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Submitted: 24 July 2018 Modified: 25 July 2018
HERDIN Record #: R04A-UPHBL-18072411151781

PERCEIVED ETHICAL PROBLEMS AND MORAL DISTRESS AMONG INTENSIVE CARE UNIT NURSES IN TERTIARY HOSPITALS OF LAGUNA.

Lyka Camille B. Batilo,
Merry Anne Joy Y. Dionesio,
Ma. Krizia Jay F. Flores,
Bill Jason N. Francisco,
Ruby N. Purisima,
John Savio S. Romano

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      The study focuses on the ethical and moral distress encountered by the Intensive Care Unit nurses in 4 tertiary hospitals in Laguna. Ethics in nursing is very important for nurses. This is the basis on how a nurse should act whether it is  good or bad, and how they are able to treat their patient morally good or bad.


     The evaluation of nurses encountered in the ICU which includes their charge nurses and chief nurse in order to assess the nurses' abilities to face and do their responsibilities for their patient to give care.


       The researchers conducted this study to evaluate nurses of what they encountered in the Intensive Care Unit in Tertiary Hospital in Laguna. The study sought to answer the following questions: What is the profile of the respondent's in terms of age, gender, length of service and their response.


     What are the 3 ethical problems encountered in terms of (autonomy), justices, beneficence, and non-maleficence). What are the moral distress encountered in terms of (conflict with self, Physician/Nurses, work environment and, organizations) is there any difference between the demographic profile and ethical problems when grouped accordingly. Is there any significance difference between the demographic profile and moral distress when grouped accordingly.


      This study used the descriptive research to evaluate the perceived ethical problems and moral distress among Intensive Care Unit Nurses in tertiary hospitals in Laguna.


     The data needed in the study were gathered through a survey type questionnaire. The study was conducted by handling out questionnaire to the staff nurses, charge nurses and head nurses in the 4 chosen tertiary hospitals in Laguna. The aggregations of the elements from which the sample is selected composed of 1 staff nurses, 3 charge nurses and 1 head nurse (18 female and17 male) residing a different tertiary hospitals in Laguna. The statistical treatments used in the study were frequency and percentage distribution, weighted mean and t-test.


     The summary of findings of ethical problem and moral distress in terms of age, gender, lenght of service and their position is that the majority of the respondents are 26 years of age above, female, have less than 3 years of experiences in the hsopital and staff nurses have great majority over the charge and head nurse.


     The ethical problem was encountered in ICU in terms of autonomy with an average weighted mean of 1.6; in terms of justice was rarely with an average of 1.46; in terms of maleficence and non-maleficence was never, this means that there is no ethical problem that has encountered, with an average of 1.14, 1.09 1.11 and 1.17


     The moral distress that was encountered in the ICU in terms of conflict with self in emotional exhaustion was rarely with average weighted mean of 2.14; In terms of conflict with physicians/nurses is hierarchal within healthcare system was rarely with an average weighted mean of 1.83; in terms of conflict with environment was never this means that there is no moral distress encountered in terms of conflict with organization is adequate staffing of staff who are not adequately trained to provide the required care was often with an average of weighted mean of 2.29.


     The t-test computed were all lower than the t-table at 10.05 level of significance =2.05 therefore there is a significance difference in ethical problems in terms of autonomy between male and female and the rest is not significant when grouped according gender and the t-test computed were all lower than t-table which means that there is no significant difference in ethical problems of the respondents when grouped according to length of service. Since the t-test values (t=2.22) whithin the rejection region, then the Ho can be ejected at 5% significance level. Therefore there is a significant difference in ethical problems in terms of beneficence between staff nurses and Charge/Head Nurses and the rest is not significant when grouped according to position.


     Since the test value (t=2.24) within the rejection region, then the Ho can be rejected at 5% significance level. Therefore there is a significant difference in Moral Distress of the respondents in terms of Conflict with Self between Young (25 below) and Old (26 above) and the rest is not significant when grouped according to Age. The t-test computed were all lower that the t-table which means that there is no significance in Moral Distress of the respondents when grouped according to Gender.


      The t-test computed were all lower than the t-table which means that there is no significant difference in Moral Distress of the respondents when grouped according to Length of Service. Since the t-test value (t=4.95, 4.14) within the rejection region then the Ho can be ejected at 5% significance level, therefore there is significancant difference in Moral Distress in terms of Conflict with Physician/Nurse and Conflict with Organization between Staff Nurses and Charge/Head Nurses and the rest is not significant when grouped according to position. The researchers constructed conclusions based on the findings of the study. Based on our data gathered the Ethical Problems that were encountered by the respondents in terms of Autonomy is Nursing care given against patient wishes, while in justice the problem is Restriction of patients freedom, in Beneficence and Non-Beneficence there were no problems that were encountered.


     Based on our data gathered the Moral Distress that were encountered by the respondents in terms of Conflict with Self is Emotional Exhaustion, while in Conflict with Physician/Nurse the distress encountered is Hierarchies within the healthcare system, in Conflict with Work Environment there were no distresses encountered, lastly in Conflict with Organization the distress encountered is Inadequate staffing of staff who are not adeqautely trained to provide the required care.


     The researchers recommend that Nursing Directors Office in collaboration with the head nurses and charge nurses should initiate programs and activities to obsolete the ethical and moral characteristics of Intensive Care Unit staff nurses in terms of rendering care to patient, Conduct discussions, lectures and seminars about ethical problems and moral distress, through quality care improvement and research for Intensive Care Unit Staff Nurses and lower level managers in different tertiary hospitals in Region IV-A and lastly the Factors that affect the ethical and moral trits level of Intensive Care Unit Staff nurses and Head Nurses/Charge nurses can be looked into future studies.

Publication Type
Thesis/Dissertations
Thesis Degree
BS
Specialization
Nursing
Publication Date
May 2017
LocationLocation CodeAvailable FormatAvailability
UPH-Dr. Jose G. Tamayo Medical University/Medical Center N1120 Abstract Print Format