Survey Results: "Gender and the Experience of Moral Distress in Critical Care Nurses"

by coconne 4,503 Views | 7 Comments

Below is the abstract from my graduate thesis on gender and moral distress in critical care nurses. Thank you to allnurses.com and all those individuals who participated in the study. I am awaiting a decision on journal publication.

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    Survey Results: "Gender and the Experience of Moral Distress in Critical Care Nurses"

    Background

    Nursing practice is becoming more complex and nurses are challenged by increasingly intricate moral and ethical judgments. One result of this, inadequately studied in underrepresented groups in nursing, is moral distress. Moral distress is a serious problem for healthcare professionals with deleterious effects to patients, nurses and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or the profession altogether. Moral distress in nurses has been correlated with ethical climate, leadership characteristics, nurse characteristics, collaboration and professional autonomy.

    Aim

    The purpose of this study was to determine if gender differences existed in the moral distress experiences in a sample of critical care nurses. It was hypothesized that no such significant gender difference would be reported.

    Design and Participants

    This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine if gender differences exist in their mean moral distress scores. Participants (n = 31) completed Hamricís Moral Distress Scale-Revised (MDS-R) Adult Nurse version over a 5-day period, revealing a gender difference in the mean moral distress scores. The MDS-R is a valid and reliable instrument for measuring moral distress in healthcare professionals with total scores ranging from 0-336.

    Results

    Data were cleaned, validated and uploaded to IBM SPSS version 21 for statistical analysis. Preliminary testing for normality showed a normal distribution of scores for both males (p = 0.36) and females (p = 0.2). Results from the independent samples t-test demonstrated that females reported statistically significantly higher moral distress scores than did males (p < 0.05) with a moderate effect size (d = 0.5). Female mean moral distress scores were 112.75 compared to 60.43 in males. The null hypothesis was therefore not accepted. Moral distress for this sample was related to end-of-life and medical futility issues, which is consistent with most previous studies on the subject.

    Conclusions

    Mean moral distress scores and individual item sub scores were consistent with previously reported findings. Also consistent with previous studies was the result of higher moral distress scores associated with age and professional experience of the nurse. Although generalizability is limited due to the sampling methodology employed, these results would also appear to support findings of higher levels of moral sensitivity in females. Still, due to the dearth of evidence on gender experiences and their influence on moral distress, larger comparisons cannot be made.

    Recommendations

    Overall, the moral distress scores for both groups were relatively low, but the results of this study suggest a need for continuing research on moral distress in underrepresented groups in nursing. Before effective interventions can be designed to prevent and alleviate moral distress, factors and nurse characteristics contributing to the experience need to be better understood.
    Last edit by Joe V on Sep 8, '13
    juan de la cruz, imintrouble, Joe V, and 4 others like this.
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  3. About coconne

    July 30, 2013 by Chris O, MSN, RN, PHN, CFN; A Capstone Presented to the Nursing Faculty of Western Governors University in Partial Fulfillment of the Requirements for the Degree Master of Science, Nursing Leadership and Management

    coconne joined Jul '13 - from 'Garden Grove, CA, US'. coconne has '8+' year(s) of experience and specializes in 'Critical Care, PACU, Education'. Posts: 6 Likes: 9; Learn more about coconne by visiting their allnursesPage

    7 Comments so far...

  4. 0
    Thanks for sharing.
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    "Moral distress in nurses has been correlated with ethical climate, leadership characteristics, nurse characteristics, collaboration and professional autonomy.

    Correlate verb (used with object)1.
    to place in or bring into mutual or reciprocal relation; establish in orderly connection: to correlate expenses and income.

    How do you mean, moral distress correlates with these things? I can't correlate moral distress with collaboration (or any of those other nouns); that doesn't make any sense. Do you mean, level of moral distress varies with different levels of those factors?
    Altra and pinkiepieRN like this.
  6. 1
    Quote from GrnTea
    "Moral distress in nurses has been correlated with ethical climate, leadership characteristics, nurse characteristics, collaboration and professional autonomy.

    Correlate verb (used with object)1.
    to place in or bring into mutual or reciprocal relation; establish in orderly connection: to correlate expenses and income.

    How do you mean, moral distress correlates with these things? I can't correlate moral distress with collaboration (or any of those other nouns); that doesn't make any sense. Do you mean, level of moral distress varies with different levels of those factors?
    Perhaps she meant to add a qualifier such as "low levels of moral distress in nurses has been correlated with ethical climate, leadership characteristics, nurse characteristics, collaboration and professional autonomy"? I'm not sure it makes much more sense that way but I think it might just be a good idea phrased badly.
    juan de la cruz likes this.
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    Quote from dolcebellaluna
    Perhaps she meant to add a qualifier such as "low levels of moral distress in nurses has been correlated with ethical climate, leadership characteristics, nurse characteristics, collaboration and professional autonomy"? I'm not sure it makes much more sense that way but I think it might just be a good idea phrased badly.
    Or to put it in a more specific light, I think the statement would have meant "low levels of moral distress among nurses have been associated with settings that foster a higher degree of healthcare team collaboration and professional autonomy within the practice of nursing.
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    Can you post the "Hamric’s Moral Distress Scale-Revised"? I missed your survey.
    pinkiepieRN likes this.
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    "Female mean moral distress scores were 112.75 compared to 60.43 in males."

    I wonder if the results might be skewed by the possibility of men not being willing to admit their true level of moral distress (out of fear of being perceived as "weak").

    I dunno.
    SoldierNurse22 and pinkiepieRN like this.
  10. 0
    Food for thought, I found a similar paper by a graduate nursing student: http://kb.osu.edu/dspace/bitstream/h...pdf?sequence=1. I haven't read it all yet because it's 50+ pages, but it should prove interesting in response to the above study.


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