Urmia University of Medical Sciences, Iran.
Tabriz University of Medical Sciences, Iran.
Nurs Ethics. 2019 Sep;26(6):1834-1847. doi: 10.1177/0969733018779210. Epub 2018 Jun 24.
Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse's burnout.
To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying.
The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences.
This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying.
The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly.
Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.
道德困境和工作场所欺凌是护理工作场所的重要问题，似乎会影响护士的倦怠。
调查伊朗护士的道德困境与倦怠之间的关系，其工作场所欺凌感起中介作用。
这项研究得到了乌尔米亚医科大学伦理委员会的批准。
这是一项相关性研究，采用横断面设计，使用匿名问卷作为研究工具（即修订后的道德困境量表、马斯拉赫倦怠量表和修订后的负面行为问卷）。数据来自伊朗西北部西阿塞拜疆省首府乌尔米亚的五所教学医院的 278 名护士。采用结构方程模型和自举程序来识别他们对工作场所欺凌的看法的中介作用。
参与者的道德困境、倦怠和负面行为问卷修订版的平均得分为 91.02±35.26、79.9±18.27 和 45.4±15.39。结果证实了我们的假设模型。研究的所有潜在变量都以预测的方向显著相关。道德困境和欺凌是倦怠的显著预测因素。欺凌感部分中介了道德困境与倦怠之间的关系。欺凌的中介作用表明，道德困境直接和间接地增加了倦怠。
护理管理人员应该意识到护理工作场所中的道德困境和欺凌在增加倦怠方面的作用。
