ارتباط بین دیسترس اخلاقی و تاب آوری در پرستاران
مجله اخلاق پزشکی - علمی پژوهشی,
دوره 14 شماره 45 (1399),
30 March 2020
,
صفحه 1-14
https://doi.org/10.22037/mej.v14i45.26874
چکیده
زمینه و هدف: دیسترس اخلاقی یکی از موضوعات شایع مطرحشده در پرستاری است که میتواند تأثیرات متفاوتی بر سلامت و عملکرد پرستاران و بیماران و سازمانهای بهداشتی درمانی داشته باشد. تابآوری، به عنوان ظرفیتهای اجتماعی و شخصی برای بازیابی، سازگاری و تداوم در برابر سختیها تعریف شده که میتواند به پرستاران در کاهش دیسترس اخلاقی کمک کند. این پژوهش با هدف تعیین ارتباط دیسترس اخلاقی و تابآوری در پرستاران انجام شد.
مواد و روشها: این مطالعه از نوع همبستگی ـ مقطعی بر روی 250 پرستار شاغل در بیمارستانهای وابسته به دانشگاه علوم پزشکی شهید صدوقی شهر یزد در سال 1398 که به صورت نمونهگیری تصادفی طبقهای انتخاب شدند، انجام شد. ابزار گردآوری دادهها شامل سه پرسشنامه مشخصات دموگرافیک، دیسترس اخلاقی تعدیلشده همریک و همکاران و تابآوری کانر و دیویدسون بود. تجزیه و تحلیل دادهها با استفاده از آمار توصیفی و استنباطی (تی مستقل، آنالیز واریانس یکطرفه، آزمون تعقیبی توکی و پیرسون) در نرمافزار آماری SPSS 20 انجام شد.
یافتهها: یافتهها نشان داد که بین میانگین نمره دیسترس اخلاقی و تابآوری پرستاران ارتباط آماری معنیداری وجود ندارد (P=0/67 ،r=0/027). از بین ابعاد تابآوری بین «کنترل» و «پذیرش مثبت تغییر و روابط ایمن» با دیسترس اخلاقی ارتباط معکوس و معنیداری وجود دارد (0/05>P). میانگین نمره دیسترس اخلاقی 9/99±31/36 بود که نشاندهنده سطح متوسط دیسترس اخلاقی است. میانگین نمره تابآوری پرستاران 11/11±64/87 بود. بالاترین نمره مربوط به بعد «تأثیرات معنوی» (20/22±68/05) و پایینترین نمره مربوط به بعد «اعتماد به غرایز فردی، تحمل عاطفه منفی» (13/38±60/44) بود. ارتباط آماری معنیداری بین دیسترس اخلاقی و جنس، وضعیت تأهل، وضعیت نوبتکاری، گروههای سنی، وضعیت استخدامی و سابقه کاری وجود داشت (0/05>P). همچنین تابآوری با متغیرهای جنس، وضعیت تأهل، سطح تحصیلات و وضعیت استخدامی ارتباط آماری معنیدار داشت (0/05>P).
ملاحظات اخلاقی: این مطالعه توسط کمیته اخلاق در تحقیقات پزشکی تأیید شده است. ملاحظات اخلاقی نظیر تکمیل فرم رضایت آگاهانه، مشارکت داوطلبانه، توضیح اهداف تحقیق و اطمینان در مورد محرمانه بودن اطلاعات رعایت گردید.
نتیجهگیری: افراد با توانایی «کنترل» و «پذیرش مثبت تغییر و روابط ایمن» بالاتر، دیسترس اخلاقی کمتری را تجربه میکنند، لذا میتوان با به کاربردن استراتژیهای آموزشی ارتقادهنده این ابعاد و حمایت مدیران پرستاری، موجبات کاهش دیسترس اخلاقی و پیامدهایی نظیر حفظ نیروی کار و ارتقای کیفیت مراقبت از بیمار را فراهم نمود.
- دیسترس اخلاقی، تابآوری، پرستار
ارجاع به مقاله
مراجع
Lin FY, Rong JR, Lee TY. Resilience among caregivers of children with chronic conditions: A concept analysis. Journal of Multidisciplinary Healthcare 2013; 6(1): 323-333.
