title: Moral distress in physicians practicing in hospitals affiliated to medical sciences universities.
abstract: BACKGROUND
  Researchers have regarded moral distress as a major concern in the health care system. Symptoms associated with moral distress may manifest as frustration, dissatisfaction, and anxiety and may lead to burnout, job leaving, and finally, failure to provide safe and competent care to patients. Proper management of this phenomenon can be fulfilled through study of its causes at different levels of health services and taking necessary measures to solve them.
  
  
  OBJECTIVE
  This study aimed to determine the status of moral distress in physicians practicing in hospitals affiliated to Medical Sciences Universities in Tehran.
  
  
  METHODS
  This cross-sectional study was carried out using the Standard Hamric Scale to collect data after modification and evaluation of its reliability and validity. A total of 399 physicians responded to the scale. Data analysis was performed using descriptive and correlation statistics with respect to the variables.
  
  
  RESULTS
  Results showed that the frequency of moral distress of physicians was 1.24 ± 0.63 and the intensity of moral distress and composite score of moral distress were 2.14 ± 0.80 and 2.94 ± 2.38, respectively. A significant negative correlation existed between age and frequency and composite score (r = -0.15, P < 0.01 and r = -0.16, P < 0.01, respectively) as well as years of experience and composite score (r = -0.11, P = 0.04). Moral distress composite score in adults specialists was higher than pediatricians (P = 0.002), but lower in physicians participated in medical ethics training courses compared to those not participated.
  
  
  CONCLUSIONS
  Physicians may encounter moral distress during their practice; therefore, the common causes of distress should be identified in order to prevent its occurrence.
authors.affiliation: Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abbasi
authors.affiliation: Department of Medical Ethics, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Nejadsarvari
authors.affiliation: Nursing Ethics Department, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehrzad
authors.initials: M
authors.lastname: Kiani
authors.affiliation: Nursing Ethics Department, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Borhani
authors.affiliation: Department of Medical Ethics, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Bazmi
authors.affiliation: Faculty of Theology, Tehran University, Tehran, IR Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Nazari Tavaokkoli
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Rasouli
keywords: Hospitals; Medical Ethics; Physicians