• Journal of Digital Convergence
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• v.19 no.2
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• pp.275-288
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• 2021

This study was attemted to grasp the factors affecting the clinical decision-making ability of nurse. Data were collected from 156 nurse working in hospital in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. The most influential factor on the subjects' clinical decision-making ability was nursing Research 'very interest', critical thinking tendency, 'master/doctor', clinical experience 'more than 20 years and 1 month', moral behavior, nursing research 'important', 'single', clinical work experience '5 years, 1 month-10 years', department work experience '3 years 1 month-5 years'. The explanatory power was 51.4%. It was significant in that it was confirmed that interest and importance, moral behavior, academic background, and career are variables that influence clinical decision-making ability. The results of this study can be utilized as basic data for the development of intervention plans and programs that can increase clinical decision-making ability in the context of an ethical dilemma. In addition, developing and verifying educational programs that can increase clinical decision-making abilities in ethical dilemmas is needed.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.3
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• pp.355-365
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• 2016

Purpose: This study explores the moral distress that nursing students experience during their clinical practice in Korea. Methods: Data were collected using focus group interviews, and analyzed using qualitative content analysis. Participants were recruited from three nursing schools in three different cities; each focus group interview lasted between one to two hours. Results: Twenty-two nursing students with more than one year of clinical practice experience participated. Three categories and ten themes were extracted. The following situational categories: "unprotected patients' right and dignity," "clinical settings in which standards of care are not upheld," "disrespectful hospital culture," and "inconsistent and unsystematic clinical education" caused moral distress. Types of responses to moral distress included: "shock and confusion over the gap between reality and moral standards," "powerlessness when cannot advocate patients," "fear and doubts about nursing career," and "moral desensitization and disappointment in oneself." "Expressions of moral distress and the need for advice" and "a search for meaning and hope" were identified as coping strategies. Conclusion: These results demonstrate the need for systematic clinical practicum and education programs to minimize moral distress. These programs may offer opportunities for students to turn moral distress into opportunities for learning and growth in the future.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.1
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• pp.131-139
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• 2006

Purpose: This study was carried out to understand the degree of moral distress of nurses and to provide scientific data for searching measures to efficiently manage their moral distress. Method: The survey was conducted with 302 nurses at the general hospital in City D by using the self-report type of questionnaire composed of 66 questions of 5-point Likert scale in four dimensions. Result: The mean scores of moral distress of nurses showed higher than average in all four dimensions: $80.54{\pm}14.82$ of 150 in the situational dimension, $52.99{\pm}9.98$ of 90 in the cognitive dimension, $13.30{\pm}2.85$ of 25 in the behavioral dimension, and $48.06{\pm}7.76$ of 65 in the emotional dimension. In addition, moral stress of each factor in the situational area showed $34.20{\pm}7.27$ in negative medical behavior, $10.98{\pm}2.53$ in lack of respect for autonomy of patients, excessive economic burden $10.86{\pm}2.94$, $7.40{\pm}1.89$ in irrational organizational administration and $17.10{\pm}3.50$ in negative nursing behavior. Conclusion: It is necessary to develop the intervention program to help nurses to reduce their moral distress since its degree showed considerably high.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.4
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• pp.430-440
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• 2017

Purpose: The purpose of this study was to explore the relationship between moral distress, physical symptoms, and burnout among clinical nurses. Methods: Data were collected by self-report questionnaires targeting 140 nurses from a university hospital in Chungju. The data were analyzed by, Kruskal-Wallis, Pearson correlation coefficient, and stepwise multiple regression. Results: Moral distress due to the general characteristics of the participants showed a statistically significant difference at the current working department (${\chi}^2=36.01$, p<.001). Hospital nurses' moral distress had a statistically significant correlation with burnout (r=.358, p<.001) and physical symptoms (r=.440, p<.001). Factors influencing hospital nurses' burnout, pro were physical symptoms, moral distress, and marital status, accounting for 36% of the variance. Conclusion: The findings indicate that moral distress and physical symptoms influence burnout among hospital nurses. Therefore, interventions for burnout among hospital nurses should include an empowerment program to reduce physical symptoms and moral distress.

