Examining the effects of moral distress, compassion fatigue and burnout on intention to leave among nursing students in Hong Kong: A cross-sectional study

Abstract

Background Compassion fatigue and burnout have detrimental effects on nursing students. Moral distress has been recognized as a contributing factor to both, potentially impacting the intention to leave nursing programme.

Aim To examine relationships among moral distress, compassion fatigue and burnout on intention to leave the nursing programme among nursing students.

Methods A cross-sectional correlational design was used. Four hundred eighty-four nursing students from nine higher educations participated. Data were collected using the Moral Distress Scale-Revised, Compassion Fatigue Self-Test, and a single item examining the intention to leave.

Results Mild to moderate levels of moral distress but high levels of compassion fatigue and burnout were reported. In regression analysis, year of study (OR = 14.323, CI = 1.273–161.143, p < 0.031), length of clinical learning (OR = 1.061, CI = 1.020–1.103, p < 0.003), moral distress (OR = 3.181, CI = 1.848–5.475, p < 0.001), burnout (OR = 1.165, CI = 1.118–1.214, p < 0.001) were associated with a higher chance of intention to leave. Attendance of an ethics course for >30 h (OR = 0.164, CI = 0.041–0.653, p < 0.010) and the interaction between moral distress and burnout (OR = 0.977, CI = 0.968–0.987, p < 0.001) were associated with a significant decrease in the intention to leave.

Conclusion Burnout is a strong predictor for intention to leave the nursing programme among nursing students. Interventions addressing moral distress, compassion fatigue, and burnout might prevent intention to leave the nursing programme.