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急诊室护士的道德困境及其影响因素:伊朗的一项横断面研究。

Moral distress and its contributing factors among emergency department nurses: A cross-sectional study in Iran.

机构信息

Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.

Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran.

出版信息

Int Emerg Nurs. 2021 May;56:100982. doi: 10.1016/j.ienj.2021.100982. Epub 2021 Mar 11.

Abstract

BACKGROUND

Moral Distress (MD) is a common experience in nursing practice and constitutes one of the main reasons for professional burnout, job withdrawal, fatigue, and avoidance of patient care among nurses. The causes, frequency and severity of MD vary according to the ward and hospital of service. The present study was conducted to determine the frequency and severity of MD and its contributing factors among Emergency Department (ED) nurses in Iran.

METHODS

This descriptive cross-sectional study was conducted in 2019.A total of 203 participants were selected by census sampling from the 248 nurses working in the EDs of hospitals in Semnan Province, Iran. Data were collected using Corley's Moral Distress Scale-Revised and analyzed using descriptive and inferential statistics.

FINDINGS

The mean severity and frequency of MD were 1.36 ± 0.74 and 1.20 ± 0.68 out of 4, respectively. The MD levels were significantly higher in female nurses (p = 0.002), those under 30 years of age (p = 0.003), with less than ten years' work experience (p = 0.03), and with higher levels of education (p < 0.001). In addition, inverse and significant relationships were found between MD and the nurses' age (r = -0.202,p = 0.004) and work experience(r = -0.149, p = 0.034).

CONCLUSION

According to the results, nurses had moderate levels of MD. Numerous factors, including age, gender, work experience, and education, were associated with the total MD score.To reduce MD and its negative effects on nurses, it is necessary to address these factors and appropriately plan to identify and manage MD so as to improve the quality of nursing care.

摘要

背景

道德困境(MD)是护理实践中的常见现象,也是护士职业倦怠、离职、疲劳和回避患者护理的主要原因之一。MD 的原因、频率和严重程度因服务的病房和医院而异。本研究旨在确定伊朗急诊科(ED)护士 MD 的频率和严重程度及其影响因素。

方法

这是一项 2019 年进行的描述性横断面研究。采用整群抽样法,从伊朗塞姆南省医院急诊科的 248 名护士中选取了 203 名参与者。使用 Corley 的修订版道德困境量表收集数据,并采用描述性和推断性统计方法进行分析。

结果

MD 的平均严重程度和频率分别为 4 分中的 1.36±0.74 和 1.20±0.68。女性护士(p=0.002)、年龄在 30 岁以下(p=0.003)、工作经验不足 10 年(p=0.03)和教育程度较高(p<0.001)的护士 MD 水平显著较高。此外,MD 与护士年龄(r=-0.202,p=0.004)和工作经验(r=-0.149,p=0.034)呈显著负相关。

结论

根据研究结果,护士的 MD 水平处于中等水平。年龄、性别、工作经验和教育程度等多种因素与 MD 总分有关。为了减少 MD 及其对护士的负面影响,有必要针对这些因素进行干预,并适当计划识别和管理 MD,以提高护理质量。

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