Frequency, Severity, Rate, and Causes of Moral Distress among Nursing Students: A Cross-Sectional Study

Abstract

Background. One of the most important psychosocial issues related to the nursing profession is moral distress (MD), which has devastating effects on student performance as well as patient care. The current study was conducted to determine the frequency, severity, rate, and causes of MD in nursing students. Methods. During this cross-sectional study, 86 samples were last year undergraduate nursing students of Kermanshah University of Medical Sciences, who were entered into the study by the census method. Data gathering instruments were personal information form, Moral Distress Scale-revised (MDS-r), and Moral Distress Thermometer (MDT). Results. The mean frequency, severity, and rate of MD, according to the MDS-r questionnaire, were 1.3 ± 0.7 out of 4, 1.8 ± 0.8 out of 4, and 3.3 ± 2.3 out of 16, respectively. The average MDT score was 2.6 ± 2.5 out of 10. The most common causes of MD were working in unsafe conditions (6.8 ± 6.0), observing impaired patients health servicing (5.4 ± 5.6), and the low quality of patient care (5.1 ± 4.6). There was a statistically significant relationship between the gender, work experience, and participation in the professional ethics workshop variables and mean MDS-total and MDT. Conclusion. The rate and mean severity of MD were reported at a moderate level. Also, the MDT average was reported at a mild to an uncomfortable level, and the overall MD was equal to moderate. Therefore, student administrators should take steps to eliminate or reduce the causes of MD. In this regard, the need for teaching preventive methods against MD to nursing students before their clinical courses seems crucial. Also, students with MD must be referred to the psychiatric/psychologist.

Moral Distress Work Motivation and Job Satisfaction of Medical-Surgical Nurses During the COVID-19 Pandemic: A Correlation Study

“…Regarding moral distress, the respondents are experiencing low moral distress; this means that they may not be affected by the harmful effects of high levels of moral distress like indifference and pessimism about nurses and decrease interest in their profession [18]. This finding is also parallel to the results of [19] during the pre-COVID-19 pandemic and [7] during the COVID-19 pandemic.…”

Moral Distress in Nursing Undergraduates: A Qualitative Study

“…It is important to describe how various factors contribute to moral distress in nursing students during their clinical experience and professional training. Moral distress may affect their educational qualification [1,22,23].…”

“…One problem that nurses experience as a result of ethical dilemmas is moral distress. Moral distress is a problem experienced by nurses when they know the appropriate action to take, but are forced to take action that is completely opposite to their personal and professional values [1][2][3]. Studies have shown that moral distress is a common serious problem.…”

“…Moral distress is the third common kind of ethical problem seen in nursing today. It may cause physical and emotional stress in nurses, affect the quality, quantity, and cost of nursing care, and may even cause the thought of leaving the nursing profession [1,4,5]. Moral distress concerns nursing students as well as nurses [2].…”

“…In the clinical training process, nursing students may experience ethical conflicts and dilemmas that can lead to moral distress at varying levels [6][7][8][9][10][11]. And, as a result, they may suffer physical and psychological health problems [1,3,7]. By the end of the effective clinical training, the students will have been prepared for their profession through the development of all their cognitive, affective, and behavioral skills.…”