Assessment of moral distress and its institutional factors among nurses working in selected departments at University Teaching Hospital of Kigali, Rwanda

Abstract

Background: Moral distress has been evidenced as an element that compromised the ability of nurses to deliver the optimum patient care and may lead to job turnover. However, little is known about the moral distress among nurses and its association factors in Rwanda

Aim: The present research aims to assess the level of moral distress and its institutional factors among nurses working in selected departments at CHUK, Rwanda.

Methods: A cross sectional quantitative questionnaire survey of 167 registered nurses was conducted to evaluate the level of moral distress and its institutional factors. A revised version of the Moral distress scale (MDS-R) was used. A proportional randomly sampling strategy was used in this research. The data were analyzed using SPSS version 21.

Results: The majority of participants in this research were female married with bachelor degree. The level of moral distress of the participants in this research was moderate. The maximum moral distress score was 303 and minimum was 73, the standard deviation of moral distress score was 43.12 and the moral distress score mean was 152. The data analysis of this research on the relationship of factors and moral distress level by calculating p- value for each demographic variables and institutional factors showed that the only shortage of nursing staff with p value of 0.022 and lack of institutional support with p value of 0.029 were linked with the highest moral distress. No significance of demographic characteristics on level of moral distress.

Conclusion and recommendation: The present study indicates that nurses experienced an overall moderate level of moral distress. The shortage of nursing staff and lack of institutional support were most frequently causing higher level moral distress. This research will inform policy makers in the development of strategies that can reduce moral distress and fostering nurses’ satisfaction and subsequently, patient care.