Religious responses of ICU nurses to moral distress: A qualitative study
Abstract
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Background and Objectives: Nowadays, intensive care unit nurses face with numerous moral distress. Moral distress causes a series of responses in nurses. With recognizing these responses, strategies can be used for reducing them. This research was conducted to explain religious responses of ICU nurses to moral distress.
Materials and Methods: This qualitative study (which is part of a doctoral thesis) with content analysis approach was done in order to describe of ICU nurses’ religious responses to moral distress. In this study, the data were collected by semi-structured and deep interviews with 18 individual and two group interviews with clinical nurses whom working in different cities in Iran. A Purposive sampling and data analysis with conventional content analysis were done.
Results: 26 nurses were participated in this study. During the process of content analysis, 5 subcategories, and 2 categories were obtained. These categories of ICU nurses ‘religious responses to moral distress’ included: "religious beliefs", and "Impairment of religious beliefs". Results of this study showed a firm faith in God and trust in him causes positive response. Weakness and insecurity in the faith cause negative response to moral distress. Main theme in this research was religious responses.
Conclusion: Results of this study showed that ICU nurses use various positive and negative responses in deal of moral distress. Nurse administrators can help ICU nurses to diminish moral distress, learn the correct religious beliefs, and prevent harmful outcomes. Teaching religious beliefs, during college, empowering and enhancing the religious capacity is necessary for coping with moral distress.
Keywords: religious response, nurses, moral distress, ICU, content analysis
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References
Mobley MJ, Rady MY, Verheijde JL, Patel B, Larson JS. The relationship between moral distress and perception of futile care in the critical care unit. Intensive & critical care nursing: the official journal of the British Association of Critical Care Nurses. 2007;23(5):256-63.
Benjamin M, Curtis J. Ethics in nursing: Oxford University Press, USA; 1992.
Ha-ping Yung H. Ethical decision-making and the perception of the ward as a learning environment: a comparison between hospital-based and degree nursing students in Hong Kong. International journal of nursing studies. 1997;34(2):128-36.
Ulrich C, O'Donnell P, Taylor C, Farrar A, Danis M, Grady C. Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Social science & medicine 2007;65(8):1708-19.
Bailey S. Decision making in acute care: A practical framework supporting the best interests' principle. Nursing Ethics. 2006;13(3):284-91.
Storch JL, Kenny N. Shared moral work of nurses and physicians. Nursing Ethics. 2007;14(4):478-91.
Ersoy N, Akpinar A. Turkish nurses' decision making in the distribution of intensive care beds. Nursing Ethics. 2010;17(1):87-98.
Corley MC. Nurse moral distress: a proposed theory and research agenda. Nursing Ethics. 2002;9(6):636-50
McCarthy J, Deady R. Moral distress reconsidered. Nursing Ethics. 2008;15(2):254-62.
Ellis JR, Hartley CL. Nursing in today's world: trends, issues & management. 9 ed: Lippincott Williams & Wilkins; 2008.
Maiden JM. A Quantitative and Qualitative Inquiry Into Moral Distress, Compassion Fatigue, and Medication Error in Critical Care Nurses: University of San Diego; 2008.
Hamric AB. Moral distress in everyday ethics. Nursing Outlook. 2000;48(5):199-201.
Badger JM, O'Connor B. Moral discord, cognitive coping strategies, and medical intensive care unit nurses: insights from a focus group study. Critical care nursing quarterly. 2006; 29(2): 147-51.
Pendry PS. Moral distress: recognizing it to retain nurses. Nursing economic. 2007; 25(4): 217.
Austin W, Kelecevic J, Goble E, Mekechuk J. An overview of moral distress and the paediatric intensive care team. Nursing Ethics. 2009; 16(1): 57-68.
Park H-A, Cameron ME, Han S-S, Ahn S-H, Oh H-S, Kim K-U. Korean nursing students' ethical problems and ethical decision making. Nursing Ethics. 2003;10(6):638-53.
Corley MC, Minick P, Elswick RK, Jacobs M. Nurse moral distress and ethical work environment. Nursing Ethics. 2005;12(4):381-90.
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.
Schluter J, Winch S, Holzhauser K, Henderson A. Nurses' moral sensitivity and hospital ethical climate: A literature review. Nursing Ethics. 2008;15(3):304-21.
Tschudin V. Ethics in Nursing: The Caring Relationship. 3 ed: Butterworth-Heinemann; 2003.
Büssing A, Balzat H, Heusser P. Spiritual needs of patients with chronic pain diseases and cancer-validation of the spiritual needs questionnaire. European journal of medical research. 2010;15(6):266-73.
Koslander T, da Silva AB, Roxberg Å. Existential and spiritual needs in mental health care: An ethical and holistic perspective. Journal of Holistic Nursing. 2009:34-42.
King MB, Koenig HG. Conceptualising spirituality for medical research and health service provision. BMC Health Services Research. 2009;9(1):116 (1-11).
Spinale J, Cohen SD, Khetpal P, Peterson RA, Clougherty B, Puchalski CM, et al. Spirituality, social support, and survival in hemodialysis patients. Clinical journal of the American society of Nephrology. 2008;3(6):1620-7.
