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护士的复原力、同情疲劳、道德困扰和道德伤害。

Resilience, compassion fatigue, moral distress and moral injury of nurses.

作者信息

Albaqawi Hamdan Mohammad, Alshammari Mohammed Hamdan

机构信息

University of Hail.

出版信息

Nurs Ethics. 2025 May;32(3):798-813. doi: 10.1177/09697330241287862. Epub 2024 Oct 8.

Abstract

Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this study. The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey's description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Nurse leaders should develop programmes and initiate efforts to improve nurses' resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. There was no public or patient participation in this study.

摘要

同情疲劳、道德困扰和道德伤害是相互关联的现象,对护理服务的提供产生不利影响。护士具备有效应对这三种不良情况所需的内在复原力。本研究旨在确定复原力对沙特阿拉伯护士同情疲劳、道德困扰和道德伤害的中介作用。最终成果是一个采用定量相关横断面设计生成的结构方程模型(SEM),并且我们在本研究中遵循了STROBE指南。该研究涉及511名在职护士样本,采用连续抽样法选取。研究在沙特阿拉伯的三家政府医院进行。本研究于2021年3月5日获得伦理委员会批准,批准号为H - 2021 - 151。调查问卷的描述和同意声明以英文和阿拉伯文清晰呈现于谷歌调查问卷表单上。结果显示,复原力对道德困扰有负面影响,而同情疲劳和道德伤害有正面影响。同样,同情疲劳对道德困扰和道德伤害有直接的正面影响,道德困扰对道德伤害有直接的正面影响。分析还表明,复原力通过同情疲劳和道德困扰的中介作用对道德伤害有正向的间接影响。同样,同情疲劳通过道德困扰的中介作用对道德伤害有正向的间接影响。因为复原力使护士能够适应,所以它有助于他们克服职业和职业生涯中的障碍。护士经常将复原力视为一种保护特质。道德伤害、同情疲劳和道德困扰会对护士的健康产生负面影响。护士领导者应制定方案并采取措施,提高护士的复原力,将其作为抵御同情疲劳、道德困扰和道德伤害的重要保护特质。本研究没有公众或患者参与。

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