Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study

Kleinknecht-Dolf, Michael; Frei, Irena Anna; Spichiger, Elisabeth; Müller, Marianne; Martin, Jacqueline S.; Spirig, Rebecca

doi:10.1177/0969733014534875

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study
Authors:	Kleinknecht-Dolf, Michael Frei, Irena Anna Spichiger, Elisabeth Müller, Marianne Martin, Jacqueline S. Spirig, Rebecca
DOI:	10.1177/0969733014534875
Published in:	Nursing Ethics
Page(s):	77
Pages to:	90
Issue Date:	2014
Publisher / Ed. Institution:	Sage
ISSN:	0969-7330 1477-0989
Language:	English
Subjects:	Acute care nurses; Instrument development; Moral distress; Cross-sectional studies; Hospital nursing staff; Pilot projects; Reproducibility of results; Psychological stress; Surveys and questionnaires; Switzerland; Attitude of health personnel
Subject (DDC):	610.73: Nursing
Abstract:	Background: In the context of new reimbursement systems like diagnosis-related groups, moral distress is becoming a growing problem for healthcare providers. Moral distress can trigger emotional and physical reactions in nurses and can cause them to withdraw emotionally from patients or can cause them to change their work place. Objective: The aim of this pilot study was to develop an instrument to measure moral distress among acute care nurses in the German-speaking context, to test its applicability, and to obtain initial indications of the instrument’s validity. Method: The study was designed in 2011 as a cross-sectional pilot survey. Conducted on eight units of one university hospital in German-speaking Switzerland, 294 registered nurses were asked to fill out a web-based questionnaire on moral distress. Ethical considerations: The study proposal was approved by the cantonal ethics committee. All participating nurses provided informed consent and were assured of data confidentiality. Results: The survey had a response rate of 55%. The results show the prevalence of statements on the questionnaire indicating situations with the potential to trigger moral distress. The entire range of answers was used in the responses. Most participants found the questionnaire comprehensible, while some criticized the phraseology of certain statements. Many more found the registration process prior to online access to be too time consuming. Nurses confirmed that the results reflect their subjective assessment of their situation and their experience of moral distress. Conclusion: The newly developed moral distress questionnaire appears to produce face validity and is sufficiently applicable for use in our study. The results indicate that moral distress appears to be a relevant phenomenon also in Swiss hospitals and that nurses were experiencing it prior to the introduction of Swiss diagnosis-related groups.
URI:	https://digitalcollection.zhaw.ch/handle/11475/13295
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Engineering
Organisational Unit:	Institute of Data Analysis and Process Design (IDP)
Appears in collections:	Publikationen School of Engineering

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Kleinknecht-Dolf, M., Frei, I. A., Spichiger, E., Müller, M., Martin, J. S., & Spirig, R. (2014). Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study. Nursing Ethics, 77–90. https://doi.org/10.1177/0969733014534875

Kleinknecht-Dolf, M. et al. (2014) ‘Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study’, Nursing Ethics, pp. 77–90. Available at: https://doi.org/10.1177/0969733014534875.

M. Kleinknecht-Dolf, I. A. Frei, E. Spichiger, M. Müller, J. S. Martin, and R. Spirig, “Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study,” Nursing Ethics, pp. 77–90, 2014, doi: 10.1177/0969733014534875.

KLEINKNECHT-DOLF, Michael, Irena Anna FREI, Elisabeth SPICHIGER, Marianne MÜLLER, Jacqueline S. MARTIN und Rebecca SPIRIG, 2014. Moral distress in nurses at an acute care hospital in Switzerland : results of a pilot study. Nursing Ethics. 2014. S. 77–90. DOI 10.1177/0969733014534875

Kleinknecht-Dolf, Michael, Irena Anna Frei, Elisabeth Spichiger, Marianne Müller, Jacqueline S. Martin, and Rebecca Spirig. 2014. “Moral Distress in Nurses at an Acute Care Hospital in Switzerland : Results of a Pilot Study.” Nursing Ethics, 77–90. https://doi.org/10.1177/0969733014534875.

Kleinknecht-Dolf, Michael, et al. “Moral Distress in Nurses at an Acute Care Hospital in Switzerland : Results of a Pilot Study.” Nursing Ethics, 2014, pp. 77–90, https://doi.org/10.1177/0969733014534875.