# The effect of moral distress experienced by intensive care nurses on end-of-life care attitudes and care behaviours: a single-centre cross-sectional and correlational study

## TL;DR

This study found that moral distress in ICU nurses does not significantly affect their attitudes or behaviors toward end-of-life care.

## Contribution

The study provides new insights into the relationship between moral distress and end-of-life care practices among ICU nurses.

## Key findings

- ICU nurses experienced moderate levels of moral distress.
- Moral distress did not directly affect attitudes or behaviors toward end-of-life care.
- Caring behaviors were positively correlated with end-of-life care attitudes and behaviors.

## Abstract

This study aimed to evaluate the effect of moral distress experienced by intensive care nurses on their attitudes toward end-of-life care and their care behaviors.

This cross-sectional and correlational study was conducted with 121 nurses working in intensive care units (ICUs). Data collection tools included the ICU Nurse Information Form, the Moral Distress Scale-Revised (MDS-R), the Caring Behaviors Inventory-24 (CBI-24), and the Nurses’Attitudes and Behaviors of Intensive Care Nurses Toward End-of-Life Care (EoLC) Scale.

The moral distress mean score of ICU nurses was 76.61 ± 22.72, attitudes and behaviors toward EoLC mean score 51.56 ± 10.39, and CBI-24 mean score was 122.72 ± 16.39.The correlation coefficients between the Distress subscale of the MDS-R and the mean scores of EoLC Attitudes were found to be positive and significant. (r = 0.200; p < 0.05; p = 0.028). The correlation coefficients between the CBI-24 and the EoLC Attitudes (r = 0.253, p < 0.01, p = 0.005) and Behaviors (r = 0.186, p < 0.05, p = 0.041) subscale were found to be positive and significant. Moral distress did not directly affect attitudes and behaviors toward EoLC, and care behaviour (p < 0.05).

In this study, ICU nurses were found to experience moderate levels of moral distress, have good perceptions of caring behaviors, and exhibit moderate levels of attitudes and behaviors toward end-of-life care. However, moral distress was found to have no significant effect on their attitudes toward end-of-life care or on their caring behaviors.

Not applicable.