Showing 29 results for Stress
Zahra Mahmoodzadeh, Tahereh Ashktorab, Seid Mohammad Kazem Naeeni,
Volume 12, Issue 0 (3-2019)
Abstract
One of the most common ethical issues in nursing profession is moral distress which causes discomfort and impedes nurses proper moral performance, despite having sufficient knowledge. Moral distress disturbs the relationship between nurse and patient which leads to the decreased quality of care. Caring behaviors greatly contribute to improving the quality of care and patient safety. The present study aimed to determine the correlation between moral distress and caring behaviors of nurses in intensive care units of Bandar Abbas hospitals in 2018. This was a descriptive correlational study that was performed on 173 nurses working in ICU and NICU departments of Bandar Abbas hospitals. The data collection tools were demographic information questionnaire, the moral distress scale of nurses of intensive care units, and nursing Caring Behaviors Inventory. Data were analyzed using IBM SPSS 20. Moral distress in nurses in the intensive care unit was in the middle range (1.75 ± 0.81 of 4 score). Also, the mean score of nurses' caring behavior was 5.28 ± 0.48 of 6 score which was considered as an acceptable level. There was a significant negative correlation between moral distress and caring behavior (r = -0.150, P = 0.049). Regarding the importance of moral distress, as well as the role of caring behaviors in improving the quality of care of nurses and satisfaction of patients, it seems necessary that nurses get more familiarized with this concept and attempts to provide solutions for coping and reducing moral distress and improving nurses' caring behaviors.
Farshid Shamsaei, Marzieh Jahani Sayad Noveiri, Naser Mohammadgholimezerji, Shirin Ranjbar, Mehdi Khazaei, Zahra Maghsoudi,
Volume 13, Issue 0 (3-2020)
Abstract
Undesirable experience as “moral distress” is one of the major issues faced by nurses when making moral decisions. The spiritual dimension is one of the dimensions that influences their moral distress; therefore, this study was conducted with the aim of determining the relationship between spiritual health and the moral distress of nurses working in the emergency departments. In this descriptive-analytic study, 140 nurses working in the emergency departments of the educational and medical centers of Hamedan participated by census sampling. Data were collected through a three-part questionnaire, including demographic information, Paloutzian and Ellison spiritual health questionnaires and Corly moral distress questionnaire. The data was analyzed by Chi-square test and Pearson correlation coefficients using SPSS software, version 16. The mean age of participants was 31.9 ± 7.31 years. The spiritual health score and moral distress of most nurses were moderate. A negative and significant correlation was observed between spiritual health and the severity of nurses' moral distress, (r = -0.200, p = 0.05), meaning that the higher the nurse's spiritual health score, the lower their moral distress. The results indicate that spiritual health is an effective parameter in reducing moral distress in nurses, so it is suggested to pay attention to spiritual’s dimension in promotion of nurses' health.
Esmatsadat Hashemi, Maasoumeh Barkhordari-Sharifabad , Mohammad Mehdi Salaree,
Volume 13, Issue 0 (3-2020)
Abstract
Turnover and moral distress are considered as one of the challenges in health care systems. Nursing leaders are one of the factors influencing the thoughts and behaviors of nurses in organizational environments. The aim of this study was to determine the relationship between ethical leadership, moral distress and the turnover intention of nurses working in hospitals affiliated to Kerman University of Medical Sciences in 2019-2020. The research method was descriptive-correlation. A total of 130 participants were enrolled by stratified sampling method from 3 hospitals. Data were collected using demographic information questionnaires, Ethical Leadership in Nursing, moral distress, and turnover intention. Then data were analyzed using descriptive and inferential statistics by SPSS software version 16. The results showed that ethical leadership and all its components were at the desired level. Also, moral distress and intention to leave were moderate. There was a significant negative correlation between ethical leadership and all its dimensions with the turnover intention and moral distress. Also, there was a significant positive correlation between the variables of turnover intention and the moral distress. Therefore, considering the significant relationship between ethical leadership, moral distress, and the turnover, by adopting this type of leadership approach by nursing managers, moral distress and the turnover intention among nurses can be reduced.
