Nurses’ moral distress and leadership communication in hospitals serving Black patients during COVID-19

IF 4.1 2区医学 Q1 NURSING Nursing Outlook Pub Date : 2024-05-28 DOI:10.1016/j.outlook.2024.102189

Eileen T. Lake PhD, RN, FAAN , Jessica G. Smith PhD, RN , Jeannette A. Rogowski PhD , Emily Cramer PhD , Vaneh Hovsepian PhD, RN , Hal Chen MS , Nehemiah Weldeab MPH , Connie Ulrich PhD, RN, FAAN

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Abstract

Background

Poorer leadership communication during COVID-19 may have contributed to the moral distress of nurses in hospitals where Black patients predominantly access their care (BSH).

Purpose

To compare nurse moral distress and leadership communication during the COVID-19 pandemic in hospitals that serve disproportionately many or few patients of Black race.

Methods

In a national hospital sample (n = 90), nurse survey data were collected (March 2021). Nurse moral distress was analyzed in linear regression models. The key covariates were BSH category (Medicare Black patient percentage) and leadership communication.

Discussion

Nurses in high-BSH had significantly greater moral distress and more difficulty accessing personal protective equipment than nurses in low-BSH. The percentage of nurses in high-BSHs with high moral distress was double that of nurses in low-BSHs. Poorer leadership communication in BSHs accounted for the nurses’ greater moral distress.

Conclusion

Policies should improve leadership communication, mitigate distress, and support nurses in under-resourced settings.

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在 COVID-19 期间，为黑人患者提供服务的医院中护士的道德困扰与领导沟通。

背景：目的：比较在COVID-19大流行期间，黑人患者人数过多或过少的医院中护士的精神压力和领导沟通情况：方法：在全国医院样本（n = 90）中收集护士调查数据（2021 年 3 月）。通过线性回归模型分析了护士的精神压力。主要协变量为BSH类别（医保黑人患者比例）和领导沟通：讨论：与低 BSH 护士相比，高 BSH 护士的精神压力明显更大，获得个人防护设备的难度也更大。高BSH护士中精神压力大的比例是低BSH护士的两倍。BSHs中领导沟通较差是造成护士精神压力较大的原因：政策应改善领导层的沟通，减轻困扰，并为资源不足环境中的护士提供支持。

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来源期刊

Nursing Outlook 医学-护理

CiteScore

6.20

自引率

7.00%

发文量

109

审稿时长

25 days

期刊介绍： Nursing Outlook, a bimonthly journal, provides innovative ideas for nursing leaders through peer-reviewed articles and timely reports. Each issue examines current issues and trends in nursing practice, education, and research, offering progressive solutions to the challenges facing the profession. Nursing Outlook is the official journal of the American Academy of Nursing and the Council for the Advancement of Nursing Science and supports their mission to serve the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The journal is included in MEDLINE, CINAHL and the Journal Citation Reports published by Clarivate Analytics.