Study of factors affecting moral distress among nurses: a review of previous studies

Nurses are disposed to emotional conflicts as they frequently face large numbers of patients and witness their subsequent deaths. Moral distress appears when the person knows what they ought to do but a set of factors and obstructions convince them that doing the proper action is not possible. Moral distress is thus related to professional reluctance, lack of job satisfaction, reduction of interaction with patients and their families, and ultimately professional exhaustion. This study aimed to determine the history of the concept of ‘moral distress’ and the factors affecting it in nurses’ society by reviewing other studies. Researchers used Medline, Proquest, Ovid, SID and IranMedex databases in addition to library research. Articles published in 1996 to 2010 were studied. ‘Moral distress’ was used as a keyword to find relevant articles. 23 articles related to moral distress were eventually included in the present study. Various studies revealed that the factors affecting moral distress include: ‘direct contact with patient’, ‘inadequate resources’ ‘provision of vain medical care’, ‘lack of respect toward the patients’ independence’, ‘relationships among physicians and nurses’ and ‘inability to prevent death’ which all can affect the nurses’ clinical performance and the quality of healthcare. Regarding the effects of moral distress on nurses, nurse managers should focus on resources to confront moral distress. Employing nurses in ethics committees can be used as another solution for this problem.