Almutairi Adel F, Salam Mahmoud, Adlan Abdallah A, Alturki Abdullah S
Science and Technology Unit, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard health affairs, Riyadh, Saudi Arabia,
Bioethics Section, King Abdullah International Medical Research center, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Psychol Res Behav Manag. 2019 Feb 11;12:107-115. doi: 10.2147/PRBM.S191037. eCollection 2019.
Moral distress is a serious problem in healthcare environments that requires urgent attention and management. It occurs when healthcare providers are unable to provide the care that they feel is right or take, what they believe to be, ethically appropriate actions for their patients. Thus, this study aims to examine moral distress among nurses and physicians working in tertiary teaching hospitals in Saudi Arabia, as well as to evaluate the level of association between moral distress and turnover.
This cross-sectional study, which employed an anonymous 21-item Moral Distress Scale, was undertaken at a large medical institution located in different regions of Saudi Arabia. The data were analyzed using bivariate analyses, and logistic regression.
Of the 342 participants, 239 (69.9%) were nurses/staff physicians and 103 (30.1%) were fellows/consultants. Approximately 24.3% of respondents experienced severe moral distress, whereas 75.7% reported mild moral distress. There was no statistically significant difference between men and women in terms of moral distress. Age was found to be a notable factor: moral distress was significantly higher in those younger than 37 years compared to those 37 years and older (=0.015). Less than half of the participants (137, 42.8%) indicated their willingness to leave their jobs. A significant association was observed between severe moral distress and leaving the career (OR=3.16; <0.01). Job category was also an important factor: nurses/staff physicians were almost two times more likely (OR =1.95, =0.038) to leave their positions compared to fellows/consultants.
This study revealed that moral distress, which is a serious problem that compromises the well-being of caregivers, was a predictive variable for the intention of healthcare providers to leave their jobs. Therefore, it should be routinely examined, and efficient action plans should be implemented to alleviate its consequences.
道德困扰是医疗环境中的一个严重问题，需要紧急关注和处理。当医疗服务提供者无法提供他们认为正确的护理，或采取他们认为符合伦理道德的行动来照顾患者时，就会出现道德困扰。因此，本研究旨在调查沙特阿拉伯三级教学医院护士和医生中的道德困扰情况，并评估道德困扰与离职率之间的关联程度。
本横断面研究采用一份包含21个条目的匿名道德困扰量表，在沙特阿拉伯不同地区的一家大型医疗机构开展。数据采用双变量分析和逻辑回归进行分析。
在342名参与者中，239名（69.9%）是护士/住院医师，103名（30.1%）是研究员/顾问。约24.3%的受访者经历过严重道德困扰，而75.7%报告有轻度道德困扰。在道德困扰方面，男性和女性之间没有统计学上的显著差异。年龄是一个显著因素：与37岁及以上的人相比，37岁以下的人道德困扰明显更高（=0.015）。不到一半的参与者（137名，42.8%）表示愿意离职。在严重道德困扰与离职之间观察到显著关联（比值比=3.16；<0.01）。工作类别也是一个重要因素：与研究员/顾问相比，护士/住院医师离职的可能性几乎高出两倍（比值比=1.95，=0.038）。
本研究表明，道德困扰是一个严重影响医护人员幸福感的问题，是医疗服务提供者离职意向的一个预测变量。因此，应定期对其进行检查，并实施有效的行动计划以减轻其后果。
