Influencing Factors of Moral Distress in Emergency and Critical Care Nurses:a Systematic Review
CHEN Chen
GUAN Yan
ZHANG Chi
JIN Hua
WANG Yan
WANG Zheyun
Abstract：Objective To systematically evaluate the factors influencing moral distress among emergency and critical care nurses.Methods A comprehensive search was conducted in The Cochrane Library,PubMed,Embase,Web of Science,CBM,CNKI,Wanfang and VIP for literature on factors associated with moral distress in emergency and critical care nurses.The search period was from database inception to October 31,2025.Two researchers independently screened the literature,evaluated the quality,and extracted and summarized the data.Results A total of 23 studies involving 6 278 nurses were included.Qualitative synthesis results indicated that the influencing factors of moral distress can be categorized into personal factors and organizational factors.Moral distress were positively correlated with job burnout and turnover propensity,and negatively correlated with job satisfaction.Conclusion Moral distress is prevalent among emergency and critical care nurses and is influenced by multiple factors.Nursing managers should identify nurses at risk based on these influencing factors and develop targeted interventions to mitigate the occurrence of moral distress.
Keywords：emergency and critical care nursemoral distressinfluencing factorsnursingsystematic review
Publication Date：2026-02-10
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：7( 162-168 )