Journal of Korean Academy of Psychiatric and Mental Health Nursing (정신간호학회지)

The Korean Academy of Psychiatric and Mental Health Nursing (한국정신간호학회)
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Moral Distress, Moral Sensitivity and Ethical Climate of Nurses Working in Psychiatric Wards

정신과 병동 간호사의 도덕적 고뇌, 도덕적 민감성 및 윤리적 환경

  • Noh, Dabok (Nursing Policy Research Institute, College of Nursing, Yonsei University) ;
  • Kim, Sunah (College of Nursing, Yonsei University) ;
  • Kim, Sanghee (College of Nursing, Yonsei University)
  • 노다복 (연세대학교 간호대학 정책연구소) ;
  • 김선아 (연세대학교 간호대학) ;
  • 김상희 (연세대학교 간호대학)
  • Received : 2013.08.16
  • Accepted : 2013.12.23
  • Published : 2013.12.31
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Abstract

Purpose: The purpose of this study was to explore level of moral distress, moral sensitivity, and ethical climate of nurses working in psychiatric wards and identify factors that influence moral distress. Also this study was done to describe the content of moral distress. Methods: Data were collected through self-report questionnaires and focus group interviews. A survey was conducted with 108 psychiatric nurses and 8 volunteers were interviewed. Instruments used in this study were the Moral Distress Scale for Psychiatric Nurses, Korean version of the Moral Sensitivity Questionnaire, and Ethical Climate Questionnaire. Data were analyzed using SPSS/WIN 20.0 program and content analysis. Results: The mean score for moral distress was 3.74 and for moral sensitivity, 4.67. The significant factors influencing moral distress were clinical career in psychiatric wards, moral sensitivity, personal profit and friendship. As a result of content analysis, 3 domain of moral distress were found: moral distress situations, responses in moral distress situations, factors to overcome moral distress and resources that enable ethical nursing. Conclusion: The results suggest that in the development of interventions to decrease moral distress for nurses working in psychiatric wards, factors identified as influencing moral distress and content of moral distress should be considered.

