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1

Savel, Richard H., and Cindy L. Munro. "Moral Distress, Moral Courage." American Journal of Critical Care 24, no. 4 (2015): 276–78. http://dx.doi.org/10.4037/ajcc2015738.

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Pye, Kate. "Moral distress." Cancer Nursing Practice 5, no. 1 (2006): 8–10. http://dx.doi.org/10.7748/cnp.5.1.8.s10.

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3

Anthony, Maureen. "Moral Distress." Home Healthcare Now 40, no. 4 (2022): 181. http://dx.doi.org/10.1097/nhh.0000000000001091.

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4

Chehab, May. "Moral Distress." Pediatric Critical Care Medicine 18, no. 8 (2017): 814–15. http://dx.doi.org/10.1097/pcc.0000000000001243.

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5

Pineda, Yeni. "Moral Distress." AJN, American Journal of Nursing 115, no. 12 (2015): 17. http://dx.doi.org/10.1097/01.naj.0000475272.39180.c6.

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6

Robinson, Ruthie, and Cynthia Kellam Stinson. "Moral Distress." Dimensions of Critical Care Nursing 35, no. 4 (2016): 235–40. http://dx.doi.org/10.1097/dcc.0000000000000185.

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7

Burton, Melissa, Hollis Caswell, Courtney Porter, Sandra Mott, and Michele DeGrazia. "Moral Distress." Dimensions of Critical Care Nursing 39, no. 2 (2020): 101–9. http://dx.doi.org/10.1097/dcc.0000000000000403.

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8

McCarthy, Joan, and Chris Gastmans. "Moral distress." Nursing Ethics 22, no. 1 (2014): 131–52. http://dx.doi.org/10.1177/0969733014557139.

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Aim: The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. Data sources: CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers’ Index and Socindex. Review methods: A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. Results: We found that like the empirical literature, most authors in th
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9

Karakachian, Angela, and Alison Colbert. "Moral distress." Nursing 47, no. 10 (2017): 13–15. http://dx.doi.org/10.1097/01.nurse.0000525602.20742.4b.

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10

Trautmann, Jennifer. "Moral Distress." Journal of Infusion Nursing 38, no. 4 (2015): 285–89. http://dx.doi.org/10.1097/nan.0000000000000111.

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11

Erlen, Judith A. "Moral Distress." Orthopaedic Nursing 20, no. 2 (2001): 76–80. http://dx.doi.org/10.1097/00006416-200103000-00015.

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12

Houghtaling, Denise L. Hamilton. "Moral Distress." Journal of Trauma Nursing 19, no. 4 (2012): 232–37. http://dx.doi.org/10.1097/jtn.0b013e318261d2dc.

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13

&NA;. "Moral Distress." Journal of Trauma Nursing 19, no. 4 (2012): 238–39. http://dx.doi.org/10.1097/jtn.0b013e31827bf15f.

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14

Dudzinski, Denise Marie. "Navigating moral distress using the moral distress map." Journal of Medical Ethics 42, no. 5 (2016): 321–24. http://dx.doi.org/10.1136/medethics-2015-103156.

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15

Carse, Alisa. "Moral Distress and Moral Disempowerment." Narrative Inquiry in Bioethics 3, no. 2 (2013): 147–51. http://dx.doi.org/10.1353/nib.2013.0028.

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16

McAninch, Andrew. "Moral Distress, Moral Injury, and Moral Luck." American Journal of Bioethics 16, no. 12 (2016): 29–31. http://dx.doi.org/10.1080/15265161.2016.1239790.

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17

Alvarez, Allen, and May Thorseth. "Moral sensitivity, moral distress and moral functioning." Etikk i praksis - Nordic Journal of Applied Ethics, no. 1 (June 30, 2023): 1–5. http://dx.doi.org/10.5324/eip.v17i1.5109.

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18

McCarthy, Joan, and Rick Deady. "Moral Distress Reconsidered." Nursing Ethics 15, no. 2 (2008): 254–62. http://dx.doi.org/10.1177/0969733007086023.

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Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some nursing research and expresses concern about the fact that research, so far, has
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19

Woods, Martin. "Beyond moral distress." Nursing Ethics 21, no. 2 (2014): 127–28. http://dx.doi.org/10.1177/0969733013512741.

