Moral Distress and Related Factors in Nurses Working in Intensive Care Units

Introduction: The intensive care unit is a stressful environment due to the high mortality rate of patients, the occurrence of moral problems and working in a tense atmosphere. Faced with these conditions, nurses may be exposed to moral distresses. Therefore, it is important to study the moral distresses that nurses face in these units. Objective: This study aimed to determine the level of moral distress and related factors in nurses working in the intensive care units of Guilan Province, Iran. Materials and Methods: This analytical cross-sectional study was performed on nurses working in all intensive care units in 20 hospitals affiliated to Guilan University of Medical Sciences. The study samples were 414 intensive care nurses chosen by census method in 2018. The data collection instruments were the individual-social factors questionnaire and the 21-item Corley’s moral distress scale standard questionnaire. Data were analyzed using descriptive and inferential statistics (Mann-Whitney, Kruskal–Wallis and Logistic Regression). Results: The majority of the studied samples were women (90.6%), married (67.4%), full-time employees (44.6%), undergraduate (90.3%) with Mean±SD work experience of 75.69±9.93 months in the intensive care units. The mean total score of moral distress was 91.30±65.03 (out of 0-332 scores). Based on the final logistics regression model, gender (OR=2.410, CI95%; 1.19-5.6, P=0.016) and work experience in the intensive care unit (OR=0.64, CI95%; 0.43-0.94, P=0.023) were identified as two factors related to moral distress. Conclusion: The results of this study support the existence of moral distress in nurses in intensive care units, can be considered in planning to reduce the moral distress of nurses in the workplace and improve the quality of nursing care.