成人重症监护病房护士使用科雷量表的道德困境得分：系统评价。
Moral Distress Scores of Nurses Working in Intensive Care Units for Adults Using Corley's Scale: A Systematic Review.
机构信息
School of Nursing, UniCamillus-Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy.
Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy.
出版信息
Int J Environ Res Public Health. 2022 Aug 26;19(17):10640. doi: 10.3390/ijerph191710640.
BACKGROUND
No systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress experienced by nurses in ICUs, as assessed by Corley's instruments on moral distress (the Moral Distress Scale and the Moral Distress Scale-Revised). Additionally, this systematic review aimed to summarize the correlates of moral distress.
METHODS
A systematic search and review were performed using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Library of Medicine (MEDLINE/PubMed), and Psychological Abstracts Information Services (PsycINFO). The review methodology followed PRISMA guidelines. The quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale.
RESULTS
Findings showed a moderate level of moral distress among nurses working in ICUs. The findings of this systematic review confirm that there are a lot of triggers of moral distress related to patient-level factors, unit/team-level factors, or system-level causes. Beyond the triggers of moral distress, this systematic review showed some correlates of moral distress: those nurses working in ICUs with less work experience and those who are younger, female, and intend to leave their jobs have higher levels of moral distress. This systematic review's findings show a positive correlation between professional autonomy, empowerment, and moral distress scores. Additionally, nurses who feel supported by head nurses report lower moral distress scores.
CONCLUSIONS
This review could help better identify which professionals are at a higher risk of experiencing moral distress, allowing the early detection of those at risk of moral distress, and giving the organization some tools to implement preventive strategies.
背景
目前文献中尚无系统评价分析 ICU 护士的道德困境强度和频率。似乎没有研究对与高水平道德困境相关的主要个人和职业特征进行映射。本系统评价旨在描述 ICU 护士经历的道德困境的强度和频率，由 Corley 的道德困境工具（道德困境量表和修订后的道德困境量表）评估。此外，本系统评价旨在总结道德困境的相关因素。
方法
使用以下数据库进行系统搜索和综述：护理与联合健康文献累积索引（CINAHL）、美国国家医学图书馆（MEDLINE/PubMed）和心理文摘信息服务（PsycINFO）。综述方法遵循 PRISMA 指南。使用纽卡斯尔-渥太华量表对纳入研究进行质量评估。
结果
研究结果表明，在 ICU 工作的护士中存在中度水平的道德困境。本系统评价的结果证实，存在许多与患者水平因素、单位/团队水平因素或系统水平原因相关的道德困境触发因素。除了道德困境的触发因素外，本系统评价还显示了一些道德困境的相关因素：在 ICU 工作经验较少、年龄较小、女性、打算离职的护士，其道德困境水平更高。本系统评价的结果表明，专业自主性、赋权与道德困境评分呈正相关。此外，感到护士长支持的护士报告的道德困境评分较低。
结论
本综述可以帮助更好地确定哪些专业人员更容易经历道德困境，从而早期发现有道德困境风险的人员，并为组织提供一些实施预防策略的工具。
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