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20

Kim, Mi-Yeon, and Sheryl Reimer-Kirkham. "Managing Moral Distress." Journal of Christian Nursing 42, no. 2 (2025): 77–78. https://doi.org/10.1097/cnj.0000000000001270.

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21

Mack, Cheryl. "When Moral Uncertainty Becomes Moral Distress." Narrative Inquiry in Bioethics 3, no. 2 (2013): 106–9. http://dx.doi.org/10.1353/nib.2013.0037.

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22

YUN, Hye-Young, Sun-Ki KIM, Hyo-Eun JANG, Sin-Woo HWANG, and Sang-Hee KIM. "The Influence of Moral Distress and Moral Sensitivity on Moral Courage in Nursing Students." Korean Journal of Medical Ethics 21, no. 4 (2018): 360–76. http://dx.doi.org/10.35301/ksme.2018.21.4.360.

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Nursing students experience ethical conflicts that lead to moral distress and moral sensitivity in clinical practice. Most nursing students have some difficulty in speaking up when faced with morally challenging situations. Hence, increasing moral courage of these students is important to improve the quality of prac-tice, and carry out nursing responsibilities. However, research on the moral distress, moral sensitivity, and moral courage of nursing students has not been reported in South Korea. The purposes of this study were to (a) identify the levels of moral distress, moral sensitivity, and
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23

Escolar-Chua, Rowena L. "Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students." Nursing Ethics 25, no. 4 (2016): 458–69. http://dx.doi.org/10.1177/0969733016654317.

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Background: Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students. Aim/objective: The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students. Research design: The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and mo
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24

Corley, Mary C., Ptlene Minick, R. K. Elswick, and Mary Jacobs. "Nurse Moral Distress and Ethical Work Environment." Nursing Ethics 12, no. 4 (2005): 381–90. http://dx.doi.org/10.1191/0969733005ne809oa.

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This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, where
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25

Taylor, J. S. "Moral Repugnance, Moral Distress, and Organ Sales." Journal of Medicine and Philosophy 40, no. 3 (2015): 312–27. http://dx.doi.org/10.1093/jmp/jhv006.

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26

Cox, Kathleen M. "Moral Distress: Strategies for Maintaining Moral Integrity." Perioperative Nursing Clinics 3, no. 3 (2008): 197–203. http://dx.doi.org/10.1016/j.cpen.2008.04.011.

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27

Jolaei, Soudabeh, Patricia Rodney, Rosalie Starzomski, and Peter Dodek. "From Moral Distress to Moral Integrity: Qualitative Evaluation of a New Moral Conflict Assessment Tool." American Journal of Critical Care 34, no. 1 (2025): 52–59. https://doi.org/10.4037/ajcc2025500.

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Background Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested. Objective To evaluate the utility of the MCA. Methods All intensive care unit professionals in 3 hospitals were invited to attend a presentation about the MCA and to participate in semistructured interviews that followed the steps of the MCA. Transcriptions of interviews were interpreted by using qualitative
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28

Jeffers, Brenda Recchia. "Coping With Moral Distress." Critical Care Nurse 41, no. 2 (2021): 13. http://dx.doi.org/10.4037/ccn2021597.

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29

Parsh, Sophie, and Elvis Vo. "What is moral distress?" Nursing 51, no. 11 (2021): 19–21. http://dx.doi.org/10.1097/01.nurse.0000791748.26732.35.

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30

Prentice, Trisha M., Annie Janvier, Lynn Gillam, Susan Donath, and Peter G. Davis. "Moral Distress in Neonatology." Pediatrics 148, no. 2 (2021): e2020031864. http://dx.doi.org/10.1542/peds.2020-031864.

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31

Schoonover-Shoffner, Kathy. "What About Moral Distress?" Journal of Christian Nursing 34, no. 2 (2017): 73. http://dx.doi.org/10.1097/cnj.0000000000000387.

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32

Wallis, Laura. "Moral Distress in Nursing." AJN, American Journal of Nursing 115, no. 3 (2015): 19. http://dx.doi.org/10.1097/01.naj.0000461804.96483.ba.

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33

Hurst, Daniel J. "Moral distress in families." Nursing Made Incredibly Easy! 16, no. 5 (2018): 6–7. http://dx.doi.org/10.1097/01.nme.0000542476.38443.6c.

