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بررسی سطح دیسترس اخلاقی پرستاران بخش اورژانس و عوامل مؤثر بر آن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران

2 استادیار، گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران

3 دانشیار، گروه پرستاری، دانشکده پرستاری و مامایی، مرکز تحقیقات سلامت سالمندان، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران

چکیده

 
زمینه و هدف: بخش اورژانس غالباً با ازدحام و حجم کار بالا همراه است. پرستاران اورژانس معمولاً شرایطی را تجربه می‌کنند که منجر به معضلات اخلاقی می‌شود و یکی از نتایج آن، دیسترس اخلاقی می‌باشد که مهم‌ترین معضل پنهان شغلی در بین پرستاران اورژانس تعریف شده است. این مطالعه با هدف تعیین سطح دیسترس اخلاقی پرستاران بخش اورژانس و عوامل مؤثر بر آن انجام گرفت.
مواد و روش­ها: این مطالعه مقطعی بر روی 200 پرستار شاغل بخش اورژانس بیمارستان‌های سمنان و سبزوار انجام شد. از آن‌ها خواسته شد تا به روش خودگزارشی نسبت به تکمیل پرسش‌نامه‌های دیسترس اخلاقی و دموگرافیک اقدام کنند. داده‌ها با نرم‌افزار SPSS 22 و آزمون‌های آماری تی مستقل و آنالیز واریانس تجزیه تحلیل شدند.
یافته­ها: میانگین سنی مشارکت‌کنندگان 2/7 ± 20/ 32سال بود. نمره کلی دیسترس اخلاقی 10/1± 54/ 61می‌باشد که در سطح پایینی قرار دارد و نشان از کم بودن دیسترس اخلاقی در بیمارستان‌های دولتی شهر سمنان و سبزوار است. کمترین میزان دیسترس اخلاقی مربوط به رضایت شغلی بالا و بیشترین نمره دیسترس اخلاقی مربوط به رابطه نامطلوب پرستاران با پزشکان بود.
نتیجه‌گیری: با توجه به عوارض منفی ناشی از دیسترس اخلاقی بر کیفیت مراقبت‌های پرستاری، لازم است مدیران بیمارستان‌ها، تمهیدات لازم را در راستای شناسایی علائم دیسترس اخلاقی در پرستاران اتخاذ کردند و با انجام مداخلات لازم گام مثبتی در راستای کاهش دیسترس اخلاقی پرستاران و در نتیجه افزایش کیفیت خدمات ارائه‌شده به بیماران بردارند.

تازه های تحقیق

    https://scholar.google.com/citations?hl=fa&user=6CDrjBQAAAAJ            

               https://www.ncbi.nlm.nih.gov/myncbi/hossein_eu@orcid     

https://scholar.google.com/citations?user=E2JK-qcAAAAJ&hl=en

https://www.ncbi.nlm.nih.gov/myncbi/nazanin.fekri.1/bibliography/public/

https://scholar.google.com/citations?user=aaBUOKkAAAAJ&hl=en

https://isid.research.ac.ir/Mostafa-Rad

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Investigating the Level of Moral Distress and Factors Affecting it in the Nurses of Accidents and Emergency Department

نویسندگان [English]

  • seyyed hossein shahcheragh 1
  • Nazanin Fekri 2
  • Mustafa Rad 3

1 Student Research Committee, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran

2 Assistant Professor, Department of Biostatistics, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran

3 Associate Professor, Department of Nursing, School of Nursing and Midwifery, Iranian Research Center of Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran

چکیده [English]

