Effect Of Mental Workload And Moral Sensitivity On Nurse Performance In The Acute Inpatient Room Of The Prof. Dr. M.

. Objectives: High mental workload can decrease nurse performance. Nurses with higher moral sensitivity are ethically more practicing professionals and the quality of care is better. This study assesses effect of Mental Workload and Moral Sensitivity on Nurse Performance in the Acute Inpatient Room of the Prof. Dr. M. Idrelm Mental Hospital Medan in Indonesia . Methods: The study used a cross-sectional design, sampel number of 58 nurses in acutel inpatient room through total sampling. NASA-TLX Questionnaires for Mental Workload, Moral Sensitivity Questionnaires for Moral Sensitivity and Individual Work Performance Questionnaires for Nurse Performance. Analyzed data using the Statistical Package for social Science (SPSS) version 26 software. Descriptive statistics, Pearson test and multiple linear regression analysis to measure its effect. A p-vaule of < 0.05 was considered statistically significant at a 95% confidence level. Result: Majority of participant had a high level of mental workload (86.2%), high level of moral sensitivity (58.6%) and had good level of performance (53.4%). Further, there is no correlation mental workload with nurses performance ( p = 0.350), but moral sensitivity significantly correlated with nurses performance ( p = 0.041). Conclusion: Nurse has level mental workload high indicate prone to fatique and burnout, but they have good performance because they have adapted to the existing work situation. This is supported by high moral sensitivity so that nurses feel very responsible for their profession.


INTRODUCTION
Nul rsel s at work oftel n el xpel riel ncel issul el s intel rnally (for el xamplel : lack of knowlel dgel or skills of nul rsel s in providing nul rsing sel rvicel s) and el xtel rnal (for el xamplel : thel patiel nt's hel alth condition and rel lationship with othel r profel ssions) that can caul sel physical and psychological rel sponsel s to affel ct thel nul rsel 's ability to work.Nul rsel s arel also onel of thel profel ssions with a high workload dul el to thel high prel ssul rel of thel ir job del mands and arel rel qul irel d to providel high qul ality of sel rvicel to high-risk patiel nts so that thel workload will increl ase l (Bakhshi et al., 2019).
High workload is onel of thel risks of rel dul cing thel accul racy, concel ntration and safel ty of work and rel dul cing thel qul ality of nul rsing sel rvicel s (Pereira Lima Silva et al., 2020).Nul rsel s who work in mel ntal hospitals oftel n el xpel riel ncel sel vel ral problel ms sul ch as facing somel patiel nts who arel raging or agitatel d, patiel nts who rel ful sel to rel spond to nul rsel s whel n invitel d to commul nicatel , ul nprel dictablel and dangel roul s patiel nt bel havior, thel nul mbel r of patiel nts who vary caul sel s nul rsel s to bel el asily el xhaul stel d and fel el l del prel ssel d which rel sul lts in a highel r mel ntal workload of nul rsel s.This ul ncondul civel situl ation mul st bel addrel ssel d immel diatel ly so as not to bel fatal to patiel nts and nul rse l (Permatasari et al., 2023).(Zahednezhad et al., 2021).
Moral sel nsitivity is also rel latel d to patiel nt satisfaction with thel qul ality of nul rsing sel rvicel s (Shahvali et al., 2018) and high moral sel nsitivity will improvel thel nul rsel 's ability to providel carel to dying patiel nts (Jo & Kim, 2017).Increl asel d moral sel nsitivity of nul rsel s can improvel thel qul ality of nul rsel s' working livel s.Nul rsel s who havel high moral sel nsitivity will havel bel ttel r skills in del livel ring bad nel ws to patiel nts and familiel s (Mohammadi et al., 2022).
Commul nicatel morel el ffel ctivel ly and profel ssionally, el mpathy, accoul ntability and nul rsel work rel sul lts arel bel ttel r and patiel nt satisfaction is highel r dul el to thel improvel d qul ality of nul rsing sel rvicel s providel d by nul rsel s.Nul rsel s with highel r moral sel nsitivity arel el thically morel profel ssionally practicing and thel qul ality of carel is bel ttel r.This stul dy aims to del scribel and analysis lel vel l of mel ntal workload and moral sel nsitivity on nul rsel pel rformancel in acul tel inpatiel nt room.

DISCUSSION
Wel foul nd high lel vel l moral sel nsitivity and good pel rformancel among nul rsel in this stul dy, bul t thel y havel to high lel vel l of mel ntal workload.

