Iranian Journal of Medical Ethics and History of Medicine

Moral distress has been identified in nursing literature as a major dilemma affecting nurses in all healthcare systems. It is viewed as an important factor threatening the integrity of nurses and ultimately the quality of patient care. The present study attempted to determine levels of moral distress among the nursing staff employed in hospitals across the city of Malayer. This was a descriptive and cross-sectional study conducted on 195 nurses of Malayer hospitals during 2015. Data were collected using a demographic questionnaire and the standard moral distress scale (MDS). Data analysis was performed by descriptive and analytical statistics using SPSS software version 18.

In this study, 88 nurses (45.1%) were found to be suffering from severe moral distress. The most important factors causing moral distress pertained to substandard care and treatment due to a shortage of health professionals and care providers (6.6±0.21), physician orders for unnecessary tests, treatments and care (6±0.12), and measures taken by staff who lacked clinical competency (5.9±0.22). Among the nurses’ demographic data, gender (P=0.001), job experience (P=0.001) and nursing ward (P=0.01) were significantly related to the level of moral distress experienced by the nursing staff. The results imply that in nursing, moral distress is a highly important and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.