Moral distress and associated factors among nurses in West Arsi zone public hospitals, south-east Ethiopia, 2023
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Date
2023
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Addis Ababa University
Abstract
Background: Healthcare personnel, particularly nurses, are at a significant risk of developing and
experiencing moral distress globally. African nurses' moral suffering has not been the subject of
many research. Existing publications mostly focused on qualitative studies. Furthermore, data on
the prevalence and associated variables of moral distress among Ethiopian nurses and across all
working units in public hospitals is scarce.
Objective: The aim of this study was to assess the level and associated factors of moral distress
among nurses working in the West Arsi zone, south-east Ethiopia, in 2023.
Methods: An institutional-based cross-sectional study was carried out from February 13 to March
2, 2023. A total of 349 study participants were selected by a simple random sampling method.
Data was collected using a structured self-administered questionnaire, entered into EpiData 3.1,
and exported to SPSS V.26 statistical software for further analysis. Descriptive statistics and
logistic regression analysis were performed. Then, finally, statistical significance was determined
using a p value < 0.05 and 95% CI.
Results: A total of 349 participants were enrolled in this study, with a response rate of 98.5%. The
mean (SD) age of the participants was 39.2 ± 7.0. Among all of the participants, 194 (55.6%) were
female. The majority of the nurses, 293 (84.0%), hold a bachelor's degree in the nursing profession.
The mean year of experience was 7.7 ± 6.9. The proportion of high moral distress among nurses
was 73.1%. Being female nurse [AOR: 0.457, 95% CI (0.283, 0.740)], job dissatisfaction
[AOR=7.67, 95% CI: 3.075, 19.121], and unfavourable working environment [AOR=4.069, 95%
CI: 1.915, 8.648] were significantly associated with high level of moral distress.
Conclusion and recommendation: According to this study, the proportion of nurses experiencing
moral distress was high. Female nurses, job dissatisfaction, and unfavourable working
environment were shows significant association with high level of moral distress. More qualitative
research is needed to identify the fundamental cause of the problem and its relationship to female
nurses, job dissatisfaction, and unfavourable working environment.
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Keywords
Moral distress, ethical conflict, MDS-R, nurse, Ethiopia