Moral distress, organizational climate, and the risk of burnout among oncology physician assistants.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11018-11018
Author(s):  
Eric Daniel Tetzlaff ◽  
Heather Marie Hylton ◽  
Karen Ruth ◽  
Zachary Hasse ◽  
Michael J. Hall
Keyword(s):  
Organizational Climate ◽  
Moral Distress ◽  
Interaction Model ◽  
Maslach Burnout Inventory ◽  
Physician Assistants ◽  
Professional Autonomy ◽  
Or Practice ◽  
Specialty Practice ◽  
Robust Poisson Regression ◽  
The Relationship

11018 Background: Moral Distress (MD) is the result of barriers or constraints that prevent providers from carrying out what they believe to be ethically appropriate care and has been associated with burnout. Advances have been made in our understanding of burnout in the oncology (Onc) workforce but our understanding of MD remains limited. This study was initiated to explore associations between moral distress, burnout, and the organizational climate (OC) for Onc Physician Assistants (PAs). Methods: A national survey of onc PAs was conducted in 2020. MD and Burnout were assessed with the Maslach Burnout Inventory and the Measure of MD – Healthcare Professionals (MMD-HP). To assess OC, the Nurse Practitioner Primary Care OC Questionnaire (NP-PCOCQ) was revised for Onc PAs and assessed professional visibility (PV), administrative relations (AR), physician relations (PR), and professional autonomy and support (PAS). A robust Poisson regression model was used to estimate risk ratios (RR) for burnout associated with MD and OC variables. Results: Respondents who completed the survey included 146 Onc PAs that were mostly female (90%), White/Caucasian (84%), married/partnered (78%), and in medical Onc (73%). Mean MMD-HP score was 71.5 and burnout was reported by 39.7% of PAs. MMD-HP scores did not differ based on specialty, practice setting or practice type. PCOCQ subscale scores were lower for PAs with burnout vs. without burnout (p=0.003 to p < 0.001). Increasing levels of MD were associated with increased levels of emotional exhaustion (p<0.001), depersonalization (p<0.001) and a higher overall rate of burnout. For Low, Medium and High MMD, burnout rates were 10%, 44% and 66% respectively (p<0.001). Risk of burnout was associated with increasing levels of MD, which remained when adjusted for the PCOCQ subscales. An interaction model with the PCOCQ subscales and the association between burnout and MD was not significant. Conclusions: Higher levels of MD and unfavorable organizational climate are associated with Onc PA burnout. The relationship between MD and burnout does not appear to be moderated by organizational climate. Additional research is needed to identify potential moderators of the MD/Burnout relationship. Risk Ratio estimate for Burnout.[Table: see text]

scholarly journals Impact of Nurse–Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants

2022 ◽  
Vol 19 (2) ◽  
pp. 661
Author(s):  
Yunmi Kim ◽  
Younjae Oh ◽  
Eunhee Lee ◽  
Shin-Jeong Kim
Keyword(s):  
Job Satisfaction ◽  
Moral Distress ◽  
Physician Assistants ◽  
Professional Autonomy ◽  
Professional Relationship ◽  
Contributing Factors ◽  
Convenience Sample ◽  
Correlational Research ◽  
Hospital Environments ◽  
The Impact

Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse–physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p < 0.001), where ‘cooperativeness’ (β = 0.469, p = 0.001) from nurse–physician collaboration, ‘institutional and contextual factor’ from moral distress (β = −0.292, p = 0.014), and professional autonomy (β = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their 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 The relationship between professional autonomy and moral distress in ICU nurses of Guilan University of Medical Sciences in 2017

2019 ◽  
Author(s):  
Mohammad Reza Yeganeh ◽  
Moluk Pouralizadeh ◽  
Atefeh Ghanbari
Keyword(s):  
Decision Making ◽  
Standard Deviation ◽  
Moral Distress ◽  
Cross Sectional Study ◽  
Professional Autonomy ◽  
Full Time ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background & Aim: Professional autonomy is a key component of decision-making and empowerment of the nurses. However, ICU nurses sometimes experience a degree of moral distress in their decision-making but the relationship of this distress with their autonomous performance in intensive care units is unclear. The aim of this study is determining the relationship between professional autonomy and moral distress of ICU nurses. Methods & Materials: In this correlational cross-sectional study, 180 ICU nurses were selected by census method from educational hospitals of Guilan University of Medical Sciences in 2017. Research tools were Varjuss professional autonomy and Corely et al. moral distress questionnaires. Data were analyzed using SPSS software version 16. Results: Most of the subjects were female (93.89%), full-time nurses (61.67%), with age mean and standard deviation of 35±5.97. Mean and standard deviation of professional autonomy and moral distress were 77.04±4 and 140.85±5.45, respectively. Moral distress of most nurses (55.6%) was moderate. There was a positive and significant correlation between professional autonomy and moral distress scores (p<0.001, r=0.33). Conclusion: This study showed that by increasing the professional autonomy, the moral distress of ICU nurses increases as well. These results, by informing nursing mangers, remind the necessity of using some approaches for reducing the moral distress of nurses along with improving their professional autonomy.