Abbaszadeh A, Borhani F, Kalantary S. The moral distress of nurses in health centers in the city of Bam in 1390. Medical Ethics Journal 2016; 5(17): 119-140. [Persian]
Bucknall TK. Critical care nurses' decision-making activities in the natural clinical setting. J Clin Nurs 2000; 9(1): 25-35.
Ahmadi R, Sharifi Darmandi P. A Studyof the Effect of Resilience Training on Mental Health of People with Drug Dependency at Touska Camp in Tehran. Quarterly of Clinical Psychology Studies 2014; 4(16): 1-17. [Persian]
Salimi S, Pakpour V, Feizollahzadeh H, Rahmani A. Resilience and its association with the intensive care unit nurses’ intention to leave their profession. Hayat 2017; 23(3): 254-265. [Persian]
King CA, Broom C. Ethics in Perioperative Practice Values, Integrity, and Social Policy. AORN Journal 2002; 76(6): 1047-1053.
Massoudi R, Aetemadifar S, Afzali SM, Khayri F, Hassanpour Dehkordi A. The influential factors on burnout among nurses working in private hospitals in Tehran. Iranian Journal of Nursing Research 2008; 3(9): 47-58. [Persian]
Seifert PC. Ethics in perioperative practice-duty to self. Aorn J 2002; 76(2): 306-308.
Abbaszadeh A, Nakhaee N, Borhani F, Roshanzadeh M. Moral distress in the nurse’s practical action: A descriptive-cross sectional study. Medical Ethics Journal 2016; 6(21): 113-130. [Persian]
Mardani Hamooleh M, Iranshahi M, Seyedfatemi N, Haghani H. An evaluation of moral distress levels among the nursing staff of Malayer hospitals: A cross-sectional study. Journal of Medical Ethics and History of Medicine 2016; 9(2): 42-53. [Persian]
Mohammadi Nafchi S, Borhani F, Roshanzadeh M. Relationship between moral distress and environmental empowerment for nurses in education hospitals in Kerman. Medical Ethics Journal 2015; 8(26): 91-113. [Persian]
Robaee N, Atashzadeh-Shoorideh F, Ashktorab T, Baghestani A, Barkhordari-Sharifabad M. Perceived organizational support and moral distress among nurses. BMC Nursing 2018; 17(2): 1-7.
Haghighinezhad G, Atashzadeh-Shoorideh F, Ashktorab T, Mohtashami J, Barkhordari-Sharifabad M. Relationship between perceived organizational justice and moral distress in intensive care unit nurses. Nursing Ethics 2019; 26(2): 460-470.
Mohammadi S, Borhani F, Roshanzadeh L, Roshanzadeh M. Moral distress and compassion fatigue in patient care: a correlational study on nurses. Journal of Medical Ethics and History of Medicine 2014; 7(2): 69-79. [Persian]
Mahdavi Fashtami S, Mohammadehzadeh Zarankesh S, Esmaeilpour Bandboni M. Moral distress among emergency department nurses: frequency, intensity, effect. Medical Sciences Journal of Islamic Azad University 2016; 26(4): 248-255. [Persian]
Borhani F, Esmaeli-Abdar M, Razban F, Roshanzadeh M. Moral distress in the nursing and relationship with job burnout. Medical Ethics Journal 2012; 7(25): 123-144. [Persian]
Abbaszadeh A, Borhani F, Foroogh Ameri G, Najmi Dolat-Abadi S. Relation between moral distress and Work engagement in nurse’s cross-sectional-correlation study. Medical Ethics Journal 2015; 7(24): 33-53. [Persian]
Abbaszadeh A, Borhani F, Sharif F, Toghrai FA-S. The relationship between nurse’s moral distress and end of life decision making in ICU. Medical Ethics Journal 2016; 7(22): 117-133. [Persian]
Krautscheid L, Mood L, McLennon SM, Mossman TC, Wagner M, Wode J. Examining Relationships Between Resilience Protective Factors and Moral Distress Among Nursing Students. Nursing Education Perspectives 2020; 41(1): 43-45.
