Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy.

To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P < 0.001); and (2) intention to resign (r = 0.244, P < 0.0001). The frequency of occurrence of moral distress was associated with the intention of nurses to resign (r = -0. 209, P < 0.0001). Moral distress seems to be associated with the intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress. Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession.

Karanikola MN ，Albarran JW ，Drigo E ，Giannakopoulou M ，Kalafati M ，Mpouzika M ，Tsiaousis GZ ，Papathanassoglou ED ... -  《-》

Professional autonomy, collaboration with physicians, and moral distress among European intensive care nurses.

Papathanassoglou ED ，Karanikola MN ，Kalafati M ，Giannakopoulou M ，Lemonidou C ，Albarran JW ... -  《-》

Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.

Mason VM ，Leslie G ，Clark K ，Lyons P ，Walke E ，Butler C ，Griffin M ... -  《-》

Nurse-physician collaboration and associations with perceived autonomy in Cypriot critical care nurses.

Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses' autonomy and pertinent nurses' characteristics in adult intensive care units (ICUs) in Cyprus. Descriptive correlational study with sampling of the entire adult ICU nurses' population in Cyprus (five ICUs in four public hospitals, n = 163, response rate 88·58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. The average CSACD score was 36·36 ± 13·30 (range: 7-70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores (t = 2·056, p = 0·04). CSACD correlated positively with years of ICU nursing experience (r = 0·332, p < 0·0001) and professional satisfaction (r = 0·455, p < 0·0001). The mean autonomy score was 76·15 ± 16·84 (range: 18-108). Higher degree of perceived collaboration (CSACD scores) associated with higher autonomy scores (r = 0·508, p <0·0001). Our findings imply low levels of nurse-physician collaboration and satisfaction with care decisions and moderate levels of autonomy in ICU nurses in Cyprus. The results provide insight into the association between nurse-physician collaboration and nurses' autonomy and the correlating factors.

Georgiou E ，Papathanassoglou E ，Pavlakis A 《-》

Job stress and its relationship with nurses' autonomy and nurse-physician collaboration in intensive care unit.

To determine nurses' job stress and its relationship with professional autonomy and nurse-physician collaboration in intensive care unit (ICU). Low professional autonomy, high job stress and lack of nurse-physician collaboration can affect nursing care in ICU and the main reasons ICU nurses leave the occupation or transfer to other clinical units. A cross-sectional, correlational study was conducted on 398 nurses in teaching hospitals in Urmia, Iran, in 2020. Data were collected using the Dempster Practice Behaviors Scale, the Health and Safety Executive tool and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration. The mean job stress (115.53 ± 12.42) and professional autonomy (102.19 ± 11.88) of ICU nurses were 'moderate', and nurse-physician collaboration (74.25 ± 5.10) was 'good'. There was a positive relationship between professional autonomy and job stress (r = .506) and nurse-physician collaboration (r = .242). Professional autonomy was a predictor of job stress in nurses (p < .000), and work experience in ICU can cause job stress in nurses (p = .024). Increasing nurses' professional autonomy causes an increase in job stress and improves nurse-physician collaboration in ICU. Nursing managers should implement practical strategies to improve nurses' autonomy, enhance nurse-physician collaboration and decrease their job stress.

Parizad N ，Lopez V ，Jasemi M ，Gharaaghaji Asl R ，Taylor A ，Taghinejad R ... -  《-》