Background: The emergency department is often associated with congestion and high workload. Emergency nurses usually experience situations that lead to moral challenges, and one of its consequences is moral distress, defined as the most important hidden job challenge among emergency nurses. This study was conducted with the aim of determining nurses’ level of moral distress and factors affecting it in the accidents and emergency department.
Materials and Methods: This cross-sectional study was conducted on 200 nurses working in the emergency department of hospitals in Semnan and Sabzevar, Iran. They were asked to complete the moral distress and demographic questionnaires by self-reporting. The data was analyzed with SPSS 22 using independent t-test and analysis of variance.
Results: The mean age of the participants was 32.20 ± 7.2 years. The overall score of moral distress was 54.61 ± 10.1, which shows a low level of moral distress in these public hospitals. The lowest level of moral distress was related to high job satisfaction while the highest score of moral distress was related to unfavorable relationship between nurses and doctors.
Conclusion: Considering the negative effects caused by moral distress on the quality of nursing care, it is necessary for managers of organizations to take necessary measures to identify the symptoms of moral distress in nurses and take a positive step towards reducing it by interventions and, as a result, increase the quality of services provided to patients.

کلیدواژه‌ها [English]

  • moral distress
  • nurse
  • emergency department
مراجع
  1. Toloei M, Faghihzadeh S, Sadooghi Asl A. The nurses’ motivating factors in relation to patient training. Hayat. 2006;12(2):43-51 URL: http://hayat.tums.ac.ir/article-1-210-en.html.
  2. Zomorodi M, Foley BJ. The nature of advocacy vs. paternalism in nursing: clarifying the ‘thin line’. Journal of advanced nursing. 2009;65(8):1746-52. https://doi.org/10.1111/j.1365-2648.2009.05023.x
  3. Zavotsky KE, Chan GK. Exploring the relationship among moral distress, coping, and the practice environment in emergency department nurses. Advanced Emergency Nursing Journal. 2016;38(2):133-46. https://doi.org/10.1097/TME.0000000000000100
  4. Hamric AB, Borchers CT, Epstein EG. Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research. 2012;3(2):1-9. https://doi.org/10.1080/21507716.2011.652337
  5. Austin JM, D’Andrea G, Birkmeyer JD, Leape LL, Milstein A, Pronovost PJ, et al. Safety in Numbers. Journal of patient safety. 2014;10(1):64-71. https://www.jstor.org/stable/26633040
  6. Pham JC, Story JL, Hicks RW, Shore AD, Morlock LL, Cheung DS, et al. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. The Journal of emergency medicine. 2011;40(5):485-92. https://doi.org/10.1016/j.jemermed.2008.02.059
  7. Kleinknecht‐Dolf M, Spichiger E, Müller M, Bartholomeyczik S, Spirig R. Advancement of the German version of the moral distress scale for acute care nurses—A mixed methods study. Nursing open. 2017;4(4):251-66. https://doi.org/10.1002/nop2.91
  8. Ando M, Kawano M. Responses and results to ethical problems by psychiatric nurses in Japan. Archives of psychiatric nursing. 2016;30(5):527-30. https://doi.org/10.1016/j.apnu.2016.04.012
  9. Abbaszadeh A, Nakhaei N, Borhani F, Roshanzadeh M. The relationship between moral distress and retention in nurses in Birjand teaching hospitals. Iranian Journal of Medical Ethics and History of Medicine. 2013;6(2):57-66. URL: http://ijme.tums.ac.ir/article-1-5015-en.html
  10. Sasso L, Bagnasco A, Bianchi M, Bressan V, Carnevale F. Moral distress in undergraduate nursing students: A systematic review. Nursing ethics. 2016;23(5):523-34. doi:10.1177/0969733015574926
