Moral distress experienced by psychiatric nurses in Japan

2010 ◽  
Vol 17 (6) ◽  
pp. 726-740 ◽  
Author(s):  
Kayoko Ohnishi ◽  
Yasuko Ohgushi ◽  
Masataka Nakano ◽  
Hirohide Fujii ◽  
Hiromi Tanaka ◽  
...  
Keyword(s):  
Psychiatric Care ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Psychiatric Nurses ◽  
General Survey ◽  
Low Levels ◽  
Distress Scale ◽  
Frequency Score

This study aimed to: (1) develop and evaluate the Moral Distress Scale for Psychiatric nurses (MDS-P); (2) use the MDS-P to examine the moral distress experienced by Japanese psychiatric nurses; and (3) explore the correlation between moral distress and burnout. A questionnaire on the intensity and frequency of moral distress items (the MDS-P: 15 items grouped into three factors), a burnout scale (Maslach Burnout Inventory — General Survey) and demographic questions were administered to 391 Japanese psychiatric nurses in 2007—2008. These nurses experienced relatively low levels of moral distress despite the fact that they were commonly confronted by morally distressing situations. All the circumstances in which the participants experienced moral distress were included in the ‘low staffing’ factor, which reflects the characteristics of Japanese psychiatric care. The frequency score of the low staffing factor was a significant predictor of burnout.

scholarly journals Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers?

2014 ◽  
Vol 22 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Graziele de Lima Dalmolin ◽  
Valéria Lerch Lunardi ◽  
Guilherme Lerch Lunardi ◽  
Edison Luiz Devos Barlem ◽  
Rosemary Silva da Silveira
Keyword(s):  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Burnout Syndrome ◽  
Bivariate Analysis ◽  
Rio Grande Do Sul ◽  
Weak Correlation ◽  
Professional Performance ◽  
Moderating Variables ◽  
Professional Fulfillment ◽  
Distress Scale

OBJECTIVE: to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. METHODS: this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. RESULTS: the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. CONCLUSION: the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

Moral Distress Scale for Psychiatric Nurses

2010 ◽  
Author(s):  
Kayoko Ohnishi ◽  
Yasuko Ohgushi ◽  
Masataka Nakano ◽  
Hirohide Fujii ◽  
Hiromi Tanaka ◽  
...  
Keyword(s):  
Moral Distress ◽  
Psychiatric Nurses ◽  
Distress Scale

Relationships among moral distress, sense of coherence, and job satisfaction

2016 ◽  
Vol 25 (5) ◽  
pp. 571-579 ◽  
Author(s):  
Michiyo Ando ◽  
Masashi Kawano
Keyword(s):  
Job Satisfaction ◽  
Sense Of Coherence ◽  
Moral Distress ◽  
General Health Questionnaire ◽  
Psychiatric Nurses ◽  
Satisfaction Scale ◽  
Cross Sectional ◽  
Unethical Conduct ◽  
Patients Rights ◽  
Distress Scale

Background: Since moral distress affects psychological aspects of psychiatric nurses, it is an important theme. Previous studies showed relationships between moral distress and job satisfaction; however, there are few studies which investigate relationships between moral distress and other effective variables and then we highlighted relationships among these variables. Objective: This study aimed to (1) examine relationships among moral distress, sense of coherence, mental health, and job satisfaction and (2) clarify the most predictive variable to job satisfaction. Research design: This study is a cross-sectional study. Participants were 130 psychiatric nurses in a hospital in Japan. They completed the Moral Distress Scale for Psychiatric nurses (Unethical conduct, Low staffing, and Acquiescence to patients’ rights violations), the sense of coherence scale (Comprehensibility, Manageability, and Meaning), the General Health Questionnaire, and the Job Satisfaction scale. Ethical consideration: This study was approved by the ethical board of St Mary’s College. Nurses participated voluntarily and were anonymous. Results: Results showed that subscales of the Moral Distress Scale for Psychiatric nurses negatively correlated to the sense of coherence and the Job Satisfaction. A multiple regression analysis showed that “Acquiescence to patients’ rights violations” of the Moral Distress Scale for Psychiatric nurses and “Meaning” of the sense of coherence influenced the Job Satisfaction much more than other variables. These two variables were correlated to job satisfaction scale, and other variables without them did not significantly correlate to job satisfaction scale. Discussion: These results suggest that moral distress negatively related to sense of coherence and job satisfaction, a subscale of the Moral Distress Scale for Psychiatric nurses and that of the sense of coherence affected the job satisfaction the most. Conclusion: Decreasing of acquiescence to patients’ rights violations and finding meaning in nursing may improve job satisfaction.

