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  1. The Moral Distress Instrument (MDI): Development, Validation and Associations with Burnout among Finnish Social Workers.Maija Mänttäri-van der Kuip, Denise Michelle Brend & Mari Herttalampi - 2024 - Ethics and Social Welfare 18 (3):264-284.
    Moral distress (MD), the suffering experienced by professionals due to their restricted moral agency, has become a popular subject of study in the fields of social work and health care. Many of the existing measures of MD are targeted at certain professionals, such as health care workers, and are thus restricted to such contexts. This has challenged the conceptual development and empirical examination of MD as a phenomenon occurring across diverse professional groups in different work settings. This study introduces a (...)
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  • Predictors and consequences of moral distress in home-care nursing: A cross-sectional survey.Julia Petersen & Marlen Melzer - 2023 - Nursing Ethics 30 (7-8):1199-1216.
    Background Nurses frequently face situations in their daily practice that are ethically difficult to handle and can lead to moral distress. Objective This study aimed to explore the phenomenon of moral distress and describe its work-related predictors and individual consequences for home-care nurses in Germany. Research design A cross-sectional design was employed. The moral distress scale and the COPSOQ III-questionnaire were used within the framework of an online survey conducted among home-care nurses in Germany. Frequency analyses, multiple linear and logistic (...)
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  • Moral distress in nurses: Resources and constraints, consequences, and interventions.Mohammad Javad Ghazanfari, Amir Emami Zeydi, Reza Panahi, Reza Ghanbari, Fateme Jafaraghaee, Hamed Mortazavi & Samad Karkhah - 2022 - Clinical Ethics 17 (3):265-271.
    Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, (...)
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  • Moral distress interventions: An integrative literature review.Vanessa K. Amos & Elizabeth Epstein - 2022 - Nursing Ethics 29 (3):582-607.
    Moral distress has been well reviewed in the literature with established deleterious side effects for all healthcare professionals, including nurses, physicians, and others. Yet, little is known about the quality and effectiveness of interventions directed to address moral distress. The aim of this integrative review is to analyze published intervention studies to determine their efficacy and applicability across hospital settings. Of the initial 1373 articles discovered in October 2020, 18 were appraised as relevant, with 1 study added by hand search (...)
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  • Moral Distress: What Are We Measuring?Laura Kolbe & Inmaculada de Melo-Martin - 2022 - American Journal of Bioethics 23 (4):46-58.
    While various definitions of moral distress have been proposed, some agreement exists that it results from illegitimate constraints in clinical practice affecting healthcare professionals’ moral agency. If we are to reduce moral distress, instruments measuring it should provide relevant information about such illegitimate constraints. Unfortunately, existing instruments fail to do so. We discuss here several shortcomings of major instruments in use: their inability to determine whether reports of moral distress involve an accurate assessment of the requisite clinical and logistical facts (...)
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  • Psychometric evaluation of the Moral Distress Scale–Revised among Iranian Nurses.Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh & Bianca Panarello - 2019 - Nursing Ethics 26 (4):1226-1242.
    Background: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. Objective: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale–Revised among a sample of Iranian nurses. Research design: In this methodological study, 310 nurses were recruited (...)
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  • Moral Distress and the Nursing Care Quality: A Correlational Study in Teaching Hospitals.Arezo Azarm, Masoumeh Hasanlo, Mitra Hojt Ansari, Fatemeh Mohammadi, Hossein Ebrahimi & Mohammad Asghari Jafarabadi - 2017 - Health, Spirituality and Medical Ethics 4 (3):38-47.
    Background and Objectives: Achieving high quality healthcare services and patients' satisfaction with the healthcare services represents an important issue in healthcare delivery systems. Moral distress is one of the effective factors on this issue. Regarding the significance of the nursing care quality, it is necessary to investigate association between moral distress and the nursing care quality to reduce moral distress. Methods: The participants of this descriptive-correlational study were 545 nurses of the ICUs, CCUs, and psychiatric departments selected by census. Data (...)