Chochinov HM. Dying, Dignity, and New Horizons in Palliative End‐of‐Life Care1. CA: a cancer journal for clinicians. 2006;56(2):84-103.
Lin YP, Tsai YF, Chen HF. Dignity in care in the hospital setting from patients’ perspectives in Taiwan: a descriptive qualitative study. Journal of clinical nursing. 2011;20(5-6):794-801.
Iranmanesh S, Tirgari B, Cheraghi MA. Developing and testing a spiritual care questionnaire in the Iranian context. Journal of religion and health. 2012;51(4):1104-16.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004;24(2):105-12.
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative: Lippincott Williams & Wilkins; 2011.
Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005; 15(9):1277-88.
Elo S, Kyngäs H. The qualitative content analysis process. Journal of advanced nursing. 2008;62(1):107-15.
Goethals S, Gastmans C, de Casterlé BD. Nurses’ ethical reasoning and behaviour: A literature review. International Journal of Nursing Studies. 2010;47(5):635-50.
Pereira SM, Fonseca AM, Carvalho AS. Burnout in palliative care: A systematic review. Nursing Ethics. 2011;18(3):317-26.
ief Executive Officers in University Hospitals and Its Relation to Their Demographic Features. Health Information Management. 2011.
Pendleton SM, Cavalli KS, Pargament KI, Nasr SZ. Religious/spiritual coping in childhood cystic fibrosis: A qualitative study. Pediatrics. 2002;109(1):8-23.
McClain CS, Rosenfeld B, Breitbart W. Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. The Lancet. 2003;361(9369):1603-7.
Thune-Boyle IC, Stygall JA, Keshtgar MR, Newman SP. Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social science & medicine. 2006;63(1):151-64.
Aguilar-Vafaie ME. Coping-Health Inventory for parents: Assessing coping among Iranian parents in the care of children with cancer and introductory development of an adapted Iranian Coping-Health Inventory for parents. Children's Health Care. 2008;37(4):237-60.
Cotton S, Grossoehme D, Rosenthal SL, McGrady ME, Roberts YH, Hines J, et al. Religious/spiritual coping in adolescents with sickle cell disease: A pilot study. Journal of pediatric hematology/oncology. 2009;31(5):313.
Benjamins MR. Religion and Functional Health Among the Elderly Is There a Relationship and Is It Constant? Journal of Aging and Health. 2004;16(3):355-74.
Badger JM. A descriptive study of coping strategies used by medical intensive care unit nurses during transitions from cure-to comfort-oriented care. Heart & Lung: The Journal of Acute and Critical Care. 2005;34(1):63-8.
Boero M, Caviglia M, Monteverdi R, Braida V, Fabello M, Zorzella L. Spirituality of health workers: a descriptive study. International journal of nursing studies. 2005;42(8):915-21.
Hodge DR. Spiritual assessment: A review of major qualitative methods and a new framework for assessing spirituality. Social work. 2001;46(3):203-14.
Chamratrithirong A, Miller BA, Byrnes HF, Rhucharoenpornpanich O, Cupp PK, Rosati MJ, et al. Spirituality within the family and the prevention of health risk behavior among adolescents in Bangkok, Thailand. Social science & medicine. 2010;71 (10): 1855-63.
Boyatzis CJ, Quinlan KB. Women’s body image, disordered eating, and religion: a critical review of the literature. Research in the Social Scientific Study of Religion. 2008;19(1):183-208.
Meert KL, Thurston CS, Briller SH. The spiritual needs of parents at the time of their child's death in the pediatric intensive care unit and during bereavement: A qualitative study*. Pediatric Critical Care Medicine. 2005;6(4):420-7.
Johnson WB, Barnett JE. Preventing problems of professional competence in the face of life-threatening illness. Professional Psychology: Research and Practice. 2011;42(4):285.
Tilburt JC, James KM, Sinicrope PS, Eton DT, Costello BA, Carey J, et al. Factors influencing cancer risk perception in high risk populations: a systematic review. Hereditary cancer in clinical practice. 2011;9(2).
Lee B-J. Moderating effects of religious/spiritual coping in the relation between perceived stress and psychological well-being. Pastoral Psychology. 2007;55(6):751-9.
Aronson J. Praying in face of life-threatening illness: INSTITUTE FOR CLINICAL SOCIAL WORK (CHICAGO); 2008.
Nguyen M. The effects of spiritual practices on managing employee work-related stress: University of Phoentx; 2009.
Goodman Jr H, Stone MH. The efficacy of adult Christian support groups in coping with the death of a significant loved one. Journal of Religion and Health. 2009;48(3):305-16.
Hodge DR, Roby JL. Sub-Saharan African women living with HIV/AIDS: an exploration of general and spiritual coping strategies. Social work. 2010;55(1):27-37.
Lavretsky H. Spirituality and aging. Aging Health. 2010; 6(6): 749-69.
De Sousa A. Spirituality and Geriatric Psychiatry: A Review. Indian Journal of Gerontology. 2011; 25(3): 345-54.
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