Evaluation of moral distress and its related factors in nurses working in hospitals in Western Mazandaran

Moral distress as one of the important issues affects the physical and mental health of nurses and the quality of patient care. Considering the importance of moral distress, the aim of this study was to determine moral distress and its related factors in nurses working in hospitals in Western Mazandaran.

In this descriptive-analytical cross-sectional study, 142 nurses working in two hospitals in Western Mazandaran were selected using the convenience sampling method. The data were collected using the moral distress scale (MDS) validated in Iran. The MDS included 10 questions about environmental contexts of distress, scored from very low to high and 30 questions related to moral distress factors, scored on a Likert scale from 1 (very low distress) to 7 (very distress) as well as the moral distress score was ranged from 30 to 210. The data were analyzed using descriptive and analytical statistics (independent t-test and Spearman correlation coefficient) through SPSS 18 at a significant level of P<0.05.

Based on the results of this study, the mean intensity of moral distress of the nurses was high (4.96±1.82). The highest percentage of moral distress was related to working and caring for the patient in unsafe conditions due to low nursing staff numbers in the ward (5.88 ± 1.34). Among the related factors, work experience, employment status and type of departments were significantly associated with moral distress.

Due to the high level of moral distress, it is necessary for nurses to adopt strategies in order to care for the patient in safe conditions. It is also suggested that more attention should be paid to the concept of moral distress in the training program of hospital nurses.