• Title/Summary/Keyword: Moral Distress

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Influencing factors on Moral Distress in Long-term Care Hospital and Facility Nurses

  • Kim, Hyun Sook;Yu, Sujeong;Lim, Kyung Choon
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.5
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    • pp.121-130
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    • 2019
  • The purpose of this study was to explore the level of the moral distress for nurses working in long-term care hospitals or nursing homes, and identify factors that influence the moral distress. Data were collected through self-reported questionnaires including the Korean version of Moral Distress Scale-Revised (KMDS-R), Jefferson Empathy Scale for Health professionals (K-JSE-HP), Moral Sensitivity Questionnaire (K-MSQ), and the Hospital Ethical Climate Survey (HECS). A total of 194 nurses from 11 long-term care hospitals or 27 nursing homes completed the structured questionnaires. Data were analyzed using IBM SPSS Statistics version 25. As results, the mean score for moral distress was $73.81{\pm}51.29$ in this study. The moral distress of nurses working at nursing homes was higher than that of nurses working in long-term care hospitals. Among the sub-factors of moral distress, the 'futile care' was the highest score and the 'limit to claim the ethical issue' was the lowest. The main factor affecting moral distress among nurses in this study was the ethical climate of organization. In this paper, we propose that in order to effectively reduce the moral distress of nurses working in a long-term care hospital or a nursing home, it is more impactful to address structural issues related to the caregiver workplace than to adjust individual factors.

A Structural Model on the Moral Distress in Clinical Nurses (임상간호사의 도덕적 고뇌 구조모형 구축)

  • Lee, Eun Ja;Chae, Young Ran
    • Journal of muscle and joint health
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    • v.29 no.3
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    • pp.194-204
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    • 2022
  • Purpose: This study was to build a path model geared toward explaining the relationships of influential variables for the moral distress of clinical nurses by analyzing literatures of earlier studies. Methods: Data were collected from four hospitals with 300 beds or more. The participants were 257 nurses with more than 1 year of clinical experience. The data collection period was from June 14 to October 24, 2017. The questionnaire included general and ethical education-related characteristics, personality type, moral dilemma experience, moral sensitivity, moral climate and moral distress. Results: The direct influencing factors of moral distress were the individual's experience of moral dilemma, moral sensitivity, and the moral climate of the organization. Factors that indirectly affected via moral sensitivity were personality type, experience in ethical education, and moral climate. The explanatory power was 40.3%. Conclusion: It is necessary to develop an intervention program that can reduce moral distress by considering the factors influencing the moral distress of clinical nurses. In addition, it is necessary to identify additional influencing factors of moral distress.

The Experience of Nursing Students' Moral Distress in Clinical Practice (임상실습 현장에서 간호대학생이 경험하는 도덕적 고뇌)

  • Kim, Chanhee;Choi, Heeseung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.3
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    • pp.355-365
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    • 2016
  • Purpose: This study explores the moral distress that nursing students experience during their clinical practice in Korea. Methods: Data were collected using focus group interviews, and analyzed using qualitative content analysis. Participants were recruited from three nursing schools in three different cities; each focus group interview lasted between one to two hours. Results: Twenty-two nursing students with more than one year of clinical practice experience participated. Three categories and ten themes were extracted. The following situational categories: "unprotected patients' right and dignity," "clinical settings in which standards of care are not upheld," "disrespectful hospital culture," and "inconsistent and unsystematic clinical education" caused moral distress. Types of responses to moral distress included: "shock and confusion over the gap between reality and moral standards," "powerlessness when cannot advocate patients," "fear and doubts about nursing career," and "moral desensitization and disappointment in oneself." "Expressions of moral distress and the need for advice" and "a search for meaning and hope" were identified as coping strategies. Conclusion: These results demonstrate the need for systematic clinical practicum and education programs to minimize moral distress. These programs may offer opportunities for students to turn moral distress into opportunities for learning and growth in the future.

The relationships between moral distress and quality of nursing care in oncology nurses (암 병동 간호사의 도덕적 고뇌와 암 환자 간호의 질과의 관계)

  • Kim, Sae Mi;Shin, Yong Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.4
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    • pp.366-373
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    • 2020
  • Purpose: The study aimed to investigate the relationship between moral distress and the quality of nursing care. Methods: This cross-sectional correlation study included nurses working at oncology nursing units of two secondary general hospitals in Seoul and Gyeonggi-do, Korea. A total of 207 nurses participated. Moral distress was measured by the Moral Distress Scale-Revised Nurse Questionnaire and quality of nursing care was evaluated by the Quality of Oncology Nursing Care Scale. Data were collected from October 5 to 31, 2018. Data analysis included descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis. Results: The quality of oncology nursing care showed a negative correlation with moral distress (r=-.19, p=.007). The factors affecting the quality of oncology nursing care were religion (β=-.22, p=.001), clinical experience in oncology units (β=.27, p=.007), and moral distress (β=-.16, p=.018). Moral distress showed a statistically significant predictive power of 13% in the regression model (F=8.70, p=<.001). Conclusion: The findings of this study suggest that management of moral distress is important to increase the quality of oncology nursing care.

