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      The Relationship Between Moral Sensitivity, Missed Nursing Care and Moral Distress Among New Nurses: A Cross‐Sectional Study

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          ABSTRACT

          Moral sensitivity, missed nursing care and moral distress among healthcare professionals have received considerable attention in recent years. These factors represent important healthcare challenges for new nurses (graduation to 2 years of work experience). However, studies on the relationships among these variables in the context of new nurses in China remain lacking.

          Aims

          To explore the relationships among moral sensitivity, missed nursing care and moral distress in the context of new nurses in China.

          Research Design

          A cross‐sectional descriptive survey was conducted.

          Participants and Research Context

          A total of 228 new nurses were recruited from three tertiary hospitals in Qingdao, Shandong Province, China. Participants provided their sociodemographic and professional information and completed the Chinese Moral Sensitivity Questionnaire‐Revised Version, the Chinese Missed Nursing Care Survey Version and the Chinese Moral Distress Scale‐Revised Version. The data were analysed using Spearman's correlation analysis and multiple linear regression analysis.

          Results

          The means and standard errors of moral sensitivity, missed nursing care and moral distress were 40.71 (0.39), 9.82 (0.78) and 34.87 (2.41), respectively. The variable of missed nursing care exhibited a significant negative relationship with moral sensitivity and a significant positive relationship with moral distress. Regression analysis revealed that the main factors influencing new nurses' moral distress were educational background, nature of job, current unit, frequency of night shifts and the dimensions of moral strength and responsibility. These factors can explain 14.9% of the total variation.

          Conclusion

          The findings revealed that higher rates of missed nursing care were associated with lower moral sensitivity and greater moral distress among new nurses. Therefore, developing interventions to reduce missed nursing care may be a promising strategy for improving moral sensitivity and preventing moral distress among new nurses.

          Implications for the Profession and/or Patient Care

          In hospitals, moral distress can be improved by focusing on modifiable factors such as staffing resources, leading to better promoting new nurses' health and improving the quality of care. This study can highlight practices accounting for moral sensitivity and missed nursing care in nursing research and training programmes.

          Reporting Method

          Strengthening the reporting of observational studies in epidemiology (STROBE) statement.

          Patient or Public Contribution

          No patient or public contribution.

          Related collections

          Most cited references79

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          Transition shock: the initial stage of role adaptation for newly graduated registered nurses.

          The aim of this paper is to provide a theoretical framework of the initial role transition for newly graduated nurses to assist managers, educators and seasoned practitioners to support and facilitate this professional adjustment appropriately. The theory of Transition Shock presented here builds on Kramer's work by outlining how the contemporary new graduate engaging in a professional practice role for the first time is confronted with a broad range and scope of physical, intellectual, emotional, developmental and sociocultural changes that are expressions of, and mitigating factors within the experience of transition. This paper offers cumulative knowledge gained from a programme of research spanning the last 10 years and four qualitative studies on new graduate transition. New nurses often identify their initial professional adjustment in terms of the feelings of anxiety, insecurity, inadequacy and instability it produces. The Transition Shock theory offered focuses on the aspects of the new graduate's roles, responsibilities, relationship and knowledge that both mediate the intensity and duration of the transition experience and qualify the early stage of professional role transition for the new nursing graduate. Transition shock reinforces the need for preparatory theory about role transition for senior nursing students and the critical importance of bridging undergraduate educational curricula with escalating workplace expectations. The goal of such knowledge is the successful integration of new nursing professionals into the stressful and highly dynamic context of professional practice.
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            Moral distress among healthcare professionals: report of an institution-wide survey.

            Moral distress is a phenomenon affecting many professionals across healthcare settings. Few studies have used a standard measure of moral distress to assess and compare differences among professions and settings.
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              Unfinished nursing care, missed care, and implicitly rationed care: State of the science review.

              The purposes of this review of unfinished care were to: (1) compare conceptual definitions and frameworks associated with unfinished care and related synonyms (i.e. missed care, implicitly rationed care; and care left undone); (2) compare and contrast approaches to instrumentation; (3) describe prevalence and patterns; (4) identify antecedents and outcomes; and (5) describe mitigating interventions.
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                Author and article information

                Contributors
                Journal
                Journal of Clinical Nursing
                Journal of Clinical Nursing
                Wiley
                0962-1067
                1365-2702
                August 29 2024
                Affiliations
                [1 ] School of Nursing Qingdao University Qingdao China
                [2 ] Qilu Hospital, Shandong University (Qingdao) Qingdao China
                [3 ] School of Nursing and Rehabilitation Shandong University Jinan China
                Article
                10.1111/jocn.17420
                bea6ca89-c3f2-4b10-b547-17462a047493
                © 2024

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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