The relationship between moral distress in nurses and ethical climate in selected hospitals of the Iranian Social Security Organization
Open accessAbstract
the present study was conducted to determine the relation between nurses’ moral distress and the ethical climate in selected hospitals of the Iranian Social Security Organization (ISSO). This descriptive-analytical correlational study was conducted in 6 hospitals under the coverage of the Iranian Social Security Organization in 2016. Three hundred nurses were selected by convenience sampling method. Data were gathered using Corley’s Standard Moral Distress and Olson’s Hospital Ethical Climate Scales. Data were analyzed using SPSS software version 19. The mean score of the nurses’ moral distress was 1.94 ± 0.66, which is considered moderate. The mean score of ethical climate was 88.97, indicating desirable ethical climate in these hospitals. The frequency score of moral distress had a unilateral reverse correlation with the total score of ethical climate as well as its dimensions, including colleagues, patients, hospitals and physicians. The score of the intensity of nurses’ moral distress also had a unilateral reverse correlation with the total score of ethical climate and the scores of the hospital and physicians dimensions. These results emphasized the importance of creating a positive ethical climate to decrease moral distress as well as the need for professional interventions to increase support in moral issues.
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More than half of nurses experience moral distress in their work environment.
“According to evidence more than half of nurses experience moral distress in their work environment [48, 49].”
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Cites
Nurses’ Reports On Hospital Care In Five Countries
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H. F., Giovannetti, P., Hunt, J., Rafferty, A. M., & Shamian, J. (2001) · Health Affairs · doi:10.1377/hlthaff.20.3.43 · Cited by 1,623 · see citing works
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 758 · see citing works
Nurse Moral Distress: a proposed theory and research agenda
Corley, M. C. (2002) · Nursing Ethics · doi:10.1191/0969733002ne557oa · Cited by 735 · see citing works
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 · see citing works
Moral Distress of Staff Nurses in a Medical Intensive Care Unit
Elpern, E. H., Covert, B., & Kleinpell, R. M. (2005) · American Journal of Critical Care · doi:10.4037/ajcc2005.14.6.523 · Cited by 515 · see citing works
Registered Nurses’ Perceptions of Moral Distress and Ethical Climate
Pauly, B., Varcoe, C., Storch, J. L., & Newton, L. J. (2009) · Nursing Ethics · doi:10.1177/0969733009106649 · Cited by 401 · see citing works
Ulrich, C. M., O’Donnell, P., Taylor, C., Farrar, A., Danis, M., & Grady, C. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.05.050 · Cited by 353 · see citing works
Nurses' Moral Sensitivity and Hospital Ethical Climate: a Literature Review
Schluter, J., Winch, S., Holzhauser, K., & Henderson, A. J. (2008) · Nursing Ethics · doi:10.1177/0969733007088357 · Cited by 339 · see citing works
Hospital Ethical Climates and Registered Nurses' Turnover Intentions
Hart, S. (2005) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2005.00030.x · Cited by 256 · see citing works
Moral Stress: synthesis of a concept
Lützén, K., Cronqvist, A., Magnusson, A., et al. (2003) · Nursing Ethics · doi:10.1191/0969733003ne608oa · Cited by 253 · see citing works
Rice, E. M., Rady, M. Y., HAMRICK, A., Verheijde, J. L., & Pendergast, D. (2008) · Journal of Nursing Management · doi:10.1111/j.1365-2834.2007.00798.x · Cited by 209 · see citing works
de Veer, A. J. E., Francke, A. L., Struijs, A., & Willems, D. L. (2012) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2012.08.017 · Cited by 199 · see citing works
Moral distress: recognizing it to retain nurses.
