The effect of moral distress and stress levels of pediatric nurses on their quality of work life: Turkey sample

This study aimed to examine the effect of moral distress and stress levels of pediatric nurses on the level of nurses' quality of work life and the factors affecting it. The descriptive, correlational, comparative and cross-sectional study was conducted with 115 pediatric nurses between June 2023 and June 2024. 'Descriptive Information Form', 'Nurse Stress Scale', 'Quality of Life Scale for Employees' and 'Moral Distress Scale for Pediatric Nurses' were used to collect the data. In the analysis of the data, t-test, ANOVA test, Tukey test, Pearson correlation analysis and simple linear regression analysis were used. The mean age of the nurses participating in the study was 29.37 ± 5.00 years, 95.65% were female and 64.35% were undergraduate graduates. The mean working time was 6.88 ± 0.23 years and the mean working time in pediatrics was 5.17 ± 5.06 years. It was found that the mean scores of stress and moral distress explained 36% of the professional satisfaction of pediatric nurses; patient death (p=0.000), conflict with physician (p=0.006), patient and family autonomy scores (p=0.002) had a significant effect on professional satisfaction. Stress and moral distress mean scores explained 39% of burnout; patient death (p=0.000), conflict with physician (p=0.000), inadequate support (p=0.008), suffering patient (p=0.011), patient and family autonomy (p=0.018), professional autonomy (p=0.008), moral distress scale mean scores (p=0.002) had a significant effect on burnout. Stress and moral distress mean scores explained 27% of compassion fatigue, while workload had a negative and significant effect on compassion fatigue (p = 0.021). This study showed that spiritual distress and stress levels of pediatric nurses had significant effects on professional satisfaction, burnout, and compassion fatigue. Especially the death of the patient and conflicts with the physician play an important role in professional satisfaction and burnout. The workload of nurses also negatively affects compassion fatigue. In line with these results, increasing the stress and demoralization management skills of nurses, strengthening institutional supports and resolving conflicts with physicians are presented as critical recommendations to improve the quality of work life.