Dariush Azimi,
Volume 14, Issue 0 (3-2021)
Abstract
The widespread and increasing number of deaths due to the Corona virus has caused many psychological injuries, including stress. Therefore, the aim of this study was to study the relationship between perceived stress and coping strategies of the family members of patients with Corona virus admitted to the Intensive Care Unit (ICU) of Ardabil medical centers. The present study is a descriptive-analytical study. Sampling was done by available method among the companions of patients with Corona virus infection admitted to the ICU (between May and September 2020). The number of research samples according to the results of a pilot study was estimated at 462 people. Available sampling method was used for sampling. Data collected included patient demographics, Cohen's Perceived Stress Questionnaire, and the Blinges-Moss Coping Styles Questionnaire. The collected data were analyzed using independent t-test, Mann-Whitney, Spearman and Chi-square tests and one-way analysis of variance by SPSS software version 24. The results showed that the mean and standard deviation of perceived stress were 44.80 ± 5.92 and emotion-oriented and problem-oriented coping styles were 19.08 ± 3.02 and 32.35 ± 5.54, respectively. Spearman correlation coefficient test showed a significant relationship between perceived stress with problem-oriented coping style (r = 0.321) and emotion-oriented coping style (r = 0.113) (p <0.05). This study showed that the companions of coronary patients admitted to the intensive care unit use more emotional coping methods, which results in increased emotional behaviors. Therefore, in order to help the psychological health of coronary patients, it is possible to strengthen the application of problem-oriented coping style by designing and implementing educational and supportive-care programs.
Maryam Kashani, Mansoureh Ashqli Farahani, Fatemeh Golestan,
Volume 17, Issue 0 (12-2024)
Abstract
The intensive care unit (ICU) environment presents numerous ethical challenges, contributing to significant levels of moral distress among ICU nurses. This distress negatively impacts their well-being and job satisfaction. Recognizing this critical issue, researchers have investigated the potential of moral empowerment programs to alleviate moral distress. This scoping review aimed to systematically synthesize existing literature on these programs and evaluate their efficacy in mitigating moral distress among ICU nurses. A comprehensive search of PubMed, Scopus, and CINAHL databases was conducted, utilizing keywords such as "moral empowerment," "moral distress," and "intensive care unit nurses." Fifteen articles meeting predefined inclusion criteria, including publication between 2010 and 2022 and a specific focus on moral empowerment programs for ICU nurses, were selected for analysis. The scoping review revealed that moral empowerment programs demonstrated positive outcomes in reducing moral distress among ICU nurses. These programs, encompassing workshops, case-based discussions, reflective exercises, and role-playing simulations, were designed to enhance moral reasoning, ethical decision-making, and moral resilience. Consistent findings indicated a significant decrease in moral distress among nurses who participated in these programs. Participants reported increased confidence in navigating ethical dilemmas, making sound clinical decisions, and effectively advocating for patients' rights. Moreover, moral empowerment programs fostered a sense of moral agency, empowering nurses to address ethical challenges proactively. Moral distress poses a significant challenge for ICU nurses, impacting their well-being and potentially compromising the quality of patient care. Moral empowerment programs offer a promising approach to mitigating this distress and enhancing ethical decision-making capabilities. The successful implementation of these programs requires a supportive work environment that fosters open dialogue and ethical reflection. Nurse leaders and educators play a crucial role in collaborating with ethics committees to develop and implement tailored interventions, including integrating moral empowerment modules into new nurse orientations and ongoing professional development programs. Continuous support through follow-up sessions, mentoring, and debriefing is essential to sustain the long-term benefits of these programs. Ethical consultation services and interprofessional collaboration further contribute to the ethical well-being of ICU nurses. While this review provides valuable insights, further research is warranted to investigate the long-term effects and broader implications of moral empowerment programs in the ICU setting.
Sepide Ghavidel, Sajedeh Ghaani, Seyedehghodsieh Bahreinitousi, Mohaddeseh Mohsenpour,
Volume 17, Issue 0 (12-2024)
Abstract
Moral distress is a common topic in medical ethics, referring to a state where individuals, despite possessing knowledge and the ability to act ethically, are unable to perform the right ethical actions due to external constraints. Ethical courage is a crucial virtue for conscientious performance by healthcare providers, particularly nurses and nursing students. It facilitates the delivery of nursing care and is especially important in today’s healthcare environment, where factors such as increased patient awareness, evolving health needs, social justice issues, and access to healthcare services have contributed to heightened levels of moral distress among nurses and nursing students. This study aims to investigate the relationship between ethical courage and moral distress in nursing students. This descriptive, cross-sectional study was conducted in 2023 in Mashhad, Iran. The study population consisted of third-semester nursing students at Mashhad University of Medical Sciences. A total of 40 third-semester nursing students, both male and female, participated in the study. Data were collected using two questionnaires: the Moral Distress Scale (Corley) and the Ethical Courage Questionnaire (designed by Sekerka and colleagues). The data were analyzed using SPSS version 25, employing descriptive statistics and Pearson correlation tests. The majority of the students were female (51.2%), while 36.6% were male. The average age of the participants was 21.14 years. Among the students, 75.6% were single, and 4.9% were married. The findings revealed a weak, non-significant negative correlation between moral distress and ethical courage (r = -0.055, p > 0.05). The average moral distress score was 75.34 ± 10.81 (range: 12–16), while the average ethical courage score was 85 ± 9.33 (range: 60–103). The study found a weak, non-significant negative correlation between moral distress and ethical courage among nursing students. Based on these findings, it is recommended to implement workshops focused on ethical motivation and educational programs designed to reduce moral distress and enhance ethical courage among nursing students. Additionally, the non-significant correlation may be attributed to the small sample size. Therefore, future studies with larger sample sizes are suggested to validate these findings.
