The Relationship Between Health Anxiety and Perceived Stress With Moral Distress in Emergency Nurses: The Mediating Role of Distress Tolerance

Background: Nurses in emergency departments always experience stress and moral issues due to job stressors. This study was conducted to present a model of the relationship between health anxiety and perceived stress with moral distress containing the mediating role of distress tolerance in emergency department nurses. Materials and Methods: This descriptive correlational study was performed on 230 emergency nurses in Tehran, Iran, in 2020. They were recruited using the convenience sampling method. In this study, the perceived stress questionnaire (Cohen, Kamark, and Marmelstein, 1983), health anxiety (Salkowski and Warwick, 2002), distress tolerance (Simons and Gahr , 2005), and Jameton moral perturbation questionnaire were used. Data analysis was performed by path analysis using SPSS v. 24 and Amos v. 24. Results: The study’s findings showed that perceived stress (t=5.58) and health anxiety (t=7.1) had a positive and direct effect on moral distress. Nevertheless, distress tolerance (t=8.33) had a negative and direct effect on moral distress (P<0.01). Furthermore, distress tolerance has a mediating role in the relationship between perceived stress and health anxiety with moral distress (P<0.01). Conclusion: Distress tolerance mediates the relationship between perceived stress and health anxiety with moral distress. The findings of this study can improve distress tolerance and the level of work ethic and reduce the moral distress of emergency department nurses.