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34

Green, Michael M., Mark R. Wicclair, Lucia D. Wocial, Andy Kondrat, and Debjani Mukherjee. "Moral Distress in Rehabilitation." PM&R 9, no. 7 (2017): 720–26. http://dx.doi.org/10.1016/j.pmrj.2017.05.006.

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35

Arbe Montoya, Alejandra I., Susan Hazel, Susan M. Matthew, and Michelle L. McArthur. "Moral distress in veterinarians." Veterinary Record 185, no. 20 (2019): 631. http://dx.doi.org/10.1136/vr.105289.

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Moral distress is a psychological state of anguish that has been widely studied in healthcare professionals. Experiencing moral distress can lead to problems including avoidance of patients and increased staff turnover. Moral distress in veterinarians has not yet been explored to the extent seen in the human medical field, and there is limited data regarding moral distress in veterinarians. However, it is expected to be prevalent in these professionals. So far, it has been reported that veterinarians commonly experience moral conflict, ethical challenges and ethical dilemmas during their caree
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36

Burston, Adam S., and Anthony G. Tuckett. "Moral distress in nursing." Nursing Ethics 20, no. 3 (2012): 312–24. http://dx.doi.org/10.1177/0969733012462049.

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Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications moral distress has on the nurse and the nursing workforce:
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37

Pierce, Susan F. "Dealing with moral distress." Nursing Critical Care 1, no. 5 (2006): 25–26. http://dx.doi.org/10.1097/01244666-200609000-00006.

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38

&NA;. "Dealing with moral distress." Nursing 45, no. 3 (2015): 6. http://dx.doi.org/10.1097/01.nurse.0000460739.58774.88.

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39

Jones, Ashley. "Moral Distress Among Nurses." Journal of Emergency Nursing 40, no. 1 (2014): 4. http://dx.doi.org/10.1016/j.jen.2013.03.022.

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40

Isfahani, Mehdi Nasr, Fatemeh Asghari Pari, Fahimeh Pakravan, and Mehrdad Esmailian. "Evaluation of moral distress and moral intelligence among medical residents." Medicina e Morale 73, no. 1 (2024): 11–21. http://dx.doi.org/10.4081/mem.2024.1256.

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Background: Medical ethics is necessary in the medical field to protect patient rights, enhance professional conduct, manage complex situations, prevent malpractice, and advance healthcare policy. Aim: This study aimed to examine the levels of moral distress and moral intelligence among medical residents and explore the relationship between these two concepts. Methods: This descriptive-analytical cross-sectional study was performed on 221 medical residents in 2021. The participants were recruited by census sampling method. Data were collected by two standard questionnaires, including Corley’s
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41

Repenshek, Mark. "Moral Distress: Inability to Act or Discomfort with Moral Subjectivity?" Nursing Ethics 16, no. 6 (2009): 734–42. http://dx.doi.org/10.1177/0969733009342138.

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Amidst the wealth of literature on the topic of moral distress in nursing, a single citation is ubiquitous, Andrew Jameton’s 1984 book Nursing practice. The definition Jameton formulated reads ‘... moral distress arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. Unfortunately, it appears that, despite the frequent use of Jameton’s definition of moral distress, the definition itself remains uncritically examined. It seems as if the context of how moral distress arises (i.e. anger, frustration etc.) has bee
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42

Ohnishi, Kayoko, Kazuyo Kitaoka, Jun Nakahara, Maritta Välimäki, Raija Kontio, and Minna Anttila. "Impact of moral sensitivity on moral distress among psychiatric nurses." Nursing Ethics 26, no. 5 (2018): 1473–83. http://dx.doi.org/10.1177/0969733017751264.

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Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: To examine the impact of moral sensitivity on moral distress among psyc
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43

Traudt, Terri, Joan Liaschenko, and Cynthia Peden-McAlpine. "Moral Agency, Moral Imagination, and Moral Community: Antidotes to Moral Distress." Journal of Clinical Ethics 27, no. 3 (2016): 201–13. http://dx.doi.org/10.1086/jce2016273201.

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44

Elpern, Ellen H., Barbara Covert, and Ruth Kleinpell. "Moral Distress of Staff Nurses in a Medical Intensive Care Unit." American Journal of Critical Care 14, no. 6 (2005): 523–30. http://dx.doi.org/10.4037/ajcc2005.14.6.523.