• Journal of East-West Nursing Research
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• v.26 no.1
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• pp.63-70
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• 2020

Purpose: The purpose of this study was to compare the moral distress and burnout between long-term care hospital nurses and general nurses. Methods: This study was a cross-sectional survey. Participants were 193 nurses (long-term care hospital 95, general hospital 98) working in a hospital in Seoul, Daegu and Busan city. Data were collected from October 02 to November 30, 2018 using a structured questionnaires and analyzed with SPSS/PC ver 21.0 programs. Results: The scores of moral distress by nurses working in long-term care hospitals were higher than those of nurses in general hospitals. The score of burnout by nurses working in general hospitals was significantly higher than that of nurses in long-term care hospitals. There was a significant positive relationship between moral distress and burnout in both long-term care hospital nurses and general hospital nurses. Conclusion: This research shows that long-term care hospital nurses have higher moral distress and burnout than those of general hospital nurses. Therefore, nursing managers and organization should strive to raise the perception of moral distress and burnout in long-term care hospital nurses.

• The Journal of the Convergence on Culture Technology
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• v.7 no.3
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• pp.135-146
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• 2021

This study is a descriptive research study to identify the relationship between the performance of end-of-Life care of ICU nurses, moral distress, ethical climate, difficulties in end-of-life care, and positive psychological capital. Data were collected with structured questionnaires from 144 ICU nurses at a university hospital in J city, Gyeongnam, from October to November in 2020, and analyzed using SPSS/WIN 21.0. The subjects' performance of end-of-life care of ICU nurses is significantly different depending on marital status, experiences of end-of-life care education. The variables that had a significant effect on the performance of end-of-life care among ICU nurses were positive psychological capital and difficulties in end-of-life care. The explanatory power was 24.8%. Based on these results, it is necessary to intervention program and education to reduce difficulties in end-of-life care and increase positive psychological capital for ICU nurses.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.2
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• pp.167-175
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• 2020

Purpose: The purpose of this study was to explore the subjective experience of moral distress among nurses working in long-term care hospitals. Methods: A phenomenological approach was used for the study. Data were collected from May to July, 2019 using open-ended questions during in-depth interviews. Participants were nurses working in long-term care hospitals and had reported experiences of moral distress. Nine nurses participated in this study. Results: Three themes emerged from the analysis using Colaizzi's method: (1) confusion and distress about the meaning of care, (2) a feeling of helplessness caused by connivance, (3) enduring in the organization. Conclusion: Sufficient labor supply, environmental improvements, programs for improving interpersonal skills, education and counseling on end-of-life care, and recognition improvement about long-term care hospitals are suggested to reduce the moral distress of long-term care hospital nurses.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.2
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• pp.228-239
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• 2016

Purpose: To develop and test the validity and reliability of the Korean version of the Moral Distress Scale-Revised (KMDS-R) to assess its applicability to Korean hospital nurses. Methods: The KMDS-R was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity was calculated using SPSSWIN(19.0). Survey data were collected from 188 nurses from a university hospital in Gangwon-do, South Korea. Results: The KMDS-R showed reliable internal consistency with a Cronbach's alpha of .69-.87 and a Guttman Split-half of .69-.82 for the total scale. Factor loading of the 21 items on the five subscales ranged from .41-.80. The KMDS-R was validated by factor analysis and explained 63% of moral distress for Korean hospital nurses. Criterion validity compared to Yoo's MDS showed significant correlation. Conclusion: The results suggest promising evidence of the KMDS-R's reliability and validity. It is used to measure moral distress for Korean hospital nurses.

• The Journal of the Korea Contents Association
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• v.22 no.9
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• pp.592-601
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• 2022

This study was attempted to suggest future directions for nursing ethics education by analyzing research trends related to ethical conflicts among nurses and the current status of nursing ethics education. In four domestic databases, it was searched as a combination of words 'nurse', 'ethics', 'moral', 'bioethics', 'conflict', 'sensitivity', 'dilemma', 'issue', and 'value'. As a result, 591 papers were confirmed from 2000 to December 2021, of which 111 papers were finally analyzed. The status of nursing ethics education was analyzed for 184 out of 203 schools that operated a four-year bachelor's degree program registered with the Korean Accreditation Board of Nursing Education. As a result of the study, the number of studies related to ethical conflicts among nurses steadily increasing, and quantitative studies on nurses in general hospitals were the most common. The main keywords were identified as moral sensitivity, moral agony, ethical dilemma, and biomedical ethics awareness. Nursing ethics education was operated by 68% of universities as a major subject, and more than half of universities opened it in the first and second grades with one or two credits. As a result of this study, ethical conflicts experienced by nurses are increasing according to social change. Therefore, it is necessary for universities to further expand the proportion of nursing ethics education and to establish an educational model for each grade level for the continuity of the educational effect.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.2
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• pp.176-184
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• 2020

Purpose: We explored emergency nurses' experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses' coping with moral distress was "a passive emotion-based response." We also extracted three categories of coping strategies: "uncritical adaptation to anguished situation," "self-justification for not acting," and "flight from ethical decision making." Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.