Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Nurs Ethics. 2023 Sep;30(6):822-831. doi: 10.1177/09697330221142079. Epub 2023 Mar 29.
The increasing prevalence of moral distress in the stressful environment of the intensive care unit (ICU) provides grounds for nursing error and endangers patients' health, safety, and even life. One of the most important reasons for this distress is the treatment team's second victim syndrome (SVS), especially nurses, following errors in the treatment system.
The present study aimed to determine the relationship between moral distress and SVS in ICUs.
This cross-sectional study involved a sample size of 96 ICU nurses working in hospitals affiliated with Tehran University of Medical Sciences, Iran, in the 2021-2022 period, who were selected via a simple random sampling method. Data were collected using the Demographic Questionnaire, the second victim experience and support tool (SVEST) and Moral Distress Scale-Revised (MDS-R). Descriptive statistics (percentage, frequency, mean, and SD) and analytical tests (Spearman correlation coefficient test, independent t-test, and ANOVA) were employed for data analysis.
This study used a sample size of 96 intensive care unit nurses working in hospitals affiliated to Tehran University of Medical Sciences selected by simple random sampling.
The study obtained research ethics approval, and all participants were informed of the voluntary and anonymous nature of their participation.
The results showed that 59.4% of nurses suffered a low level of moral distress, and 40.6% suffered from a moderate level of moral distress. The SVS score of 86.5% of the nurses was moderate. There was no significant and direct correlation between moral distress and SVS in nurses; however, there was a significant and inverse correlation between the moral distress intensity and SVS ( = 0.011).
Despite no significant correlation between moral distress and SVS, these variables were at moderate levels. Accordingly, it is suggested to provide a proper ground for expressing morally stressful situations, counseling and training strategies to deal with moral distress, creating support resources for those suffering from SVS, and implementing empowerment programs.
重症监护病房（ICU）紧张环境下道德困境的日益普遍为护理差错提供了理由，并危及患者的健康、安全甚至生命。造成这种困境的一个最重要原因是治疗团队的第二受害者综合征（SVS），尤其是护士，在治疗系统出现错误后。
本研究旨在确定 ICU 中道德困境与 SVS 之间的关系。
这是一项横断面研究，样本量为 96 名在伊朗德黑兰大学医学科学附属医院工作的 ICU 护士，于 2021-2022 年期间采用简单随机抽样法选取。采用一般情况问卷、第二受害者经历和支持工具（SVEST）以及修订后的道德困境量表（MDS-R）收集数据。采用描述性统计（百分比、频率、均值和标准差）和分析检验（Spearman 相关系数检验、独立 t 检验和 ANOVA）进行数据分析。
本研究采用简单随机抽样法，选取了 96 名在德黑兰大学医学科学附属医院工作的 ICU 护士作为样本。
本研究获得了研究伦理批准，所有参与者均被告知参与研究是自愿和匿名的。
结果显示，59.4%的护士遭受低水平的道德困境，40.6%的护士遭受中度道德困境。86.5%的护士 SVS 评分为中度。护士的道德困境与 SVS 之间没有显著的直接相关性；然而，道德困境的强度与 SVS 之间存在显著的负相关（=0.011）。
尽管道德困境与 SVS 之间没有显著的相关性，但这两个变量都处于中等水平。因此，建议为表达道德困境提供适当的场所，提供咨询和处理道德困境的培训策略，为遭受 SVS 的人创建支持资源，并实施赋权计划。