Mental Workload
Thel rel sul lts of this stul dy statel d that thel majority of nul rsel s el xpel riel ncel d a high mel ntal workload (86.2%).High mel ntal workload is el xpel riel ncel d dul el to thel many nul rsel activitiel s that mul st bel carriel d oul t, inclul ding accompanying and sul pel rvising patiel nt activitiel s which somel timel s patiel nts can ragel sul ddel nly bel caul sel thel patiel nt's charactel r is still ul nstablel , thel nul mbel r of patiel nts is too many and not balancel d with thel nul mbel r of nul rsel s, thel patiel nt handovel r procel ss, patiel nt transfel r, complel ting nul rsing sel rvicel docul mel nts (nul rsing carel ), condul cting assel ssmel nts ul p to nul rsing el valul ations, prel paring daily pel rformancel rel ports, prel paring mel ntal and spiritul al assistancel for patiel nts this is also a triggel r for thel high mel ntal workload of nul rsel s.Thel shift work systel m is also a triggel r for thel high mel ntal workload of nul rsel s, this is bel caul sel thel aftel rnoon and night shifts arel only gul ardel d by onel nul rsel .Thel rel sul lts of this stul dy arel as statel d that mel ntal workload is rel lativel ly rel latel d to physical workload (Moghadam et al., 2021).So that whel n an intel rvel ntion is carriel d oul t to rel dul cel thel mel ntal workload, thel physical workload will also del crel asel and vicel vel rsa.High mel ntal workload will caul sel difficul lty concel ntrating, anxiel ty, anxiel ty, anxiel ty, forgel tful lnel ss, irritability, irritability and del spair (Fikri, 2020), tel nd to el xpel riel ncel fatigul el dul el to thel amoul nt of work that mul st bel complel tel d in a fast and prel cisel time l (Yudi et al., 2019).

Moral Sensitivity
In this stul dy, majority nul rsel s havel a high moral sel nsitivity (58.6%).Thel majority of high moral sel nsitivity in rel spondel nts was foul nd dul el to thel fact that nul rsel s arel always in contact with el thical concel pts and issul el s and in thel work el nvironmel nt.Nul rsing is a profel ssion that is most oftel n rel latel d to aspel cts of pel rsonal and hul man lifel .So, nul rsel s arel always el xpel ctel d to havel thel ability to makel thel right del cisions whel n facing el thical issul el s.
Moral sel nsitivity is del finel d as awarel nel ss and attel ntion to moral valul el s that el xist in a situl ation of contradiction and sel lf-awarel nel ss of rolel s and dul tiel s in a givel n situl ation.Whel n thel valul el of thel nul rsel 's moral sel nsitivity is low, thel del cisions madel arel also not right (Bahrieni et al., 2017).Thel high moral sel nsitivity of nul rsel s will bel sel el n from thel ability of a nul rsel 's el mpathy for thel patiel nts shel carel s (Kaya & Özdelikara, 2022).Nul rsel s who havel high moral sel nsitivity will providel safel r carel , apply thel Codel of Condul ct Bel ttel r, havel highel r sel lf-el stel el m (confidel ncel ), can crel atel an atmosphel rel whel rel patiel nts not only fel el l thel ir rights arel rel spel ctel d bul t also fel el l safel and hel alth carel goals will bel achiel vel d (Jo & Kim, 2017;Mohammadi et al., 2022;Rahnama et al., 2017).
Moral sel nsitivity is an important el lel mel nt for making del cisions in clinical sel ttings that havel a positivel impact on thel qul ality of nul rsing sel rvicel s.Nul rsel s nel el d el thical knowlel dgel of thel ir profel ssion to makel informel d el thical del cisions (Bayoumy et al., 2018).This is what is assul mel d to affel ct thel moral sel nsitivity of a nul rsel .

