Intent to Stay, Moral Distress, and Nurse Practice Environment Among Long-Term Care Nurses: A Cross-Sectional Questionnaire Survey Study

Details

• Personal Author:
  Backhaus R ; Capezuti E ; Samuels WE ; Tan AK Jr. ; Wagner LM
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Health Personnel Occupational Health Safety Stress, Psychological Workplace
• Keywords:
  Author Keywords: Intent To Stay Cross Sectional Studies Employee Satisfaction Job Stress Long-term Care Moral Distress Nurse Practice Environment Nurses Structural Equation Modeling Work Environment
• ISSN:
  1527-6546
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; New York ; OSHA Region 2 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  430-441
• Volume:
  56
• Issue:
  3
• NIOSHTIC Number:
  nn:20069303
• Citation:
  J Nurs Scholarsh 2024 May; 56(3):430-441
• Contact Point Address:
  Amil Kusain Tan Jr, The Graduate Center, City University of New York, New York, NY, USA
• Email:
  at5528@hunter.cuny.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Nursing Scholarship
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:581048e93b697da1225cd7aa9ca247bdf890efad21dbbdf29d78d16178ca82bbad072cde0850e5a87219f0148ac36fd56bef9d2746ea27010dca66026537dcfc
• Download URL:
  https://stacks.cdc.gov/view/cdc/207805/cdc_207805_DS1.pdf
• File Type:
  [PDF - 509.22 KB ]