Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
J Crit Care. 2019 Apr;50:122-125. doi: 10.1016/j.jcrc.2018.11.030. Epub 2018 Nov 29.
To assess the association between moral distress and general workplace distress in intensive care unit (ICU) personnel.
We administered the Moral Distress Scale Revised and the Job Content Questionnaire to all clinicians (870 nurses, 68 physicians, 452 other health professionals) in 13 ICUs (3 tertiary, 3 large community, 7 small community) in British Columbia, Canada. We used mixed effects regression, treating ICUs as clusters, to examine the association between the Moral Distress Score and each Job Content Questionnaire scale (decision latitude, psychological stressors, social support, psychological strain) after adjusting for age, sex, and years of experience of respondents; separate analyses were done for each profession.
Overall response rate was 45%. Nurses and other health professionals had higher moral distress scores than physicians, but there were no differences in general workplace distress scores among professional groups. After adjustment for demographic characteristics, higher moral distress in nurses was associated with lower decision latitude and social support, and with higher psychological stressors and psychological strain. For physicians and other professionals, these relationships were similar.
Moral distress is associated with general workplace distress in ICU personnel. Interventions that ameliorate either type of distress may also ameliorate the other.
评估重症监护病房（ICU）人员道德困境与一般工作场所困境之间的关联。
我们向加拿大不列颠哥伦比亚省 13 个 ICU（3 个三级、3 个大型社区、7 个小型社区）的所有临床医生（870 名护士、68 名医生、452 名其他卫生专业人员）发放了修订后的道德困境量表和工作内容问卷。我们使用混合效应回归，将 ICU 作为聚类，调整受访者的年龄、性别和工作年限后，研究道德困境评分与工作内容问卷各量表（决策自由度、心理压力源、社会支持、心理紧张）之间的关联；对每个专业分别进行了分析。
总体回复率为 45%。护士和其他卫生专业人员的道德困境评分高于医生，但专业群体之间的一般工作场所困境评分无差异。在调整人口统计学特征后，护士的道德困境评分越高，决策自由度和社会支持越低，心理压力源和心理紧张度越高。对于医生和其他专业人员，这些关系是相似的。
道德困境与 ICU 人员的一般工作场所困境相关。改善任何一种困境的干预措施也可能改善另一种困境。
