Malliarou Maria, Nikolentzos Athanasios, Papadopoulos Dimitrios, Bekiari Theodora, Sarafis Pavlos
Nursing Department, University of Thessaly, Greece.
Hellenic Open University, Greece.
Mater Sociomed. 2021 Jun;33(2):88-93. doi: 10.5455/msm.2021.33.88-93.
Moral distress is an unpleasant feeling that arises when one is forced to behave in such a way that it violates one's personal beliefs and values about what is right and what is wrong. Moral distress, unlike other forms of distress, contains an incompatible conflict between one's personal moral limitations and the acts that accompany it.
to investigate moral distress and its effects on the ICU nursing staff, their professional quality of life as well as, related factors.
The total sample of this cross-sectional study comprised of 258 ICU nurses working in reference hospitals for COVID 19 recruited online using google forms. The study tools are: a) "Measure of Moral Distress for Healthcare Professionals (MMD-HP)" to assess intensity and frequency of moral distress b) "Professional Quality of Life Scale (ProQOL-5)" to assess professional quality of life. Data were analyzed using IBM SPSS Statistics 25,0 (IBM Analytics, IBM Software Group Statistical Package).
Overall MMD-HP score ranged from 3 to 262 with a mean score of 116.52 (SD= 68.56). Distress score ranged from 5 to 79 with a mean score of 43.67 (SD=17.44) while intensity score ranged from 3 to 108 with a mean score 52.04 (SD=22.69). Bivariate analysis showed there is a statistically significant positive correlation between the intensity of moral distress and overall moral distress score with years of service in ICU and age. Nurses' Assistants (m=48.1 p=0.021) scored higher than Registered nurses in distress and intensity score (m=54.1 p=0.020) while female also scored higher in overall MMD-HP (m=121.2 p=0.049). Multivariate logistic regression analysis, showed that secondary trauma scale was independently associated with a higher distress scale score and a higher MMD-HP.
Educational support that provide information about dealing with moral distress during the coronavirus pandemic and how ICU nurses should deal with ethical issues that may confront in the everyday professional life is essential. Hospitals should monitor moral distress and there should be workshops that could build moral resilience and maintain high professional quality of life.
道德困扰是一种令人不快的感觉，当一个人被迫以违背其关于对错的个人信念和价值观的方式行事时就会产生。与其他形式的困扰不同，道德困扰包含个人道德限制与其伴随行为之间的不相容冲突。
调查道德困扰及其对重症监护病房（ICU）护理人员的影响、他们的职业生活质量以及相关因素。
这项横断面研究的总样本包括258名在新冠肺炎定点医院工作的ICU护士，通过谷歌表单在线招募。研究工具包括：a）“医疗保健专业人员道德困扰量表（MMD-HP）”，用于评估道德困扰的强度和频率；b）“职业生活质量量表（ProQOL-5）”，用于评估职业生活质量。使用IBM SPSS Statistics 25.0（IBM分析软件集团统计包）对数据进行分析。
MMD-HP总分范围为3至262，平均分为116.52（标准差=68.56）。困扰得分范围为5至79，平均分为43.67（标准差=17.44），而强度得分范围为3至108，平均分为52.04（标准差=22.69）。双变量分析表明，道德困扰强度与总体道德困扰得分与在ICU的服务年限和年龄之间存在统计学上显著的正相关。护士助理（均值=48.1，p=0.021）在困扰和强度得分上高于注册护士（均值=54.1，p=0.020），而女性在总体MMD-HP上得分也更高（均值=121.2，p=0.049）。多变量逻辑回归分析表明，继发性创伤量表与更高的困扰量表得分和更高的MMD-HP独立相关。
提供有关在新冠疫情期间应对道德困扰以及ICU护士在日常职业生活中应如何处理可能面临的伦理问题的信息的教育支持至关重要。医院应监测道德困扰，并且应该举办能够增强道德复原力并维持高职业生活质量的研讨会。