Masten AS, Best KM, Garmezy N. Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology 1990; 2(4): 425-444.
Madewell AN, Ponce-Garcia E. Assessing resilience in emerging adulthood: The resilience scale (RS), Connor-Davidson resilience scale (CD-RISC), and scale of protective factors (SPF). Personality and Individual Differences 2016; 97(1): 249-255.
Lachman VD. Moral resilience: managing and preventing moral distress and moral residue. Medsurg Nursing 2016; 25(2): 121-124.
Lin CC, Liang HF, Han CY, Chen LC, Hsieh CL. Professional resilience among nurses working in an overcrowded emergency department in Taiwan. International Emergency Nursing 2019; 42(1): 44-50.
Hart PL, Brannan JD, De Chesnay M. Resilience in nurses: An integrative review. Journal of Nursing Management 2014; 22(6): 720-734.
Brown R, Wey H, Foland K. The relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses. Journal of Nursing Scholarship 2018; 50(3): 306-313.
Hodges HF, Troyan PJ, Keeley AC. Career persistence in baccalaureate‐prepared acute care nurses. Journal of Nursing Scholarship 2010; 42(1): 83-91.
Grafton E, Gillespie B, Henderson S. Resilience: the power within. Oncology Nursing Forum 2010; 37(6): 698-705.
Matos PS, Neushotz LA, Griffin MTQ, Fitzpatrick JJ. An exploratory study of resilience and job satisfaction among psychiatric nurses working in inpatient units. International Journal of Mental Health Nursing 2010; 19(5): 307-312.
Johnson SJ, Willis SM, Evans J. An examination of stressors, strain, and resilience in academic and non-academic UK university job roles. International Journal of Stress Management 2018; 25(1): 1-16.
Crowder R, Sears A. Building resilience in social workers: An exploratory study on the impacts of a mindfulness-based intervention. Australian Social Work 2017; 70(1): 17-29.
Cameron F, Brownie S. Enhancing resilience in registered aged care nurses. Australasian Journal on Ageing 2010; 29(2): 66-71.
Azizi A, Sepahvani M, Mohamadi J. Relationship between Moral Distress and Mental Health among Female Nurses. Iran Journal of Nursing (IJN) 2015; 27(92): 57-64. [Persian]
Khoshnazary S, Hosseini M, Fallahi Khoshknab M, Bakhshi E. The Effect of Emotional Intelligence (EI) Training on Nurses' Resiliency in Department of Psychiatry. Iranian Journal of Psychiatric Nursing (IJPN) 2016; 3(4): 28-37. [Persian]
Mohammadi J, Ghadampour E, Azizi A. Assessment the relationship between moral turmoil with job demand-control in Tabriz hospitals nurses. Journal of Education and Ethics in Nursing 2014; 3(3): 23-30. [Persian]
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.
Connor KM, Davidson JR. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depression and Anxiety 2003; 18(2): 76-82.
Corley MC, Minick P, Elswick RK, Jacobs M. Nurse moral distress and ethical work environment. Nurs Ethics 2005; 12(4): 381-390.
Werner EE, Smith RS. Journeys from childhood to midlife: Risk, resilience and recovery. New York: Cornell University Press; 2001.
Rushton CH, Batcheller J, Schroeder K, Donohue P. Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care 2015; 24(5): 412-420.
Krautscheid L, Mood L, McLennon SM, Mossman TC, Wagner M, Wode J. Examining Relationships Between Resilience Protective Factors and Moral Distress Among Nursing Students. Nursing Education Perspectives 2019; 41(1): 43-45.
Pishgooie AH, Barkhordari-Sharifabad M, Atashzadeh-Shoorideh F, Falcó-Pegueroles A. Ethical conflict among nurses working in the intensive care units. Nursing Ethics 2019; 26(7-8): 2225-2238.
Smith GD, Yang F. Stress, resilience and psychological well-being in Chinese undergraduate nursing students. Nurse Education Today 2017; 49(1): 90-95.
Delgado C, Roche M. Workplace resilience and emotional labour of Australian mental health nurses: Results of a national survey. International Journal of Mental Health Nursing 2020; 29(1): 35-46.