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  • Relationships among moral distress, sense of coherence, and job satisfaction.Michiyo Ando & Masashi Kawano - 2018 - Nursing Ethics 25 (5):571-579.
    Background: Since moral distress affects psychological aspects of psychiatric nurses, it is an important theme. Previous studies showed relationships between moral distress and job satisfaction; however, there are few studies which investigate relationships between moral distress and other effective variables and then we highlighted relationships among these variables. Objective: This study aimed to (1) examine relationships among moral distress, sense of coherence, mental health, and job satisfaction and (2) clarify the most predictive variable to job satisfaction. Research design: This study (...)
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  • Psychiatric nurses’ experience of moral distress: Its relationship with empowerment and coping.Michiko Tomura - 2023 - Nursing Ethics 30 (7-8):1095-1113.
    Background Research has shown that moral distress negatively impacts nurses, patients, and organizations; however, several scholars have argued that it can be an opportunity for positive outcomes. Thus, factors that may mitigate moral distress and catalyze positive change need to be explored. Research aim The purpose of this study was to explore the relationships among structural and psychological empowerment, psychiatric staff nurses’ experience of moral distress, and strategies for coping with moral distress. Research design A descriptive cross-sectional correlational study. Participants (...)
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  • Estimation of moral distress among nurses: A systematic review and meta-analysis.Zainab Alimoradi, Elahe Jafari, Chung-Ying Lin, Raheleh Rajabi, Zohreh Hosseini Marznaki, Mostafa Soodmand, Marc N. Potenza & Amir H. Pakpour - 2023 - Nursing Ethics 30 (3):334-357.
    Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. (...)
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  • COVID-19 Pandemic and Moral Distress.Emine Korkmaz & Sevda Korkut - 2021 - Türkiye Biyoetik Dergisi 8 (1):3-10.
    COVID-19, a severe acute respiratory disease caused by a newly discovered corona virus, was declared a global pandemic by the World Health Organization on March 11, 2020. As in disasters, wars and epidemics throughout history, healthcare professionals are at the forefront of providing healthcare services in the fight against the COVID-19 pandemic. This process in which deeply affected both the health system and health professionals, the entire health community has come face to face with moral distress. Moral distress is an (...)
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  • Moral distress among nurses in caring COVID-19 patients.Rosyidah Arafat, Takdir Tahir & Akbar Harisa - 2023 - Clinical Ethics 18 (1):62-66.
    During the COVID-19 pandemic, nurses experienced tremendous dilemmas including the need to perform their duties in caring for patients while they have concerns about contracting the disease. This study described the moral distress of nurses in-charge of handling COVID-19 patients which can be used as baseline data for intervention programs in overcoming moral distress among nurses. This descriptive, cross-sectional study was conducted with nurses in-charge of handling COVID-19 treatment rooms. Before conducting the survey, ethical approval was obtained from the Medical (...)
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  • Moral distress in Turkish intensive care nurses.Serife Karagozoglu, Gulay Yildirim, Dilek Ozden & Ziynet Çınar - 2017 - Nursing Ethics 24 (2):209-224.
    Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...)
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  • Moral distress experienced by nurses.Younjae Oh & Chris Gastmans - 2015 - Nursing Ethics 22 (1):15-31.
    Nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence, nurses report experiencing moral distress. The aim of this review was to synthesize the available quantitative evidence in the literature on moral distress experienced by nurses. We appraised 19 articles published between January 1984 and December 2011. This review revealed that many nurses experience moral distress associated with difficult care situations and feel burnout, which can have an impact on their professional position. Further research is required (...)
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  • Moral distress in correctional nurses: A national survey.Tiziano Lazzari, Stefano Terzoni, Anne Destrebecq, Luca Meani, Loris Bonetti & Paolo Ferrara - 2020 - Nursing Ethics 27 (1):40-52.
