Zare-Kaseb Akbar, Borhani Fariba, Abbaszadeh Abbas, Nazari Amir Mohamad
Medical Ethics and Low Research Center, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Medical Ethics and Low Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Nurs. 2025 Jan 6;24(1):15. doi: 10.1186/s12912-024-02673-7.
Oncology nurses have a vital role in providing care for individuals with cancer. Ethical dilemmas arise for oncology nurses caring for these patients. Nurses experience moral distress when work conflicts with personal beliefs, leading to inappropriate responses or uncertainty about ethics. The ethical climate might influence nurses' response to moral distress. Moral distress in nurses can lead to work-related stressors like compassion fatigue.
This study examined the relationship between moral distress, ethical climate, and compassion fatigue in oncology nursing. Moreover, the role of moral distress as a mediator in the link between ethical climate and compassion fatigue was examined.
A descriptive correlational design was recruited. One hundred twenty-two participants were recruited using the convenience sampling method. The study data were collected using a demographic information form, Corley's Moral Distress Questionnaire, Revised Victor and Cullen's Ethical Climate Questionnaire, and the Professional Quality of Life questionnaire. The Ethics Research Center of Shahid Beheshti University of Medical Sciences approved the study.
The overall moral distress, compassion fatigue, and ethical climate mean scores were 125.54 ± 37.50, 31.50 ± 9.23, and 49.03 ± 7.49, respectively. The analysis showed that among the dimensions of ethical climate (including egoism, benevolence and principled climate), egoism directly (p=0.03) and indirectly (p<0.001) and benevolence indirectly (p<0.001) (through moral distress) were significantly related to compassion fatigue. The principled ethical climate did not show any direct or indirect impact (p=0.72 and p=0.64, respectively).
Our findings showed moderate moral distress and low compassion fatigue among oncology nurses. In the examined oncology wards, the prevailing ethical climate was benevolent. Moral distress acts as a mediator between egoistic and benevolence ethical climate and compassion fatigue.
肿瘤护理护士在为癌症患者提供护理方面发挥着至关重要的作用。肿瘤护理护士在照顾这些患者时会出现伦理困境。当工作与个人信仰冲突时，护士会经历道德困扰，导致不适当的反应或对伦理问题的不确定性。伦理氛围可能会影响护士对道德困扰的反应。护士的道德困扰可能会导致与工作相关的压力源，如同情疲劳。
本研究探讨了肿瘤护理中道德困扰、伦理氛围和同情疲劳之间的关系。此外，还研究了道德困扰在伦理氛围与同情疲劳之间的联系中作为中介的作用。
采用描述性相关性设计。使用便利抽样方法招募了122名参与者。研究数据通过人口信息表、科利道德困扰问卷、修订后的维克托和卡伦伦理氛围问卷以及职业生活质量问卷收集。设拉子医科大学伦理研究中心批准了该研究。
总体道德困扰、同情疲劳和伦理氛围平均得分分别为125.54±37.50、31.50±9.23和49.03±7.49。分析表明，在伦理氛围的维度（包括利己主义、仁爱和原则性氛围）中，利己主义直接（p=0.03）和间接（p<0.001）以及仁爱间接（p<0.001）（通过道德困扰）与同情疲劳显著相关。原则性伦理氛围未显示出任何直接或间接影响（分别为p=0.72和p=0.64）。
我们的研究结果表明，肿瘤护理护士中存在中度道德困扰和低度同情疲劳。在所研究的肿瘤病房中，普遍的伦理氛围是仁爱的。道德困扰在利己主义和仁爱伦理氛围与同情疲劳之间起中介作用。
