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

coconne, MSN, RN

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.

Purpose Of Study

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 Hamric's 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

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.