Hasanzadeh Moghadam Mahdieh, Heshmati Nabavi Fatemeh, Heydarian Miri Hamid, Saleh Moghadam Amir Reza, Mirhosseini Seyedmohammad
School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Public Health and Psychiatric Nursing Department, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Nurs Ethics. 2024 Mar-May;31(2-3):202-212. doi: 10.1177/09697330231177418. Epub 2023 Jun 26.
RESEARCH QUESTION/AIM/OBJECTIVES: Providing care for hospitalized children causes moral distress to nurses. Employee participation in discovering and solving the everyday problems of the workplace is one of the ways to hear the voices of nurses. This study aimed to evaluate the effect of participatory management programs on perceived organizational support and moral distress in pediatric nurses.
A quasi-experimental study.
The present study was conducted on 114 pediatric nurses in Iran. Data were collected using the Perceived Organizational Support Scale and the Moral Distress Scale of nurses. The intervention included implementing a participatory management program in three treatment departments that were randomly selected and it lasted 4 months. Participatory management was at the level of problem-solving with a focus on investigating, solving, and correcting issues and problems of work shifts and departments concerning the physical environment, equipment of the department, improvement of work processes, and team cooperation. In the control group, ordinary organizational approaches to problem-solving were used.
This study was approved by the Ethics Committee of Mashhad School of Nursing and Midwifery. Informed consent was obtained from the study participants.
FINDINGS/RESULTS: Based on the results, both groups were homogenous before the intervention in terms of moral distress and perceived organizational support. The results showed that the moral distress mean scores in the intervention group decreased from 1.45 (0.52) to 1.03 (0.37) after the intervention. Also, the score of the perceived organizational support was 2.12 (1.2) increased after the intervention to 2.68 (1.10) in the intervention group.
It was found that the participation of nurses in the problem-solving process to solve daily workplace issues can be effective in increasing their perceived organizational support and reducing their moral distress.
研究问题/目的/目标：为住院儿童提供护理会给护士带来道德困扰。员工参与发现和解决工作场所的日常问题是倾听护士声音的途径之一。本研究旨在评估参与式管理项目对儿科护士感知到的组织支持和道德困扰的影响。
一项准实验研究。
本研究对伊朗的114名儿科护士进行。使用护士感知组织支持量表和道德困扰量表收集数据。干预措施包括在随机选择的三个治疗科室实施参与式管理项目，为期4个月。参与式管理处于解决问题的层面，重点是调查、解决和纠正与工作班次和科室有关的身体环境、科室设备、工作流程改进以及团队合作等问题。对照组采用常规的组织问题解决方法。
本研究获得了马什哈德护理与助产学院伦理委员会的批准。研究参与者均签署了知情同意书。
结果显示，在道德困扰和感知到的组织支持方面，两组在干预前具有同质性。结果表明，干预后干预组的道德困扰平均得分从1.45（0.52）降至1.03（0.37）。此外，干预组感知组织支持的得分从干预前的2.12（1.2）提高到了2.68（即1.10）。
研究发现，护士参与解决工作场所日常问题的过程，对于提高他们感知到的组织支持和减少道德困扰是有效的。
