Moral distress in nursing students: Cultural adaptation and validation study.

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 exams necessary to progress to the next level). RESEARCH DESIGN: The study used a cross-sectional research design. PARTICIPANTS AND RESEARCH CONTEXT: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy. ETHICAL CONSIDERATIONS: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent. RESULTS: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753-0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate. DISCUSSION: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students. CONCLUSION: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

Uso de contraceptivos por puérperas adolescentes / Use of birth control by teenage who have just given birth

Objetivo: Averiguar a utilização dos métodos contraceptivos pelas puérperas adolescentes a fim de relacionar o seu (des)uso com a gravidez na adolescência. Método: Estudo transversal, descritivo, realizado por meio de instrumento estruturado com 181 puérperas adolescentes que tiveram seus partos no hospital participante da pesquisa. Os dados foram coletados no período de dezembro de 2008 a dezembro de 2009. Resultados: 64,1% das puérperas faziam uso de algum método contraceptivo antes de ficarem grávidas e os métodos mais utilizados foram anticoncepcional oral 51% e o preservativo masculino 29%. Para 75% das adolescentes a gravidez foi planejada e justificada pelo desejo e a vontade própria de vivenciar a maternidade. Conclusão: Considerando que quase metade das adolescentes entrevistadas desejavam a gestação, aponta-se que pesquisar e discutir apenas o uso ou não dos métodos contraceptivos não é adequado. É necessário aprofundar as investigações acerca dos significados de ser mãe na adolescência.

Objective: To investigate about the use of birth control by teenagers who have just given birth, to relate their lack of use with teenage pregnancy. Method: Transversal descriptive research, made by a structured instrument with 181 teenagers who had just given birth in the hospital that participated in the investigation. The data was collected since December 2008 to December 2009 period. Results: 64,1% of the teenagers who had just given birth used some contraceptive method prior to their pregnancy; the most used methods were oral birth control pills (51%) and male preservative (29%). For the 75% of the teenagers their pregnancy was planned and justified by the desire and will of experimenting motherhood. Conclusion: Considering that almost half of the interviewed teenagers wanted to get pregnant, it is deduced that investigation of only the use of contraceptives it is not appropriate. It is necessary to make deeper investigations about the meaning of being a mother during adolescence.

Objetivo: Indagar el uso de métodos contraceptivos por las puérperas adolescentes a fin de relacionar su (des)uso con el embarazo en la adolescencia. Método: Estudio transversal, descriptivo, realizado por medio de un instrumento estructurado con 181 puérperas adolescentes que tuvieron sus partos en el hospital participante de la investigación. Los datos fueron recolectados en el período de diciembre de 2008 a diciembre de 2009. Resultados: El 64,1% de las puérperas usaba algún método contraceptivo antes del embarazo; los métodos más utilizados fueron el anticoncepcional oral (51%) y el preservativo masculino (29%). Para el 75% de las adolescentes el embarazo fue planeado y justificado por el deseo y la voluntad propia de experimentar la maternidad. Conclusión: Considerando que casi la mitad de las adolescentes entrevistadas deseaba el embarazo, se deduce que investigar y discutir apenas el uso o no de los métodos contraceptivos no es adecuado. Es necesario profundizar las investigaciones acerca de los significados de ser madre en la adolescencia.