Health care reform in Iran: Implications for nurses’ moral distress, patient rights, satisfaction and turnover intention

Hadipour, Maryam; Hosseini, Mohammadali; Bernstein, Colleen; Ranjbar, Hadi

doi:10.1111/jonm.12699

Cited by 25 publications

(17 citation statements)

References 37 publications

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“…O'Connell's study, meanwhile, found that women had a higher moral distress than men [38]. However, the results of some studies have not shown a relationship between gender and experienced moral distress [9,28,30,39].…”

Section: Discussionmentioning

confidence: 98%

Moral Distress and Related Factors in Nurses Working in Intensive Care Units

Habibzadeh

Masouleh

Chehrzad

et al. 2020

J. Holist. Nurs. Midwifery

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The intensive care unit is a stressful environment due to the high mortality rate of patients, the occurrence of moral problems and working in a tense atmosphere. Faced with these conditions, nurses may be exposed to moral distresses. Therefore, it is important to study the moral distresses that nurses face in these units. Objective: This study aimed to determine the level of moral distress and related factors in nurses working in the intensive care units of Guilan Province, Iran. Materials and Methods: This analytical cross-sectional study was performed on nurses working in all intensive care units in 20 hospitals affiliated to Guilan University of Medical Sciences. The study samples were 414 intensive care nurses chosen by census method in 2018. The data collection instruments were the individual-social factors questionnaire and the 21-item Corley's moral distress scale standard questionnaire. Data were analyzed using descriptive and inferential statistics (Mann-Whitney, Kruskal-Wallis and Logistic Regression). Results: The majority of the studied samples were women (90.6%), married (67.4%), full-time employees (44.6%), undergraduate (90.3%) with Mean±SD work experience of 75.69±9.93 months in the intensive care units. The mean total score of moral distress was 91.30±65.03 (out of 0-332 scores). Based on the final logistics regression model, gender (OR=2.410, 95%CI; 1.19-5.6, P=0.016) and work experience in the intensive care unit (OR=0.64, 95%CI; 0.43-0.94, P=0.023) were identified as two factors related to moral distress. Conclusion: The results of this study support the existence of moral distress in nurses in intensive care units, can be considered in planning to reduce the moral distress of nurses in the workplace and improve the quality of nursing care.

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Section: Discussionmentioning

confidence: 98%

Moral Distress and Related Factors in Nurses Working in Intensive Care Units

Habibzadeh

Masouleh

Chehrzad

et al. 2020

J. Holist. Nurs. Midwifery

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“…Por lo anterior, es importante que los servicios de salud y el personal directivo consideren a la bioética dentro de sus políticas, organización, normas éticas y otras regulaciones, los cuales resultan útiles para limitar conflictos éticos y estrés laboral en el personal de salud. Las instituciones de salud deben estar comprometidas con mejorar las condiciones de la organización, así como con clarificar y difundir las regulaciones éticas, formar y/o fortalecer a su comité de ética, así como establecer programas de entrenamiento para el manejo del estrés mediante estrategias complementarias como la atención plena, la reflexología, la meditación guiada, además de apoyar a los profesionales de la salud con asesorías para la toma de decisiones bioéticas que no comprometan la salud de los pacientes y limiten el estrés laboral y ético de los trabajadores de la salud (38,39). Otro aspecto importante a considerar es la participación del personal de salud en la integración de comités de ética, en los cuales se expongan los dilemas éticos que podrían tener, con el objetivo consensar la toma de decisiones a partir de los principios de la bioética y lograr una disminución del estrés en los profesionales que, a su vez, determine la calidad del cuidado que estos brindan a sus pacientes (40).…”

Section: Discussionunclassified

Clima ético, estrés de conciencia y laboral de enfermeras y médicos que laboran en cuidados intensivos neonatal

Castillo

García

Alonso-Castillo

et al. 2020

Rev. latinoam. bioet

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El objetivo del presente estudio fue determinar la relación entre la percepción del clima ético, el estrés moral y el relacionado con el trabajo. El diseño fue descriptivo correlacional y el muestreo fue tipo censo con un total de muestra de 106 participantes (80 profesionales de enfermería y 26 médicos). Los resultados mostraron que existe una relación negativa y significativa del clima ético con el estrés laboral (rs =-.326, p<.01). Además, se identificó como hallazgo adicional que el clima ético predice el estrés relacionado con el trabajo, tanto en médicos como en enfermeras (R2=7.9, p=.004). La evidencia científica del presente estudio confirma que la bioética como ciencia debe ser competencia de todos los profesionales de la salud y, en particular, de la enfermería, debido a los desafíos éticos y morales de su práctica profesional, especialmente en áreas críticas debido a las políticas, la normatividad y los recursos con los que cuentan el lugar de trabajo. Tanto el clima ético como el estrés moral y laboral deben ser considerados por las instituciones de salud, teniendo en cuenta que pueden influir negativamente en la salud de los médicos y enfermeras que brindan los cuidados, lo cual limita la calidad de la atención.

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“…Indeed, with the implementation of the HSEP and expansion of public health coverage, and the subsequent reduction in treatment tariffs in public centers, referrals to these centers have increased. However, the number of nurses has remained stable, leading to an increased workload for nurses working in public health centers [ 37 , 38 ].…”

Section: Iranian Health Systemmentioning

confidence: 99%

Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making

Maleki

Mardani

Vaismoradi

2021

IJERPH

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Job security influences the ability of nurses to provide high-quality nursing care. The Iranian health system has always faced nursing shortages, and the COVID-19 pandemic has worsened this situation. Although nurses have been labelled ‘heroes’ across the globe, many of them have been hired using insecure employment contracts. This commentary aims to describe issues surrounding job contracts for Iranian nurses during the COVID-19 pandemic and discusses how the current situation can be improved. Iranian nurses are at the frontline of the fight against COVID-19 and need to receive better support in terms of job security and dignity. They should participate more in policymaking activities to improve their job condition and prevent the development and implementation of the short-term and insecure job contracts that lead to job insecurity.

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Health care reform in Iran: Implications for nurses’ moral distress, patient rights, satisfaction and turnover intention

Cited by 25 publications

References 37 publications

Moral Distress and Related Factors in Nurses Working in Intensive Care Units

Moral Distress and Related Factors in Nurses Working in Intensive Care Units

Clima ético, estrés de conciencia y laboral de enfermeras y médicos que laboran en cuidados intensivos neonatal

Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making

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