Leila Masoudiyekta, Ehsan Hassanpour Pazevar , Alireza Parsapour, Ehsan Shamsi Gooshki, Mohammd Jalili, Amirahmad Shojaei,
Volume 18, Issue 1 (3-2025)
Abstract
Moral distress constitutes a significant challenge for healthcare professionals, arising when individuals find themselves unable to act in accordance with their personal and professional values due to both internal and external pressures. Healthcare professionals may face scenarios that prompt them to question the ethical acceptability of their decisions and treatment practices, often feeling powerless in the face of perceived unethical changes. This study sought to explore the experiences of moral distress encountered by emergency medicine physicians and nurses in the emergency department. This study was conducted using qualitative content analysis. Data were collected through semi-structured interviews with 25 healthcare providers selected via purposive sampling. Data analysis was conducted using MAXQDA 2018 software. The results indicated that the experiences of moral distress among emergency medicine physicians and nurses in the emergency department can be classified into four primary categories including those related to: 1. patient rights, 2. medical staff and colleagues, 3. management, and 4. professionals. Notably, factors such as overcrowding, inadequate staffing, discrepancies between salaries and workloads, and poor management of human and physical resources emerge as significant contributors to moral distress in the emergency department of Imam Khomeini Hospital. To improve patient care quality, it is essential to implement strategies that enhance triage processes, prioritize human resources, align resources with patient needs, monitor patient attendance, and develop a comprehensive protocol for staff.
Reza Abdollahi, Haleh Ghavami,
Volume 18, Issue 1 (3-2025)
Abstract
Due to the inherently demanding nature of their profession, nurses face significant job-related stress that can adversely affect their lives and the quality of nursing care. Moral courage may serve as a key factor influencing occupational stress among nurses. Accordingly, this study aimed to examine the relationship between moral courage and occupational stress among nurses. This descriptive-analytical cross-sectional study was conducted in 2024 with 120 nurses from emergency departments of educational and therapeutic hospitals in Urmia, Iran, who were selected via two-stage sampling. Data were collected through a demographic information form, Sekerka’s Moral Courage Scale, and Gray-Toft and Anderson’s Nursing Stress Scale. Data were analyzed using Pearson correlation coefficient, multiple linear regression, independent t-test, and one-way ANOVA in SPSS software version 23. The results showed the mean scores for professional moral courage and occupational stress were 85.93 ± 15.68 and 10.77 ± 0.23, respectively. Moreover, there was a significant negative relationship between moral courage and occupational stress in nurses (r = -0.33 and P< 0.05). Specific dimensions of moral courage, such as moral factor, threat tolerance, and moral purpose, had a significant negative effect on occupational stress (P< 0.05). These findings suggested that moral courage plays a significant role in mitigating occupational stress among nurses, which can influence their performance and, consequently, the quality of nursing care. Therefore, by fostering an environment that promotes moral courage, nursing managers can play a vital role in decreasing and mitigating the occupational stress experienced by nurses as well as enhancing the quality of care.
Mohammadmahdi Pazhavand, Maasoumeh Barkhordari-Sharifabad, Khadijeh Nasiriani,
Volume 18, Issue 1 (3-2025)
Abstract
Identifying an effective coping strategy for moral distress, as an important and common phenomenon among intensive care unit nurses, seems essential. The knowledge-to-action model aims to identify effective methods for implementing evidence into clinical practice. The present study sought to determine the effect of an intervention based on the knowledge-to-action model on moral distress among nurses working in intensive care units. This was an experimental study, and the statistical population included nurses working in the intensive care units of Namazi Hospital in Shiraz, Iran. A total of 100 eligible nurses were selected through convenience sampling and then randomly assigned to intervention and control groups. For the intervention group, the knowledge-to-action model was implemented. Data were collected using the Hamric Moral Distress Scale before and one month after the intervention. Both groups completed the questionnaire at these time points. Data were analyzed using descriptive and inferential statistics with SPSS version 19. The findings showed that the two groups were similar in terms of demographic characteristics and mean moral distress scores before the intervention. After the intervention, the mean scores of moral distress in the intervention group were significantly reduced in the frequency dimension (2.12±0.34) and severity dimension (2.32±0.46) compared to the control group (frequency: 2.51±0.43; severity: 2.57±0.55) (p<0.001). The results indicated that implementing the knowledge-to-action model reduces moral distress in intensive care unit nurses. Therefore, it is recommended that nursing managers adopt this model to improve the quality of care.
