title: Moral distress and intention to leave: A comparison of adult and paediatric nurses by hospital setting.
abstract: OBJECTIVE
  To assess moral distress intensity and frequency in adult/paediatric nurses in critical care and non-critical care units; and explore relationships of nurse characteristics and moral distress with intention to leave.
  
  
  METHODS
  A descriptive, correlational design was used to administer an online survey using the Moral Distress Scale to nurses across multiple settings.
  
  
  METHODS
  Intensity and frequency of moral distress and intention to leave current position.
  
  
  RESULTS
  The survey response rate was 43% (n=426/1000). Critical care nurses had the highest levels of moral distress intensity and frequency, compared to non-critical care specialties (M=2.5±0.19, p=0.005 for intensity and M=1.6±0.11, p<0.001 for frequency). Moral distress frequency showed a positive relationship with intention to leave a position of employment. Each unit increase in moral distress frequency doubled the odds of intention to leave when adjusting for age, gender, ethnicity and specialty area (p=0.003). Hispanic nurses had significantly higher levels of moral distress intensity (p=0.01).
  
  
  CONCLUSIONS
  Moral distress is a complex phenomenon requiring further study, particularly with regard to the role of ethnic and cultural differences on perceptions of moral distress.
authors.affiliation: School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, United States. Electronic address: melissa.dyo@csulb.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Dyo
authors.affiliation: Long Beach Memorial, 2801 Atlantic Avenue, Long Beach, CA 90806, United States.
authors.forename: Peggy
authors.initials: P
authors.lastname: Kalowes
authors.affiliation: Long Beach Memorial, 2801 Atlantic Avenue, Long Beach, CA 90806, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Devries
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D033182:Intention; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009014:Morals; D000072222:Nurses, Pediatric / Q000523:psychology*; D009740:Nursing Staff / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires
keywords: Critical care; Cultural differences; Moral distress; Nursing