Table 1
Description of background and moral distress variables (n, %).
| VARIABLE | n | % |
|---|---|---|
| Gender | ||
| Male | 149 | 11.7 |
| Female | 1125 | 88.3 |
| Age | ||
| 18–34 | 267 | 20.9 |
| 35–44 | 318 | 24.9 |
| 45–54 | 374 | 29.2 |
| 55–67 | 319 | 25.0 |
| Region | ||
| Region 1 | 421 | 32.9 |
| Region 2 | 640 | 50.0 |
| Region 3 | 218 | 17.0 |
| Occupation | ||
| Nurse | 605 | 47.3 |
| Physician | 62 | 4.8 |
| Practical nurse | 274 | 21.4 |
| Social worker | 78 | 6.1 |
| Social counsellor | 124 | 9.7 |
| Superior | 136 | 10.6 |
| Work sector | ||
| Social services | 182 | 14.3 |
| Hospital | 346 | 27.2 |
| Primary health care | 145 | 11.4 |
| Services for older people | 287 | 22.6 |
| Administration | 60 | 4.7 |
| Mental health and substance abuse | 134 | 10.5 |
| Rehabilitation | 71 | 5.6 |
| Other | 46 | 3.6 |
| Frequency of ethical conflicts | ||
| never | 75 | 5.9 |
| once a year | 124 | 9.7 |
| sometimes a year | 301 | 23.5 |
| monthly | 377 | 29.5 |
| weekly | 340 | 26.6 |
| daily | 62 | 4.8 |
| Intensity of ethical conflicts | ||
| never | 187 | 15.0 |
| seldom | 256 | 20.6 |
| sometimes | 418 | 33.6 |
| often | 286 | 23.0 |
| continuously | 97 | 7.8 |
[i] Note: Valid percentages are reported. Missing values from total varied from 35 (3%, intensity of ethical conflicts) to 0 (0%, region, occupation, and frequency of ethical conflicts).
Table 2
Means and factor analysis for aspects of ethical conflicts.
| ITEM WORDING | FACTOR LOADINGS1 | |||
|---|---|---|---|---|
| MEAN (SD) | ETHICAL RESPONSIBILITIES | AMBIGUOUS DECISION-MAKING | CONFLICTING DEMANDS | |
| 1. I felt a temptation to advance interests of my own or my work community by acting dishonestly, unfairly or against ethical codes2 | 1.21 (0.60) | |||
| 2. I had to decide how I should react to a transgression made by another person2 | 1.91 (1.27) | |||
| 3. I considered my responsibilities for the wellbeing or support of another person | 3.50 (1.36) | 0.58 | ||
| 4. Several people had contradictory expectations towards me, and I had to decide among them | 2.50 (1.36) | 0.47 | ||
| 5. Other people pressed me, consciously or unconsciously, to act against my values | 1.79 (1.16) | 0.81 | ||
| 6. Some of my own values were in contradiction with each other, and I had to decide between them | 1.86 (1.13) | 0.50 | ||
| 7. I was unsure how a certain rule or instruction should be applied | 2.19 (1.28) | 0.71 | ||
| 8. I did not have the expert knowledge to make the right decision | 2.06 (1.20) | 0.71 | ||
| 9. The responsibility for decision-making was unclear | 2.06 (1.24) | 0.78 | ||
| 10. I did not have the power in the ultimate decision-making regarding the problem | 2.36 (1.42) | 0.41 | ||
| 11. I disagreed with other workers | 2.05 (1.23) | 0.67 | ||
| 12. I had difficulties to comply with demands of the more powerful party | 1.91 (1.18) | 0.67 | ||
| 13. The decision affected my relationships/relations with patients/clients and their close ones2 | 1.59 (1.0) | |||
| 14. The decision affected my relationships with my co-workers | 1.57 (0.94) | 0.66 | ||
| 15. I considered the rights and duties of the parties involved | 2.99 (1.35) | 0.86 | ||
| 16. I considered the consequences of alternative solutions for the parties involved | 2.99 (1.30) | 0.87 | ||
| Eigenvalues | 4.88 | 1.73 | 1.29 | |
| Percentage variance (%) | 37.56 | 13.33 | 9.90 | |
| Cronbach’s Alpha for selected items | 0.80 | 0.76 | 0.83 | |
| Mean (SD)2 | 3.16 (1.11) | 2.17 (0.98) | 1.95 (0.85) | |
[i] 1 Factor loadings > 0.40 are reported.