Pendry, P. S. (2007) · PubMed · Cited by 175 · see citing works
Raines, M. L. (2000) · PubMed · Cited by 166 · see citing works
Moral Distress in Neonatal Intensive Care Unit RNs
Cavaliere, T. A., Daly, B. J., Dowling, D., & Montgomery, K. E. (2010) · Advances in Neonatal Care · doi:10.1097/anc.0b013e3181dd6c48 · Cited by 159 · see citing works
Nurses in Australian general practice: implications for chronic disease management
Halcomb, E., Davidson, P. M., Salamonson, Y., Ollerton, R. L., & Griffiths, R. (2008) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2007.02141.x · Cited by 154 · see citing works
Moral sensitivity and moral distress in Iranian critical care nurses
Borhani, F., Abbaszadeh, A., Mohamadi, E., Ghasemi, E., & Hosseinabadi-Farahani, M. (2015) · Nursing Ethics · doi:10.1177/0969733015604700 · Cited by 153 · see citing works
Development of a Model of Moral Distress in Military Nursing
Fry, S. T., Harvey, R., Hurley, A. C., & Foley, B. J. (2002) · Nursing Ethics · doi:10.1191/0969733002ne522oa · Cited by 126 · see citing works
Silén, M., Svantesson, M., Kjellström, S., Sidenvall, B., & Christensson, L. (2011) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2011.03753.x · Cited by 120 · see citing works
Moral Problems Experienced by Nurses when Caring for Terminally Ill People: a literature review
Georges, J., & Grypdonck, M. H. F. (2002) · Nursing Ethics · doi:10.1191/0969733002ne495oa · Cited by 116 · see citing works
Moral Distress in Emergency Nurses
Fernandez-Parsons, R., Rodriguez, L., & Goyal, D. (2013) · Journal of Emergency Nursing · doi:10.1016/j.jen.2012.12.009 · Cited by 111 · see citing works
Ethical climate in health care organizations.
Olson, L. (1995) · PubMed · Cited by 86 · see citing works
Moral distress questionnaire for clinical nurses: instrument development
Eizenberg, M. M., Desivilya, H. S., & Hirschfeld, M. J. (2009) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2008.04945.x · Cited by 81 · see citing works
Magnusson, A., Lützén, K., & Severinsson, E. (2002) · Journal of Nursing Management · doi:10.1046/j.0966-0429.2001.00292.x · Cited by 52 · see citing works
A study of nurses’ ethical climate perceptions
Humphries, A., & Woods, M. (2015) · Nursing Ethics · doi:10.1177/0969733014564101 · Cited by 40 · see citing works
Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care
Bartholdson, C., af Sandeberg, M., Lützén, K., et al. (2015) · Nursing Ethics · doi:10.1177/0969733015587778 · Cited by 37 · see citing works
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Research works printed but not linked: 3
- [24]Hariri GR Yaghmaei F Zagheri Tafreshi M Shakeri N Assessment of some factors related to leave in nurses and their demographic characters in educational hospitals of Shahid Beheshti University of Medical Sciences Journal of Health Promotion Management 2012 1 3 17 27
- [29]Fazljoo E Borhani F Hoseini SH Abbaszadeh A Nurse’s perception of moral distress and ethical climate in the city of Yazd Medical Ethics Journal 2017 11 44 7 15 [in Persian]
- [31]Cummings CL The Effect of Moral Distress on Nursing Retention in the Acute Care Setting [dissertation] 2009 USA University of North Florida
Cited by
Sorted by citations
Khaghanizadeh, M., Koohi, A., Ebadi, A., & Vahedian-Azimi, A. (2023) · BMC Medical Ethics · doi:10.1186/s12910-023-00938-5 · Cited by 40 · see citing works
- Authors
- Bayat, M., Shahriari, M., & Keshvari, M.
- Affiliations
- Isfahan University of Medical Sciences (IR)
- Corresponding author
- Shahriari, Mohsen
- Venue
- Journal of Medical Ethics and History of Medicine
- Publisher
- Knowledge E DMCC
- Published
- 2019-08-06
- Volume
- 12
- Pages
- 8-8
- ISSN
- 2008-0387 (ISSN-L)
- PMC
- PMC7166247
- OpenAlex
- W2964510444
- Cited by
- 34
- References
- 26
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 8 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 2
- FWCI
- 5.45
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Medical Ethics and History of Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Social Sciences › Decision Sciences › Information Systems and Management › Ethics in Business and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- moral distress, nurses, ethical climate, hospital ethics
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