The Relationship between Health Anxiety and Perceived Stress with moral distress in Emergency Nurses: The Mediating Role of distress tolerance

Introduction: Nurses in emergency departments are exposed to stress and ethical issues due to the specific nature of their job. Therefore, the aim of the present study was to present a relationship between health anxiety and perceived stress with Moral distress and mediation of turmoil tolerance in emergency department nurses. Methods: This descriptive correlational study was performed on 230 emergency nurses in Tehran in 1399 using available sampling method. In this study, the Cohen, Kamark and Marmelstein (1983) Perceived Stress Questionnaire, Salkowski and Warwick (2002), Simmons and Gahr (2005) Perturbation Tolerance, and Jamton's Moral Perturbation Questionnaire were used. Data analysis was performed by path analysis using SPSS-24 and Amos-24 software. Results: The findings of the study showed that perceived stress (t = 5.58) and health anxiety (t = 7.1) had a positive and direct effect on Moral distress and distress Tolerance(t = 8.33) on Moral distress. The effect is negative and direct (P <0.01). The results also showed that disturbance tolerance has a mediating role in the relationship between perceived fear and health anxiety with moral distress (P <0.01). Conclusion: distress Tolerance mediates the relationship between perceived stress and health anxiety with Moral distress. The findings of this study can be used to improve the degree of distress Tolerance and improve the level of work ethic and reduce the Moral distress of emergency department nurses.