Moral Distress in Pediatric Nursing: A Cross-Sectional Analysis from Sichuan, China
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By
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Li Li
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Yulan Shi
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Menglin Tang
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April 29, 2026
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Clinical Scorecard: Moral Distress in Pediatric Nursing: A Cross-Sectional Analysis from Sichuan, China
At a Glance
| Category | Detail |
|---|
| Condition | Moral Distress among Pediatric Nurses |
| Key Mechanisms | Influenced by department, professional title, gender, hospital ethical climate, moral sensitivity, and nurse-physician collaboration. |
| Target Population | Pediatric nurses in Sichuan Province, China |
| Care Setting | Tertiary hospitals with Pediatric Intensive Care Units (PICUs), Neonatal Intensive Care Units (NICUs), and general pediatric wards. |
Key Highlights
- Median total moral distress score was 64.00 (IQR: 36.00–84.00).
- Higher levels of moral distress reported in PICUs and NICUs compared to general pediatric units.
- Female nurses experienced more severe moral distress than male nurses.
- Six independent predictors of moral distress identified, accounting for 40.2% of variance.
- Moral distress is linked to emotional exhaustion and job satisfaction.
Guideline-Based Recommendations
Diagnosis
- Utilize the Revised Moral Distress Scale–Nurse Pediatric Version (MDNPV) for assessment.
Management
- Implement the standardized '4A' process (Ask, Affirm, Assess, Act) for addressing moral distress.
Monitoring & Follow-up
- Regularly assess moral distress levels among pediatric nursing staff.
Risks
- Increased risk of burnout and intention to leave the profession due to moral distress.
Patient & Prescribing Data
Pediatric patients in intensive care and general pediatric settings.
Addressing moral distress can improve nurse retention and patient care quality.
Clinical Best Practices
- Foster a supportive hospital ethical climate.
- Enhance nurse-physician collaboration.
- Provide training on moral sensitivity and ethical decision-making.
References
