The Journal of Korean Academic Society of Nursing Education (한국간호교육학회지)

The Korean Academic Society of Nursing Education (한국간호교육학회)
권호 표지
DOI QR코드

DOI QR Code

The relationships between moral distress and quality of nursing care in oncology nurses

암 병동 간호사의 도덕적 고뇌와 암 환자 간호의 질과의 관계

  • Received : 2020.07.30
  • Accepted : 2020.10.23
  • Published : 2020.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The study aimed to investigate the relationship between moral distress and the quality of nursing care. Methods: This cross-sectional correlation study included nurses working at oncology nursing units of two secondary general hospitals in Seoul and Gyeonggi-do, Korea. A total of 207 nurses participated. Moral distress was measured by the Moral Distress Scale-Revised Nurse Questionnaire and quality of nursing care was evaluated by the Quality of Oncology Nursing Care Scale. Data were collected from October 5 to 31, 2018. Data analysis included descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis. Results: The quality of oncology nursing care showed a negative correlation with moral distress (r=-.19, p=.007). The factors affecting the quality of oncology nursing care were religion (β=-.22, p=.001), clinical experience in oncology units (β=.27, p=.007), and moral distress (β=-.16, p=.018). Moral distress showed a statistically significant predictive power of 13% in the regression model (F=8.70, p=<.001). Conclusion: The findings of this study suggest that management of moral distress is important to increase the quality of oncology nursing care.

Keywords

References

  1. Kim S, Kim JH, Park JY, Suh EY, Yang HJ, Lee SY, et al. Oncology nurses' professional quality of life in a tertiary hospital. Journal of Korean Clinical Nursing Research. 2010;16(3):145-155.
  2. Radwin L. Oncology patients' perceptions of quality nursing care. Research in Nursing & Health. 2000;23(3):179-190. https://doi.org/10.1002/1098-240x(200006)23:3<179::aid-nur2>3.0.co;2-t
  3. Burston AS, Tuckett AG. Moral distress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics. 2013; 20(3):312-324. https://doi.org/10.1177/0969733012462049
  4. Ko HK, Chin CC, Hsu MT. Moral distress model reconstructed using grounded theory. Journal of Nursing Research. 2018;26(1):18-26. https://doi.org/10.1097/jnr.0000000000000189
  5. Corley MC. Development and evaluation of a moral distress scale. Journal of Advanced Nursing. 2001;33(2):250-256. https://doi.org/10.1046/j.1365-2648.2001.01658.x
  6. Jameton A. Nursing practice, the ethical issues. International Journal of Nursing Studies. 1984;22(4):331-343.
  7. Wilkinson JM. Moral distress in nursing practice: Experience and effect. Nursing Forum. 1987;23(1):16-29. https://doi.org/10.1111/j.1744-6198.1987.tb00794.x
  8. Park BH, Oh YJ. Moral distress experienced by nurses in South Korea: An integrated review. Korean Journal of Medical Ethics. 2016;19(3):312-327. https://doi.org/10.35301/ksme.2016.19.3.312
  9. You MS. Concept analysis of moral distress in nurses. Journal of Korean Academy of Nursing Administration. 2004;10(1): 49-62.
  10. Kim MJ, Lee EN. Development of an instrument to measure intra-operative caring behaviors perceived by regional anesthesia patients. Journal of Korean Academy of Nursing. 2012; 42(5):749-758. https://doi.org/10.4040/jkan.2012.42.5.749
  11. Shafipour V, Esmaeili R, Heidari MR, Aghaei N, Saadatmehr SR, Sanagoo A. Investigating the level of moral distress and its related factors among nurses in Mazandaran burn center. Journal of Mazandaran University of Medical Sciences. 2015;25(126):58-67.
  12. Lievrouw A, Vanheule S, Deveugele M, De Vos M, Pattyn P, Belle V, et al. Coping with moral distress in oncology practice: Nurse and physician strategies. Oncology Nursing Forum. 2016;43(4):505-512. https://doi.org/10.1188/16.ONF.505-512
  13. Mehlis K, Bierwirth E, Laryionava K, Mumm FH, Hiddemann W, HeuBner P, et al. High prevalence of moral distress reported by oncologists and oncology nurses in end of life decision making. Psych-Oncology. 2018;27(12):2733-2739. https://doi.org/10.1002/pon.4868
  14. Seo MJ. Burnout and coping type of oncology nurse [Unpublished master's thesis]. Seoul: Yonsei University; 2001. p. 1-66.
  15. Hamric AB, Borchers CT, Epstein EG. Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research. 2012;3(2):1-9. https://doi.org/10.1080/21507716.2011.652337
  16. Chae YR, Yu SJ, Lee EJ, Kang KJ, Park MS, Yu M. Validity and reliability of the Korean version of the moral distress scale-revised for Korean hospital nurses. The Korean Academic Society of Nursing Education. 2016;22(2):228-239. https://doi.org/10.5977/jkasne.2016.22.2.228
  17. Charalambous A, Adamakidou T. Construction and validation of the Quality of Oncology Nursing Care Scale (QONCS). BMC Nursing. 2014;13(1):48-58. https://doi.org/10.1186/s12912-014-0048-4
  18. Sirilla J. Moral distress in nurses providing direct care on inpatient oncology units. Clinical Journal of Oncology Nursing. 2014;18(5):536-541. https://doi.org/10.1188/14.CJON.536-541
  19. Oh YJ, Gastmans C. Moral distress experienced by nurses: A quantitative literature review. Nursing ethics. 2015;22(1):15-31. https://doi.org/10.1188/14.CJON.536-541
  20. Seo JY, Yi MS. Hermeneutic phenomenological study on caring experience of nurses working in a chemotherapy ward in Korea. Asian Oncology Nursing. 2017;17(1):55-67. https://doi.org/10.5388/aon.2017.17.1.55
  21. No JY, Ahn HR. Compassion fatigue experience of oncology nurses. Journal of the Korea Academia-Industrial Cooperation Society. 2016;17(1):304-314. https://doi.org/10.1188/17.CJON.E61-E66
  22. Barlem ELD, Lunardi VL, Lunardi GL, Tomaschewski-Barlem JG, Silveira RSD. Moral distress in everyday nursing: Hidden traces of power and resistance. Revista Iatino-Americana De Enfermagem. 2013;21(1):293-299. https://doi.org/10.1590/S0104-11692013000100002
  23. Austin CL, Robert S, Phillip JF. Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychological Trauma: Theory, Research, Practice, and Policy. 2017;9(4):399-406. https://doi.org/10.1037/tra0000201
  24. Park AR, So HS, Chae MC. Recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics. Asian Oncology Nursing. 2014;14(1):23-31. https://doi.org/10.5388/aon.2014.14.1.23
  25. Johnstone MJ, Hutchinson A. 'Moral distress'-time to abandon a flawed nursing construct? Nursing Ethics. 2015;22(1):5-14. https://doi.org/10.1177/0969733013505312
  26. Bahrami M. Why differences exist? An interpretive approach to nurses'perception of cancer patients' quality of life. Iranian Journal of Nursing and Midwifery Research. 2011;16(1):117-124.
  27. Kim HR, Kwon IS. A phenomenological study on oncology adaptation experiences of new nurses. Asian Oncology Nursing. 2014;14(2):127-138. https://doi.org/10.5388/aon.2014.14.2.127
  28. Park SY. Issues and challenges of nursing workforce supply to improve the quality of health care services. Korean Journal of Converging Humanities. 2018;6(1):31-54. https://doi.org/10.14729/converging.k.2018.6.1.31