Moral distress in nursing students: Cultural adaptation and validation study

2021 ◽  
pp. 096973302110306
Author(s):  
Rocco Mazzotta ◽  
Maddalena De Maria ◽  
Davide Bove ◽  
Sondra Badolamenti ◽  
Simonì Saraiva Bordignon ◽  
...  
Keyword(s):  
Nursing Students ◽  
Research Design ◽  
Moral Distress ◽  
Central Italy ◽  
Well Being ◽  
Ethical Dimension ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Smallest Detectable Change ◽  
Distress Scale

Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students. Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level). Research design: The study used a cross-sectional research design. Participants and research context: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy. Ethical considerations: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent. Results: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753–0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate. Discussion: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students. Conclusion: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

Moral distress in undergraduate nursing students

2019 ◽  
Vol 26 (7-8) ◽  
pp. 2325-2339 ◽  
Author(s):  
Simoní Saraiva Bordignon ◽  
Valéria Lerch Lunardi ◽  
Edison Luiz Devos Barlem ◽  
Graziele de Lima Dalmolin ◽  
Rosemary Silva da Silveira ◽  
...  
Keyword(s):  
Nursing Students ◽  
Undergraduate Students ◽  
Moral Distress ◽  
Intensity Level ◽  
Linear Regression Models ◽  
Design Data ◽  
Cross Sectional ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing ◽  
Distress Scale

Background: Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints. Objectives: To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil. Method: Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models. Ethical considerations: Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande. Findings: The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000). Conclusion: The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician.

scholarly journals Frequency, Severity, Rate, and Causes of Moral Distress among Nursing Students: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Maryam Janatolmakan ◽  
Amirabbas Dabiry ◽  
Shahab Rezaeian ◽  
Alireza khatony
Keyword(s):  
Nursing Students ◽  
Patient Care ◽  
Student Performance ◽  
Work Experience ◽  
Moral Distress ◽  
Personal Information ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Scale

Background. One of the most important psychosocial issues related to the nursing profession is moral distress (MD), which has devastating effects on student performance as well as patient care. The current study was conducted to determine the frequency, severity, rate, and causes of MD in nursing students. Methods. During this cross-sectional study, 86 samples were last year undergraduate nursing students of Kermanshah University of Medical Sciences, who were entered into the study by the census method. Data gathering instruments were personal information form, Moral Distress Scale-revised (MDS-r), and Moral Distress Thermometer (MDT). Results. The mean frequency, severity, and rate of MD, according to the MDS-r questionnaire, were 1.3 ± 0.7 out of 4, 1.8 ± 0.8 out of 4, and 3.3 ± 2.3 out of 16, respectively. The average MDT score was 2.6 ± 2.5 out of 10. The most common causes of MD were working in unsafe conditions (6.8 ± 6.0), observing impaired patients health servicing (5.4 ± 5.6), and the low quality of patient care (5.1 ± 4.6). There was a statistically significant relationship between the gender, work experience, and participation in the professional ethics workshop variables and mean MDS-total and MDT. Conclusion. The rate and mean severity of MD were reported at a moderate level. Also, the MDT average was reported at a mild to an uncomfortable level, and the overall MD was equal to moderate. Therefore, student administrators should take steps to eliminate or reduce the causes of MD. In this regard, the need for teaching preventive methods against MD to nursing students before their clinical courses seems crucial. Also, students with MD must be referred to the psychiatric/psychologist.

scholarly journals Healthcare Advocacy And Moral Distress In The Practice Of Nurses

10.3823/2578 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Aline Marcelino Ramos ◽  
Edison Luiz Devos Barlem ◽  
Jamila Geri Tomaschewski Barlem ◽  
Laurelize Pereira Rocha ◽  
Rosemary Silva da Silveira ◽  
...  
Keyword(s):  
Moral Distress ◽  
Research Question ◽  
Linear Regression Analysis ◽  
Well Being ◽  
University Hospital ◽  
Human Beings ◽  
Cross Sectional ◽  
Brazilian Version ◽  
Distress Scale

