ABSTRACT
OBJECTIVES: To assess moral distress intensity and frequency in adult/paediatric nurses in critical care and non-critical care units; and explore relationships of nurse characteristics and moral distress with intention to leave. METHODS/SETTING: A descriptive, correlational design was used to administer an online survey using the Moral Distress Scale to nurses across multiple settings. MAIN OUTCOME MEASURES: Intensity and frequency of moral distress and intention to leave current position. RESULTS: The survey response rate was 43% (n=426/1000). Critical care nurses had the highest levels of moral distress intensity and frequency, compared to non-critical care specialties (M=2.5±0.19, p=0.005 for intensity and M=1.6±0.11, p<0.001 for frequency). Moral distress frequency showed a positive relationship with intention to leave a position of employment. Each unit increase in moral distress frequency doubled the odds of intention to leave when adjusting for age, gender, ethnicity and specialty area (p=0.003). Hispanic nurses had significantly higher levels of moral distress intensity (p=0.01). CONCLUSION: Moral distress is a complex phenomenon requiring further study, particularly with regard to the role of ethnic and cultural differences on perceptions of moral distress.
