Moral Distress and the Nursing Care Quality: A Correlational Study in Teaching Hospitals

Background and Objectives: Achieving high quality healthcare services and patients' satisfaction with the healthcare services represents an important issue in healthcare delivery systems. Moral distress is one of the effective factors on this issue. Regarding the significance of the nursing care quality, it is necessary to investigate association between moral distress and the nursing care quality to reduce moral distress. Methods: The participants of this descriptive-correlational study were 545 nurses of the ICUs, CCUs, and psychiatric departments selected by census. Data collection was conducted by Moral Distress Scale and Quality Patient Care Scale that were distributed among the participants and collected within eleven months. Data analysis was conducted by descriptive statistics and Pearson correlation coefficient in SPSS 13. Results: Mean scores for moral distress and nursing care quality were 141.89±29.6 (moderate) and 195.97±28.05 (relatively desirable), respectively. According to Pearson correlation coefficient (0.058=α), the two variables were not correlated. Although moral distress was not significantly different between the nurses of the ICUs and CCUs and those of the psychiatric department (P=0.056), t-test indicated that nursing care quality was more desirable in the psychiatric department (P=0.016). Conclusion: The levels of moral distress were moderate among the nurses and care quality was higher in the psychiatric department. It is recommended to implement educational programs such as prevention of exposure to stressful conditions, identify associated factors, and promote nurses' knowledge about moral distress and its consequences in order to manage tension. To promote care quality in ICUs, survey of nurses' perspectives is necessary to remove current barriers according to their perspectives and priority should be given to this issue in managers' operational agendas.