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• Background Moral distress is caused by situations in which the ethically appropriate course of action is known but cannot be taken. Moral distress is thought to be a serious problem among nurses, particularly those who practice in critical care. It has been associated with job dissatisfaction and loss of nurses from the workplace and the profession.• Objectives To assess the level of moral distress of nurses in a medical intensive care unit, identify situations that result in high levels of moral distress, explore implications of moral distress, and evaluate associations among moral distress
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45

Carnevale, Franco A. "Confronting moral distress in Nursing: recognizing nurses as moral agents." Revista Brasileira de Enfermagem 66, spe (2013): 33–38. http://dx.doi.org/10.1590/s0034-71672013000700004.

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The concept of moral distress has brought forth a substantively different way of understanding some of the difficulties confronted by nurses in their practice. This concept highlights that nurses' distress can be an indication of nurses' conscientious moral engagement with their professional practice that has confronted practices or an environment that impedes them from acting according to their own ethical standards. Moral distress can be an indicator of problems in nurses' practice environments. This concept is described and related to moral agency in nursing practice. Selected research on m
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46

Giannetta, Noemi, Giulia Villa, Loris Bonetti, et al. "Moral Distress Scores of Nurses Working in Intensive Care Units for Adults Using Corley’s Scale: A Systematic Review." International Journal of Environmental Research and Public Health 19, no. 17 (2022): 10640. http://dx.doi.org/10.3390/ijerph191710640.

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Background: No systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress experienced by nurses in ICUs, as assessed by Corley’s instruments on moral distress (the Moral Distress Scale and the Moral Distress Scale–Revised). Additionally, this systematic review aimed to summarize the correlates of moral distress. Methods: A sys
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47

Griggs, Sherry, Debra Hampton, Jean Edward, and Jessica McFarlin. "Impact of Case Review Debriefings on Moral Distress of Extracorporeal Membrane Oxygenation Nurses." Critical Care Nurse 43, no. 3 (2023): 12–18. http://dx.doi.org/10.4037/ccn2023870.

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Background Moral distress occurs when nurses know the ethically correct action to take but are restrained from taking it. Moral distress is prevalent in nurses who work in intense stress situations, as do extracorporeal membrane oxygenation nurses. Local Problem Nurses who work in critical care settings have higher levels of moral distress than nurses who work in other practice areas. The purpose of this project was to evaluate the effectiveness of case review debriefings on moral distress of extracorporeal membrane oxygenation nurses. Methods Thirty-nine critical care registered nurses with s
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48

Prentice, Trisha M., Lynn Gillam, Peter G. Davis, and Annie Janvier. "Always a burden? Healthcare providers’ perspectives on moral distress." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 5 (2017): F441—F445. http://dx.doi.org/10.1136/archdischild-2017-313539.

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BackgroundCurrent conceptualisations of moral distress largely portray a negative phenomenon that leads to burnout, reduced job satisfaction and poor patient care.ObjectiveTo explore clinical experiences, perspectives and perceptions of moral distress in neonatology.DesignAn anonymous questionnaire was distributed to medical and nursing providers within two tertiary level neonatal intensive care units (NICUs)—one surgical and one perinatal—seeking their understanding of the term and their experience of it. Open-ended questions were analysed using qualitative methodology.ResultsA total of 345 h
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49

Fry, Sara T., Rose M. Harvey, Ann C. Hurley, and Barbara Jo Foley. "Development of a Model of Moral Distress in Military Nursing." Nursing Ethics 9, no. 4 (2002): 373–87. http://dx.doi.org/10.1191/0969733002ne522oa.

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The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are
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50

Shah, Suleman, and Arnel B. Salgado. "Moral distress among staff nurses in RAS AL khaimah hospitals, united arab emirates." i-manager’s Journal on Nursing 11, no. 4 (2022): 25. http://dx.doi.org/10.26634/jnur.11.4.18344.

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Nurses suffer from moderate to high levels of moral distress in different clinical settings that affect nurses' quality of care and the organization's reputation. Moral distress causes nurses' dissatisfaction, burnout and eventually change or quit their position. The aim of this study is to describe the moral distress intensity, frequency, association with demographic variables and specialty of care. The impact of moral distress on the staff nurses is also described. A descriptive study is used to achieve the objectives of this study. Twenty one (21) items of the Moral Distress Scale-Revised (
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