Background. One of the most important psychosocial issues related to the nursing profession is moral distress (MD), which has devastating effects on student performance as well as patient care. The current study was conducted to determine the frequency, severity, rate, and causes of MD in nursing students. Methods. During this cross-sectional study, 86 samples were last year undergraduate nursing students of Kermanshah University of Medical Sciences, who were entered into the study by the census method. Data gathering instruments were personal information form, Moral Distress Scale-revised (MDS-r), and Moral Distress Thermometer (MDT). Results. The mean frequency, severity, and rate of MD, according to the MDS-r questionnaire, were 1.3 ± 0.7 out of 4, 1.8 ± 0.8 out of 4, and 3.3 ± 2.3 out of 16, respectively. The average MDT score was 2.6 ± 2.5 out of 10. The most common causes of MD were working in unsafe conditions (6.8 ± 6.0), observing impaired patients health servicing (5.4 ± 5.6), and the low quality of patient care (5.1 ± 4.6). There was a statistically significant relationship between the gender, work experience, and participation in the professional ethics workshop variables and mean MDS-total and MDT. Conclusion. The rate and mean severity of MD were reported at a moderate level. Also, the MDT average was reported at a mild to an uncomfortable level, and the overall MD was equal to moderate. Therefore, student administrators should take steps to eliminate or reduce the causes of MD. In this regard, the need for teaching preventive methods against MD to nursing students before their clinical courses seems crucial. Also, students with MD must be referred to the psychiatric/psychologist.

中文翻译：

---

护生发生频率，严重性，发生率和道德困扰的原因：跨学科研究

背景。与护理专业有关的最重要的社会心理问题之一是精神困扰（MD），它对学生的表现以及患者的护理产生毁灭性的影响。进行本研究是为了确定护理系学生出现MD的频率，严重程度，发生率和原因。方法。在这项横断面研究中，有86个样本来自克曼沙姆医科大学的护理学专业的去年本科生，他们通过普查方法进入研究。数据收集工具包括个人信息表，修订的道德苦恼量表（MDS-r）和道德苦恼温度计（MDT）。结果。根据MDS-r问卷调查，MD的平均频率，严重程度和发生率分别为4分中的1.3±0.7、4分中的1.8±0.8和16分中的3.3±2.3。MDT的平均得分为2.6±2.5（满分10分）。最常见的MD原因是在不安全的条件下工作（6.8±6.0），观察到患者的健康服务受损（5.4±5.6）和患者护理质量低下（5.1± 4.6）。性别，工作经验以及参加职业道德研讨会变量与平均MDS总计和MDT之间存在统计学上的显着关系。结论。据报道，MD的发生率和平均严重程度为中等水平。此外，据报告，MDT的平均值处于轻度至令人不舒服的水平，而总体MD则等于中度。因此，学生管理员应采取措施消除或减少MD的原因。在这方面，在护理课程开始前向护理学生教授预防MD的预防方法的需求显得至关重要。此外，患有MD的学生必须转介给精神病学/心理学家。