Background: By focusing in prioritizing patients and their rights, occasional limitations may arise and prevent nurses from doing their work according to their social and professional commitment. This may culminate in Moral Distress, resulting from the incoherence between the nurses' actions and their personal convictions. Research question: Is there any relationship between healthcare advocacy and moral distress in the practice of nurses working in hospitals? Objective: Analyzing the relation between healthcare advocacy and moral distress in the practice of nurses working in hospitals. Research design: Quantitative, analytical cross-sectional study. The data collection instruments comprise the Moral Distress Scale Revised – Brazilian version and the Protective Nursing Advocacy Scale – Brazilian version. Data analysis was carried out with elements of descriptive statistics, Pearson's correlation and linear regression analysis. Participants and research context: The participants comprised 157 nurses working in two hospitals located in a city in southern Brazil. One of the institutions is a public university hospital and the other is a philanthropic institution. Ethical considerations: All the international directives for research with human beings were observed. Findings: The constructs barriers to the advocacy practice and negative implications to the advocacy practice were pointed out as predictors of moral distress.   Discussion: The situations approached in this study illustrate that certain organizational and cultural contexts have negative impacts on nurses, who are in constant contact with the necessity of promoting patient well being and increasing access to healthcare, especially under the perception of vulnerability in risk situations, or when the quality of the services provided decreases and patients are not given adequate assistance. Conclusion: We hope that this study encourages the reflection about the relationship between patient advocacy and moral distress, and the search for resources that may contribute to the quality of the assistance provided by nurses.

Moral distress in Turkish intensive care nurses

2015 ◽  
Vol 24 (2) ◽  
pp. 209-224 ◽  
Author(s):  
Serife Karagozoglu ◽  
Gulay Yildirim ◽  
Dilek Ozden ◽  
Ziynet Çınar
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Moral Distress ◽  
Measurement Tool ◽  
Validity And Reliability ◽  
Turkish Version ◽  
Cross Sectional ◽  
Intensive Care Nurses ◽  
Country Culture ◽  
Distress Scale

Background: Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue. Aim/objective: The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level. Method: The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. Results: In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Conclusion: Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care.

Spiritual well-being and moral distress among Iranian nurses

2016 ◽  
Vol 26 (4) ◽  
pp. 1101-1113 ◽  
Author(s):  
Mohammad Ali Soleimani ◽  
Saeed Pahlevan Sharif ◽  
Ameneh Yaghoobzadeh ◽  
Mohammad Reza Sheikhi ◽  
Bianca Panarello ◽  
...  
Keyword(s):  
Moral Distress ◽  
Organizational Factors ◽  
Well Being ◽  
Cross Sectional ◽  
Correlational Design ◽  
Organizational Arrangement ◽  
Spiritual Well Being ◽  
Medical Research Ethics ◽  
Distress Scale ◽  
The Relationship

Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. Research design: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress ( r = −.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. Discussion and conclusion: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.

scholarly journals VALIDADE E CONFIABILIDADE DO MORAL DISTRESS SCALE ADAPTADO EM UMA AMOSTRA DE ENFERMEIROS

2016 ◽  
Vol 7 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Julia Zancan Bresolin ◽  
Graziele De Lima Dalmolin ◽  
Isolina Maria Alberto Fruet ◽  
Tania Solange Bosi de Souza Magnago ◽  
Amanda Ceschini Rigue
Keyword(s):  
Moral Distress ◽  
Rio Grande ◽  
Work Conditions ◽  
Cross Sectional Study ◽  
Three Dimensions ◽  
Rio Grande Do Sul ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Del Rio ◽  
Distress Scale

Objetivo: buscou-se analisar a validade e confiabilidade do Moral Distress Scale (MDS), adaptado em amostra de enfermeiros de uma instituição hospitalar. Metodologia: trata-se de uma pesquisa de abordagem quantitativa realizada com 144 enfermeiros de instituição hospitalar da região central do Rio Grande do Sul, através da aplicação do MDS adaptado, validado e normatizado para uso no Brasil. Para análise dos dados, utilizou-se análise fatorial, alfa de Cronbach e estatística descritiva. Resultados: a partir da análise, foi realizado o agrupamento das questões validadas em três fatores associados ao sofrimento moral: falta de competência na equipe de trabalho, negação do papel da Enfermagem como advogada do paciente e condições de trabalho insuficientes. Conclusão: o instrumento utilizado na pesquisa mostrou-se válido e fidedigno na realidade estudada.Descritores: Enfermagem, Moral, Estresse Psicológico, Ética em Enfermagem.VALIDITY AND RELIABILITY OF THE ADAPTED MORAL DISTRESS SCALE IN A SAMPLE OF NURSESObjective: the study aimed to analyze the validity and reliability of the adapted Moral Distress Scale (MDS) in a sample of nurses from a hospital. Methodology: it is a cross-sectional study conducted with 144 hospital nurses from the central region of Rio Grande do Sul, through the application of the MDS adapted, validated and standardized for use in Brazil. For data analysis we used factor analysis, Cronbach alpha and descriptive statistics. Results: the factorial analysis of the instrument allowed the grouping of the issues validated in three dimensions associated with moral suffering: staff’s lack of competence; the nursing denial of their role as patient advocacy; inadequate work conditions. Conclusion: the instrument used in the study proved to be valid and reliable in the studied reality.Descriptors: Nursing, Morale, Stress Psychological. Ethics, Nursing.VALIDEZ Y CONFIABILIDAD DEL MORAL DISTRESS SCALE ADAPTADO EN MUESTRA DE ENFERMEROSObjetivo: el estudio buscó analizar la validez y confiabilidad del Moral Distress Scale (MDS) adaptado en una muestra de enfermeros de una institución hospitalaria. Mertodologia: se trata de un estudio transversal realizado con 144 enfermeros de institución hospitalaria de la región central del Río Grande del Sur, a través de la aplicación del MDS adaptado, validado y normatizado para el uso en Brasil. Para el análisis de los datos, se utilizó el análisis factorial, alfa de Cronbach y estadística descriptiva. Resultados: El análisis factorial del instrumento permitió la agrupación de las cuestiones validadas en tres dimensiones asociadas al sufrimiento moral: falta de competencia del equipo de trabajo; negación del papel de la enfermería como abogada del paciente; conditiones de trabajo insuficientes. Conclusión: el instrumento utilizado en la investigación se mostró válido y fidedigno en la realidad estudiada.Descriptores: EEnfermería, Moral, Estrés Psicológico, Ética en Enfermería.

