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    Work Engagement, Moral Distress, Education Level, and Critical Reflective Practice in Intensive Care Nurses

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    Author
    Lawrence, Lisa Ann
    Issue Date
    2009
    Keywords
    Critical Reflective Practice
    Moral Distress
    Work Engagement
    Committee Chair
    Reed, Pamela G.
    
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    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    The purpose of this study was to examine how nurses' critical reflective practice, education level, and moral distress related to their work engagement. This is an area of study relevant to nursing, given documented United States Registered Nurse (RN) experiences of job related distress and work dissatisfaction, and the nursing shortage crisis. Nurses are central players in the provision of quality health care. There is need for better understanding of RNs' work engagement and factors that may enhance their work experience. A theoretical framework of critical reflective practice was developed and examined in this study.A non-experimental, descriptive, correlational design was used to examine the relationships among four study variables: critical reflective practice, education level, moral distress, and work engagement. The purposive sample consisted of 28 intensive care unit RNs (ICU-RNs) from three separate ICUs (medical, neonatal, and pediatric) in a 355-bed Southwest magnet-designated hospital. Measures of the key variables were as follows: (1) Critical Reflective Practice Questionnaire (CRPQ) developed for this study; (2) a subscale of Mary C. Corley's Moral Distress Scale; (3) Education level measured as the highest nursing degree earned to practice as a RN; and (4) the Utrecht Work Engagement Scale. All instruments demonstrated adequate reliability and validity.Pearson correlation and multiple regression analyses indicated support for the theoretical framework: There was a negative direct relationship between moral distress and work engagement, a positive direct relationship between critical reflective practice and work engagement, and moral distress and critical reflective practice, together, explained 47% of the variance in work engagement. Additionally, in the NICU, results indicated a positive direct relationship between increased educational level and critical reflective practice. Results also indicated that moral distress was a clinically significant issue for ICU-RNs in this sample.Strategies to promote critical reflective practice and reduce moral distress are recommended. Additionally, the findings support continued study of critical reflective practice and moral distress, and the role of education level, in nurses' work engagement. Research goals include continued study of the theoretical framework in larger study samples and in reference to additional explanatory factors.
    Type
    text
    Electronic Dissertation
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Nursing
    Graduate College
    Degree Grantor
    University of Arizona
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