Health care reform in Iran: Implications for nurses' moral distress, patient rights, satisfaction and turnover intention.

AIM

The aim of the present study was to assess the implications of Iran's recent health care reforms on nurses' experience of moral distress, their perceptions of the respect for patient rights and the relationship of these variables to job and income dissatisfaction and turnover intention.

BACKGROUND

Health systems around the world are reforming themselves to adapt to meeting the future needs of increasing patient care to an ever-growing population.

METHODS

This was a cross-sectional correlational study. The participants were 276 nurses at six large private and public hospitals in Tehran, Iran.

FINDINGS

Negative correlations were reported between turnover intention and respecting patient rights (r = -0.560, p < 0.001), satisfaction with job (r = -0.710, p < 0.001) and satisfaction with income (r = -0.226, p < 0.001). The correlation between moral distress intensity (r = 0.626, p < 0.001) and frequency (r = 0.701, p < 0.001) was positive with turnover intention.

CONCLUSIONS

Moral distress was significantly correlated to poor respect for patient rights, poor job satisfaction and income satisfaction and was a major predictor of turnover intention.

IMPLICATIONS FOR NURSING MANAGEMENT

Health system reform must take into account the concomitant increasing workload and its negative impact in order to ensure that reform does not lead to unintentional detrimental outcomes of increased moral distress, decreased satisfaction and increased turnover rates among nursing personnel.