Moral distress and intention to leave among intensive care unit nurses in the United Arab Emirates

The study aimed to examine the severity of moral distress and intention to leave among ICU nurses in the United Arab Emirates (UAE), and explore the influencing factors of intention to leave.

The study utilized a cross-sectional research design. A convenience non-probability sample of 341 nurses from various private and government hospitals across different emirates in the UAE participated in June 2022. Data were collected using a self-administered questionnaire comprising demographic information, the Moral Distress Scale-Revised. Multivariable logistic regression was used to identify factors associated with intention to leave.

The study found that a large majority (71.9 %) of ICU nurses experienced severe moral distress, and more than 35 % had intention to leave. Futile end-of-life interventions emerged as the most distress-provoking aspect of practice [16.0 (0, 16.0)]. Multivariable analysis revealed nurses experiencing severe moral distress had 3.73 times the odds of intending to leave their job compared with those experiencing mild distress (95 %CI: 1.81, 7.69; P < 0.001) and being aged 31-40 years (OR = 2.02; 95 %CI: 1.23, 3.33; P = 0.005) was independently associated with a higher intention to leave.

Severe moral distress was prevalent among ICU nurses in the UAE and strongly associated with intention to leave, and also those aged 31-40 years. Promoting ethical support, shared decision-making, and nurse empowerment is vital to improving retention and care quality.