Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study.

Autor: Tan AK Jr; The Graduate Center, City University of New York, New York, New York, USA.; Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA., Capezuti E; The Graduate Center, City University of New York, New York, New York, USA.; Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA., Samuels WE; The Graduate Center, City University of New York, New York, New York, USA.; Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA., Backhaus R; Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.; Living Lab in Ageing and Long-Term Care, Maastricht, Netherlands., Wagner LM; University of California San Francisco, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing [J Nurs Scholarsh] 2024 May; Vol. 56 (3), pp. 430-441. Date of Electronic Publication: 2024 Jan 02.
DOI: 10.1111/jnu.12953
Abstrakt: Background: Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment.
Objective: The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress.
Design: This study was a descriptive, cross-sectional survey using targeted sampling.
Participants: A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting.
Methods: This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses.
Results: The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001).
Conclusion: Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
Clinical Relevance: Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay. Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
(© 2024 Sigma Theta Tau International.)
Databáze: MEDLINE
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