The Association between Nurses’ Quality of Work Life and Moral Distress: A Cross-Sectional Study in Rasht, Iran

Nurses play a crucial role in delivering healthcare services, emphasising the need for healthcare managers to prioritise their well-being. The quality of work life (QWL) is a significant factor influencing the recruitment and retention of nurses. This study aimed to investigate the relationship between the QWL and moral distress among nurses working in educational-remedial hospitals in Rasht, Iran. This cross-sectional analytical study utilised multi-stage sampling to survey all nurses in educational-remedial hospitals in Rasht, excluding those in ICUs, and in administrative, educational and research roles. A structured questionnaire was employed as the primary data collection tool, with data analysis conducted using SPSS version 16. The study found that over 50% of nurses reported a QWL below the mean. Significant correlations were observed between the QWL and variables, such as age (r = 0.349, p < 0.001); work experience (r = 0.319, p < 0.001); marital status (p = 0.036); level of education (p = 0.023); work shifts (p < 0.001); employment status (p < 0.001); and work position (p = 0.014). Additionally, the nurses’ moral distress levels were generally low, with a notable negative correlation between the nurses’ total QWL score and total moral distress scores (rS = –0.305, p < 0.001). The findings suggest that nurses experiencing moral distress due to executing unnecessary physician orders; ineffective team communication; and providing futile patient care are likely to face diminished QWL. Moreover, heightened moral distress levels can contribute to a decline in overall job satisfaction and well-being among nurses.