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Health care reform in Iran: Implications for nurses’ moral distress, patient rights, satisfaction and turnover intention
Author(s) -
Hatamizadeh Maryam,
Hosseini Mohammadali,
Bernstein Colleen,
Ranjbar Hadi
Publication year - 2019
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.12699
Subject(s) - job satisfaction , workload , turnover intention , distress , nursing , psychology , medicine , population , social psychology , clinical psychology , environmental health , computer science , operating system
Aim The aim of the present study was to assess the implications of Iran's recent health care reforms on nurses’ experience of moral distress, their perceptions of the respect for patient rights and the relationship of these variables to job and income dissatisfaction and turnover intention. Background Health systems around the world are reforming themselves to adapt to meeting the future needs of increasing patient care to an ever‐growing population. Methods This was a cross‐sectional correlational study. The participants were 276 nurses at six large private and public hospitals in Tehran, Iran. Findings Negative correlations were reported between turnover intention and respecting patient rights ( r = −0.560, p < 0.001), satisfaction with job ( r = −0.710, p < 0.001) and satisfaction with income ( r = −0.226, p < 0.001). The correlation between moral distress intensity ( r = 0.626, p < 0.001) and frequency ( r = 0.701, p < 0.001) was positive with turnover intention. Conclusions Moral distress was significantly correlated to poor respect for patient rights, poor job satisfaction and income satisfaction and was a major predictor of turnover intention. Implications for Nursing Management Health system reform must take into account the concomitant increasing workload and its negative impact in order to ensure that reform does not lead to unintentional detrimental outcomes of increased moral distress, decreased satisfaction and increased turnover rates among nursing personnel.