The Impact of nurses' moral distress on the quality of nursing care by explaining the mediating role of narcissism and motivational self-regulation: Structural Equation Modeling

Nurses are the largest group of care providers in the health care system. Therefore, In the field of health services, the quality of care among the nurses is considered as one of the most important factors.

The present study was a descriptive correlation with the structural equation modeling approach. The study population consisted of 393 nurses of public hospitals in Borujerd, from which 195 people were selected as sample members by two methods of random cluster sampling and systematic random method. Data were collected by nurseschr(chr('39')39chr('39')) moral distress, quality of nursing care, narcissism and motivational self-regulation standard questionnaires. The quality of the measurement model and the structural model were confirmed by cv.com and cv.red tests, respectively. According to the GOF index, the quality of the final research model was equal to 0.451. These indicated that the model had a strong fitting.

The results Showed that, moral distress has a negative effect on the quality of nursing care(-0.518)and motivational self-regulation(-0.399)and a positive effect on narcissism (0.527). arcissism has a negative effect on the quality of nursing care (-0.170) and motivational self-regulation has a positive effect on the quality of nursing care (0.160). Also, Also, the mediating role of narcissism and motivational self-regulation reduces the effect of nurseschr(chr('39')39chr('39')) moral distress on the quality of nursing care (-0.090) and (-0.064), respectively.

According to the finding and results of the study, it is necessary for managers to pay attention to reduce nurseschr(chr('39')39chr('39')) moral distress and improve their motivational self-regulation by emphasizing the reduction of the role of narcissism to increase the quality of nursing care.