Moral distress among Iranian neonatal intensive care units’ health care providers: a multi-center cross sectional study

Tajalli, Saleheh; Rostamli, Somayeh; Dezvaree, Nazi; Shariat, Mamak; Kadivar, Maliheh

doi:10.18502/jmehm.v14i12.7667

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…MDS-R scores were slightly lower in physicians than in nurses/physiotherapists, although the difference was not significant. Although this result contrasts with that of some studies which found higher MD levels in nurses than in other professional categories [ 15 , 18 , 26 , 43 , 53 , 54 , 59 ], it is in line with others which instead found no differences in MD levels between physicians and non-physicians [ 36 , 49 , 60 ]. The differences between the various studies may be due to the different social and cultural characteristics of the study samples and the different organizational contexts.…”

Section: Discussioncontrasting

confidence: 99%

Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Carletto

Ariotti

Garelli³

et al. 2022

IJERPH

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Moral distress (MD) in healthcare providers is widely recognized as a serious issue in critical care contexts. It has the potential to have negative impacts on both personal and professional wellbeing, the quality of care provided and staff turnover. The aim of this study was to investigate the relationship between MD and burnout among neonatal intensive care unit (NICU) healthcare professionals and identify the possible factors associated with its occurrence. Participants were asked to complete an online survey, which covered sociodemographic and professional information and included two self-report questionnaires (Italian Moral Distress Scale-Revised and Maslach Burnout Inventory). The sample comprised 115 healthcare providers (nurses and physiotherapists: 66.1%; physicians: 30.4%; healthcare assistants: 3.5%) working in four NICUs located within the province of Turin, Italy. The results revealed overall low levels of MD, with no significant differences between nurses/physiotherapists and physicians. Nurses/physiotherapists showed a statistically significant higher percentage of personal accomplishment burnout (32.9%) compared with physicians (8.6%; p = 0.012). MD was associated with the emotional exhaustion dimension of burnout. Spirituality and/or religiousness was shown to be a moderating variable. Further research is needed to deepen our understanding of the correlation between MD and burnout and the role of spirituality and/or religiousness as moderators.

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Section: Discussioncontrasting

confidence: 99%

Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Carletto

Ariotti

Garelli³

et al. 2022

IJERPH

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“…However, additional studies are needed to enhance these findings and draw conclusions. Unlike most recent studies on cultural adaptation of MD measurement instruments [ 49 , 50 , 51 , 52 ], which only tested reliability, our one includes in-depth validation analysis with dimensionality and validity tests. We deem it proof to consider the new scale an appropriate measure of MD and a valuable base for further research efforts.…”

Section: Discussionmentioning

confidence: 99%

Moral Distress in Healthcare Providers Who Take Care of Critical Pediatric Patients throughout Italy—Cultural Adaptation and Validation of the Italian Pediatric Instrument

Grasso

Massidda²,

Maslak

et al. 2022

IJERPH

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Background: Although Moral Distress (MD) is a matter of concern within the Pediatric Intensive Care Unit (PICU), there is no validated Italian instrument for measuring the phenomenon in nurses and physicians who care for pediatric patients in Intensive Care. The authors of the Italian Moral Distress Scale-Revised (Italian MDS-R), validated for the adult setting, in 2017, invited further research to evaluate the generalizability of the scale to clinicians working in other fields. Our study aims to reduce this knowledge gap by developing and validating the pediatric version of the Italian MDS-R. Methods: We evaluated the new instrument for construct validity, then we administered it in a multicenter, web-based survey that involved healthcare providers of three PICUs and three adult ICUs admitting children in northern, central, and southern Italy. Finally, we tested it for internal consistency, confirmatory factorial validity, convergent validity, and differences between groups analysis. Results: The 14-item, three-factor model best fit the data. The scale showed good reliability (a = 0.87). Still, it did not correlate with the Emotional Exhaustion and Depersonalization sub-scales of the Maslach Burnout Inventory (MBI) or with the 2-item Connor-Davidson Resilience Scale (CD-RISC 2) or the Satisfaction with Life Scale (SWLS). A mild correlation was found between the Italian Pediatric MDS-R score and intention to resign from the job. No correlation was found between MD and years of experience. Females, nurses, and clinicians who cared for COVID-19 patients had a higher MD score. Conclusions: The Italian Pediatric MDS-R is a valid and reliable instrument for measuring MD among Italian health workers who care for critically ill children. Further research would be helpful in better investigating its applicability to the heterogeneous scenario of Italian Pediatric Critical Care Medicine.

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“…The feeling of unfamiliarity and powerlessness, loss of control, caring for the same patients and having to deal with restrictions have caused nurses to face challenges in implementation of ethical requirements and as a result experience moral distress ( 6 ) . Moral distress is a painful and unstable psychological feeling that occurs when a nurse is fully aware of a moral act, but unable to perform it ( 7 , 8 ) .…”

Section: Introductionmentioning

confidence: 99%

“…The study by Henrich et al showed that moral distress at the individual level causes negative emotional reactions in nurses such as fatigue, embarrassment about not providing good care, inappropriate level of care, worthlessness and discouragement ( 15 ) . Termination of employment in the organization and leaving work are other consequences of moral distress that inflict irreparable damage on the organization and the health service delivery system ( 8 , 16 ) .…”

Section: Introductionmentioning

confidence: 99%

Moral distress and moral courage among Iraqi nurses during the COVID-19 pandemic: a cross-sectional study

Hthelee,

Sadooghiasl,

Kermanshahi

2023

jmehm

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In the years following its outbreak in 2019, COVID-19 changed the health-care system structures, the context of professional activity, and nurses’ moral performance. The present study aimed to examine the moral distress and moral courage of Iraqi nurses during the COVID-19 pandemic. This cross-sectional and correlational study was conducted in 2021 on 168 nurses selected by convenience sampling methods. Data were collected by self-reported instruments including a demographic questionnaire, the Professional Moral Courage (PMC), and the Moral Distress Scale (MDS). Data were analysed using descriptive statistics, the Spearman, Mann-Whitney and Kruskal-Wallis tests, and SPSS version 22. Most nurses showed a moderate level of moral distress (98.80%) and a high level of moral courage (99.40%).The dimension of multiple values had the highest mean (12.45 ± 1.47) and endurance of threats had the lowest mean (9.15 ± 1.79). There was a statistically significant correlation between moral distress and moral courage (P = 0.007, r = - 0.2), and moral distress and the dimensions of endurance of threat (P < 0.001, r = - 0.26), going beyond compliance (P < 0.001, r = - 0.037), and moral goals (P < 0.001, r = - 0.173). A statistically significant relationship was also found between moral distress and work shift, position and gender (P < 0.05), and between moral courage and position (P < 0.05). We concluded that nurses need more organizational support in terms of protective facilities, job security and organizational incentives to be able to show ethical behaviors.

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Moral distress among Iranian neonatal intensive care units’ health care providers: a multi-center cross sectional study

Cited by 6 publications

References 26 publications

Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Moral Distress in Healthcare Providers Who Take Care of Critical Pediatric Patients throughout Italy—Cultural Adaptation and Validation of the Italian Pediatric Instrument

Moral distress and moral courage among Iraqi nurses during the COVID-19 pandemic: a cross-sectional study

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