Moral caring competency and moral distress among Ghanaian nurses in adult care settings: A descriptive-correlational study

Background: Nurses in adult care settings frequently encounter moral distress due to the
daily ethical obligations they must fulfill. In contrast to other healthcare professionals, nurses
often grapple with a heightened frequency of moral dilemmas, resulting in increased moral
distress.
Objective: This study aimed to explore the levels and relationship between moral caring
competency and moral distress among Ghanaian nurses in adult care settings.
Methods: This quantitative study utilized a descriptive-correlational design. A multistage
sampling was used to select three public hospitals. Simple random sampling was used to
recruit 231 nurses from the three public hospitals. Data were collected from June to July 2023
using validated questionnaires. The study utilized frequency and percentages, mean and
standard deviation, and Spearman’s Correlation.
Results: The nurses had a low level of moral caring competency (M = 2.18, SD = 0.340). The
composite moral distress score was 227.31, indicating a high level of moral distress among
the nurses. Furthermore, there was a moderate, negative significant relationship between
moral caring competency and moral distress (rs = -.474, N = 231, p <0.001).
Conclusions: Nurses in public hospitals had limited personal cognitive, affective, and
psychomotor abilities to address patient moral issues. The nurses also experience significant
moral distress when delivering patient care. Furthermore, to decrease the level of moral
distress, moral caring competency should be strengthened among nurses. Therefore, it is
recommended that nurse administrators provide adequate organizational support and
implement continuous moral training to improve nurses’ moral caring competency and mitigate
their moral distress. Healthcare policymakers are encouraged to develop or refine policies to
navigate moral dilemmas and reduce moral distress among nurses. Future studies employing
qualitative designs can explore the influence of culture on moral caring competency within the
Ghanaian setting.