Moral distress and burnout in Iranian nurses: The mediating effect of workplace bullying

2018 ◽  
Vol 26 (6) ◽  
pp. 1834-1847 ◽  
Author(s):  
Fardin Ajoudani ◽  
Rahim Baghaei ◽  
Mojgan Lotfi
Keyword(s):  
Workplace Bullying ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Mediating Role ◽  
Distress Scale ◽  
The Relationship ◽  
Negative Acts

Background: Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse’s burnout. Aim: To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. Ethical considerations: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. Method: This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying. Results: The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly. Conclusion: Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.

scholarly journals Complex interplay between moral distress and other risk factors of burnout in ICU professionals: findings from a cross-sectional survey study

2021 ◽  
pp. bmjqs-2020-012239
Author(s):  
Niek Kok ◽  
Jelle Van Gurp ◽  
Johannes G van der Hoeven ◽  
Malaika Fuchs ◽  
Cornelia Hoedemaekers ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emotional Exhaustion ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Root Cause ◽  
Distress Scale

BackgroundBurnout threatens intensive care unit (ICU) professionals’ capacity to provide high-quality care. Moral distress is previously considered a root cause of burnout, but there are other risk factors of burnout such as personality, work–life balance and culture. This study aimed to disentangle the associations of ICU professionals’ moral distress and other risk factors with the components of burnout—emotional exhaustion, depersonalisation and personal accomplishment—suggesting informed burnout prevention strategies.MethodsCross-sectional survey completed in 2019 of ICU professionals in two Dutch hospitals. The survey included validated measure for burnout (the Dutch Maslach Burnout Inventory), moral distress (Moral Distress Scale), personality (short Big Five Inventory), work–home balance (Survey Work–Home Interaction Nijmegen) and organisational culture (Culture of Care Barometer). Each of the three components of burnout was analysed as a separate outcome, and for each of the components, a separate regression analysis was carried out.Results251 ICU professionals responded to the survey (response rate: 53.3%). Burnout prevalence was 22.7%. Findings showed that moral distress was associated with emotional exhaustion (β=0.18, 95% CI 0.9 to 0.26) and depersonalisation (β=0.19, 95% CI 0.10 to 0.28) and with increased emotional exhaustion mediated by negative work-to-home spillover (β=0.09, 95% CI 0.04 to 0.13). Support from direct supervisors mitigates the association between moral distress and emotional exhaustion (β=0.16, 95% CI 0.04 to 0.27).ConclusionsUnderstanding moral distress as a root cause of burnout is too simplified. There is an important interplay between moral distress and work–home imbalance. Interventions that support individual coping with moral distress and a work–home imbalance, and the support of direct supervisors, are paramount to prevent burnout in physicians and nurses.

scholarly journals The Relationship Between Moral Distress With Level of Burnout on Nurses in Intensive Care Room at the dr. Soebandi Hospital Jember

2021 ◽  
Vol 5 (2) ◽  
pp. 273
Author(s):  
Siswoyo Siswoyo ◽  
Kholid Rosyidi Muhammad Nur ◽  
Faizatul Ulya
Keyword(s):  
Intensive Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Bivariate Analysis ◽  
P Value ◽  
Care Providers ◽  
Distress Scale ◽  
Spearman Test ◽  
The Relationship

Moral distress is defined as psychological disequilibrium and negative feelings that results from recognizing an ethically appropriate action, yet not taking it because of such barriers. This causes an increase workload of nurses in the intensive care room, resulting burnout that affects nurses, patients and health care providers. This study aimed to analyze the relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember. This study used a quantitative descriptive observational analytic with the approach cross sectional design selected 47 nurses as respondents used total sampling. Data collected by Measure of Moral Distress Scale - Healthcare Professionals (MMD-HP) and Maslach Burnout Inventory (MBI). The results revealed that most respondents experienced low moral distress (85.1%) and low burnout (61.7%). The bivariate analysis showed with spearman test that p-value was < 0.001 (α = 0.05; r = 0.531). There was a relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember with moderate and positive relationship strength. A healthy work environment plays an important role in the low level of moral distress and burnout, if there are staff skilled in communication, good collaboration between people or professions, effective decision making, proper staffing, recognition and leadership.

scholarly journals Impact of moral sensitivity on moral distress among psychiatric nurses

2018 ◽  
Vol 26 (5) ◽  
pp. 1473-1483 ◽  
Author(s):  
Kayoko Ohnishi ◽  
Kazuyo Kitaoka ◽  
Jun Nakahara ◽  
Maritta Välimäki ◽  
Raija Kontio ◽  
...  
Keyword(s):  
Research Ethics ◽  
Structural Equation ◽  
Moral Distress ◽  
Equation Model ◽  
Psychiatric Nurses ◽  
Moral Sensitivity ◽  
Ethical Problems ◽  
The Right ◽  
Distress Scale ◽  
The Impact

Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: To examine the impact of moral sensitivity on moral distress among psychiatric nurses, and affirm the hypothesis that nurses with higher moral sensitivity will suffer moral distress more than nurses with less moral sensitivity in two different samples. Ethical consideration: The study obtained ethical approval from the Research Ethics Committee of the Faculty of Medicine at Mie University (# 1111, 20.4.2010), and by the Turku University Ethics Board (29.5.2012). Permissions to undertake the study was obtained from the in two hospital districts and in one city (§ 48/4.10.2012, § 63/4.9.2012, 51/2012 27.8.2012). Informed consent was not formally obtained, because the questionnaire was anonymously reported by the participants who volunteered to answer. The participants responded voluntarily and anonymously. Methods: An anonymous questionnaire containing the Revised Moral Sensitivity Questionnaire and the Moral Distress Scale for Psychiatric nurses was conducted to 997 nurses in 12 hospitals in Japan, and 974 nurses in 10 hospitals in Finland after obtaining of approval by research ethics committees. Data were analyzed using a multi-group structural equation model analysis. Findings: A set of analyses imply that the association of moral sensitivity with moral distress is significant and similar between Japan and Finland, whereas the factor structures of moral sensitivity and moral distress may be partially different. Discussion: The result of this study may indicate that nurses with high moral sensitivity can sense and identify moral problems, but not resolve them. Therefore, supporting nurses to solve ethical problems, not benumbing them, can be important for better nursing care and prevention of nurses’ resignation. Conclusion: Moral sensitivity and moral distress were positively correlated among psychiatric nurses in both Japan and Finland, although the participating nurses from the two countries were different in qualification, age, and cultural background. Nurses with high moral sensitivity suffer from moral distress.

scholarly journals Moral distress and burnout in internal medicine residents

2017 ◽  
Vol 8 (1) ◽  
pp. e36-43 ◽  
Author(s):  
Sharareh Sajjadi ◽  
Monica Norena ◽  
Hubert Wong ◽  
Peter Dodek
Keyword(s):  
Internal Medicine ◽  
Moral Distress ◽  
Clinical Teaching ◽  
Maslach Burnout Inventory ◽  
Intention To Leave ◽  
Internal Medicine Residents ◽  
Distress Score ◽  
Teaching Unit ◽  
High Level ◽  
Distress Scale

Background: Residents frequently encounter situations in their workplace that may induce moral distress or burnout. The objective of this study was to measure overall and rotation-specific moral distress and burnout in medical residents, and the relationship between demographics and moral distress and burnout.Methods: The revised Moral Distress Scale and the Maslach Burnout Inventory (Human Service version) were administered to Internal Medicine residents in the 2013-2014 academic year at the University of British Columbia.Results: Of the 88 residents, 45 completed the surveys. Participants (mean age 30+/-3; 46% male) reported a median moral distress score (interquartile range) of 77 (50-96). Twenty-six percent of residents had considered quitting because of moral distress, 21% had a high level of burnout, and only 5% had a low level of burnout. Moral distress scores were highest during Intensive Care Unit (ICU) and Clinical Teaching Unit (CTU) rotations, and lowest during elective rotations (p<0.0001). Women reported higher emotional exhaustion. Moral distress was associated with depersonalization (p=0.01), and both moral distress and burnout were associated with intention to leave the job.Conclusion: Internal Medicine residents report moral distress that is greatest during ICU and CTU rotations, and is associated with burnout and intention to leave the job.

Intensive care nurses’ perception of futility

2013 ◽  
Vol 20 (4) ◽  
pp. 436-447 ◽  
Author(s):  
Dilek Özden ◽  
Şerife Karagözoğlu ◽  
Gülay Yıldırım
Keyword(s):  
Job Satisfaction ◽  
Intensive Care ◽  
Health Care Professionals ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Satisfaction Questionnaire ◽  
Minnesota Satisfaction Questionnaire ◽  
Intensive Care Nurses ◽  
Low Levels ◽  
The Relationship

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine.

Critical Care Nurses’ Perceptions of Futile Care and Its Effect on Burnout

2004 ◽  
Vol 13 (3) ◽  
pp. 202-208 ◽  
Author(s):  
Lilia Susana Meltzer ◽  
Loucine Missak Huckabay
Keyword(s):  
Critical Care ◽  
Emotional Exhaustion ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Critical Care Nurses ◽  
Full Time ◽  
Care Experience ◽  
Futile Care ◽  
Nurses Perceptions ◽  
Distress Scale

• Background Nurses’ perceptions of futile care may lead to emotional exhaustion. • Objectives To determine the relationship between critical care nurses’ perceptions of futile care and its effect on burnout. • Methods A descriptive survey design was used with 60 critical care nurses who worked full-time and had a minimum of 1 year of critical care experience at the 2 participating hospitals (350–470 beds). Subjects completed a survey on demographics, the Moral Distress Scale, and the Maslach Burnout Inventory. Six research questions were tested. The results of the following question are presented: Is there a relationship between frequency of moral distress situations involving futile care and emotional exhaustion? • Results A Pearson product moment correlational analysis indicated a significant positive correlation between the score on the emotional exhaustion subscale of the Maslach Burnout Inventory and the score on the frequency subscale of the Moral Distress Scale. Moral distress accounted for 10% of the variance in emotional exhaustion. Demographic variables of age, education, religion, and rotation between the critical care units were significantly related to the major variables. • Conclusions In critical care nurses, the frequency of moral distress situations that are perceived as futile or nonbeneficial to their patients has a significant relationship to the experience of emotional exhaustion, a main component of burnout.

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