The Relationship between Moral Distress and Quality of Care among ICU Nurses in a Tertiary Hospital in Zamboanga City

Abstract

Moral distress, stemming from conflicts between ethical judgment and external constraints, significantly affects Intensive Care Unit nurses, leading to diminished care quality and nurse turnover. This study investigated the correlation between moral distress and the quality of care rendered by ICU nurses at a tertiary-level hospital in Zamboanga City. The study used a cross-sectional correlational design with 47 ICU nurses from various units. Data were collected via validated instruments—the Moral Distress Scale and the Quality Nursing Care Scale ICU. Pearson's correlation coefficient analyzed the relationship between moral distress and nursing care quality. The study’s findings indicate that ICU nurses at a tertiary-level hospital in Zamboanga City experience a low level of moral distress, with an overall mean frequency of 1.99 and a mean disturbance of 2.26. For the FMD and the QNCS-ICU, there was a moderate positive correlation between the two variables, r(32) = 0.465, p = 0.006. Meanwhile, for the DMD and the QNCS-ICU, there was a weak positive correlation between the two variables, r(32) = 0.354, p = 0.040. These findings suggest that an increase in moral distress, even at a lower level, correlates with a decline in the quality of nursing care. Effective stress management among ICU nurses is essential for reducing moral distress and enhancing patient care, while integrating patient and family feedback can further improve nursing practices. Hospital management should develop ongoing support programs to strengthen nurses' well-being and performance. Furthermore, future research could explore these dynamics by utilizing qualitative methods, expanding sample sizes, and extending study durations, providing a more comprehensive understanding of how moral distress impacts nursing outcomes.