The effect of communication skills training on nurses’ moral distress: A randomized controlled trial

Ali Dehghani; Mohammad Sobhanian; Mohsen Faseleh Jahromi

doi:10.29333/ejgm/12313

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Ali Dehghani ¹ ^* , Mohammad Sobhanian ² , Mohsen Faseleh Jahromi ²

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¹ Department of Community Health Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, IRAN² Department of Nursing, School of Nursing and Paramedical, Jahrom University of Medical Sciences, Jahrom, IRAN^* Corresponding Author

Abstract

Background: Moral distress is one of the ethical concepts in healthcare which leads to negative consequences in patients and health care providers. Communication problems could result in moral distress in nurses. This study aimed to examine the effect of communication skills training on nurses’ moral distress.
Methods: This is a randomized-controlled trial study. 53 nurses working in Jahrom University of Medical Sciences in southern Iran were selected randomly. Data were collected using the Hamric moral distress. Data were analyzed using SPSS 21.
Findings: The results of Mann-Whitney test showed significant difference in the moral distress of nurses between the intervention and control groups (p<0.001) one month after the intervention. Wilcoxon test showed that the mean of moral distress in nurses was significantly lower after the intervention (p<0.001).
Conclusion: The findings of this study indicate that program of communication skills training reduced moral distress in nurse.

Keywords

training
communication skills
moral distress
nursing

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 19, Issue 6, December 2022, Article No: em404

