The Effect of An Intervention Based on the Knowledge-to-Action  Model on Moral Distress in Critical Care Nurses

MohammadMahdi Pazhavand; Maasoumeh  Barkhordari-Sharifabad; Khadijeh Nasiriani

doi:10.18502/ijme.v18i10.19332

MohammadMahdi Pazhavand MSc in Critical Care Nursing, Department of Nursing, School of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran; & PhD Student in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Maasoumeh Barkhordari-Sharifabad Associate Professor, Department of Nursing, School of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran.
Khadijeh Nasiriani Professor, Nursing Department, Research Center for Nursing and Midwifery Care, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/ijme.v18i10.19332

Keywords: Moral distress, Intensive care unit, Nursing ethics, Knowledge-to-action model.

Abstract

Identifying an effective coping strategy for moral distress, as an important and common phenomenon among intensive care unit nurses, seems essential. The knowledge-to-action model aims to identify effective methods for implementing evidence into clinical practice. The present study sought to determine the effect of an intervention based on the knowledge-to-action model on moral distress among nurses working in intensive care units. This was an experimental study, and the statistical population included nurses working in the intensive care units of Namazi Hospital in Shiraz, Iran. A total of 100 eligible nurses were selected through convenience sampling and then randomly assigned to intervention and control groups. For the intervention group, the knowledge-to-action model was implemented. Data were collected using the Hamric Moral Distress Scale before and one month after the intervention. Both groups completed the questionnaire at these time points. Data were analyzed using descriptive and inferential statistics with SPSS version 19. The findings showed that the two groups were similar in terms of demographic characteristics and mean moral distress scores before the intervention. After the intervention, the mean scores of moral distress in the intervention group were significantly reduced in the frequency dimension (2.12±0.34) and severity dimension (2.32±0.46) compared to the control group (frequency: 2.51±0.43; severity: 2.57±0.55) (p<0.001). The results indicated that implementing the knowledge-to-action model reduces moral distress in intensive care unit nurses. Therefore, it is recommended that nursing managers adopt this model to improve the quality of care.