Keywords

References

  1. Austin, W., Bergum, V., & Goldberg, L. (2003). Unable to answer the call of our patients: Mental health nurses' experience of moral distress. Nursing Inquiry, 10, 177-183. https://doi.org/10.1046/j.1440-1800.2003.00181.x
  2. Cha, E. S., Kim, K. H., & Erlen, J. A. (2007). Translation of scales in cross-cultural research: Issues and techniques. Journal of Advanced Nursing, 58, 386-395. https://doi.org/10.1111/j.1365-2648.2007.04242.x
  3. Cho, M. J. (2005). Case analysis on ethical problems perceived by nurses at psychiatric inpatient setting. Unpublished doctoral dissertation, Ewha Womans University, Seoul.
  4. Corley, M. C. (2002). Nurse moral distress: A proposed theory and research agenda. Nursing ethics, 9, 636-650. https://doi.org/10.1191/0969733002ne557oa
  5. Corley, M. C., Elswick, R. K., Gorman, M., & Clor, T. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33, 250-256. https://doi.org/10.1046/j.1365-2648.2001.01658.x
  6. Corley, M. C., Minick, P., Elswick, R. K., & Jacobs, M. (2005). Nurse moral distress and ethical work environment. Nursing Ethics, 12, 381-390. https://doi.org/10.1191/0969733005ne809oa
  7. Deady, R., & McCarthy, J. (2010). A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspectives in Psychiatric Care, 46, 209-220. https://doi.org/10.1111/j.1744-6163.2010.00260.x
  8. Han, S. S. (2005). The moral distress experienced by hospital nurses. Journal of the Korean Bioethics Association, 6 (2), 31-47.
  9. Han, S. S., Kim, J., Kim, Y. S., & Ahn, S. (2010). Validation of a Korean version of the Moral Sensitivity Questionnaire. Nursing Ethics, 17, 99-105. https://doi.org/10.1177/0969733009349993
  10. Jameton, A. (1993). Dilemmas of moral distress: Moral responsibility and nursing practice. AWHONN's Clinical Issues in Perinatal and Women's Health Nursing, 4 , 542-551.
  11. Joo, Y. S. (2005). Ensure the right to health and human rights. Monthly Welfare Trends, 79, 27-32.
  12. Kang, M. J., & Lee, H. J. (2006). The effect of assertiveness training on communication related factors and personnel turnover rate among hospital nurses. Journal of Korean Academy of Nursing, 36, 681-690. https://doi.org/10.4040/jkan.2006.36.5.681
  13. Kim, H. R., & Ahn, S. H. (2010). Moral sensitivity and moral distress among Korean hospital nurses. Korean Journal of Medical Ethics, 13, 321-336.
  14. Krueger, R. A., & Casey M. A. (2009). Focus groups: A practical guide for applied research(4th ed.). Los Angeles: SAGE.
  15. Lee, K. J., & Yoo, S. Y. (2011). Relationships between nurses' ethical dilemma, coping types, job satisfaction and turnover intention in Korea. Journal of Korean Clinical Nursing Research, 17, 1-15.
  16. Lutzen, K., Blom, T., Ewalds-Kvist, B., & Winch, S. (2010). Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nursing Ethics, 17, 213-224. https://doi.org/10.1177/0969733009351951
  17. Lutzen, K., Evertzon, M., & Nordin, C. (1997). Moral sensitivity in psychiatric practice. Nursing Ethics, 4, 472-482. https://doi.org/10.1177/096973309700400604
  18. Lutzen, K., Johansson, A., & Nordstrom, G. (2000). Moral sensitivity: Some differences between nurses and physicians. Nursing Ethics, 7, 520-530. https://doi.org/10.1177/096973300000700607
  19. Nam, J. E. (2010). Relationship among ethical climate, job stress and career involvement of nurse. Unpublished master's thesis, Hanyang University, Seoul.
  20. National Human Rights Commission of Korea. (2008). A survey on the mentally disorders in mental health facilities. Seoul: Author.
  21. National Human Rights Commission of Korea. (2009). Case studies of countries and advanced model building to improve human rights of mental disabled. Seoul: Author.
  22. Ohnishi, K., Ohgushi, Y., Nakano, M., Fujii, H., Tanaka, H., Kitaoka, K., et al. (2010). Moral distress experienced by psychiatric nurses in Japan. Nursing Ethics, 17, 726-740. https://doi.org/10.1177/0969733010379178
  23. Park, J. H. (2003). Psychiatric nurse's perception in ethical conflict situation. Unpublished master's thesis, Yonsei University, Seoul.
  24. Patton, M. (1990). Qualitative evaluation and research methods. Beverly Hills, CA: SAGE.
  25. Pauly, B., Varcoe, C., Storch, J., & Newton, L. (2009). Registered nurses' perceptions of moral distress and ethical climate. Nursing Ethics, 16, 561-573. https://doi.org/10.1177/0969733009106649
  26. Schluter, J., Winch, S., Holzhauser, K., & Henderson, A. (2008). Nurses' moral sensitivity and hospital ethical climate: A literature review. Nursing Ethics, 15, 304-321. https://doi.org/10.1177/0969733007088357
  27. Victor, B., & Cullen, J. B. (1988). The organizational bases of ethical work climates. Administrative Science Quarterly, 33, 101-125. https://doi.org/10.2307/2392857
  28. Waltz, C., Strickland, O., & Lenz, E. (1984). Measurement in nursing research. Philadelphia: F.A. Davis Co.
  29. Yoo, M. S. (2003). The development of a measurement tool for moral distress in nurses. Unpublished doctoral dissertation, Yonsei University, Seoul.
  30. Yoo, M. S., & Shon, K. C. (2012). Effects of nursing ethics education on biomedical ethics awareness, moral sensitivity and moral judgment of nursing students. Journal of the Korean Bioethics Association, 12 (2), 61-76.

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