Rushton CH. Defining and addressing moral distress: tools for critical care nursing leaders. AACN Advanced Critical Care 2006; 17(2): 161-168.
Henrich NJ, Dodek PM, Alden L, Keenan SP, Reynolds S, Rodney P. Causes of moral distress in the intensive care unit: A qualitative study. Journal of Critical Care 2016; 35(1): 57-62.
Siebert A. The resiliency advantage: Master change, thrive under pressure and bounce back from setbacks. San Francisco: Berrett-Koehler Publishers; 2005.
Burston AS, Tuckett AG. Moral distress in nursing: contributing factors, outcomes and interventions. Nursing Ethics 2013; 20(3): 312-324.
Pauly B, Varcoe C, Storch J, Newton L. Registered nurses’ perceptions of moral distress and ethical climate. Nursing Ethics 2009; 16(5): 561-573.
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. Journal of Nursing Management 2008; 16(3): 360-373.
Ohnishi K, Ohgushi Y, Nakano M, Fujii H, Tanaka H, Kitaoka K, et al. Moral distress experienced by psychiatric nurses in Japan. Nursing Ethics 2010; 17(6): 726-740.
Wahlberg L, Nirenberg A, Capezuti E. Distress and Coping Self-Efficacy in Inpatient Oncology Nurses. Oncology Nursing Forum 2016; 43(6): 738-746.
Silen M, Svantesson M, Kjellstrom S, Sidenvall B, Christensson L. Moral distress and ethical climate in a Swedish nursing context: perceptions and instrument usability. J Clin Nurs 2011; 20(23-24): 3483-3493.
Moon IO, Park SK, Jung JM. Effects of resilience on work engagement and burnout of clinical nurses. Journal of Korean Academy of Nursing Administration 2013; 19(4): 525-535.
Elqerenawi A, Thabet A, Vostanis P. Job Stressors, Coping and Resilience among Nurses in Gaza Strip. Clinical and Experimental Psychology 2017; 3(159): 1-8.
Gerami Nejad N, Hosseini M, Mousavi Mirzaei S, Ghorbani Moghaddam Z. Association between Resilience and Professional Quality of Life among Nurses Working in Intensive Care Units. Iran Journal of Nursing 2019; 31(116): 49-60.
Mohammadi S, Borhani F, Roshanzadeh M. Moral distress in students: A cross-sectional study in educational environment. Medical Ethics Journal 2015; 9(31): 29-47. [Persian]
Etebari-Asl Z, Etebari-Asl F, Nemati K. A Survey on the Level of Moral Distress among Nurses of Special Wards Affiliated to Educational-Therapeutic Centers in Ardabil University of Medical Sciences in 2016: A Short Report. Journal of Rafsanjan University of Medical Sciences. 2017;16(2): 169-178. [Persian]
Ebrahimi H, Kazemi A, Asghari Jafarabadi M, Azarm A. Moral distress in nurses working in educational hospitals of Northwest Medical Universities of Iran. Iranian Journal of Medical Ethics and History of Medicine 2013; 6(4): 80-88. [Persian]
Shafipour V, Esmaeili R, Heidari MR, Aghaei N, Saadatmehr SR, Sanagoo A. Investigating the Level of Moral Distress and its Related Factors among Nurses in Mazandaran Burn Center. Journal of Mazandaran University of Medical Sciences 2015; 25(126): 58-67. [Persian]
Ang SY, Uthaman T, Ayre TC, Mordiffi SZ, Ang E, Lopez V. Association between demographics and resilience-a cross-sectional study among nurses in Singapore. International Nursing Review 2018; 65(3): 459-466.
Tahghighi M, Brown JA, Breen LJ, Kane R, Hegney D, Rees CS. A comparison of nurse shift workers' and non-shift workers' psychological functioning and resilience. Journal of Advanced Nursing 2019; 75(11): 2570-2578.
Gillespie BM, Chaboyer W, Wallis M. The influence of personal characteristics on the resilience of operating room nurses: A predictor study. International Journal of Nursing Studies 2009; 46(7): 968-976.
- چکیده مشاهده شده: 1426 بار
- PDF دانلود شده: 178 بار