Predicting Moral Distress Through the Dimensions of Psychological Empowerment in Nurses
Advances in Nursing & Midwifery,
Vol. 30 No. 4 (2021),
15 October 2021
,
Page 21-27
Abstract
Abstract
Introduction: Moral distress is an important challenge among critical care nurses. psychological empowerment can pave the ground for proper moral performance and prevention of moral distress among nurses. This study aimed to predicting moral distress through the dimensions of psychological empowerment in nurses.
Methods: This descriptive cross-sectional and analytical study carried out in 2018. For this purpose, 190 nurses were selected by convenience sampling from the critical care units in Southern Khorasan Province, Iran. Data were collected using Corli's Moral Distress Questionnaire and Spreitzer's Psychological Empowerment Questionnaire. Data were analyzed in IBM SPSS ver. 16 using descriptive and inferential statistics.
Results: Finding showed that moral distress intensity was (4.8±0.51) and negatively correlated whit psychological empowerment (P=0.03, r=-0.5). Moral distress frequency was (5.2± 0.56). The psychological empowerment was (4.1± 0.44). The results of the multiple regression indicated that 2 % variation of moral distress intensity explained by psychological empowerment (ADJ.R2:0.238). Among these dimensions, three dimensions meaning, competence and self-determination significantly predict the intensity of moral distress (R2=0.25, P< 0.05). Moral distress correlated with age, working experience, and type of the ward (P<0.05).
Conclusions: Nurses with a greater psychological empowerment showed less intensified symptoms of distress where they were able to perform morally proper action.
- Moral Distress
- Psychological
- Empowerment
- Nurse
How to Cite
References
REFERENCES
Grace PJ, Robinson EM, Jurchak M, Zollfrank AA, Lee SM. Clinical ethics residency for nurses: an education model to decrease moral distress and strengthen nurse retention in acute care. J Nurs Adm. 2014;44(12):640-6. doi: 10.1097/NNA.0000000000000141 pmid: 25393140
Johnstone MJ, Hutchinson A. 'Moral distress'--time to abandon a flawed nursing construct? Nurs Ethics. 2015;22(1):5-14. doi: 10.1177/0969733013505312 pmid: 24311238
Brandon D, Ryan D, Sloane R, Docherty SL. Impact of a pediatric quality of life program on providers' moral distress. MCN Am J Matern Child Nurs. 2014;39(3):189-97. doi: 10.1097/NMC.0000000000000025 pmid: 24759312
Woods M. Beyond moral distress: preserving the ethical integrity of nurses. Nurs Ethics. 2014;21(2):127-8. doi: 10.1177/0969733013512741 pmid: 24622728
Bernhofer EI, Sorrell JM. Nurses Managing Patients' Pain May Experience Moral Distress. Clin Nurs Res. 2015;24(4):401-14. doi: 10.1177/1054773814533124 pmid: 24836821
Sunderland N, Harris P, Johnstone K, Del Fabbro L, Kendall E. Exploring health promotion practitioners' experiences of moral distress in Canada and Australia. Glob Health Promot. 2015;22(1):32-45. doi: 10.1177/1757975914532505 pmid: 24853825
Elpern EH, Covert B, Kleinpell R. Moral distress of staff nurses in a medical intensive care unit. Am J Crit Care. 2005;14(6):523-30. pmid: 16249589
Tajabadi A, Ahmadi F, Sadooghi Asl A, Vaismoradi M. Unsafe nursing documentation: A qualitative content analysis. Nurs Ethics. 2020;27(5):1213-24. doi: 10.1177/0969733019871682 pmid: 31476968
Kennedy MS. Mitigating the Effects of Moral Distress. AJN America J Nurs. 2017;117(2):7. doi: 10.1097/01.NAJ.0000521948.22577.6d
Lazzarin M, Biondi A, Di Mauro S. Moral distress in nurses in oncology and haematology units. Nurs Ethics. 2012;19(2):183-95. doi: 10.1177/0969733011416840 pmid: 22457383
Sirilla J, Thompson K, Yamokoski T, Risser MD, Chipps E. Moral Distress in Nurses Providing Direct Patient Care at an Academic Medical Center. Worldviews Evid Based Nurs. 2017;14(2):128-35. doi: 10.1111/wvn.12213 pmid: 28253430
Borhani F, Mohammadi S, Roshanzadeh M. Moral distress and perception of futile care in intensive care nurses. J Med Ethic Hist Med. 2015;8(2).
