From the Department of Nursing, Faculty of Health Science, Zonguldak Bülent Ecevit University, Zonguldak.
Department of Nursing, Faculty of Health Science, Karabük University, Karabük.
Pediatr Emerg Care. 2023 Sep 1;39(9):692-697. doi: 10.1097/PEC.0000000000003019. Epub 2023 Jul 19.
Emergency services are patient circulation units that require chaos, trauma, and high tension. It was aimed to determine the moral distress levels of pediatric nurses in pediatric emergency and emergency departments and relevant factors.
This study is a descriptive and cross-sectional study. It consists of 255 nurses with their data. The Participant Information Form and the Moral Distress Scale-Revised for Pediatric Nurses (MDS-R) were used to collect data.
In the study, the mean score of MDS-R frequency was found to be 27.36 ± 13.16, the mean score of MDS-R intensity to be 37.65 ± 17.53, and the mean total score of MDS-R to be 58.96 ± 39.40. It was determined that 93.7% of the nurses received training on moral distress, and education level was effective on moral distress levels of the nurses. The nurses working in the pediatric emergency service had higher moral distress levels than the nurses serving pediatric patients in the emergency department ( P(total MDS-R) = 0.02, P(frequency of MDS-R) = 0.008). Job satisfaction ( P(total MDS-R) = 0.003, P(frequency of MDS-R) < 0.001, P(intensity of MDS-R) < 0.001) and frequency of thinking about changing working unit ( P(frequency of MDS-R) = 0.02, P(intensity of MDS-R) = 0.01) were found to be effective on the level of moral distress. It was determined that the type of emergency service, the working time in the emergency service, and the level of job satisfaction significantly affected the total moral distress scores of the nurses ( P < 0.001, R2 = 0.09).
It was found in the study that nurses had low levels of moral distress; however, many factors relevant to working conditions were associated with moral distress. The pediatric emergency service nurses were determined to experience a higher moral distress compared with the emergency department nurses serving pediatric patients.
急救服务是患者循环单位，需要应对混乱、创伤和高压等情况。本研究旨在确定儿科急诊和急救部门儿科护士的道德困境水平及其相关因素。
这是一项描述性和横断面研究，共纳入 255 名护士。使用参与者信息表和儿科护士道德困境量表修订版（MDS-R）收集数据。
研究中，MDS-R 频率的平均得分为 27.36±13.16，MDS-R 强度的平均得分为 37.65±17.53，MDS-R 总得分的平均得分为 58.96±39.40。研究发现，93.7%的护士接受过道德困境培训，教育程度对护士的道德困境水平有影响。在儿科急诊工作的护士比在急救部门服务儿科患者的护士有更高的道德困境水平（P（总 MDS-R）=0.02，P（MDS-R 频率）=0.008）。工作满意度（P（总 MDS-R）=0.003，P（MDS-R 频率）<0.001，P（MDS-R 强度）<0.001）和变更工作单位的频率（P（MDS-R 频率）=0.02，P（MDS-R 强度）=0.01）对道德困境水平有影响。研究还发现，急救服务类型、在急救服务中的工作时间以及工作满意度显著影响护士的总道德困境评分（P<0.001，R2=0.09）。
本研究发现护士的道德困境水平较低，但与工作条件相关的许多因素与道德困境有关。与服务儿科患者的急救部门护士相比，儿科急诊护士的道德困境水平更高。
