University of Maryland School of Nursing, Baltimore, MD.
University of Maryland School of Nursing, Baltimore, MD.
Nurs Outlook. 2023 Sep-Oct;71(5):102026. doi: 10.1016/j.outlook.2023.102026. Epub 2023 Aug 12.
Nurse leaders face immense organizational pressures exacerbating their distress, which has not been prioritized as much as frontline nurses. This review synthesized the literature to examine theoretical models, measures, contributing factors, outcomes, and coping strategies related to moral distress in nurse leaders. PubMed, Embase, CINAHL, and PsycINFO were searched, and 15 articles-2 quantitative and 13 qualitative studies were extracted. The scoping review identified one study using a theoretical model and two measures-the ethical dilemmas questionnaire and the Brazilian moral distress scale. Contributing factors of moral distress include internal and organizational constraints, increased workload, and lack of support impacting physical and emotional well-being and intention to quit. This review did not yield any intervention studies emphasizing the need for research to identify specific predictors of moral distress and examine their relationship to nurse leader retention, so organizations can explore targeted interventions to promote coping and mitigate distress.
护理领导者面临着巨大的组织压力，加剧了他们的痛苦，但这并没有像一线护士那样受到重视。本综述综合了文献，以检查与护理领导者道德困境相关的理论模型、测量方法、促成因素、结果和应对策略。检索了 PubMed、Embase、CINAHL 和 PsycINFO，并提取了 15 篇文章，其中 2 篇为定量研究，13 篇为定性研究。范围综述确定了一项使用理论模型和两种测量方法的研究，即道德困境问卷和巴西道德困境量表。道德困境的促成因素包括内部和组织限制、工作量增加以及缺乏支持，这些因素会影响身体和情绪健康以及离职意愿。本综述没有产生任何干预研究，强调需要研究确定道德困境的具体预测因素，并研究它们与护理领导者留任的关系，以便组织可以探索有针对性的干预措施来促进应对和减轻困境。