2 Items were excluded from the analysis due to poor communalities in preliminary analyses.
Table 3
Means, standard deviations and Spearman’s correlations for major variables.
| MEAN | SD | 1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. Ethical responsibilities | 10.91 | 5.43 | ||||||||||
| 2. Ambiguous decision-making | 7.64 | 4.72 | .61*** | |||||||||
| 3. Conflicting demands | 6.83 | 4.18 | .75*** | .66*** | ||||||||
| 4. Job autonomy | 3.72 | 0.89 | –.09** | –.17*** | –.23*** | |||||||
| 5. Organisational justice | 3.58 | 0.90 | –.15*** | –.22*** | –.24*** | .41*** | ||||||
| 6. Participative safety | 3.83 | 0.95 | –.18*** | –.18*** | –.25*** | .32*** | .63*** | |||||
| 7. Time pressure | 3.61 | 0.99 | .30*** | .26*** | .30*** | –.23*** | –.18*** | -.10*** | ||||
| 8. General health | 3.00 | 0.73 | –.20*** | –.28*** | –.31*** | .28*** | .25*** | .20*** | -.35*** | |||
| 9. Job satisfaction | 3.82 | 0.39 | –.17*** | –.24*** | –.28*** | .49*** | .40*** | .36*** | –.27*** | .37*** | ||
| 10. Turnover intentions | 2.60 | 1.42 | .22*** | .24*** | .30*** | –.37*** | –.37*** | –.33*** | .26*** | –.38*** | –.53*** | |
| 11. Age | 45.26 | 11.01 | .12*** | .04 | .12* | -.05 | -.04 | -.03 | -.03 | .05 | -.05 | .19*** |
[i] ** p < .01, *** p < .001 Note: ns vary from 1208 to 1274.
Table 4
Summary of regression analyses for work-related well-being.
| MODEL 1 | MODEL 2 | |||
|---|---|---|---|---|
| ΔR2 | ΔR2 | |||
| General health | F(4, 1179) = 36.20 | .11*** | F(8, 1175) = 39.23 | .21*** |
| Job satisfaction | F(4, 1178) = 30.10 | .09*** | F(8, 1174) = 74.41 | .33*** |
| Turnover Intentions | F(4, 1176) = 41.70 | .12*** | F(8, 1172) = 58.41 | .28*** |
[i] *** p < .001.
Table 5
Standardized coefficients for independent variables.
| GENERAL HEALTH | JOB SATISFACT. | TURNOVER INTENTIONS | |
|---|---|---|---|
| Model 1 | |||
| Age | –.02 | .04 | -.17*** |
| Ethical Responsibilities | –.01 | .13** | -.03 |
| Ambiguous Decision-making | –.14*** | -.12** | .07 |
| Conflicting Demands | .23*** | -.30*** | .27*** |
| Model 2 | |||
| Age | .02 | .03 | –.17*** |
| Ethical Responsibilities | .00 | .05 | .02 |
| Ambiguous Decision-making | –.10** | –.07* | .02 |
| Conflicting Demands | –.12** | –.09* | .11* |
| Job autonomy | .13*** | .33*** | –.20*** |
| Organisational justice | .09** | .16*** | –.17*** |
| Participative safety | .04 | .10** | –.11* |
| Time pressure | –.24*** | -.14*** | .14*** |
[i] * p < .05, ** p < .01, *** p < .001.