A Study of the Relationships between Nursing Students’ Meanings of Life, Positive Beliefs, and Well-Being

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Fu-Ju Tsai ◽  
Cheng-Yu Chen ◽  
Gwo-Liang Yeh ◽  
Yih-Jin Hu ◽  
Chie-Chien Tseng ◽  
...  
Keyword(s):  
Health Promotion ◽  
Nursing Students ◽  
Analysis Of Variance ◽  
Rank Correlation ◽  
Meaning Of Life ◽  
Well Being ◽  
Social Health ◽  
Cross Sectional ◽  
Nursing Educators ◽  
Spearman’S Rank Correlation

Background: Nursing educators should train nursing students to pursue physical, psychological, spiritual, and social health promotion. The purpose of this study was to explore relationships between nursing students’ meaning of life, positive beliefs, and well-being. Methods: A cross-sectional correlational study with a quantitative approach was adopted. Purposive sampling was used. A total of 170 nursing students voluntarily participated in this study. A 56-item questionnaire was used to examine nursing students’ meaning of life (1-25 items), positive beliefs (1-11 items), and well-being (1-20 items). The content validity index (CVI) of the study questionnaire was established as 0.95 by seven expert scholars. The reliability values for the three parts of the measure were as follows: meaning of life, Cronbach’s α 0.96; positive beliefs, Cronbach’s α 0.93; and well-being, Cronbach’s α 0.95. Percentages, frequencies, means, SDs, Kruskal-Wallis one-way analysis of variance by rank, Spearman’s rank correlation, one-way analysis of variance, Spearman’s rho correlation, and regression analysis were used for the data analysis. Results: Nursing students had the following mean scores: meaning of life with 4.02 (SD 0.56); positive beliefs with 3.92 (SD 0.62); and well-being with 3.95 (SD 0.57). The results indicate that for all nursing students, meaning of life was positively correlated with positive beliefs, r=0.83 (P<.01); similarly, all nursing students had positive beliefs that were positively correlated with meaning of life, r=0.83 (P<.01). In the results of the study, the nursing students’ background, meaning of life and positive beliefs explained 63% of the variance in well-being (Adjusted R2 squared =0.63, F=33.41, P<.001). Conclusions: Nursing students’ sense of meaning of life and positive beliefs may impact their well-being. Therefore, nursing educators can promote meaning of life and positive beliefs to nursing students as a way to increase their well-being for physical, psychological, spiritual, and social health promotion.

