Nurses’ Moral Sensitivity and its Relationship with the Quality of Care Patients Receive and Patients’ Satisfaction in the Medical Wards of Tabriz

Abstract

Abstract: Background and purpose: The quality of nursing care is one of the most important factors affecting the satisfaction of patients in health care centers. Nurses are faced with serious situations in their professional lives, which requires abilities in moral decision-making. Moral sensitivity is the first step in moral performance. The aim of this study was to determine the relationship between the moral sensitivity of nurses and the satisfaction of patients admitted to the internal clinical wards of Tabriz University of Medical Sciences. Methods: This study was a descriptive correlational study conducted with the participation of 198 nurses and 198 qualified patients in 2016 in 17 medical wards of the hospitals affiliated with Tabriz University of Medical Sciences. Nurses were sampled by the census method. In this study, for each nurse, a patient was selected randomly from the same ward. The data collection tools were the Moral Sensitivity Questionnaire (MSQ), the Quality Patient Quality Scale (QUALPAC) and Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ). The data were analyzed by descriptive statistics and Pearson correlation coefficient tests in the software SPSS version 13. Findings: The mean of nurses' moral sensitivity was 136.47 ± 13.30, the total mean score of nurses’ quality care was 196.36 ± 44.10 and the mean score of patients’ satisfaction was 72.84 ± 19.07. The results showed there was no significant relationship between the mean scores of patient care and nurses' moral sensitivity (r = −.14, p =.5). The results of the Pearson correlation coefficient showed that there was no significant relationship between the mean of patient satisfaction with the care received and moral sensitivity of nurses in hospitals affiliated with Tabriz University of Medical Sciences (r = 0.04, p = 0.8). However, there was a significant inverse relationship between the dimension of “moral conflict” experience and the overall score of quality care (r = −.50, p =.04), the dimensions of “psychosocial (r = −.50, p =.04)” and “physical (r = −.50, p =.03).” Conclusion: Considering the significant inverse relationship between the score of patient quality care and the dimension of moral conflict experience, it seems If this tension is not resolved properly, it can find its way to distant patients and be the underlying basis for indifference shown when providing them moral care. Although the moral sensitivity of the nurses under study was desirable, considering that nurses had a higher score in terms of compliance with the rules and a lower score in the case of respect for patient independence, in addition, considering the high level of patients’ dissatisfaction with “nurses’ routine work,” it seems that ethical decision-making in the real situation is not merely due to the moral sensitivity of nurses. Therefore, policy makers in the health system should be able to change or modify the barriers facing nurses