    Background: Moral distress is an increasingly documented problem in nursing and might foster nurses’ intention to leave their workplace. It has been studied in different settings, but no specific research has been conducted in Italian correctional facilities. A recent Italian study produced a preliminary validation of the Moral Distress Scale for Correctional Nurses, which needs to be completed. Objectives: To investigate the level of moral distress of nurses working in the Italian correctional setting, by completing the validation process of the (...)
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  • To change or not to change - translating and culturally adapting the paediatric version of the Moral Distress Scale-Revised.Margareta af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén & Pernilla Pergert - 2017 - BMC Medical Ethics 18 (1):14.
    Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were (...)
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  • The Impact of Moral Stress Compared to Other Stressors on Employee Fatigue, Job Satisfaction, and Turnover: An Empirical Investigation. [REVIEW]Kristen Bell DeTienne, Bradley R. Agle, James C. Phillips & Marc-Charles Ingerson - 2012 - Journal of Business Ethics 110 (3):377-391.
    Moral stress is an increasingly significant concept in business ethics and the workplace environment. This study compares the impact of moral stress with other job stressors on three important employee variables—fatigue, job satisfaction, and turnover intentions—by utilizing survey data from 305 customer-contact employees of a financial institution’s call center. Statistical analysis on the interaction of moral stress and the three employee variables was performed while controlling for other types of job stress as well as demographic variables. The results reveal that (...)
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  • The severity of moral distress in nurses: a systematic review and meta-analysis.Masoud Mohammadi, Mohammad-Rafi Bazrafshan, Mohsen Kazeminia, Behnam Khaledi-Paveh, Shamarina Shohaimi & Nader Salari - 2022 - Philosophy, Ethics, and Humanities in Medicine 17 (1):1-14.
    BackgroundMoral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to (...)
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  • A Second-Order Confirmatory Factor Analysis of the Moral Distress Scale-Revised for Nurses.Hamid Sharif Nia, Vida Shafipour, Kelly-Ann Allen, Mohammad Reza Heidari, Jamshid Yazdani-Charati & Armin Zareiyan - 2019 - Nursing Ethics 26 (4):1199-1210.
    Background: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. Objectives: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale–Revised in intensive care and general nurses. Research design: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017. Participants completed the Moral Distress Scale–Revised, (...)
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  • Moral distress among nurses: A mixed-methods study.Chuleeporn Prompahakul, Jessica Keim-Malpass, Virginia LeBaron, Guofen Yan & Elizabeth G. Epstein - 2021 - Nursing Ethics 28 (7-8):1165-1182.
    Background: Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand. Objective: This study aims to describe the experience of moral distress and related factors among Thai nurses. Design: A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of (...)
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  • Relationship between perceived organizational justice and moral distress in intensive care unit nurses.Ghazaleh Haghighinezhad, Foroozan Atashzadeh-Shoorideh, Tahereh Ashktorab, Jamileh Mohtashami & Maasoumeh Barkhordari-Sharifabad - 2019 - Nursing Ethics 26 (2):460-470.
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  • Spiritual well-being and moral distress among Iranian nurses.Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Mohammad Reza Sheikhi, Bianca Panarello & Ma Thin Mar Win - 2019 - Nursing Ethics 26 (4):1101-1113.
    Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to (...)
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  • Nurses’ attitudes toward ethical issues in psychiatric inpatient settings.Nurhan Eren - 2014 - Nursing Ethics 21 (3):359-373.
    Background: Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. Objectives: The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. Research Design: The study design was descriptive and cross-sectional. Research context: Methods comprised of a questionnaire administered to psychiatric nurses (n = 202) from five psychiatric hospitals in Istanbul, Turkey, instruction in (...)
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  • Moral distress in nursing: contributing factors, outcomes and interventions.Adam S. Burston & Anthony G. Tuckett - 2013 - Nursing Ethics 20 (3):312-324.
    Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications (...)
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  • Moral sensitivity and moral distress in Iranian critical care nurses.Fariba Borhani, Abbas Abbaszadeh, Elham Mohamadi, Erfan Ghasemi & Mohammad Javad Hoseinabad-Farahani - 2017 - Nursing Ethics 24 (4):474-482.