The Relation Among Moral Distress, Physical Symptoms and Burnout of Hospital Nurses (병원간호사의 도덕적 고뇌, 신체증상 및 소진의 관계)

  • Chae, Youngran;Yu, SuJeong;Lee, Eun Ja;Park, Eun Ha
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.430-440
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    • 2017
  • Purpose: The purpose of this study was to explore the relationship between moral distress, physical symptoms, and burnout among clinical nurses. Methods: Data were collected by self-report questionnaires targeting 140 nurses from a university hospital in Chungju. The data were analyzed by, Kruskal-Wallis, Pearson correlation coefficient, and stepwise multiple regression. Results: Moral distress due to the general characteristics of the participants showed a statistically significant difference at the current working department (${\chi}^2=36.01$, p<.001). Hospital nurses' moral distress had a statistically significant correlation with burnout (r=.358, p<.001) and physical symptoms (r=.440, p<.001). Factors influencing hospital nurses' burnout, pro were physical symptoms, moral distress, and marital status, accounting for 36% of the variance. Conclusion: The findings indicate that moral distress and physical symptoms influence burnout among hospital nurses. Therefore, interventions for burnout among hospital nurses should include an empowerment program to reduce physical symptoms and moral distress.

Morl Distress and Ethical Values of Nursing Students (간호대학생의 윤리적 가치관과 도덕적 고뇌)

  • Lee, So-young
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.3
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    • pp.119-124
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    • 2019
  • The study aimed to identify the relationship between moral distress and ethical values among nursing student. The participants were 150 nursing students. The data were analyzed with SPSS 21.0 program. In the results, moral distress and ethical values showed positive correlations. Statistically significant differences were found in moral distress according to grade, select the reason for department and ethical values according to age, grade, select the reason, one's associate for department. Moral distress was positively correlated with ethical values. The findings suggest that programs aimed at decreasing moral distress and ethical values intention should be developed. Furthermore, future studies should explore variables that influence moral distress.

Concept Analysis of Moral Distress in Nurses (간호사의 도덕적 고뇌 개념분석)

  • Yoo, Myung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.1
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    • pp.49-62
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    • 2004
  • purpose: The study was done to analyze the concept of moral distress in nurses. Method: The Hybrid Model was used in this study. For the theoretical phase, nursing and other literature were reviewed to analyze attributes and develop a working definition of the concept, moral distress in nurses. For the fieldwork phase, In-depth interviews were conducted with six nurses. Results: Four higher level concepts of moral distress in nurses were found; situational, cognitive, behavioral, and emotional, and 8 subscales, negative medical behavior, negative nursing behavior, excessive economic load, irrational organization administration, internal restraints, external restraints, negative behavioral responses, and negative emotional responses. Conclusion: it is necessary to develop programs of arbitration that will lessen the moral distress in nurses working in clinical practice.

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Relationship between Moral Distress and Turnover Intention among Hospital Nurses (간호사가 지각하는 도덕적 고뇌와 이직의도)

  • Han, Su-Jeong
    • The Journal of the Korea Contents Association
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    • v.12 no.3
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    • pp.276-284
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    • 2012
  • This study aimed to identify the relationship between moral distress and turnover intention among hospital nurses. The participants were 281 hospitals nurses. The moral distress scale and the turnover intention scale for nurses were used. Data were analyzed using SPSS/WIN 15.0 program. The mean score of moral distress was 3.08 and that of turnover intention was 5.09. Statistically significant differences were found in moral distress according to age (F = 5.87, p = .003), education level (F = 11.50, p < .001), nursing experience (F = 7.00, p <. 001) and department of duty (F = 3.81, p =. 005). Statistically significant differences were found in turnover intention according to age (F = 11.54, p <. 001) and nursing experience (F = 5.87, p = .001). Moral distress was positively correlated with turnover intention (r = .29, p < .001). The findings suggest that programs aimed at decreasing moral distress and turnover intention should be developed. Furthermore, future studies should explore variables that influence moral distress.

Emergency nurses' experience of coping with moral distress (응급실 간호사의 도덕적 고뇌 대응 경험)

  • Lee, Na Kyoung;Hwang, Jee-In
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.2
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    • pp.176-184
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    • 2020
  • Purpose: We explored emergency nurses' experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses' coping with moral distress was "a passive emotion-based response." We also extracted three categories of coping strategies: "uncritical adaptation to anguished situation," "self-justification for not acting," and "flight from ethical decision making." Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

The Mediating Effect of Biomedical Ethics Awareness in the Relationship between the Moral Distress and Moral Sensitivity of Hospital Nurses (병원 간호사의 도덕적 민감성과 도덕적 고뇌와의 관계에서 생명의료윤리의식의 매개효과)

  • Kim, Ok-Hyun;Ahn, Seong-Ah;Oh, Su-Mi;Kong, Jeong-Hyeon;Choi, Hye-Ok
    • Journal of Convergence for Information Technology
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    • v.9 no.9
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    • pp.78-86
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    • 2019
  • In the study, the moral sensitivity, moral distress, and biomedical ethics awareness levels of hospital nurses are examined, and the mediating effect of biomedical ethics awareness in the relationship between moral sensitivity and moral distress is verified. As the study subjects, 153 hospital nurses were selected from both university hospitals and general hospitals in S city and J city. Using the SPSS WIN 21.0 system, data analysis was conducted via t-tests, the Sheffe test, correlation analysis, multiple regression analyses, Sobel test. The average level of moral sensitivity experienced by the hospital nurses was 4.70(out of 7), moral distress was 62.80(out of 336), and biomedical ethics awareness was 2.21(out of 4). Moral distress had a static correlation with moral sensitivity and biochemical ethics awareness, and moral sensitivity had a static correlation with biomedical ethics awareness. Finally, biomedical ethics awareness showed a partial mediating effect in the relationship between moral sensitivity and moral distress. It is important to develop a biomedical ethics education program that can help hospital nurses to resolve moral issues, thereby improving moral sensitivity and diminishing their moral distress.