The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Registered Nurses’ Perceptions of Moral Distress and Ethical Climate
Abstract
Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Aiken, L. H. (2002) · JAMA · doi:10.1001/jama.288.16.1987 · Cited by 5,226
Nursing practice, the ethical issues
(1985) · International Journal of Nursing Studies · doi:10.1016/0020-7489(85)90057-4 · Cited by 1,476
Hamric, A. B., & Blackhall, L. J. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000254722.50608.2d · Cited by 792
Development and evaluation of a moral distress scale
Corley, M. C., Elswick, R. K., Gorman, M., & Clor, T. (2001) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2001.01658.x · Cited by 754
Nurse Moral Distress: a proposed theory and research agenda
Corley, M. C. (2002) · Nursing Ethics · doi:10.1191/0969733002ne557oa · Cited by 735
Living with conflicts-ethical dilemmas and moral distress in the health care system
Kälvemark, S., Höglund, A. T., Hansson, M. G., Westerholm, P., & Arnetz, B. (2004) · Social Science & Medicine · doi:10.1016/s0277-9536(03)00279-x · Cited by 624
Nurse Moral Distress and Ethical Work Environment
Corley, M. C., Minick, P., Elswick, R. K., & Jacobs, M. (2005) · Nursing Ethics · doi:10.1191/0969733005ne809oa · Cited by 593
Moral Distress in Nursing Practice: Experience and Effect
Wilkinson, J. M. (1987) · Nursing Forum · doi:10.1111/j.1744-6198.1987.tb00794.x · Cited by 521
Moral Distress of Staff Nurses in a Medical Intensive Care Unit
Elpern, E. H., Covert, B., & Kleinpell, R. (2005) · American Journal of Critical Care · doi:10.4037/ajcc2005.14.6.523 · Cited by 515
Hospital Nurses' Perceptions of the Ethical Climate of Their Work Setting
Olson, L. L. (1998) · Image: the Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.1998.tb01331.x · Cited by 333
Cited by
Development and Testing of an Instrument to Measure Moral Distress in Healthcare Professionals
Hamric, A. B., Borchers, C. T., & Epstein, E. G. (2012) · AJOB Primary Research · doi:10.1080/21507716.2011.652337 · Cited by 623
Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019) · AJOB Empirical Bioethics · doi:10.1080/23294515.2019.1586008 · Cited by 580
What is ‘moral distress’? A narrative synthesis of the literature
Morley, G., Ives, J., Bradbury-Jones, C., & Irvine, F. (2019) · Nursing Ethics · doi:10.1177/0969733017724354 · Cited by 523
Lamiani, G., Borghi, L., & Argentero, P. (2017) · Journal of Health Psychology · doi:10.1177/1359105315595120 · Cited by 522
Moral Distress Among Healthcare Professionals: Report of an Institution‐Wide Survey
Whitehead, P. B., Herbertson, R. K., Hamric, A. B., Epstein, E. G., & Fisher, J. M. (2015) · Journal of Nursing Scholarship · doi:10.1111/jnu.12115 · Cited by 512
Metadata
- Authors
- Pauly, B., Varcoe, C., Storch, J., & Newton, L.
- Venue
- Nursing Ethics
- Publisher
- SAGE Publications
- Published
- 2009-08-11
- Volume
- 16
- Issue
- 5
- Pages
- 561-573
- ISSN
- 0969-7330 (ISSN-L)
- 1477-0989
- OpenAlex
- W2107368943
- Cited by
- 401
- References
- 35
- FWCI
- 38.49
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Registered Nurses’ Perceptions of Moral Distress and Ethical Climate. https://app.cochat.ai/papers/10.1177/0969733009106649
- The paper
- Pauly, B., Varcoe, C., Storch, J., & Newton, L. (2009). Registered Nurses’ Perceptions of Moral Distress and Ethical Climate. Nursing Ethics. https://doi.org/10.1177/0969733009106649
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
