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

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.