The moral distress and resilience among emergency nurses in Arar city: Saudi Arabia.

Understanding moral distress and resilience is crucial for supporting the well-being of emergency nursing staff and improving patient care. However, there is limited research specifically examining moral distress and resilience among emergency nursing staff in ARAR city hospitals. This study aims to examine moral distress and resilience levels among emergency nursing staff in ARAR city hospitals. Specifically, the study seeks to determine the correlation between moral distress and resilience among emergency nursing staff and examine differences in the levels of moral distress and resilience among different demographic and occupational characteristics. A cross-sectional study design was employed, involving a non-probability stratified sample of emergency nursing staff from two hospitals in ARAR city. The participants completed a Brazilian Moral Distress Scale in Nurses (MDSN-BR) and Rushton Moral Resilience Scale in Nurses (RMRS). Statistical analyses, including descriptive statistics and one-way- ANOVA, were conducted to analyze the data. The study found that emergency nursing had a moderate level of moral distress, with a mean frequency of 2.70 (SD = 1.02) and a mean intensity of 2.79 (SD = 1.04). The overall self-reported moral resilience was also moderate, with a mean score of 2.48 (SD = 0.77). Significant positive correlations were observed between resilience and both moral distress frequency (r = 0.48, p = 0.001) and intensity (r = 0.48, p = 0.001). Educational levels and nursing positions were associated with variations in moral distress and resilience. Postgraduate diploma emergency nursing reported the highest levels of moral distress frequency (3.12, SD = 1.14) and intensity (3.21, SD = 1.16). A bachelor's degree in nursing exhibited higher levels of personal integrity (3.06, SD = 0.87), while a master's degree in nursing showed higher levels of moral efficacy (2.88, SD = 1.09). Head nurses experienced higher levels of moral distress compared to other positions (3.08, SD = 1.37 for frequency; 3.18, SD = 1.29 for intensity). The study revealed that emergency nursing experienced relatively moderate levels of moral distress, which could be attributed to insufficient multidisciplinary teams and unprepared actions. The findings also highlighted moderate levels of moral resilience, particularly in relational integrity. Educational levels and nursing positions were found to influence moral distress and resilience. These results underscore the need for targeted interventions to support the well-being of emergency nurses and enhance ethical decision-making.

Jazzaa Alruwaili A ，Jamil Alkuwaisi M ，Jazzaa Alruwaili E 《-》

The Effects of Moral Distress on Resilience in Pediatric Emergency Department Nurses.

Moral distress is widespread in health care, and nurses working in high-pressure environments, such as emergency departments, experience stress at high rates. Understanding how moral distress affects pediatric emergency nursing care is essential to moderate its negative impacts. Increased resilience has been promoted as a tool to mitigate moral distress. The purpose of this study, conducted prior to the pandemic, was to examine patterns of moral distress and the impact of moral distress on resilience among pediatric emergency nurses. A cross-sectional exploratory study of pediatric emergency nurses was performed. Moral Distress Scale-Revised (Pediatric) and Connor-Davidson Resilience Scale 25© scores were collected and calculated. Exploratory factor analysis with principal components was used to identify patterns of moral distress that impact resilience. Four distinct patterns of moral distress that impact resilience were identified: (1) incompetent practice, (2) incongruent truth-telling, (3) potentially inappropriate care, and (4) discordant health care teams. Our study was the first to identify 4 patterns of moral distress in pediatric emergency nurses. As a result, actions to promote resilience include: (1) supporting competent practice, (2) upholding appropriate truth-telling, (3) recognizing and addressing potentially inappropriate care, and (4) building concordant health care teams and systems. This pre-pandemic data provides a foundational understanding of the relationship between moral distress and resilience in pediatric emergency nurses. Identifying factors of moral distress that impact resilience has significant implications for pediatric emergency nursing, including the development of future initiatives, education, and research.

Sexton JR ，Truog AW ，Kelly-Weeder S ，Loftin C ... -  《-》

Moral distress in Iranian pediatric nurses.

Ghasemi E ，Negarandeh R ，Janani L 《-》

Latent profiles of nurses' moral resilience and compassion fatigue.

Chen X ，Zhang Y ，Zheng R ，Hong W ，Zhang J ... -  《-》

Examining the effect of moral resilience on moral distress.

Kovanci MS ，Atli Özbaş A 《-》