Impact of ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses: a cross-sectional study

Abstract

Background While several studies have been performed on turnover intention among nurses, limited studies have considered the ethical perspectives on turnover intention among haemodialysis nurses. The purpose of this study was to clarify the impact of ethical factors, namely ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses. Methods This cross-sectional research was conducted between July and August 2017. A total of 148 haemodialysis nurses were invited to participate in the study by convenience sampling from 11 general and university hospitals in South Korea. Data were analysed using SPSS for t-test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression analysis. Results In the final regression model, the adjusted R-squared significantly explained 34.6% of the variance in turnover intention (F = 22.534, p < .001) when moral distress related to physician practice (β = 0.310, p = .001) and ethical climate related to the hospital climate (β = − 0.253, p = .003) and manager (β = − 0.191, p = .024) were included. Following the stepwise multiple regression process, all subdomains related to moral sensitivity were excluded due to no statistical significance in the final regression model. Conclusion To reduce turnover intention among haemodialysis nurses, hospitals and managers should pay attention to haemodialysis nurses’ moral distress originating from physicians’ practice and improve their ethical climate. Additionally, it is required that the impact of moral sensitivity on turnover among nurses working in diverse care settings be examined further.

Care of patients undergoing withdrawal of life-sustaining treatments: an ICU nurse perspective

“…Our participants felt frustrated in situations where they perceived that physicians’ indifferent attitude toward end-of-life care hindered providing dignified nursing care for their patients. Our findings are supported by previous studies of nurses’ moral distress involving physician practice [ 36 , 38 ]. Indeed, care approaches through poor communication between physicians and nurses contradict patients’ wishes, and nurses are restricted from participating in the determination and planning of end-of-life care for their patients [ 39 , 40 ].…”

“…Moral distress refers to the inability to do the right thing despite being aware of it [ 35 ]. Organisational climate conflict with nurses’ beliefs in nursing values causes moral distress and damages moral integration, a component of professional identity [ 36 , 37 ]. ICU nurse leaders should establish a climate that supports nurses’ beliefs about nursing values.…”

Investigating the influence of risk perception on females’ public service motivation during public health emergencies

“…Additionally, through an examination of the relationship between anxiety and emotional exhaustion, we have discovered that they may have a dual mediating effect. Studies have affirmed that anxiety diminishes an individual’s capacity to regulate negative emotions and increases the likelihood of experiencing emotional exhaustion (McCarthy et al, 2016; Qin et al, 2023). Studies conducted on the consequences of the COVID-19 pandemic have unveiled a significant correlation between anxiety and emotional exhaustion among healthcare professionals (Akdağ et al, 2023).…”

Factors of Hospital Ethical Climate among Hospital Nurses in Korea: A Systematic Review and Meta-Analysis

“…After excluding demographic characteristics such as sex, religion, marital status, and ethical education experience, the variables were sorted into two categories: personal attributes (10 variables) and organizational attributes (15). [27], Kang (2019) [11], Hyun (2021) [8], Ma (2022) [28], Lee E (2022) [7], Kim (2023) [29], Hwang (2023) [30] 7…”

“…Moral distress P Park (2017) [6], Jeon (2019) [31], Kim (2019) [32], Kim (2021) [25], Lee E (2022) [7], Kim (2023) [27], Kang (2019) [11], Hyun (2021) [8], Lee M (2022) [34] O: organizational factors, P: personal factors.…”