title: Moral distress in Turkish intensive care nurses.
abstract: BACKGROUND
  Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue.
  
  
  OBJECTIVE
  The study aims to (a) validate the Turkish version of the Moral Distress Scale-Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses' moral distress level.
  
  
  METHODS
  The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale-Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality.
  
  
  RESULTS
  In parallel with the original scale, Turkish version of Moral Distress Scale-Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively.
  
  
  CONCLUSIONS
  Turkish version of Moral Distress Scale-Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care.
authors.forename: Serife
authors.initials: S
authors.lastname: Karagozoglu
authors.affiliation: Cumhuriyet University, Turkey.
authors.forename: Gulay
authors.initials: G
authors.lastname: Yildirim
authors.affiliation: Dokuz Eylül University, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Ozden
authors.affiliation: Cumhuriyet University, Turkey.
authors.forename: Ziynet
authors.initials: Z
authors.lastname: Çınar
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003220:Conflict, Psychological; D064648:Critical Care Nursing / Q000941:ethics*; D003430:Cross-Sectional Studies; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D019555:Physician-Nurse Relations; D011787:Quality of Health Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014177:Translations; D014421:Turkey; D055815:Young Adult
keywords: Intensive care; Moral Distress Scale; intensive care nursing; moral distress; validity and reliability