    Background: Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. Research objective: The present research was conducted to determine the relationship between moral sensitivity and moral distress (...)
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  • Gender and the experience of moral distress in critical care nurses.Christopher B. O’Connell - 2015 - Nursing Ethics 22 (1):32-42.
    Background: Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether. Research question: Do significant gender (...)
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  • Moral distress among acute mental health nurses: A systematic review.Sara Lamoureux, Amy E. Mitchell & Elizabeth M. Forster - 2024 - Nursing Ethics 31 (7):1178-1195.
    Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and (...)
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  • The Swedish translation and cultural adaptation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP).Margareta Brännström & Catarina Fischer-Grönlund - 2021 - BMC Medical Ethics 22 (1):1-7.
    BackgroundMoral distress has been described as an emotionally draining condition caused by being prevented from providing care according to one’s convictions. Studies have described the impact of moral distress on healthcare professionals, their situations and experiences. The Measure of Moral Distress for Healthcare Professionals (MMD-HP) is a questionnaire that measures moral distress experienced by healthcare professionals at three levels: patient, system and team. The aim of this project was to translate and make a cultural adaption of the MMD -HP to (...)
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  • Impact of moral sensitivity on moral distress among psychiatric nurses.Kayoko Ohnishi, Kazuyo Kitaoka, Jun Nakahara, Maritta Välimäki, Raija Kontio & Minna Anttila - 2019 - Nursing Ethics 26 (5):1473-1483.
    Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: (...)
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  • Removal of babies at birth and the moral distress of midwives.Wendy Marsh, Ann Robinson, Jill Shawe & Ann Gallagher - 2020 - Nursing Ethics 27 (4):1103-1114.
    Background Midwives and nurses appear vulnerable to moral distress when caring for women whose babies are removed at birth. They may experience professional dissatisfaction and their relationships with women, families and colleagues may be compromised. The impact of moral distress may manifest as anger, guilt, frustration, anxiety and a desire to give up their profession. While there has been much attention exploring the concept of moral distress in midwifery, this is the first study to explore its association in this context. (...)
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  • Moral Distress and Austerity: An Avoidable Ethical Challenge in Healthcare.Georgina Morley, Jonathan Ives & Caroline Bradbury-Jones - 2019 - Health Care Analysis 27 (3):185-201.
    Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...)
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  • Impact of ethical climate on moral distress revisited.Gülem Atabay, Burcu Güneri Çangarli & Şebnem Penbek - 2015 - Nursing Ethics 22 (1):103-116.
    Background: Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. Objectives: The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and (...)
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  • Moral distress in paediatric oncology: Contributing factors and group differences.Pernilla Pergert, Cecilia Bartholdson, Klas Blomgren & Margareta af Sandeberg - 2019 - Nursing Ethics 26 (7-8):2351-2363.
    Background: Providing oncological care to children is demanding and ethical issues concerning what is best for the child can contribute to moral distress. Objectives: To explore healthcare professionals’ experiences of situations that generate moral distress in Swedish paediatric oncology. Research design: In this national study, data collection was conducted using the Swedish Moral Distress Scale-Revised. The data analysis included descriptive statistics and non-parametric analysis of differences between groups. Participants and research context: Healthcare professionals at all paediatric oncology centres in Sweden (...)
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  • Identification of risk factors for moral distress in nurses: basis for the development of a new assessment tool.Rafaela Schaefer, Elma Lourdes Campos Pavone Zoboli & Margarida Vieira - 2016 - Nursing Inquiry 23 (4):346-357.
    This article proposes to identify risk factors for moral distress from the literature, validate them through expert analysis and provide the basis for a new tool to assess the risk of moral distress among nurses. Moral distress is related to the psychological, emotional and physiological aspects of nursing. It arises from constraints caused by various circumstances and can lead to significant negative consequences. A scoping review and validation through expert analysis were used. The research question guiding this study was as (...)
