工具。根据我们的研究结果,可以说护士遭受的道德困扰程度较低。然而,导致我们研究中的护士经历较高道德困扰水平的因素包括团队内部沟通不足、与他们认为不称职的专业人员合作以及无效治疗。