Kovanci Mustafa Sabri, Atli Özbaş Azize
Hacettepe University.
Nurs Ethics. 2025 May;32(3):864-874. doi: 10.1177/09697330241272882. Epub 2024 Aug 12.
AimsThis study aims to examine the mediating effect of moral distress on the relationship between moral resilience and the intention to leave.BackgroundMoral distress is a phenomenon that negatively impacts healthcare workers, healthcare institutions, and recipients. To eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience is important in protecting against the negative effects of moral distress, such as burnout and turnover intention. In this direction, it is necessary to increase the moral resilience of nurses to reduce negative situations such as turnover intention in nurses.MethodsIt is a descriptive-predictive study. Sociodemographic Information Form, Measure of Moral Distress - Healthcare Professionals, and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 220 clinical nurses were recruited.Ethical considerationsApproval was obtained from the university's non-interventional ethics committee, and informed consent was obtained from the participants.ResultsThe study found a total moral distress score of 6.39 ± 0.3.12 and moral resilience score of 2.69 ± 0.48. A moderate and weak negative correlation was found between moral distress and moral resilience. Moral distress has a moderating effect on the intention to leave nursing (β = -0.158, = .010) and the intention to leave the current position (β = -0.174, = .000). Individual's moral resilience directly affects the intention to leave. The presence of moral distress eliminates the direct effect of moral resilience and affects the intention to leave together with moral resilience.ConclusionsMoral resilience leads to decreased intention to leave, and moral distress mediates this situation. An increase in moral distress decreases moral resilience and increases intention to leave. It can be assumed that if moral distress is not controlled, increasing moral resilience will not affect the intention to leave the job.
目的
本研究旨在探讨道德困扰在道德复原力与离职意愿之间关系中的中介作用。
背景
道德困扰是一种对医护人员、医疗机构和接受者产生负面影响的现象。为了消除或最小化道德困扰的负面影响,有必要提高护士的道德复原力。道德复原力对于抵御道德困扰的负面影响(如倦怠和离职意愿)很重要。在这个方向上,有必要提高护士的道德复原力,以减少护士离职意愿等负面情况。
方法
这是一项描述性预测研究。使用社会人口学信息表、道德困扰测量量表——医疗专业人员版以及拉什顿道德复原力量表从护士中收集数据。共招募了220名临床护士。
伦理考量
获得了大学非干预性伦理委员会的批准,并获得了参与者的知情同意。
结果
研究发现道德困扰总得分6.39±0.312,道德复原力得分2.69±0.48。道德困扰与道德复原力之间存在中度和弱负相关。道德困扰对离职护理工作的意愿(β = -0.158,p = 0.010)和离开当前岗位的意愿(β = -0.174,p = 0.000)有调节作用。个体的道德复原力直接影响离职意愿。道德困扰的存在消除了道德复原力的直接影响,并与道德复原力一起影响离职意愿。
结论
道德复原力导致离职意愿降低,道德困扰在这种情况中起中介作用。道德困扰的增加会降低道德复原力并增加离职意愿。可以假设,如果不控制道德困扰,提高道德复原力将不会影响离职意愿。