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  • Iranian intensive care unit nurses' moral distress: A content analysis.Foroozan Atashzadeh Shorideh, Tahereh Ashktorab & Farideh Yaghmaei - 2012 - Nursing Ethics 19 (4):464-478.
    Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of (...)
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  • Relationship between nurses’ moral sensitivity and the quality of care.Elham Amiri, Hossein Ebrahimi, Maryam Vahidi, Mohamad Asghari Jafarabadi & Hossein Namdar Areshtanab - 2019 - Nursing Ethics 26 (4):1265-1273.
    Background: To provide care with high quality, nurses face a number of moral issues requiring them to have moral abilities in professional performance. Moral sensitivity is the first step in moral performance. However, its relation to the quality of care patients receive is controversial. Research objective: This study aims to determine the relationship between the moral sensitivity of nurses and the quality of care received by patients in the medical wards. Research design: A descriptive correlational study using validated tools, including (...)
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  • Moral distress and burnout in Iranian nurses: The mediating effect of workplace bullying.Fardin Ajoudani, Rahim Baghaei & Mojgan Lotfi - 2019 - Nursing Ethics 26 (6):1834-1847.
    Background: Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse’s burnout. Aim: To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. Ethical considerations: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. Method: This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach (...)
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  • Moral distress experienced by non-Western nurses: An integrative review.Chuleeporn Prompahakul & Elizabeth G. Epstein - 2020 - Nursing Ethics 27 (3):778-795.
    Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced by non-Western nurses. Review method: (...)
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  • Constructing a theoretical model of moral distress.Edison Luiz Devos Barlem & Flávia Regina Souza Ramos - 2015 - Nursing Ethics 22 (5):608-615.
    Moral distress has been characterised as one of the main ethical problems affecting nurses in all health systems, and has been depicted as a threat to nurses’ integrity and to the quality of patient care. In recent years, several studies tried to investigate moral distress, its causes and consequences for health professionals, clients and organisations. However, such studies are considered controversial and vulnerable, mainly because they lack a solid philosophical and empirical basis. The present article aimed at elaborating a theoretical (...)
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  • Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors.Hanna Tuvesson, Mona Eklund & Christine Wann-Hansson - 2012 - Nursing Ethics 19 (2):208-219.
    The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress (...)
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  • Moral distress in nurses at an acute care hospital in Switzerland.Michael Kleinknecht-Dolf, Irena Anna Frei, Elisabeth Spichiger, Marianne Müller, Jacqueline S. Martin & Rebecca Spirig - 2015 - Nursing Ethics 22 (1):77-90.
    Background: In the context of new reimbursement systems like diagnosis-related groups, moral distress is becoming a growing problem for healthcare providers. Moral distress can trigger emotional and physical reactions in nurses and can cause them to withdraw emotionally from patients or can cause them to change their work place. Objective: The aim of this pilot study was to develop an instrument to measure moral distress among acute care nurses in the German-speaking context, to test its applicability, and to obtain initial (...)
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  • The role of online ethics consultation on mental health.Kayoko Ohnishi, Teresa E. Stone, Takashi Yoshiike & Kazuyo Kitaoka - 2020 - Nursing Ethics 27 (5):1261-1269.
    Background Nurses experience moral distress when they cannot do what they believe is right or when they must do what they believe is wrong. Given the limited mechanisms for managing ethical issues for nurses in Japan, an Online Ethics Consultation on mental health (OEC) was established open to anyone seeking anonymous consultation on mental health practice. Research objective To report the establishment of the Online Ethics Consultation and describe and evaluate its effectiveness. Ethical considerations The research was conducted in accordance (...)
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  • Moral distress in nursing students: Cultural adaptation and validation study.Rocco Mazzotta, Maddalena De Maria, Davide Bove, Sondra Badolamenti, Simonì Saraiva Bordignon, Luana Claudia Jacoby Silveira, Ercole Vellone, Rosaria Alvaro & Giampiera Bulfone - 2022 - Nursing Ethics 29 (2):384-401.
    Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students. Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the (...)
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