The relationship between professional autonomy and moral distress in ICU nurses of Guilan University of Medical Sciences in 2017

Abstract

Background & Aim: Professional autonomy is a key component of decision-making and empowerment of the nurses. However, ICU nurses sometimes experience a degree of moral distress in their decision-making but the relationship of this distress with their autonomous performance in intensive care units is unclear. The aim of this study is determining the relationship between professional autonomy and moral distress of ICU nurses.
 Methods & Materials: In this correlational cross-sectional study, 180 ICU nurses were selected by census method from educational hospitals of Guilan University of Medical Sciences in 2017. Research tools were Varjuss professional autonomy and Corely et al. moral distress questionnaires. Data were analyzed using SPSS software version 16.
 Results: Most of the subjects were female (93.89%), full-time nurses (61.67%), with age mean and standard deviation of 35±5.97. Mean and standard deviation of professional autonomy and moral distress were 77.04±4 and 140.85±5.45, respectively. Moral distress of most nurses (55.6%) was moderate. There was a positive and significant correlation between professional autonomy and moral distress scores (p<0.001, r=0.33).
 Conclusion: This study showed that by increasing the professional autonomy, the moral distress of ICU nurses increases as well. These results, by informing nursing mangers, remind the necessity of using some approaches for reducing the moral distress of nurses along with improving their professional autonomy.

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

“…It seems that, firstly, having more work experience reduces certain stress-causing factors, and secondly, individuals use different methods to adapt and resolve the intensity of moral challenges. Yeganeh et al found a significant direct relationship between moral distress and the degree of professional autonomy ( 17 ). In this regard, Molloy et al found that one of the most important factors affecting moral distress among NICU nurses is their perception of moral distress.…”

“…In Swedish nurses, low intensity of moral distress was reported ( 16 ). Studies conducted in Iran have indicated moderate to high levels of perceived moral distress among nurses ( 17 - 19 ). In recent years with the advancements in neonatology, perinatology, and infertility treatments, there have been more expectations from the family and treatment team members to help infants survive despite their poor prognosis, being premature, having very low birth weight, and being sick.…”

Moral Distress Scores of Nurses Working in Intensive Care Units for Adults Using Corley’s Scale: A Systematic Review

“…Table 2 shows the main characteristics of the included studies. Four studies were conducted in Canada [ 27 , 28 , 29 ], four in Iran [ 30 , 31 , 40 , 41 ], five in the United States of America [ 32 , 33 , 36 , 37 , 38 ], two in Italy [ 11 , 14 ]; one in Israel [ 39 ], and one study was a multi-center study conducted in Croatia, Cyprus, the Netherlands, Slovenia, the United Kingdom, and Belgium [ 34 ]. A total of 16 of the 17 studies had a descriptive cross-sectional design, and only one was a quasi-experimental study [ 33 ].…”

“…According to the inclusion and exclusion criteria, all included studies used the Moral Distress Scale based on Corley’s theory. Most of them used the Moral Distress Scale–Revised with 21 items [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]; 4 of them used the Moral Distress Scale–Revised with 38 items [ 36 , 37 , 38 , 39 ]; 2 studies used the Moral Distress Scale–Revised with 18 items [ 14 , 40 ]. Lamiani et al [ 11 ] and Asayesh et al [ 41 ] used the Moral Distress Scale–Revised with 14 and 30 items, respectively.…”

“…Paper-and-pencil questionnaires were the most frequently used method for data collection in the included studies (n = 9) [ 11 , 28 , 31 , 33 , 35 , 37 , 39 , 40 ], followed by online questionnaires (n = 6) [ 14 , 29 , 32 , 34 , 36 , 38 ]. Two studies did not declare the method of data collection [ 30 , 41 ].…”