Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well (...) as Google Scholar search engine using keywords such as moral distress, intensive care unit, ICU, nurses, and critical care nurses from 1984, when the concept of MD was first introduced in the nursing literature, up to 29 October 2020. Studies focusing on the interventions for managing MD in critical care nurse were evaluated. The quality of eligible papers was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 8 studies fulfilled the eligibility criteria. Three studies had RCT design and five studies had quasi-experimental design. All studies were conducted in the United States or Iran. Educational workshop, moral empowerment program, social work intervention, nursing ethics huddles, and multifaceted resiliency bundle intervention were effective interventions for managing of MD among critical care nurses. There is limited but promising research evidence evaluating the efficacy of educational interventions for managing of MD among critical care nurses. Although some positive results have been reported, there is limited generalizable evidence due to the variability of interventions. These findings highlight the need for further studies to validate the efficacy of these interventions or develop more potent and efficient interventions for reducing MD in critical care nurses. (shrink)

Background Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses. Objective This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Materials and Methods A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital (...) of Kashan, Iran. Data collection instruments included a personal characteristics questionnaire, the Nursing Ethics Questionnaire, and the National Aeronautics and Space Administration Task Load Index. The Chi-square, the Spearman correlation coefficient, the Kruskal–Wallis, and Mann–Whitney U tests were used to analyze the data. Results A majority of nurses were females, married, and permanently employed. The mean of the overall perceived workload and adherence to professional codes of ethics were 76.36 ± 13.64 and 13.98 ± 2.58, that were at high and moderated level, respectively. Spearman correlation test showed no significant correlation between perceived workload and adherence to professional codes of ethics. A significant difference was found between the mean scores of adherence to professional codes of ethics in nurses working in different departments. Conclusion Participating nurses perceived high levels of workload but their mean adherence to professional codes of ethics was at a moderate level. The perceived workload was indirectly correlated with adherence to professional codes of ethics. (shrink)

Background:The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings.Objectives:This study aimed to evaluate Iranian nurses’ perceived professional competence in spiritual care, the relationship between perceived competence and nurses’ personal characteristics, and barriers to provide spiritual care.Research design:A cross-sectional study was conducted in the year 2014.Participants and research context:The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random (...) method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses’ competencies in spiritual care.Ethical considerations:A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent.Results:Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses’ overall score of competence in spiritual care and receiving training on spiritual care, nurses’ position, and the ward they worked in.Discussion:Confirming the findings of the international literature, this study puts light on the situation of nurses’ perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context.Conclusion:Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care. (shrink)