Berhie Alemshet Yirga, Tezera Zewdu Baye, Azagew Abere Woretaw
Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Psychol Res Behav Manag. 2020 Feb 19;13:161-167. doi: 10.2147/PRBM.S234446. eCollection 2020.
Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one's moral requirements. The study aimed to assess the proportion of moral distress and associated factors among nurses working in Northwest Amhara Regional State referral hospitals in 2018.
A cross-sectional study was conducted among nurses working at Northwest Amhara regional state referral hospitals from April 1-30/2018. A total of 423 study participants were enrolled in the study. A systematic random sampling technique was used to select the study participants. A pretested self-administered structured questionnaire was used to collect data. Moral Distress Scale-Revised (MDS-R) was used to assess the proportion of moral distress. Epi info version 7 for data entry and SPSS version 22 for data analysis were used. A binary logistic model was computed. Variables having p-value < 0.5 with 95% CI were used to declare the presence of significant associations.
A total of 423 study participants were enrolled in the study with a response rate of 97.4%. The mean (SD) age of the respondents was 30.62 ± 5.7 years. The majority of nurses 350 (85%) were degree and above holders in nursing. The proportion of moral distress among nurses was found to be 83.7%. Work experience 11-20 years [adjusted odds ratio (AOR)=2, 95% CI: 1.01, 3.34], perceived poor team communication [AOR=4.5, 95% CI: 1.78, 11.62], perceived powerlessness in decision making [AOR=3.3, 95% CI: 1.38, 7.87], inadequate staffing [AOR=2.96, 95% CI: 1.26, 6.97], and inappropriate provision of care [AOR=4.12, 95% CI: 1.55, 10.9] were significantly associated with moral distress.
Nurses frequently experienced moral distress in clinical settings. Perceived poor communication, perceived powerlessness in decision making, inadequate staffing, and inappropriate provision care were the factors associated with moral distress.
道德困扰是指当一个人感到不得不违背自己的道德要求而行动时产生的认知 - 情感失调。本研究旨在评估2018年在阿姆哈拉地区州转诊医院工作的护士中道德困扰的比例及相关因素。
于2018年4月1日至30日对在阿姆哈拉地区州转诊医院工作的护士进行了一项横断面研究。共有423名研究参与者纳入研究。采用系统随机抽样技术选取研究参与者。使用预先测试的自填式结构化问卷收集数据。采用道德困扰量表修订版（MDS - R）评估道德困扰的比例。使用Epi info 7版本进行数据录入，SPSS 22版本进行数据分析。计算二元逻辑模型。p值<0.5且95%置信区间的变量用于表明存在显著关联。
共有423名研究参与者纳入研究，应答率为97.4%。受访者的平均（标准差）年龄为30.62±5.7岁。大多数护士350名（85%）拥有护理学位及以上学历。护士中道德困扰的比例为83.7%。工作经验11 - 20年[调整后的优势比（AOR）=2，95%置信区间：1.01，3.34]、感知到团队沟通不良[AOR = 4.5，95%置信区间：1.78，11.62]、在决策中感到无力[AOR = 3.3，95%置信区间：1.38，7.87]、人员配备不足[AOR = 2.96，95%置信区间：1.26，6.97]以及护理提供不当[AOR = 4.12，95%置信区间：1.55，10.9]与道德困扰显著相关。
护士在临床环境中经常经历道德困扰。感知到的沟通不良、在决策中感到无力、人员配备不足以及护理提供不当是与道德困扰相关的因素。
