Date of Award

10-13-2025

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Dr Salma Rattani

Second Advisor

Mehak Virrani

Third Advisor

Zulekha Saleem

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Moral distress is a significant issue among critical care nurses who frequently encounter ethically complex situations that contradict their moral and professional values. In Pakistan, research on this phenomenon remains limited particularly regarding how nurses in different healthcare setting perceive and manage moral distress.
Objective: This study aimed to explore perspective of critical care nurses on the causes, psychological impact of moral distress and the strategy they use to deal with moral distress in diverse healthcare settings.
Methods: An exploratory descriptive qualitative design was used to evaluate the phenomenon, data was gathered through in-depth interviews with critical care nurses working in public sector tertiary care setting in Peshawar Pakistan. A purposive sampling technique was used to select participants with at least one year experience of working in an Intensive Care Unit. A total of 35 nurses volunteered to participate in the study. Among these 15 were interviewed based on their eligibility and availability. The data was transcribed and then analysed using (Braun & Clarke 2023) thematic framework thematic to identify themes and patterns from the data.
Result: Three themes were extracted Theme One: ‘The Genesis of Moral Distress - A Conflict Between Ethics and Reality’, theme two: ‘the Pervasive Impact, the Psychological and Professional toll’ and theme three: ‘Navigating the Aftermath: Coping in a Constrained Environment’. Findings suggest that moral distress arises from factors such as inadequate staffing, the hierarchical system in Pakistan which gives dominance to physician over nurses, systemic and resources constraint, The cohort verbalizes the consequences of moral distress includes anxiety, emotional breakdown and reduced job satisfaction lead to burnout. Coping mechanism included avoidance and detachment, peer and family support and spiritual healing, there was a lack of organizational support for coping with moral distress, participants urged for a structure and formal support from organization to mitigate moral distress.
Conclusion: The study underscores urgent need for organizational support, ethical education and supportive leadership to address moral distress among critical care nurses which directly affect patients care.

First Page

1

Last Page

97

Download

Share

COinS