Moral distress and associated factors among nurses working in central Ethiopia: a cross-sectional study

Abstract

Abstract Background Moral distress is recognized as a problem affecting nurse professionals globally. Unaddressed moral distress harms nurses’ physical and mental health, the quality of patient care, and the performance of healthcare teams and organizations. However, evidence on the magnitude and risk factors of moral distress is limited in Ethiopia in general and in the study area in particular. Thus, this study aimed to assess the magnitude of moral distress and associated factors among nurses working in Adama Comprehensive Specialized Hospital Medical College, central Ethiopia, 2023. Methods A facility-based cross-sectional study was conducted from January 1 to 30, 2023, with 219 nurses. A simple random sampling technique was employed to select the study participants. A self-administered structured questionnaire was used for data collection and Moral Distress Scale-Revised (MDS-R) was used to assess moral distress. Data were checked, coded, and entered into Epi info version 7, and then exported to the Statistical Package for Social Science version 26 for analysis. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with moral distress. The odds ratio with its 95% confidence interval was used as a measure of association and statistical significance was declared at a p-value < 0.05. Result A total of 212 nurses participated in the analysis making the response rate 96.8%. The magnitude of moral distress was 86.8% (95% CI 82.1%, 91.0%). Perceived powerlessness (AOR = 6.08; 95% CI 1.69, 11.8), lack of confidence (AOR = 7.08; 95% CI 2.05–14.41), inadequate staffing (AOR = 12.46; 95% CI 3.28,15.1), and perceived weak organizational support (AOR = 11.59; 95% CI 2.8,17.33) were significantly associated with moral distress. Conclusion The magnitude of moral distress was high among nurses in the study setting. Perceived powerlessness, lack of confidence, inadequate staffing, and perceived weak organizational support were independent determinants of moral distress. Thus, creating adequate number of staff, and establishing acceptable organizational policies are ways to reduce moral distress.