Aspectos sociodemográficos e laborais associados ao distresse moral em enfermeiros brasileiros

Nurses' assessment of the ethical climate of a university hospital in the South of Brazil

Background

Ethical climate can be defined as the healthcare professionals' perceptions of the ethical treatment of healthcare issues and human interactions in their work environment. A number of studies on ethical climate are being carried out in several countries. In Brazil, however, research on the matter is still incipient, especially among hospital nurses.

Aim

To assess nurses' perception of the ethical climate in a university hospital in the South of Brazil.

Methods

Cross-sectional study carried out with 269 nurses from a university hospital, using a sociodemographic and occupational profiling survey and the Hospital Ethical Climate Survey - Brazilian version. Data analysis was done through descriptive statistics.

Results

The nurses' perception of the ethical climate was positive (3.68 ± 0.55). Among the five assessment factors, 'peers' had the highest score (4.07 ± 0.57), whereas 'physicians' had the lowest score (3.26 ± 0.70) for ethical climate.

Conclusion

In general, the ethical climate was perceived as positive, with small variations between the factors of the instrument. Ethical climate could be enhanced through strategies that encourage interpersonal relationships. This study shows the importance of a positive ethical climate based on good relationships between healthcare professionals for ensuring better care.

Elements associated with moral deliberation in family health teams: in search of excellence in professional practice

Abstract This single-case qualitative study aims to identify the elements associated with moral deliberation in the Family Health Strategy (ESF) by interviewing thirty-five professionals from family health teams. Data were collected via interviews guided by a semi- structured script and observation and analyzed using thematic content analysis. The results showed that moral deliberation in the concrete context of the practice of ESF professionals proved to be a subjective and incipient construction, influenced by factors internal and external to individuals. We concluded that identifying the elements that influence moral deliberation in the context of the ESF can favor the ethical improvement of health practices.

Nurses' Work-Related Quality of Life and Its Influencing Demographic Factors at a Public Hospital in Western Iran: A Cross-Sectional Study

BACKGROUND

The quality of life as a concept beyond physical health stands one of the protuberant indexes, and various health-based studies required distinct measurements, which deemed necessary for their significant implications. The nurses fight at the front and play a leading role in providing services to patients at healthcare centers. They deserve a higher quality of life in catering to physical health services. This present study focuses on examining nurses' work-life quality standards and how demographic variables contribute to the hospital of Imam Reza in Kermanshah of Western Iran.

METHODS

This descriptive-analytical study recruited a sample of 271 nurses affiliated with Imam Reza Hospital and Kermanshah University of Medical Sciences by incorporating the stratified random sampling in 2019. This study used a two-part questionnaire to collect data from the targeted respondents. The first part presented the participants' demographic profiles, and the second part showed the nurses' work-related quality of life (WRQoL) on the scale developed by Van Laar et al. The study screened the data and performed analyses through the SPSS version-23. The research study conducted a descriptive analysis to measure mean and standard deviation with inferential statistics, including independent samples t-test and one-way ANOVA (P < 0.05).

RESULTS

The study findings specified that nurses' average quality of the work-life was at a moderate level 3.11 ± 0.47. Besides, results indicated that 57.50% of the nurses reported high standards of quality of work-life, 36.50% showed a modest and 5.20% revealed a lower level of work-life quality. The findings indicated that the quality of work-life significantly correlated with respondent'' age, marital status, education, work experience, position, department, shifts, and employment status (p < 0.05).

CONCLUSION

The findings of this research demonstrated that the nurses' quality of work-life was higher than the average standard. The results provide useful insight for nurses and hospital managers. The policymakers and health managers need to pay more attention to providing a better quality of work-life to the nurses.

Instruments to assess moral distress among healthcare workers: A systematic review of measurement properties

BACKGROUND

An increasing number of professionals are challenged by the evolution of modern healthcare and society, often characterized by more expectations with reduced resources. Moral distress is among the psychophysical conditions now most under investigation in order to improve the wellbeing of professionals, the sustainability of organizations and the quality of care. Over the last decades, several instruments have been developed to assess the frequency or intensity of moral distress in different studies. Yet, there has not been, so far, a systematic assessment of the qualitative properties of the various instruments measuring moral distress in healthcare workers based on a universally accepted standardized framework.

OBJECTIVE

(1) To identify all instruments for the measurement of moral distress available in recent literature; (2) to evaluate the evidence regarding their measurement properties; (3) to facilitate the selection of the most appropriate instrument to be adopted in practice and research.

DESIGN

Systematic literature review.

DATA SOURCES

PubMed, CINAHL, and PyscINFO.

REVIEW METHODS

The COnsensus-based Standards for the selection of health Measurement INstruments checklist was used to evaluate the methodological quality of the identified studies. The quality of measurement properties of each instrument was evaluated using Terwee's quality criteria.

RESULTS

Among the 1268 studies found, 88 full-text articles evaluated moral distress adopting different tools. Thirty two of them had a methodological design. The measurement instruments assessed in this review are different in terms of targeted population and items. The instruments were then divided into two main categories: (1) Corley's instruments on moral distress (Moral distress scale and Moral Distress Scale - Revised) and (2) instruments not directly derived from Corley's moral distress theory (Moral Distress thermometer, Moral Distress Risk Scale, Ethical Stress Scale or Moral Distress in Dementia Care Survey). The first set is the most frequently studied and used in different clinical settings and healthcare populations. A variety of psychometric properties have been evaluated for each instrument, revealing different qualities in the methodology used.

CONCLUSIONS

Several instruments assessing moral distress in healthcare workers have been identified and evaluated in this systematic review. Based on the criteria used here, Corley's instruments on moral distress seems to be the most useful and most appropriate to the clinical setting for practice and research purposes.

TWEETABLE ABSTRACT

The aim of this systematic review was to identify the instruments measuring moral distress now available in the literature, in order to (1) assess the evidence about their measurement properties, (2) support the selection of the most appropriate instrument to be used in practice and research.