Sweeney CD. A DAISY Nurse: Moral Distress and End-of-Life Decisions in the Pediatric Setting. J Nurs Adm. 2017;47(2):82-4. doi: 10.1097/NNA.0000000000000443 pmid: 28106679
Coombs MA. Concerns about care and communication are key causes of moral distress in intensive care staff. Aust Crit Care. 2017;30(2):107-8. doi: 10.1016/j.aucc.2017.01.007 pmid: 28292414
Roshanzadeh M, Vanaki Z, Sadooghiasl A. Sensitivity in ethical decision-making: The experiences of nurse managers. Nurs Ethics. 2020;27(5):1174-86. doi: 10.1177/0969733019864146 pmid: 31462175
Sannino P, Gianni ML, Re LG, Lusignani M. Moral distress in the neonatal intensive care unit: an Italian study. J Perinatol. 2015;35(3):214-7. doi: 10.1038/jp.2014.182 pmid: 25297004
Atabay G, Cangarli BG, Penbek S. Impact of ethical climate on moral distress revisited: multidimensional view. Nurs Ethics. 2015;22(1):103-16. doi: 10.1177/0969733014542674 pmid: 25106456
Sadooghiasl A, Parvizy S, Ebadi A. Concept analysis of moral courage in nursing: A hybrid model. Nurs Ethics. 2018;25(1):6-19. doi: 10.1177/0969733016638146 pmid: 27098415
Browning AM. CNE article: moral distress and psychological empowerment in critical care nurses caring for adults at end of life. Am J Crit Care. 2013;22(2):143-51. doi: 10.4037/ajcc2013437 pmid: 23455864
Spreitzer GM. Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academ Manage J. 1995;38(5):1442-65. doi: 10.2307/256865
Faulkner J, Laschinger H. The effects of structural and psychological empowerment on perceived respect in acute care nurses. J Nurs Manag. 2008;16(2):214-21. doi: 10.1111/j.1365-2834.2007.00781.x pmid: 18269553
Laschinger HK, Purdy N, Almost J. The impact of leader-member exchange quality, empowerment, and core self-evaluation on nurse manager's job satisfaction. J Nurs Adm. 2007;37(5):221-9. doi: 10.1097/01.NNA.0000269746.63007.08 pmid: 17479040
Laschinger HK, Finegan J, Wilk P. Context matters: the impact of unit leadership and empowerment on nurses' organizational commitment. J Nurs Adm. 2009;39(5):228-35. doi: 10.1097/NNA.0b013e3181a23d2b pmid: 19423988
Wagner JI, Cummings G, Smith DL, Olson J, Anderson L, Warren S. The relationship between structural empowerment and psychological empowerment for nurses: a systematic review. J Nurs Manag. 2010;18(4):448-62. doi: 10.1111/j.1365-2834.2010.01088.x pmid: 20609049
Knol J, van Linge R. Innovative behaviour: the effect of structural and psychological empowerment on nurses. J Adv Nurs. 2009;65(2):359-70. doi: 10.1111/j.1365-2648.2008.04876.x pmid: 19191936
McCarthy J, Gastmans C. Moral distress: a review of the argument-based nursing ethics literature. Nurs Ethics. 2015;22(1):131-52. doi: 10.1177/0969733014557139 pmid: 25505098
Thomas TA, McCullough LB. A philosophical taxonomy of ethically significant moral distress. J Med Philos. 2015;40(1):102-20. doi: 10.1093/jmp/jhu048 pmid: 25503608
Bruce CR, Miller SM, Zimmerman JL. A qualitative study exploring moral distress in the ICU team: the importance of unit functionality and intrateam dynamics. Crit Care Med. 2015;43(4):823-31. doi: 10.1097/CCM.0000000000000822 pmid: 25525754
Corley MC, Elswick RK, Gorman M, Clor T. Development and evaluation of a moral distress scale. J Adv Nurs. 2001;33(2):250-6. doi: 10.1046/j.1365-2648.2001.01658.x pmid: 11168709
Borhani F, Abbaszadeh A, Nakhaee N, Roshanzadeh M. The relationship between moral distress, professional stress, and intent to stay in the nursing profession. J Med Ethic History Med. 2014;7.
Mohammadi S, Roshanzadeh M. The relationship between psychological empowerment and psychological strain among clinical nurses in educational hospitals. J Nurs Manage. 2014;3(3).
Rice EM, Rady MY, Hamrick A, Verheijde JL, Pendergast DK. Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital. J Nurs Manag. 2008;16(3):360-73. doi: 10.1111/j.1365-2834.2007.00798.x pmid: 18324996
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