Psychometric evaluation of the Persian version of the spiritual well-being scale (SWBS) in Iranian patients with cancer

2021 ◽  
pp. 1-9
Author(s):  
Hamid Sharif Nia ◽  
Mobin Mohammadinezhad ◽  
Kelly A. Allen ◽  
Christopher Boyle ◽  
Saeed Pahlevan Sharif ◽  
...  
Keyword(s):  
Discriminant Validity ◽  
Psychometric Evaluation ◽  
Well Being ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Persian Version ◽  
Convergent And Discriminant Validity ◽  
Spiritual Well Being ◽  
Iranian Patients

Abstract Objective The spiritual well-being scale (SWBS) is a widely used clinical scale which should be evaluated for Iranian patients with cancer. The aim of this study is to evaluate the psychometric properties of the Persian version of the SWBS in Iranian patients with cancer. Method This cross-sectional, methodological study was conducted among Iranian patients with cancer (n = 400). The participants were recruited using convenience sampling. The content, construct, convergent and discriminant validity, and reliability of the Persian version of the SWBS were evaluated. Results A two-factor structure for the scale was indicated with the factors being: connecting with God and meaningless life that explained 54.18% of the total variance of the concept of spiritual well-being. The results demonstrated the model had a good fit. Cronbach's alpha, McDonald's omega, and the inter-item correlation values of the factors indicated good internal consistency of the scale. Significance of results These results suggest that the Persian version of the SWBS is a reliable and valid measure to assess the spiritual well-being of patients with cancer through 16 items related to connecting with God and meaningless life.

scholarly journals Faktor-Faktor yang Mempengaruhi Efektifitas Praktik Laboratorium Daring Pada Masa Pandemi Covid-19

JKEP ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 86-102
Author(s):  
Nurhalimah Nurhalimah ◽  
Deby Fitriayuningsih ◽  
Omi Haryati ◽  
Dwi Kartika Rahayuningtyas
Keyword(s):  
Nursing Students ◽  
Learning Outcomes ◽  
Teaching And Learning ◽  
Sampling Technique ◽  
Total Sample ◽  
Validity And Reliability ◽  
Laboratory Practice ◽  
Cross Sectional ◽  
Online Laboratory ◽  
Chi Square Analysis

The teaching and learning process during the Covid-19 pandemic underwent a change, previouslyitwasdoneface-to-face, now it must be done online, both learning theory and laboratory practice. Online laboratory practice learning will have an impact on student learning outcomes where students will have difficulty achieving learning outcomes because they cannot practice directly with appropriate tools. The study aims to identify the factors that affect the effectiveness of online method laboratory practices in nursing students of the Nursing Department of the Health Polytechnic of the Ministry of Health, JakartaIII.This research is a quantitative study with a cross sectional approach,with Chi- Square analysis, simple and multiple linear regression. The sampling technique used purposive sampling with a total sample of 143 respondents. The questionnaire was developed by researchers and validity and reliability tests have been carried out. The results of this study indicate that students' motivation and learning method scontribute 1.74 times to the success of online laboratory practical learning. It is necessary to readiness of lecturers in making practical learning media online methods and readiness of students to change learning patterns from face to face to online.

scholarly journals Moral distress among nurses working in Covid-19 wards: a cross-sectional study in 2021

2021 ◽  
Author(s):  
Mina Pooresmaeil ◽  
Masoumeh Aghamohammadi
Keyword(s):  
Significant Relationship ◽  
Work Experience ◽  
Moral Distress ◽  
Pearson Correlation ◽  
Cross Sectional Study ◽  
Moderate Level ◽  
Related Factors ◽  
Cross Sectional ◽  
Experienced Nurses ◽  
Distress Scale

Abstract Background Covid-19 is an emerging disease, which has confronted nurses with new moral distress. This study aims to determine the moral distress and its related factors among nurses working in the covid-19 wards of Ardabil city in Iran. Methods This cross-sectional descriptive study evaluated 159 nurses working in the covid-19 wards of Imam Khomeini hospital -as the only hospitalization center for the patients with covid-19 in Ardabil, 2021. The instruments used included a personal-occupational information form and Corley's moral distress scale. Data analysis was performed using descriptive and inferential statistics (Pearson correlation coefficient, independent t-test and one-way analysis of variance) in SPSS v22. Results The mean and standard deviation of the frequency and intensity of the nurses' moral distress were estimated 52.28 ± 5.24 and 51.54 ± 5.86, respectively, which indicated the moderate level of moral distress in the both dimensions. The item "I hesitate to tell the patient or the patient's family about his condition and treatment" (4.74 ± 0.75) showed the most moral distress based on the intensity and the phrase "too much work reduces the quality of my work” (4.81 ± 0.55) caused the most moral distress in the frequency dimension. The results indicated a significant relationship between the intensity and frequency of moral distress with the type of nurses' employment (P < 0.05). Moreover, a significant relationship was observed between the nurses’ position and the frequency (P = 0.04), and the nurses’ work experience and the intensity of moral distress (P = 0.02). Conclusions It seems that providing the necessary training for how to deal with the moral distress in new waves of the disease and using the experiences of the experienced nurses in this field are essential due to observing the moderate level of moral distress among nurses working in covid-19 wards.

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