The Relationships Among Moral Distress, Self-Transcendence and Professional Autonomy in Nurses Provided Care for Elderly Patients with Cognitive Impairment in Acute Care Hospitals.

Abstract

Purpose: to examine the relationships among moral distress, self-transcendence and professional autonomy in nurses who provided care to elderly patients with cognitive impairment in acute care hospitals based on the self-transcendence theory. Methodology: There research design was descriptive correlational study. The subjects were convenience sample of 188 nurses who had two or more years of clinical experience of caring for elderly patients with cognitive impairment in acute care hospitals. The instruments were Japanese Moral Distress Scale-Revised in Cognitive Impaired Elderly Patients 'Care (13 items composed of three factors, Cronbach's a=.81) and the Scale for Professional Autonomy in Nursing for Cognitive Impaired Elderly Patients (34 items composed of four factors, Cronbach's a=.96). Pearson's and Spearman's correlational analyses were used. This study obtained approval from the ethical review committee for research of Japanese EdCrss College of Nursing. Results: The subjects were 176 women (93.6%) and the means age was 31.3 (SD=6.81) years. The average years of clinical experience was 8.4 (SD=6.19) and 62.8% of them were university graduates. According to the result, the correlation between moral distress and self-transcendence was statistically significant (p=.17, p<.05). It was indicated that the level of oral distress had a small positive relationship with professional autonomy (y=.26,p<001), although moral distress were not related to professional autonomy. Discussion: These findings suggest that nurses with stronger moral distress have a higher level of self-transcendence and nurses with higher level of self-transcendence have a stronger sense of professional autonomy in providing care to elderly patients with cognitive impairment.