Safari Fateme, MohammadPour Ali, BasiriMoghadam Mahdi, NamaeiQasemnia Alireza
Department of Medical Surgical Nursing, School of Nursing, Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
BMC Nurs. 2024 Oct 9;23(1):732. doi: 10.1186/s12912-024-02368-z.
Nurses constitute the largest group of service providers in the healthcare system and significantly influence the quality of healthcare services. Factors such as ethical considerations may be related to the quality of care. This study aimed to determine the relationship between moral distress and the quality of clinical care among nurses working in Gonabad, Iran.
An analytical cross-sectional study was conducted on 252 nurses working in emergency, internal medicine, surgery, psychiatry, critical care and maternity wards at Allameh Bohlool Hospital from May to July 2023. This research used demographic information questionnaire, the revised Moral Distress Scale (MDS-R), and the Quality Patient Care Scale (QUALPAC). The significance level for the study was set at p < 0.05.
There was a significant relationship between the frequency of moral distress and the quality of clinical care (p = 0.032), as well as between the intensity of moral distress and the quality of clinical care (p = 0.043). Nurses who experienced moral distress more frequently and intensely provided better quality care. However, there was no significant relationship between the effect of moral distress and the quality of clinical care (r = 0.032, p = 0.619). Additionally, a significant statistical relationship was found between the intensity of moral distress and the physical dimension of clinical care quality (r = 0.171, p = 0.007), indicating that increased moral distress intensity was associated with higher quality of physical care.
Nurses who experience higher levels of moral distress, both in terms of frequency and intensity, perform better in the care they provide and deliver it in the best possible manner, particularly in the physical dimension of care.
护士是医疗保健系统中最大的服务提供者群体，对医疗服务质量有重大影响。伦理考量等因素可能与护理质量相关。本研究旨在确定伊朗戈纳巴德工作的护士中道德困扰与临床护理质量之间的关系。
2023年5月至7月，对阿拉梅·博赫洛尔医院急诊科、内科、外科、精神科、重症监护病房和产科病房工作的252名护士进行了一项分析性横断面研究。本研究使用了人口统计学信息问卷、修订后的道德困扰量表（MDS-R）和患者护理质量量表（QUALPAC）。研究的显著性水平设定为p < 0.05。
道德困扰的频率与临床护理质量之间存在显著关系（p = 0.032），道德困扰的强度与临床护理质量之间也存在显著关系（p = 0.043）。道德困扰发生频率更高、强度更大的护士提供的护理质量更好。然而，道德困扰的影响与临床护理质量之间没有显著关系（r = 0.032，p = 0.619）。此外，道德困扰的强度与临床护理质量的身体维度之间存在显著的统计关系（r = 0.171，p = 0.007），这表明道德困扰强度的增加与身体护理质量的提高相关。
在频率和强度方面经历更高水平道德困扰的护士，在其所提供的护理中表现更好，并以尽可能最佳的方式提供护理，特别是在护理的身体维度方面。
