Krautscheid Lorretta, DeMeester Deborah A, Orton Valorie, Smith Austin, Livingston Conor, McLennon Susan M
About the Authors Lorretta Krautscheid, PhD, RN, CNE, is an assistant professor, University of Portland School of Nursing, Portland, Oregon. Deborah A. DeMeester, PhD, RN, CNE, is a clinical assistant professor and assistant dean for prelicensure programs, Indiana University School of Nursing, Indianapolis, Indiana. Valorie Orton, MS, RN, CNL, is an instructor of nursing, Seattle Pacific University, Seattle, Washington. Austin Smith, BSN, is a registered nurse for Providence Health Systems, Portland, Oregon. Conor Livingston, BSN, is a registered nurse for Swedish Hospital, Seattle, Washington. Susan M. McLennon, PhD, ANP-BC, is an associate professor, University of Tennessee, Knoxville, Tennessee. For more information, contact Dr. Krautscheid at
Nurs Educ Perspect. 2017 Nov/Dec;38(6):313-319. doi: 10.1097/01.NEP.0000000000000214.
The three study aims were to assess moral distress among senior baccalaureate nursing students, describe ethical dilemmas contributing to their moral distress in practice settings, and identify reasons for inaction when encountering dilemmas.
Previous studies have linked postlicensure nurses' moral distress to compassion fatigue, frustration, and turnover. Little is known about this phenomenon in students.
This study employed a descriptive cross-sectional survey design to measure moral distress and reasons for not taking action across three academic sites (N = 267). Content analysis was used to identify themes of distressing clinical situations.
Aggregate mean moral distress rating was 3.12. Content analysis revealed compromised best practices, disrespect for human dignity, perceived constraints, and navigating personal values. The most frequent reasons for inaction were subordinate role, relationship preservation, incomplete knowledge, and uncertainty about speaking up.
Results help educators prioritize strategies to prevent and manage moral distress among students.
本研究的三个目的是评估护理学本科高年级学生的道德困扰，描述导致他们在实践环境中出现道德困扰的伦理困境，并确定遇到困境时不作为的原因。
先前的研究已将获得执照后的护士的道德困扰与同情疲劳、挫败感和离职率联系起来。对于学生中的这一现象，人们了解甚少。
本研究采用描述性横断面调查设计，以测量三个学术地点（N = 267）的道德困扰及不采取行动的原因。采用内容分析法确定令人苦恼的临床情况的主题。
道德困扰综合平均评分为3.12。内容分析揭示了最佳实践受到损害、对人类尊严的不尊重、感知到的限制以及个人价值观的权衡。最常见的不作为原因是从属角色、关系维护、知识不完整以及对发声的不确定性。
研究结果有助于教育工作者确定预防和管理学生道德困扰的策略优先级。