https://doi.org/10.29333/ejgm/12313

Publication date: 06 Aug 2022

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Article Downloads: 2177

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References

Novhi E, Farahbakhsh F. The importance of ethics in education and the level of complying with it from the perspective of nursing students at Kerman University of Medical Sciences. J Educ Ethics Nurs. 2016;5(1):1-7. https://doi.org/10.52547/ethicnurs.5.1.1
Borhani F, Abbaszadeh A, Kohan M, Fazael MA. Nurses and nursing students’ ethical reasoning in facing with dilemmas: a comparative study. J Med Ethics Hist Med. 2010;3(4):71-81.
Deschenes S, Kunyk D. Situating moral distress within relational ethics. Nurs Ethics. 2020;27(3):767-77. https://doi.org/10.1177/0969733019884621PMid:31802709
Asayesh H, Mosavi M, Abdi M, Masoud MP, Jodaki K. The relationship between futile care perception and moral distress among intensive care unit nurses. J Med Ethics Hist Med. 2018;11 (2): 2 -6.
Whitehead PB, Herbertson RK, Hamric AB, et al. Moral distress among healthcare professionals: Report of an institution wide survey. J Nurs Scholarsh. 2015;47(2):117-25. https://doi.org/10.1111/jnu.12115 PMid:25440758
Rabiee S, Khatiban M, Cheraghi MA. Nurses distress in intensive care unit: A survey in teaching hospitals. Iran J Med Ethics Hist Med. 2012;5(2):58-69.
Deady R, McCarthy J. A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspect Psychiatr Care. 2010;46(3):209-20. https://doi.org/10.1111/j.1744-6163.2010.00260.x PMid:20591128
Houston S, Casanova MA, Leveille M, Schmidt KL, Barnes SA, Trungale KR, et al. The intensity and frequency of moral distress among different healthcare disciplines. J Clin Ethics. 2013;24(2):98-112. PMID:23923809
Moshtagh M, Mohsenpour M. Moral distress situations in nursing care. Clin Ethics. 2019; 14(3):141-5. https://doi.org/10.1177/1477750919851058
Keighobadi F, Sadeghi H, Keighobadi F, Tabaraei Y. The relationship between moral distress and emotional exhaustion in nurses. IJME. 2014;7(3):36-47.
Motaghedi H, Donyavi R, Mirzaian B. Effectiveness of mindfulness based cognitive therapy on the distress tolerance of nurses and job burnout. J Nurs Midwifery Sci. 2016;3(4):3-12. https://doi.org/10.18869/acadpub.jnms.3.4.3
Fumis RR, Junqueira Amarante GA, de Fátima Nascimento A, Vieira Junior JM. Moral distress and its contribution to the development of burnout syndrome among critical care providers. Ann Intensive Care. 2017;7(1):71. https://doi.org/10.1186/s13613-017-0293-2 PMid:28639161 PMCid:PMC5479870
Austin CL, Saylor R, Finley PJ. Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychol Trauma: Theory Res Pract Policy. 2017;9(4):399. https://doi.org/10.1037/tra0000201 PMid:27797570
Fernandez-Parsons R, Rodriguez L, Goyal D. Moral distress in emergency nurses. J Emerg Nurs. 2013;39(6):547-52. https://doi.org/10.1016/j.jen.2012.12.009 PMid:23414814
Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics. 2017;24(4):474-82. https://doi.org/10.1177/0969733015604700 PMid:26419438
Ersoy N, Akpinar A. Turkish nurses’ decision making in the distribution of intensive care beds. Nurs Ethics. 2010;17(1):87-98. https://doi.org/10.1177/0969733009349992 PMid:20089628
Henrich NJ, Dodek PM, Alden L, Keenan SP, Reynolds S, Rodney P. causes of moral distress in the intensive care unit: A qualitative study. J Crit Care. 2016;35(9):57-62. https://doi.org/10.1016/j.jcrc.2016. 04.033 PMid:27481736
Mahmoudi H, Soori Laki A, Boulhasani M, Sepahvand MJ. The relationship between use of communication skills and job satisfaction of nurses. Daneshvar Med. 2012;20(101):77-82.
Kourkouta L, Papathanasiou IV. Communication in nursing practice. Mater Socio Med. 2014;26(1):65. https://doi.org/10.5455/msm.2014.26.65-67 PMid:24757408 PMCid:PMC3990376
Baghianimoghadam M, Esfandiari R, Nazari M. Comparison of the effect of written or speech communication skills training of health staff on clients’ satisfaction of Shiraz Health Centers. TB. 2012;11(1):32-40.
Hemsley B, Balandin S, Worrall L. Nursing the patient with complex communication needs: Time as a barrier and a facilitator to successful communication in hospital. J Adv Nurs. 2012;68(1):116-26. https://doi.org/10.1111/j.1365-2648.2011.05722.x PMid:21831131
Gillett K, O’Neill B, Bloomfield JG. Factors influencing the development of end-of-life communication skills: A focus group study of nursing and medical students. Nurs Educ Today. 2016;36(100):395-400. https://doi.org/10.1016/j.nedt.2015.10.015 PMid:26530442
Ali M. Communication skills 1: Benefits of effective communication for patients. Nurs Times. 2017;113(12):18-9.
Kwame A, Petrucka PM. Communication in nurse-patient interaction in healthcare settings in sub-Saharan Africa: A scoping review. Int J Africa Nurs Sci. 2020;12(1):100198. https://doi.org/10.1016/j.ijans.2020.100198
Grissinger M. Disrespectful behavior in health care: Its impact, why it arises and persists, and how to address it_part 2. Pharmacol Ther. 2017;42(2):74. PMID:28163550 PMCID:PMC5265230
Fakhr-Movahedi A, Rahnavard Z, Salsali M, Negarandeh R. Exploring nurse’s communicative role in nurse-patient relations: A qualitative study. J Caring Sci. 2016;5(4):267-76. https://doi.org/10.15171/jcs.2016.028 PMid:28032071 PMCid:PMC5187547
Greenhalgh J, Gooding K, Gibbons E, Dalkin S, Wright J, Valderas J, et al. How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis. J Patient-Rep Outcomes. 2018;2(1):42. https://doi.org/10.1186/s41687-018-0061-6 PMid:30294712 PMCid: PMC6153194
Gibson F. Children with cancer: Communication, an essential component of care. Principle of nursing in oncology: New challenges. Springer; 2019. p. 329.
Khodadadi E, Ebrahimi H, Moghaddasian S, Babapour J. The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of Tabriz, Iran. J Caring Sci. 2013;2(1):27-37. https://doi.org/10.5681/jcs.2013.004 PMID:25276707 PMCID:PMC4161104.
Hekmat Afshar M, Jooybari L, Sanagou A, Kalantari S. Study of factors affecting moral distress among nurses: a review of previous studies. J Educ Ethics Nurs. 2012;1:22-7.
Wang YY, Wan QQ, Lin F, Zhou WJ, Shang SM. Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. Int J Nurs Sci. 2018;5(1):81-8. https://doi.org/10.1016/j.ijnss.2017.09.007 PMID:31406806 PMCID: PMC6626231
Coombs MA. Concerns about care and communication are key causes of moral distress in intensive care staff. Aust Crit Care. 2017;30(2):107-8. https://doi.org/10.1016/j.aucc.2017.01.007 PMid:28292414
Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, et al. Communication in healthcare: A narrative review of the literature and practical recommendations. Int J Clin Pract. 2015;69(11):1257-67. https://doi.org/10.1111/ijcp.12686 PMid:26147310 PMCid:PMC4758389
Mohammadi J, Ghazanfari F, Amir A. The effectiveness of ethics training on nurses ethical distress. J Med Educ Dev. 2016;8(20):99-105.
Trotochaud K, Coleman JR, Krawiecki N, McCracken C. Moral distress in pediatric healthcare providers. J Pediatr Nurs. 2015;30(6):908. https://doi.org/10.1016/j.pedn.2015.03.001 PMid:25869472
Shoorideh FA, Ashktorab T, Yaghmaei F, Alavi Majd H. Relationship between ICU nurses’ moral distress with burnout and anticipated turnover. Nurs Ethics. 2015;22(1):64-76. https://doi.org/10.1177/0969733014534874 PMid:24948793
Rahimi Golsefid S, Jan Mohamadi S, Seyd Fatemi N, Haghani H. Effectiveness of end-of-life care education on the moral distress of nurses in neonatal intensive care units. Iran J Pediatr Nurs. 2019;5(2):75-82. https://doi.org/10.21859/jpen-050211
Ameri M, Safavibayatneed Z, Kavousi A. Moral distress of oncology nurses and morally distressing situations in oncology units. Aust J Adv Nurs. 2016;33:6-12.
Mahdavi Fashtami S, Mohammadeh Zadeh Zarankesh S, Esmaeilpour Bandboni M. Moral distress among emergency department nurses: frequency, intensity, effect. Med Sci. 2016;26(4):248-55.
Abbaszadeh A, Borhani F, Kalantary S. The moral distress of nurses in health centers in the city of Bam in 1390. Med Ethics J. 2011;5(17):119-40.
Peter E, Liaschenko J. Perils of proximity: A spatiotemporal analysis of moral distress and moral ambiguity. Nurs Inq. 2004;11(4):218-25. https://doi.org/10.1111/j.1440-1800.2004.00236.x PMid:15601410
Grace PJ, Robinson EM, Jurchak M, Zollfrank AA, Lee SM. Clinical ethics residency for nurses: An education model to decrease moral distress and strengthen nurse retention in acute care. JONA. 2014;44(12):640-6. https://doi.org/10.1097/NNA.0000000000000141 PMid:25393140
Cheraghi F, Khatiban M, Borzou R, Hosayni P, Vatandost S. Application of Peplau’s theory of interpersonal relations in nursing practice: A systematic review study. SJNMP. 2017;3(2):1-11. https://doi.org/10.29252/sjnmp.3.2.1
Abbasi S, Ghafari S, Shahriari M, Shahgholian N. Effect of moral empowerment program on moral distress in intensive care unit nurses. Nurs Ethics. 2019;26(5):1494-504. https://doi.org/10.1177/0969733018766576 PMid: 29695198
Curtis JR, Back AL, Ford DW, Downey L, Shannon SE, Doorenbos AZ, et al. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: A randomized trial. JAMA. 2013;310(21):2271-81. https://doi.org/10.1001/jama.2013.282081 PMid:24302090 PMCid:PMC4310457
Elizabeth A, Leonard. Evaluating a pilot project on nursing moral distress, PhD in Nursing Practice, Drexel University, USA, 2017.

