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道德困境:学术健康系统中住院肿瘤科护士的识别。

Moral Distress: Identification Among Inpatient Oncology Nurses in an Academic Health System.

机构信息

University of Pennsylvania.

Emory University.

出版信息

Clin J Oncol Nurs. 2020 Oct 1;24(5):500-508. doi: 10.1188/20.CJON.500-508.

Abstract

BACKGROUND

Moral distress occurs when clinicians know the morally correct action to take but are unable to follow through because of internal and external constraints. It is associated with negative consequences, such as burnout, decreased job satisfaction, avoidance, and turnover.

OBJECTIVES

The purpose of this study was to describe the frequency and level of moral distress among inpatient oncology nurses and to identify possible associations among nurses' demographic characteristics, work experience, and moral distress levels.

METHODS

Ninety-three inpatient oncology nurses from a large academic health system completed the Moral Distress Scale-Revised (MDS-R). Additional questions included intent to leave and requests for changes in patient assignments because of moral distress.

FINDINGS

Years as a nurse, changing or considering changing patient assignments, and changing care provided to a patient because of moral distress were statistically significantly associated with higher MDS-R scores. Participants reported using palliative care consultations, pastoral care, and social work to assist with their moral distress.

摘要

背景

当临床医生知道应该采取符合道德的行动,但由于内部和外部的限制而无法实施时,就会出现道德困境。它会导致负面后果,如倦怠、工作满意度降低、回避和离职。

目的

本研究的目的是描述住院肿瘤科护士道德困境的频率和程度,并确定护士的人口统计学特征、工作经验与道德困境水平之间可能存在的关联。

方法

来自一家大型学术医疗系统的 93 名住院肿瘤科护士完成了修订后的道德困境量表(MDS-R)。其他问题包括离职意向和因道德困境而要求改变患者分配。

结果

护士工作年限、改变或考虑改变患者分配,以及因道德困境而改变对患者的护理,与 MDS-R 得分呈统计学显著相关。参与者报告使用姑息治疗咨询、牧师关怀和社会工作来帮助他们应对道德困境。

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