Analytical study of care quality and moral distress in clinical situations and patient care

Author:

Hasanlo Masoumeh1,Azarm Arezo2,Asadi Parvaneh3,Amini Kourosh4,Ebrahimi Hossein5,Jafarabadi Mohammad Asghari6

Affiliation:

1. Department of Surgical Technology, Zanjan University of Medical Sciences , Zanjan , Iran

2. Education and Treatment Center of Beheshti, Zanjan University of Medical Sciences , Zanjan , Iran

3. Kermanshah University of Medical Sciences , Kermanshah , Iran

4. Zanjan Social Determinations of Health Research Center, Zanjan University of Medical Sciences , Zanjan , Iran

5. Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences , Tabriz , Iran

6. Health Services Management Research Center, Faculty of Public Health, Tabriz University of Medical Sciences , Tabriz , Iran

Abstract

Abstract Objective Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality. Methods In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13. Results Investigating moral distress domains (ignoring patient, decision-making power, and professional competence) and care quality domains (psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain (P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical (bodily), and communication domains of care quality. Conclusions Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decision-making domains, improve the professional competence, and pay attention to patients.

Publisher

Walter de Gruyter GmbH

Subject

Education,General Nursing

Reference31 articles.

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2. The ICN code of ethics for nurses: revised 2012 (2012). International Council of Nurses. Web site. https//www.icn.ch/images/stories/documents/about/icncode_english.pdf

3. Epstein EG, Hamric AB. Moral distress, moral residue, and the crescendo effect. J Clin Ethics. 2009;20:330-342.20120853

4. Cavaliere TA, Daly B, Dowling D, Montgomery K. Moral distress in neonatal intensive care unit RNs. Adv Neonatal Care. 2010;10:145-156.2050542510.1097/ANC.0b013e3181dd6c48

5. Mrayyan MT, Hamaideh SH. Clinical errors, nursing shortage and moral distress: the situation in Jordan. J Res Nurs. 2009;14:319-330.10.1177/1744987108089431

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