  11. Rennó HMS, Ramos FRS, Brito MJM. Moral distress of nursing undergraduates: Myth or reality? Nursing ethics. 2018;25(3):304-12. doi:10.1177/0969733016643862
  12. Robinson R, Stinson CK. Moral distress: a qualitative study of emergency nurses. Dimensions of Critical Care Nursing. 2016;35(4):235-40. DOI: 10.1097/DCC.0000000000000185
  13. Moslinejad L, Obiri S, Kalani N. Investigating the level of moral distress in nurses and doctors caring for patients with covid 19: a cross-sectional descriptive study in 2019. Education and ethics in nursing. 2020;9(3-4):1-8. [in Persian]DOI:10.52547/ethicnurs.9.3.4.1
  14. Salari N, Shohaimi S, Khaledi-Paveh B, Kazeminia M, Bazrafshan M-R, Mohammadi M. The severity of moral distress in nurses: a systematic review and meta-analysis. Philosophy, Ethics, and Humanities in Medicine. 2022;17(1):1-14. https://doi.org/10.1186/s13010-022-00126-0
  15. Borhani F, ESMAELI AM, Razban F, Roshanzadeh M. Moral distress in the nursing and relationship with job burnout. 2013.
  16. Fernandez-Parsons R, Rodriguez L, Goyal D. Moral distress in emergency nurses. Journal of Emergency Nursing. 2013;39(6):547-52. https://doi.org/10.1016/j.jen.2012.12.009
  17. Burhani F, Abder Ma, Rozban F, Zadeh Mar. Moral distress in nurses and its relationship with job burnout. Journal of medical-scientific research ethics. 7(25):123-44. [in Persian] https://doi.org/10.22037/mej.v7i25.5159
  18. Corley MC. Nurse moral distress: a proposed theory and research agenda. Nursing ethics. 2002;9(6):636-50. doi:10.1191/0969733002ne557oa
  19. Corley MC, Elswick RK, Gorman M, Clor T. Development and evaluation of a moral distress scale. Journal of advanced nursing. 2001;33(2):250-6. https://doi.org/10.1111/j.1365-2648.2001.01658.x
  20. Niash, Abbas, Mahmoudian, Sarvari, Ramaki, Waziri. Investigating moral distress and its related factors in nurses working in hospitals in the west of Mazandaran. Caspian Health and Aging Quarterly. 2021;6(1):20-8. [in Persian] doi: 10.22088/cjhaa.6.1.20
  21. De Brasi EL, Giannetta N, Ercolani S, Gandini ELM, Moranda D, Villa G, et al. Nurses' moral distress in end-of-life care: a qualitative study. Nursing ethics. 2021;28(5):614-27. doi:10.1177/0969733020964859
  22. Soleimani MA, Sharif SP, Yaghoobzadeh A, Sheikhi MR, Panarello B, Win MTM. Spiritual well-being and moral distress among Iranian nurses. Nursing ethics. 2019;26(4):1101-13. doi:10.1177/0969733016650993
  23. Anami, Dadkhah, Mohammadi. Investigating the level of moral tension of nurses in the emergency departments of Ardabil hospitals in 2015. Journal of health and care. 2019;21(2):166-74. [in Persian]doi: 10.29252/jhc.21.2.166
  24. Widianti E, Arinda R, Prawesti A. Nurses’ moral distress in the emergency department. Journal of Nursing Care. 2019;2(3) DOI : https://doi.org/10.24198/jnc.v2i3.21374
  25. Sedaghati A, Assarroudi A, Akrami R, Rad M. Moral distress and its influential factors in the nurses of the nursing homes in khorasan provinces in 2019: A descriptive-correlational study. Iranian Journal of Nursing and Midwifery Research. 2020;25(4):319. doi: 10.4103/ijnmr.IJNMR_158_19
  26. Karagozoglu S, Yildirim G, Ozden D, Çınar Z. Moral distress in Turkish intensive care nurses. Nursing Ethics. 2017;24(2):209-24. doi:10.1177/0969733015593408
  27. Rabiee S, Khatiban M, Cheraghi MA. Nurses distress in intensive care unit: a survey in teaching hospitals. Iranian Journal of Medical Ethics and History of Medicine. 2012;5(2):58-69. URL: http://ijme.tums.ac.ir/article-1-5044-en.html
  28. Elpern EH, Covert B, Kleinpell R. Moral distress of staff nurses in a medical intensive care unit. American Journal of Critical Care. 2005;14(6):523-30.
