TY  - JOUR
T1  - Ethical Challenges and Stress of Conscience among Nurses in Palliative Care: A Cross-Sectional Study
A1  - Sofia Romano
A1  - Elena Ricci
JF  - Journal of Integrative Nursing and Palliative Care
JO  - J Integr Nurs Palliat Care
SN  - 3006-5550
Y1  - 2024
VL  - 5
IS  - 2
DO  - 10.51847/i03RvGhsNV
SP  - 342
EP  - 351
N2  - Within healthcare settings, moral injury has become recognized as a significant ethical and psychosocial issue. Although palliative care nurses regularly face ethically challenging situations alongside continuous emotional burdens, empirical data regarding the severity of moral injury and its predicting variables in this population remain scarce. To address this gap, the current study aims to evaluate the extent of moral injury among palliative care nurses and identify its associated factors. A cross-sectional, descriptive, and correlational survey design was implemented. Using convenience sampling, palliative care nurses were recruited from palliative care departments across Anhui and Jiangsu provinces in China from December 2025 to February 2026. The subjects filled out a demographic/work-related survey, the Moral Injury Symptom Scale–Health Professional (MISS-HP), and the Emotional Labor Scale. Statistical analyses included t-tests/ANOVA, Pearson correlation, and stepwise multiple linear regression. Out of the 361 nurses invited, 349 returned valid questionnaires (96.7%). The average total score on the MISS-HP was 48.96 ± 17.35, which indicates comparatively high levels of moral injury among the sampled palliative care nurses. In the multivariable analysis (adjusted R^2 = 0.386), increased moral injury scores were significantly linked to being male, being unmarried, holding higher educational degrees, facing severe ethical conflicts more frequently over the prior year, perceiving lower support from supervisors/peers, and exhibiting higher levels of emotional labor (all P < 0.05). The results indicate that moral injury symptoms are relatively pronounced among palliative care nurses. A positive correlation was found between emotional labor and moral injury, indicating that greater emotional labor tends to correspond with more severe symptoms of moral injury. Additionally, demographic traits and occupational factors—specifically gender, marital status, academic attainment, the frequency of severe ethical dilemmas, and perceived organizational support—were significantly associated with moral injury. These outcomes underscore the need to strengthen organizational support and develop interventions to manage emotional labor, thereby alleviating moral injury and promoting nursing well-being.
UR  - https://journalinpc.com/article/ethical-challenges-and-stress-of-conscience-among-nurses-in-palliative-care-a-cross-sectional-study-ksvmwomqpw0nnja
ER  -