Background:Moral distress is one of intensive care unit nurses’ major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses’ personal and professional practice, recognizing moral distress is very important.Research objective:The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses.Research design:This study is a descriptive-correlation research.Participants and research context:A total of (...) 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included “demographic questionnaire,” “ICU Nurses’ Moral Distress Scale,” “Copenhagen Burnout Inventory” and “Hinshaw and Atwood Turnover Scale.” Data analysis was done by using SPSS19.Ethical considerations:Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran.Findings:The findings showed intensive care unit nurses’ moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses’ age, their work experience and the fraction of nurses’ number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress.Discussion:Some of the findings of this research are consistent with other studies and some of them are inconsistent.Conclusion:Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses’ moral distress, burnout and their turnover intention are essential. (shrink)

Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...) moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses’ moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care. (shrink)

Background: Leadership style adopted by nursing managers is a key element in progress and development of nursing and quality of healthcare services received by the patients. In this regard, the role of ethical leadership is of utmost importance. Objectives: The objective of the study was to elaborate on the ethical leadership and its role in professional progress and growth of nurses in the light of work condition in health providing institutes. Methods: The study was carried out as a qualitative study (...) following conventional content analysis method. In total, 14 nursing faculty members and nursing managers at different levels were selected through purposive sampling method. Semi-structured interviews were used for data gathering. The data were analyzed using latent content analysis and constant comparison analysis. Ethical considerations: This study was conducted in accordance with ethical issues in research with human participants and national rules and regulations related to informed consent and confidentiality. The study was approved by the Committee of Ethics in Research at the Shahid Beheshti University of Medical Sciences in Tehran, Iran, under the code: sbmu.rec.1393.695 on 15 February 2015. Findings: Five subcategories were obtained based on the analysis, which constituted two main categories including “all-inclusive satisfaction” and “productivity.” Nursing leaders highlighted the point that their ethical behavior creates “inner satisfaction of the leader,” “employees’ job satisfaction,” and “patients’ satisfaction.” Improvement of productivity was another outcome of ethical behavior of the leaders. This kind of behavior resulted in “providing better services” and “inspiring ethical behavior in the employees.” It has great influence on progress and growth of the nursing profession. Conclusion: By creating an ethical climate, ethical leadership leads to positive and effective outcomes—for the patients as well as for the nurses and the leaders—and professional progress and development of the nursing profession. Therefore, an ethical work environment that supports nurses’ progress and development can be developed by paying more attention to moralities in recruitment, teaching ethical values to the leaders, and using a systematic and objective approach to assess morality in the environment. (shrink)

Maintenance and promotion of patient dignity is an ethical responsibility of healthcare workers. The aim of this study was to investigate patient dignity and related factors in patients with heart failure. In this qualitative study, 22 patients with heart failure were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. Factors related to patient dignity were divided into two main categories: patient/care index and resources. Intrapersonal features (inherent characteristics and individual beliefs) and interpersonal interactions (communication, respect, enough (...) information, privacy, and authority) were classified as components of the patient/care index category. Human resources (management and staff) and environmental resources (facilities and physical space) were classified as components of the resources category. The results will increase healthcare staff's understanding of patient dignity and its related factors, and provide information regarding the development of systems and processes that support patients in ways that are consistent with these values. (shrink)

Background:The nurses’ moral sensitivity is the first step to make right decisions in difficult moral situations. Therefore, its education and promotion is highly important.Research objectives:The aim of this study was to examine the impact of poetry-based ethics education on the nurses’ moral sensitivity.Research design and methods:This was a semi-experimental study. The sample consisted of 108 nurses who were selected by convenience sampling method and randomly assigned to three groups: intervention with poetry (G1), who read a booklet about values and principles (...) of professional ethics as well as poems related to these subjects for 1 month; intervention without poetry (G2), who only read the booklet without any poetry; and control group (G3), who did not receive any intervention. Data were collected by Moral Sensitivity Questionnaire that was completed by the participants prior to the intervention (T1), 1-month post-intervention (T2), and 2-month post-intervention (T3). Data were analyzed by SPSS 16 software.Ethical considerations:This study was conducted in accord with the principles of research ethics and regulations relating to informed consent.Findings:Changes in the mean score of total moral sensitivity were significantly higher in G1 than in G2, which was in turn significantly higher than in G3. This increase was significant from T1 to T2 and T2 to T3 (P < 0.001). In all subscales, there was a significant difference between the mean changes in the three groups, so that in these subscales, the mean changes in G1 were significantly higher than those in other groups.Discussion:In line with previous studies, our results showed the effectiveness of poetry-based education on the transfer of educational concepts and increase moral sensitivity scores with greater lasting effect.Conclusion:The use of interdisciplinary subjects such as poetry, due to its entertaining, fun, and lasting effect on minds; level of awareness; and actions of nurses, can help raise nursing moral sensitivity. (shrink)