The experience of moral distress in nursing- the nurses' perception2012 (original) (raw)
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Moral distress in nursing personnel
Revista Latino-Americana de Enfermagem, 2013
Objective: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. Method: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. Results: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogue, which hold team meetings, with fewer working hours and a greater ratio of professionals to patients. Conclusion: understanding moral distress allows us to go beyond solving the problems of the workers themselves, enabling the development of an ethics of active individuals and wide opportunities, defined mainly by the relationship with oneself. Objetivo: analisar a frequência e a intensidade de sofrimento moral vivenciado por trabalhadores de enfermagem do Sul do Brasil, contemplando elementos do seu cotidiano profissional. Método: survey realizado em dois hospitais do Rio Grande do Sul, Brasil, com 247 profissionais de enfermagem. A coleta dos dados ocorreu mediante aplicação da adaptação do Moral Distress Scale. Resultados: a percepção de situações que conduzem ao sofrimento moral é intensificada em enfermeiros e em trabalhadores de enfermagem que atuam em instituições com maior abertura ao diálogo, realizam reuniões de equipe e têm menores jornadas de trabalho. Essa percepção também é intensificada quando se observa maior relação no número de profissionais por pacientes. Conclusão: compreender o sofrimento moral permite ir além da resolução dos problemas dos próprios trabalhadores, possibilitando a elaboração de uma ética de sujeitos ativos e de amplas possibilidades, definidas principalmente pelas relações consigo mesmos. Descritores: Enfermagem; Ética de Enfermagem; Esgotamento Profissional.
Psycometric characteristics of the Moral Distress Scale in Brazilian nursing professionals
Texto & Contexto - Enfermagem, 2014
The Moral Distress Scale was designed to assess the severity and frequency of the moral distress experienced by nursing professionals in everyday situations. The objective of this study was to analyze the psychometric characteristics of the Moral Distress Scale adapted to Brazilian nursing. Through factor analysis, five constructs were identified: lack of competence in the work team; disregard for patient autonomy, inadequate working conditions, denial of the nursing role as an advocate in terminal patients; denial of the nursing role as an advocate of the patient. The proposed pentafactorial solution is statistically and semantically more appropriate to the Brazilian nursing scenario. Based on these results, the scale is considered to be valid and reliable, showing the necessary requirements regarding convergent and discriminating validity as well as internal consistency to be used while evaluating the intensity and frequency of moral distress in Brazilian nursing professionals.
Psycometric characteristics of the Moral Distress Scale in Brazilian nursing professionals2014
The Moral Distress Scale was designed to assess the severity and frequency of the moral distress experienced by nursing professionals in everyday situations. The objective of this study was to analyze the psychometric characteristics of the Moral Distress Scale adapted to Brazilian nursing. Through factor analysis, five constructs were identified: lack of competence in the work team; disregard for patient autonomy, inadequate working conditions, denial of the nursing role as an advocate in terminal patients; denial of the nursing role as an advocate of the patient. The proposed pentafactorial solution is statistically and semantically more appropriate to the Brazilian nursing scenario. Based on these results, the scale is considered to be valid and reliable, showing the necessary requirements regarding convergent and discriminating validity as well as internal consistency to be used while evaluating the intensity and frequency of moral distress in Brazilian nursing professionals.
Nurses, nursing technicians and assistants: who experiences more moral distress?
Revista da Escola de Enfermagem da USP, 2014
Objective: To identify the frequency and intensity of moral distress experienced by nurses, technicians and nursing assistants who worked in hospitals in the South of Rio Grande do Sul State. Method: A survey research was conducted with 334 nursing workers from three institutions, through a questionnaire of moral distress. Constructs were validated through factorial analysis and Cronbach’s alpha: lack of competence of the working team, disrespect to the patient’s autonomy, insufficient working conditions and therapeutic obstinacy. Results: With descriptive statistics and analysis of variance, it was found that nurses and nursing assistants have higher perception of moral distress when compared to nursing technicians. Organizational questions and ways of communication influence lower perception of moral distress.Conclusion: Implementation of actions to favor coping, decision making and autonomy exercise from those workers.
