The Relationship between Moral Sensitivity and Nurses' Perception of Futile Care in Patients with Covid-19

Nurses' perceptions and attitudes about futility can sometimes lead to the cessation of valuable treatments or the refusal to provide care to patients. On the other hand, having moral sensitivity can change the perspective of nurses in the face of ethical challenges in caring for patients with Covid-19 and may be effective improve nurses’ perception of futile care and the quality of care. The aim of this study was to determine the relationship between moral sensitivity and nurses' perception of futile care in patients with Covid-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2020.

The present study is a descriptive-correlational study that was performed on 150 nurses working in selected hospitals in Hamadan province in 2020. Participants were selected by convenience sampling. Tools of data collection are used in a research study included a three-part questionnaire of demographic information, Lutzen's moral sensitivity and perception of futile care designed based on Corley's moral distress scale and review of related texts, which was distributed as a physical presence in the hospital and an electronic version. Data analysis was performed using SPSS software version 26 and descriptive statistics (frequency, mean and standard deviation) and analytical statistics (Independent T-test, ANOVA, Pearson correlation coefficient and differential correlation).

Although there no significant relationship was seen between moral sensitivity and intensity of perception of futile care (r=0.277, p=0.06) and frequency (r=0.213, p=0.15) but is a significant positive relationship between some subclasses of moral sensitivity and perception of futile care. The mean score of nurses' moral sensitivity was low (36.12±3.46) and most of the participants had a moderate perception of the intensity (47.12±8.22) and frequency of futile care (32.43±5.76). Also between moral sensitivity and work experience (r=0.324, p=0.03) and age (r=0.279, p=0.04) and work nurses’ experience with intensive care futile (r=0.311, p=0.04) and its frequency (r=0.235, p=0.02) showed a significant relationship. Ethical Considerations: This research has been approved by the ethics committee of Hamadan University of Medical Sciences (IR.UMSHA.REC.1399.572). After obtaining informed consent from the participants, the researcher assured them that all their information would be confidential.

Several factors are involved in the level of moral sensitivity and perception of nurses' futile care in the care of Covid-19 patients. No significant correlation between moral sensitivity and the perception of futile care in this study was in a situation where nurses faced the peak of the Covid-19 pandemic and were under high organizational and psychological pressures. Therefore, for better conclusions, it is suggested that this study be conducted with further sample size and in the Covid-19 and non-Covid-19 wards.