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Vancouver

Dehghani A, Sobhanian M, Faseleh Jahromi M. The effect of communication skills training on nurses’ moral distress: A randomized controlled trial. ELECTRON J GEN MED. 2022;19(6):em404. https://doi.org/10.29333/ejgm/12313

APA

Dehghani, A., Sobhanian, M., & Faseleh Jahromi, M. (2022). The effect of communication skills training on nurses’ moral distress: A randomized controlled trial. Electronic Journal of General Medicine, 19(6), em404. https://doi.org/10.29333/ejgm/12313

AMA

Dehghani A, Sobhanian M, Faseleh Jahromi M. The effect of communication skills training on nurses’ moral distress: A randomized controlled trial. ELECTRON J GEN MED. 2022;19(6), em404. https://doi.org/10.29333/ejgm/12313

Chicago

Dehghani, Ali, Mohammad Sobhanian, and Mohsen Faseleh Jahromi. "The effect of communication skills training on nurses’ moral distress: A randomized controlled trial". Electronic Journal of General Medicine 2022 19 no. 6 (2022): em404. https://doi.org/10.29333/ejgm/12313

Harvard

Dehghani, A., Sobhanian, M., and Faseleh Jahromi, M. (2022). The effect of communication skills training on nurses’ moral distress: A randomized controlled trial. Electronic Journal of General Medicine, 19(6), em404. https://doi.org/10.29333/ejgm/12313

MLA

Dehghani, Ali et al. "The effect of communication skills training on nurses’ moral distress: A randomized controlled trial". Electronic Journal of General Medicine, vol. 19, no. 6, 2022, em404. https://doi.org/10.29333/ejgm/12313