Cross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem, 2017
Objective: Cross-culturally adapt and validate the Moral Distress Scale-Revised for nurses. Method: Quantitative, analytical cross-sectional study conducted with 157 nurses of two hospital institutions of Southern Brazil, one public and one philanthropic. Procedures conducted: cultural adaptation of the instrument according to international recommendations; validation for the Brazilian context. Results: Face and content validation was considered satisfactory as assessed by a specialist committee and a pretest. The instrument demonstrated satisfactory internal consistency through frequency and intensity analysis per question in the 157 items and per subgroups of the various hospital units. Cronbach’s alpha was 0.88 for the instrument and between 0.76 and 0.94 for hospital units. Pearson’s correlation found a moderate association for moral distress among nurses. Conclusion: The Moral Distress Scale-Revised – Brazilian version is a valid instrument for the assessment of moral distress ...
Moral distress in everyday nursing: hidden traces of power and resistance
Revista Latino-Americana de Enfermagem, 2013
Objective: To know the strategies of resistance adopted by nursing staff, facing situations of moral distress, from an ethical perspective. Method: The authors conducted qualitative research through semi-structured interviews, with fifteen nursing staff members of a university hospital in the extreme south of Brazil, using textual discourse analysis and the theoretical reference of Foucault. Results: Two categories were constructed: denial of oneself and the other -in which one perceives that the nursing staff can perform actions that are governed predominantly by immobility and conformism, avoiding confrontations with whoever represents power in situations that provoke moral distress in them; possibility to care for oneself and for the other -in which nursing workers in situations that provoke moral distress for them exercise power and endurance.
Revista da Escola de Enfermagem da USP
Objective: To analyze the association between sociodemographic and occupational characteristics and the predictors of Moral Distress in nursing managers of Federal University Hospitals. Method: Cross-sectional study carried out with 126 nurses. Data were collected online between September 2019 and May 2020 applying the Brazilian Scale of Moral Distress in Nurses. The variables were analyzed using descriptive and bivariate statistics to compare the instrument mean responses in relation to sociodemographic and occupational characteristics (hospital size, region, age, gender, training and experience variables, employment relationships, and workload). Results: The highest levels of Moral Distress were experienced by nurses in large hospitals, with statistical significance among civil servants with job stability who have no management training, with less time of professional experience and with the highest weekly workload, with emphasis on predictive factors of “safe and qualified care”,...
Moral distress in everyday nursing- hidden traces of power and resistance2013
Objective: To know the strategies of resistance adopted by nursing staff, facing situations of moral distress, from an ethical perspective. Method: The authors conducted qualitative research through semi-structured interviews, with fifteen nursing staff members of a university hospital in the extreme south of Brazil, using textual discourse analysis and the theoretical reference of Foucault. Results: Two categories were constructed: denial of oneself and the other -in which one perceives that the nursing staff can perform actions that are governed predominantly by immobility and conformism, avoiding confrontations with whoever represents power in situations that provoke moral distress in them; possibility to care for oneself and for the other -in which nursing workers in situations that provoke moral distress for them exercise power and endurance.
Psychology Research and Behavior Management, 2020
Background: Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one's moral requirements. The study aimed to assess the proportion of moral distress and associated factors among nurses working in Northwest Amhara Regional State referral hospitals in 2018. Methods: A cross-sectional study was conducted among nurses working at Northwest Amhara regional state referral hospitals from April 1-30/2018. A total of 423 study participants were enrolled in the study. A systematic random sampling technique was used to select the study participants. A pretested self-administered structured questionnaire was used to collect data. Moral Distress Scale-Revised (MDS-R) was used to assess the proportion of moral distress. Epi info version 7 for data entry and SPSS version 22 for data analysis were used. A binary logistic model was computed. Variables having p-value < 0.5 with 95% CI were used to declare the presence of significant associations. Results: A total of 423 study participants were enrolled in the study with a response rate of 97.4%. The mean (SD) age of the respondents was 30.62 ± 5.7 years. The majority of nurses 350 (85%) were degree and above holders in nursing. The proportion of moral distress among nurses was found to be 83.7%. Work experience 11-20 years [adjusted odds ratio (AOR)=2, 95% CI: 1.01, 3.34], perceived poor team communication [AOR=4.5, 95% CI: 1.78, 11.62], perceived powerlessness in decision making [AOR=3.3, 95% CI: 1.38, 7.87], inadequate staffing [AOR=2.96, 95% CI: 1.26, 6.97], and inappropriate provision of care [AOR=4.12, 95% CI: 1.55, 10.9] were significantly associated with moral distress. Conclusion: Nurses frequently experienced moral distress in clinical settings. Perceived poor communication, perceived powerlessness in decision making, inadequate staffing, and inappropriate provision care were the factors associated with moral distress.