Moral comfort and its influencing factors from intensive care unit nurses’ perspective

Nursing Ethics (forthcoming)
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Abstract

Background Intensive Care Unit (ICU) nurses face ethical challenges during decision-making in terms of the sophisticated nature of in-patients. Moral comfort is known as a phenomenon with a positive effect on moral decision-making and moral actions of nurses. Aim This study investigated ICU nurses’ level of moral comfort and factors affecting it. Research Design This study used a cross-sectional descriptive design. Participants and research context A total of 350 ICU nurses were selected with the convenience sampling method. The data collection tool included the Demographic Characteristics Questionnaire and the Moral Comfort Questionnaire. The data were analyzed with SPSS19 using descriptive and inferential statistics. Ethical Considerations Upon the Committee of Ethics in Human Research’s acceptance of the research concept, approvals were secured, and informed written consent was acquired from all participants. They were assured of the information confidentiality of participation. Findings The mean moral comfort score was 112.75 ± 13.18. The mean score of personal factors related to ethics was higher than the external factors pertaining to the environment/organization. The mean scores of “moral comfort in a specific situation” and “moral comfort in general” were 50.52 ± 5.08 and 62.32 ± 9.31, respectively. The mean moral comfort score of nurses was significantly correlated with age, clinical work experience, ICU work experience, marital status, education, and employment status ( p <.05). Regression analysis revealed that ICU work experience as the strongest predictor variable predicted 17.7% of moral comfort variance. Conclusion Although moral comfort score was at a favorable level, ICU nurses did not feel comfortable when making decisions in moral situations, and nursing managers did not support the decisions of nursing staff. Consequently, this issue warrants the attention of nursing managers and policy-makers. They need to enhance the quality of healthcare by offering more support and addressing the variables influencing the moral comfort of nurses.

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