  29. Moghadam, Pazkian, Zadeh A., Abbas, Zadeh F. The relationship between moral distress and safe nursing care in emergency department nurses. Journal of nursing education. 2020;9(4):11-21. [in Persian] URL: http://jne.ir/article-1-1150-fa.html
  30. Corley MC, Selig P. Prevalence of principled thinking by critical care nurses. Dimensions of Critical Care Nursing. 1994;13(2):96-103. doi:10.1097/00003465-199403000-00007
  31. Abbaszadeh A, Borhani F, Sharif F, Toghrayi F. The relationship Moral distress of Nurses with end of life decision's in the Intensive Care Units. J Med Ethics. 2012;6(22):117-33.
  32. Norman LD, Donelan K, Buerhaus PI, Willis G, Williams M, Ulrich B, et al. The older nurse in the workplace: does age matter? Nursing Economics. 2005;23(6):282-9. http://www.medscape.com/viewarticle/521375_print
  33. Janvier A, Nadeau S, Deschenes M, Couture E, Barrington K. Moral distress in the neonatal intensive care unit: caregiver's experience. Journal of perinatology. 2007;27(4):203-8. https://doi.org/10.1038/sj.jp.7211658
  34. Mohammadi S, Borhani F, Roshanzadeh M. Moral sensitivity and moral distress in critical care unit nurses. Medical Ethics Journal. 2017;10(38):19-28. 
  35. Rahmanian, Mirzaei, Sabzevari. The relationship between moral distress and moral development in nurses of Bam University of Medical Sciences. Education and ethics in nursing. 2019;8(3-4):37-43[in Persian].doi: 10.52547/ethicnurs.8.3.4.37
  36. Wiggleton C, Petrusa E, Loomis K, Tarpley J, Tarpley M, O'Gorman ML, et al. Medical students' experiences of moral distress: development of a web-based survey. Academic Medicine. 2010;85(1):111-7. DOI: 10.1097/ACM.0b013e3181c4782b
  37. Atashzadeh Shorideh F, Ashktorab T, Yaghmaei F, Alavimajd H. Association of ICU nurses’ demographic characteristics and moral distress. Iranian Journal of Medical Ethics and History of Medicine. 2013;5(7):66-78. URL: http://ijme.tums.ac.ir/article-1-86-en.html
  38. Dodek PM, Wong H, Norena M, Ayas N, Reynolds SC, Keenan SP, et al. Moral distress in intensive care unit professionals is associated with profession, age, and years of experience. Journal of critical care. 2016;31(1):178-82. https://doi.org/10.1016/j.jcrc.2015.10.011
  39. Anami K, Dadkhah B, Mohammadi M. Moral distress of nurses in emergency department of Ardabil hospitals in 1395. Journal of Health and Care. 2019;21(2):166-74. doi: 20252/jhc.21.2.166
  40. Joolaee S, Jalili H, Rafiee F, Haggani H. The relationship between nurses’ perception of moral distress and ethical environment in Tehran University of Medical Sciences. Iranian Journal of Medical Ethics and History of Medicine. 2011;4(4):56-66. URL: http://ijme.tums.ac.ir/article-1-167-en.html
  41. Hamaideh SH. Moral distress and its correlates among mental health nurses in J ordan. International Journal of Mental Health Nursing. 2014;23(1):33-41. https://doi.org/10.1111/inm.12000
  42. Mahdavi Fashtami S, Mohammadeh zadeh Zarankesh S, Esmaeilpour Bandboni M. Moral distress among emergency department nurses: frequency, intensity, effect. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2016;26(4):248-55.doi: 20.1001.1.10235922.1395.26.4.6.5
  43. Corley MC, Minick P, Elswick R, Jacobs M. Nurse moral distress and ethical work environment. Nursing ethics. 2005;12(4):381-90. https://doi.org/10.1191/0969733005ne809oa
  44. Moral distress in special care nurses: a survey study in educational and treatment centers of Hamadan city. [in Persian]. URL: http://ijme.tums.ac.ir/article-1-5044-fa.html
مجله دانشگاه علوم پزشکی سبزوار
دوره 30، شماره 5
آذر و دی 1402
صفحه 632-644
فایل ها
سابقه مقاله
  • تاریخ دریافت: 02 مهر 1402
  • تاریخ بازنگری: 05 آبان 1402
  • تاریخ پذیرش: 05 آبان 1402
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