• 한국컴퓨터정보학회논문지
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• 제24권5호
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• pp.121-130
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• 2019

The purpose of this study was to explore the level of the moral distress for nurses working in long-term care hospitals or nursing homes, and identify factors that influence the moral distress. Data were collected through self-reported questionnaires including the Korean version of Moral Distress Scale-Revised (KMDS-R), Jefferson Empathy Scale for Health professionals (K-JSE-HP), Moral Sensitivity Questionnaire (K-MSQ), and the Hospital Ethical Climate Survey (HECS). A total of 194 nurses from 11 long-term care hospitals or 27 nursing homes completed the structured questionnaires. Data were analyzed using IBM SPSS Statistics version 25. As results, the mean score for moral distress was $73.81{\pm}51.29$ in this study. The moral distress of nurses working at nursing homes was higher than that of nurses working in long-term care hospitals. Among the sub-factors of moral distress, the 'futile care' was the highest score and the 'limit to claim the ethical issue' was the lowest. The main factor affecting moral distress among nurses in this study was the ethical climate of organization. In this paper, we propose that in order to effectively reduce the moral distress of nurses working in a long-term care hospital or a nursing home, it is more impactful to address structural issues related to the caregiver workplace than to adjust individual factors.

• 근관절건강학회지
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• 제29권3호
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• pp.194-204
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• 2022

Purpose: This study was to build a path model geared toward explaining the relationships of influential variables for the moral distress of clinical nurses by analyzing literatures of earlier studies. Methods: Data were collected from four hospitals with 300 beds or more. The participants were 257 nurses with more than 1 year of clinical experience. The data collection period was from June 14 to October 24, 2017. The questionnaire included general and ethical education-related characteristics, personality type, moral dilemma experience, moral sensitivity, moral climate and moral distress. Results: The direct influencing factors of moral distress were the individual's experience of moral dilemma, moral sensitivity, and the moral climate of the organization. Factors that indirectly affected via moral sensitivity were personality type, experience in ethical education, and moral climate. The explanatory power was 40.3%. Conclusion: It is necessary to develop an intervention program that can reduce moral distress by considering the factors influencing the moral distress of clinical nurses. In addition, it is necessary to identify additional influencing factors of moral distress.

• 한국간호교육학회지
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• 제22권3호
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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.

• 한국간호교육학회지
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• 제26권4호
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• pp.366-373
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• 2020

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.

• 한국간호교육학회지
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• 제23권4호
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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.

• 문화기술의 융합
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• 제5권3호
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• pp.119-124
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• 2019

본 연구는 간호대학생이 지각한 도덕적 고뇌와 윤리적 가치관의 관계를 규명하기 위해 시도되었다. 일 지역 간호대학생 150명을 대상으로 하여 2019년 5월 1일부터 31일까지 설문조사를 시행하여 얻은 자료를 분석한 조사연구이다. 수집된 자료는 SPSS WIN21.0 프로그램을 사용하여 분석하였으며, 연구결과 간호대학생이 지각한 도덕적 고뇌와 윤리적 가치관은 양의 상관관계를 나타내고 있었다. 대상자의 학년, 간호학과 선택 여부에 따라 도덕적 고뇌의 차이를 보였고, 윤리적 가치관은 나이, 학년, 간호학과 선택 여부, 교우 관계에 따라 차이를 보였다. 이러한 결과를 바탕으로 하여 예비 간호사인 간호대학생의 도덕적 고뇌와 윤리적 가치관을 위한 중재방안을 모색해야 할 것이다.

• 간호행정학회지
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• 제10권1호
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• pp.49-62
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• 2004

purpose: The study was done to analyze the concept of moral distress in nurses. Method: The Hybrid Model was used in this study. For the theoretical phase, nursing and other literature were reviewed to analyze attributes and develop a working definition of the concept, moral distress in nurses. For the fieldwork phase, In-depth interviews were conducted with six nurses. Results: Four higher level concepts of moral distress in nurses were found; situational, cognitive, behavioral, and emotional, and 8 subscales, negative medical behavior, negative nursing behavior, excessive economic load, irrational organization administration, internal restraints, external restraints, negative behavioral responses, and negative emotional responses. Conclusion: it is necessary to develop programs of arbitration that will lessen the moral distress in nurses working in clinical practice.

• 한국콘텐츠학회논문지
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• 제12권3호
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• pp.276-284
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• 2012

본 연구는 간호사가 지각한 도덕적 고뇌와 이직의도의 관계를 규명하기 위해 시도 되었다. 일 지역 간호사 281명을 대상으로 2011년 4월 20일부터 27일까지 설문조사를 실시하여 얻은 자료를 분석한 연구이다. 수집된 자료는 SPSS WIN 15.0 프로그램을 사용하여 분석하였다. 연구결과 간호사가 지각한 도덕적 고뇌와 이직의도 간의 관계는 양의 상관관계를 나타내고 있음을 알 수 있었다. 부정적 간호 영역을 제외한 부정적 치료, 환자의 관심 무시와 부정적 정서 영역은 모두 이직의도와 상관관계가 있었다. 대상자의 연령이 많고 재직기간이 길며, 교육수준이 높을수록 도덕적 고뇌가 높았으며, 특수병동과 내과계 근무 간호사가 산소아과계 간호사보다 도덕적 고뇌를 높이 지각하고 있었다. 이상의 결과를 토대로 이직의도와의 관련성을 고려하여 간호사의 도덕적 고뇌 경감을 위한 중재방안을 모색하여야 할 것이다.

• 한국간호교육학회지
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• 제26권2호
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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.

• 융합정보논문지
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• 제9권9호
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• pp.78-86
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• 2019

본 연구는 병원 간호사를 대상으로 병원 간호사가 경험하는 도덕적 민감성이 도덕적 고뇌에 미치는 영향을 파악하고, 도덕적 민감성과 도덕적 고뇌의 영향관계에서 생명의료윤리의식의 매개효과를 검증하는 것이다. 연구대상자는 S시, J시에 소재하고 있는 종합병원에 근무하고 있는 병원 간호사 153명을 선정하였다. 자료분석은 SPSS WIN 21.0을 이용하여 t-test, ANOVA, Scheffe test, 상관관계분석, 단순 및 다중회귀분석과 Sobel test을 하였다. 병원 간호사가 경험하는 도덕적 민감성은 평균 4.70점(7점 만점), 도덕적 고뇌는 62.80점(336점 만점), 생명의료윤리의식은 2.21점(4점 만점)이었고, 도덕적 고뇌는 도덕적 민감성과 생명의료 윤리의식과 정적 상관관계, 도덕적 민감성과 생명의료윤리의식 간에 정적상관관계가 있었다. 마지막으로 생명의료윤리의식이 도덕적 민감성과 도덕적 고뇌의 관계를 부분 매개효과가 있는 것으로 나타났다. 병원 간호사의 도덕적 민감성 향상 및 도덕적 고뇌 감소를 위해 도덕적 문제를 해결할 수 있도록 능력을 향상시키는 생명의료윤리교육 프로그램 개발이 무엇보다 중요하다.