Coetzee-Prinsloo, Isabel2025-01-172025-01-172025-04-012024-12*Citation for The degree Doctor of Philosophy The degree Doctor of Philosophy Mohannad Aljabery In this thesis, a multifaceted educational intervention to reduce moral distress among critical care nurses in Abu Dhabi, the candidate utilized a quantitative quasi-experimental pretest-posttest control group design to measure the outcomes of the developed intervention. The three study phases revealed that the intervention significantly decreased moral distress frequency, intensity, and total scores, while also reducing the number of nurses who intended to leave their positions due to moral distress. Through various tools, techniques, and strategies, the intervention supported nurses in recognizing and addressing their moral distress. Additionally, the study identified five key characteristics of moral distress from the nurses' perspective, which can inform the development of future interventions or measurement tools targeting this critical issue for nurses. The study’s findings underscore the value of targeted, comprehensive educational interventions in mitigating the impacts of moral distress, ultimately contributing to better retention and satisfaction within the critical care nursing workforce.A2025http://hdl.handle.net/2263/100154Thesis (PhD (Nursing Science))--University of Pretoria, 2024.Background: In the profession of nursing, moral distress becomes a recurrent unavoidable problem with a high prevalence. Moral distress is described as a psychological disequilibrium and painful feeling that results when the individual is constrained from doing the right moral action. The complex nature of moral distress requires continuous development and improvement for the currently utilized interventions. Despite the availability of research that addressed moral distress among nurses in the literature, there is a debate about the effectiveness of the applied interventions in reducing moral distress. Aim of the study: to measure the outcome of the development and implementation of a multifaceted educational intervention on the impact of moral distress among critical nurses in Abu Dhabi. The objectives were divided into three phases: Phase 1: Measured the magnitude of moral distress among nurses working in critical care units in two tertiary hospitals in Abu Dhabi. Phase 2: Implemented the developed multifaceted educational intervention to reduce moral distress among nurses working in critical care units in one tertiary hospital in Abu Dhabi. Phase 3: Evaluated the outcomes of the implemented multifaceted educational intervention in reducing moral distress among nurses working in critical care units in one tertiary hospital in Abu Dhabi. Methodology: The study followed a quantitative quasi-experimental pretest-posttest control group design in three consecutive phases. Phase one administered the pre-test of the quasi-experimental design. Phase two implemented the developed multifaceted educational interventions that combined four educational sessions and three booster sessions for the experimental group with no intervention implemented in the control group. Phase three administered the post-test of the quasi-experimental design. The pre-test and post-test data were collected using the socio-demographic questionnaire, the Measure of Moral Distress for Health Care Professionals, and the Moral Distress Thermometer. A convenient sampling approach was used to recruit participants who volunteered for the study. The study was implemented in two tertiary hospitals located in the Emirate of Abu Dhabi. The study had a potential population of 124 critical care nurses. In phase one, a total of 218 nurses (108 control group, and 110 experimental group) responded to the pre-test. In phase two, 80 participants attended the four educational sessions and three booster sessions. In phase three, 76 participants from the experimental group and 82 from the control group (total=158) responded to the post-test and constituted the total sample of the study. Results: Pre-intervention, the critical care nurses reported a composite moral distress score of 146.4 ± 82.62, a frequency score was 51.02 ± 22.2, and an intensity score was 59.71 ± 22.1. The top-ranked cause contributing to moral distress was “following the family's insistence to continue aggressive treatment.” The independent t-test revealed a significant difference concerning participants’ gender, marital status, educational level, receiving ethics education, and intention to leave their position. Approximately 57% of the CCNs considered leaving their position due to moral distress. A moderate positive correlation was found between participants’ experience in critical care and moral distress composite, frequency, and intensity scores. Post-intervention, the multifaceted educational intervention exhibited statistically significant reductions in the experimental group frequency, intensity, and composite moral distress scores. Conversely, moral distress scores were increased among the control group. Moreover, the intervention significantly reduced the number of nurses who intended to leave their positions from 58 to 47 in the experimental group. Conclusion: Compared with other international studies, critical care nurses had higher moral distress scores in this study. The participant’s gender, marital status, educational level, ethics education, intention to leave, age, and years of experience were associated with moral distress. The multifaceted educational intervention exerts positive outcomes in reducing moral distress across all the dimensions and improving the nurses' retention.en© 2023 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.UCTDSustainable Development Goals (SDGs)Multifaceted interventionUnited Arab EmiratesCritical care nursesMoral competencyMoral conflictMoral distressThesisu22678655https://doi.org/10.25403/UPresearchdata.28217936