The effect of a work-place based education program on moral distress
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Nancy Miller Powell, PhD, MSN, CNM, RNC-OB, NPD-BC
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- Theta Sigma
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Abstract
The primary purpose of this study was to determine if registered nurses (RNs) who attended a workplace-based educational program would have decreased intensity, frequency, and total moral distress, compared to nurses who did not attend the program. This educational program was operationalized using a framework published by the American Association of Critical Care Nurses' program entitled The 4A's to Rise Above Moral Distress (2005).
Moral distress is an insidious problem affecting many registered nurses, directly and or indirectly, with potentially harmful consequences. A review of the literature revealed that the consequences of moral distress produce a significant negative effect on the physical, behavioral, spiritual, and psychological well-being of morally distressed nurses, their peers, patient care, the work environment, and the overall efficiency of healthcare institutions.
A quasi-experimental pretest-posttest control group design was selected for this study. Using The 4A's to Rise Above Moral Distress (2005) as the intervention, Bandura's social cognitive theory and Corley's theory of nurse moral distress served as the theoretical framework for this study. The 38 item, 7-point Likert scale, Moral Distress Scale was used to measure the subscales of intensity and frequency, as well as total moral distress.
Four mid-sized, New Jersey community hospitals were randomly assigned to either the treatment or the control group. Both the treatment and control groups completed the Moral Distress Scale as a pretest. The treatment group received the education intervention, and both the treatment and control groups completed the Moral Distress Scale as a posttest. A demographic data sheet, developed by the researcher, was used to collect descriptive data about the subjects.
No statistical significance was found on independent t-tests comparing the treatment and control groups' change scores for intensity, frequency, or total moral distress. However, when an analysis of covariance (ANCOVA) approach to data analysis was used to compare the treatment and control groups on change scores, using the pretest scores as the covariate, there was a statistically significant difference for the experimental group on intensity, frequency, and total moral distress. The independent t-test also revealed that nurses employed in Magnet designated hospitals reported decreased posttest total moral distress scores and decreased posttest frequency moral distress scores, compared to the non-Magnet designated hospitals.
Correlation statistics were used to analyze the demographic data as it related to the Moral Distress Scale scores. Negative correlations were observed with age, and the more years as an RN, correlated with lower frequency of moral distress.
Nursing care should be valued and respected. This study may benefit nurses to identify strategies in order to effectively prevent or minimize the experience of moral distress. The findings generated from this study may lead to further discussion among nurses and nurse leaders to further explore strategies to enhance the professional image of nurses among other members of the health care team.
Description
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3533656; ProQuest document ID: 1221319518. The author still retains copyright.
Repository Posting Date
2020-04-08T14:52:18Z
Notes
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type Information
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Category Information
Evidence Level | Quasi-Experimental Study, Other |
Research Approach | Quantitative Research |
Keywords | Moral Distress; Nurse Education; Improving Outcomes |
CINAHL Subject(s) | Registered Nurses; Stress, Psychological; Morals; Nursing Staff, Hospital; Registered Nurses--Education; Stress, Psychological--Prevention and Control; Registered Nurses--Psychosocial Factors |
Degree Information
Grantor | Widener University |
Advisor | Baumberger-Henry, Mary |
Level | PhD |
Year | 2012 |
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