The relationship between ethical climate and moral distress from the perspective of operating room staff: A correlational study

2021 ◽  
pp. 147775092110572
Author(s):  
Fatemeh Esmaelzadeh ◽  
Fatemeh Rajabdizavandi ◽  
Monirsadat Nematollahi
Keyword(s):  
Organizational Climate ◽  
Operating Room ◽  
Ethical Climate ◽  
Moral Distress ◽  
Medical Sciences ◽  
The Social ◽  
The Mean ◽  
Distress Scale ◽  
The Relationship ◽  
Operating Room Staff

Background The organizational climate in the operating room is special due to the specific conditions of the patient, and the ethical climate may affect moral distress of the operating room staff. Objective This study determined the relationship between ethical climate and moral distress from staff working in operating rooms of hospitals affiliated to Mashhad University of Medical Sciences. Method This analytical study was performed on 169 operating room staff in Mashhad, Iran. The operating room staff was selected using stratified random sampling. The data were collected via Olson's Hospital Ethical Climate Survey and the Corley Moral Distress Scale and analyzed with IBM Statistical Package for the Social Sciences (SPSS) software version 21. Results The results showed no relationship between the ethical climate, the frequency, and intensity of moral distress of the operating room staff ( p > 0.05). In addition, the mean score of the ethical climate was 3.32 ± 0.48, indicating the average ethical climate in the operating room. The mean frequency and intensity of moral distress were 36.36 ± 11.68 and 48.8 ± 15.92, showing a moderate rate. There was a significant inverse relationship between the dimensions of ethical climate, the relationship with physicians, and the intensity of moral distress ( p <0.05). A significant relationship was found between the intensity of moral distress, the level of education, and field of study ( p <0.05). Conclusion The results of the current study showed that interventional programs should be implemented to reduce moral distress and improve the ethical climate in the operating room.

scholarly journals National Study of Burnout and Career Satisfaction Among Physician Assistants in Oncology: Implications for Team-Based Care

2018 ◽  
Vol 14 (1) ◽  
pp. e11-e22 ◽  
Author(s):  
Eric Daniel Tetzlaff ◽  
Heather Marie Hylton ◽  
Lyudmila DeMora ◽  
Karen Ruth ◽  
Yu-Ning Wong
Keyword(s):  
Career Satisfaction ◽  
Multivariable Analysis ◽  
Maslach Burnout Inventory ◽  
Physician Assistants ◽  
Personal Accomplishment ◽  
High Rate ◽  
National Study ◽  
Professional Characteristics ◽  
Potential Impact ◽  
The Relationship

Purpose: A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career satisfaction and the potential impact on the oncology PA workforce. Participants and Methods: A national survey of PAs in oncology was completed by using the Maslach Burnout Inventory from September 2015 to January 2016. Results: In all, 855 PAs were contacted and 250 submitted complete surveys (response rate, 29.2%). Respondents were representative of PAs in oncology with a mean age of 41.8 years, females (88.8%), academic practice (55.2%), urban location (61.2%), outpatient (74.4%), medical oncology (75.2%), worked 41 to 50 hours per week (52.8%), and had a mean of 9.6 years as a PA in oncology. Burnout was reported in 34.8% of PAs, 30.4% reported high emotional exhaustion, 17.6% reported high depersonalization, and 19.6% reported a low sense of personal accomplishment. In multivariable analysis, age, time spent on indirect patient care, oncology subspecialty, and relationship with collaborating physician were factors associated with burnout. Career and specialty satisfaction was high (86.4% and 88.8%, respectively). In the next 2 years, only 3.6% of PAs plan to pursue a different career or specialty and only 2.0% plan to retire. Conclusion: Despite high career and specialty satisfaction, burnout is reported in one third of PAs in oncology. Further exploration of the relationship between PAs and collaborating physicians may provide insight on methods to decrease burnout. Negligible short-term attrition of the current oncology PA workforce is anticipated.

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.

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.

ANALISA PENGARUH IKLIM ORGANISASI DAN KOMPETENSI TERHADAP KINERJA PEGAWAI PT HUTAMA KARYA

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Erik Wardhana, MM.
Keyword(s):  
Organizational Climate ◽  
Employee Performance ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Free Variable ◽  
Independent Variables ◽  
Dependent Variables ◽  
Correlational Approach ◽  
Survey Research Methods ◽  
The Relationship

This study entitled "Analysis of Effect of Climate Organization and Competence Againt Employee PT. Hutama Karya ". The purpose of this study was to obtain information on the relationship between the free variable that organizational climate (X1) and competence (X2) with the dependent variable is employee performance (Y), either partially or simultaneously, This study used survey research methods with the correlational approach and predictive, which aims for the relationship and influence between independent and dependent variables. The sampling technique can be done randomly (simple random sampling) of 852 employees, which is considered to resprentatif is 89 people. And to solve problems, to analyze and examine the relationship and influence between the independent variables on the dependent variable used models kausalistik through regression analysis with SPSS 14.0

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