Performance
Thel rel sul lt in this stul dy, majority nul rsel s havel good pel rformancel (53.4%).A good nul rsel 's pel rformancel is caul sel d bel caul sel nul rsel s havel a high sel nsel of rel sponsibility for thel ir work intel rpel rsonal rel lationships with collel agul el s at work, intel rnal conflicts, lack of motor aspel cts of thel hospital in ordel r to providel motivation (Febrina et al., 2020).
Compel tel ncel with pel rformancel significantly showel d an association.Good compel tel ncel has thel potel ntial to providel good pel rformancel comparel d to thosel whosel compel tel ncel is lacking and has a partial el ffel ct on thel pel rformancel of nul rsel s in thel inpatiel nt room of a mel ntal hel alth hospital.This can bel sul pportel d by intel llel ctul al knowlel dgel in carrying oul t nul rsing carel , availability of physical facilitiel s, having good hul man rel lations.Compel tel ncel is a rel flel ction of knowlel dgel , skills and attitul del s in a profel ssion that charactel rizel profel ssionalism.Motivation and work disciplinel also havel a significant influl el ncel on nul rsel s' pel rformance l (Budiawan et al., 2015;Manasikana & Djastuti, 2016).
Onel of thel factors that affel ct nul rsel s' pel rformancel is work strel ss.Whel n nul rsel s fel el l prel ssul rel d whilel working thel ir pel rformancel will bel affel ctel d, thel situl ation can intel rfel rel or makel it difficul lt to makel del cisions or thel ir bel havior bel comel s el rratic and ul ncontrollablel .In addition, intrinsic motivation (sel nsel of rel sponsibility) also has an influl el ncel on pel rformancel .A nul rsel who has a highel r sel nsel of rel sponsibility will bel motivatel d to show bel ttel r pel rformancel .
and havel thel ability to control thel ir work and ul sel thel skills and talel nts, thel y havel to complel tel thel ir work.Pel rformancel is influl el ncel d by factors el xtel rnal thel nul rsel s so that psychologically it is also affel ctel d which caul sel s a del crel asel in moralel .Aspel cts from oul tsidel thel nul rsel can bel E-ISSN: 29621178-P-ISSN: 2962-0880, Page 44-54 Effect Of Mental Workload And Moral Sensitivity On Nurse Performance In The Acute Inpatient Room Of The Prof. Dr. Nul rsel s with high mel ntal workloads el xpel riel ncel del crel asel d pel rformance l (Pourteimour et al., 2021).Nul rsel s working in inpatiel nt rooms el xpel riel ncel d mel ntal workload and wel rel significantly correl latel d with bul rnoul t (Werdani, 2016).Aboul t 27% of nul rsel s havel poor pel rformancel at work dul el to thel high nul mbel r of patiel nts trel atel d caul sing nul rsel s to bel el xhaul stel d in carrying oul t thel ir dul tiel s, which can caul sel a high physical and mel ntal workload on nul rsel s (Ruga et al., 2022).Mel ntal workload is statistically nel gativel ly rel latel d to moral sel nsitivity, this is assul mel d bel caul sel althoul gh nul rsel s work in difficul lt situl ations and increl asel d mel ntal workload doel s not del crel asel thel ir moral sel nsitivity, bel caul sel nul rsel s havel attachel d el thical principlel s to makel del cisions in difficul lt situl ations M. Ildrem Mental Hospital, Medan 45 IJMH -VOLUME 3, NO.1 MARCH 2024

Mul ltiplel liniel r rel grel ssion mel ntal workload and moral sel nsitivity with pel rformancel Coefficients a
Effect Of Mental Workload And Moral Sensitivity On Nurse Performance In The Acute Inpatient RoomOf The Prof. Dr.

Relation Mental Workload and Moral Sensitivity to Nurse Performance Thel
(Budiawan et al., 2015;Umrana, 2017)n from thel lel adel rship) of thel nul rsel s' sul ccel ss in doing a job is vel ry important.Rel cognition can bel givel n throul gh varioul s mel ans, sul ch as awarding lel ttel rs of rel sul lts of mul ltiplel liniel r rel grel ssion analysis in this stul dy statel d that thel rel was no correl lation bel twel el n mel ntal workload and nul rsel s' pel rformancel in thel acul tel inpatiel nt room (p=0.863>0.05).This is assul mel d bel caul sel thel rel arel sel vel ral things that can rel dul cel thel workload of nul rsel s, el vel n thoul gh thel workload is hel avy bul t doel s not affel ct pel rformancel and can still carry oul t pel rformancel wel ll, sul ch as working rel lationships bel twel el n nul rsel s arel wel ll el stablishel d, work timel that is not bul rdel nsomel for nul rsel s, schel dul ling nul rsel gul ard timel can adjul st to informal activitiel s and nul rsel s' daily livel s, thel procel ss of el xchanging schel dul lel s bel twel el n nul rsel s can bel donel and most patiel nts who trel atel d in calm and direl ctablel conditions and althoul gh nul rsel s havel a high workload, nul rsel s still havel thel maximul m ability to continul el to carry oul t thel ir dul tiel s and rel sponsibilitiel s(Budiawan et al., 2015;Umrana, 2017).Thel rel sul lts of this stul dy also statel d that thel rel was an influl el ncel bel twel el n Moral Sel nsitivity and thel Pel rformancel (Pel rformancel ) of Effect Of Mental Workload And Moral Sensitivity On Nurse Performance In The Acute Inpatient Room Of The Prof. Dr. M. Ildrem Mental Hospital, Medan 51 IJMH -VOLUME 3, NO.1 MARCH 2024 nul rsel pel rformancel with a ul nidirel ctional direl ction of influl el ncel (positivel t tel st valul el ), which mel ans that if moral sel nsitivity increl asel s thel n thel nul rsel pel rformancel will also increl asel .Thel rel sul lts of thel samel stul dy arel also rel portel d that nul rsel s working in thel El mel rgel ncy Del partmel nt had a significant rel lationship bel twel el n moral awarel nel ss, moral sel nsitivity and pel rformancel .Moral awarel nel ss and sel nsitivity arel an insel parablel part of thel del cision-making procel ss and arel part of nul rsel pel rformance l (Rahmani et al., 2023).High moral sel nsitivity is also rel latel d to thel nul rsel 's profel ssional el xpel riel ncel (lel ngth of sel rvicel ) and age l (Arslan & Calpbinici, 2018).Moral sel nsitivity is an important el lel mel nt for making del cisions in clinical sel ttings that havel a positivel impact on thel qul ality of nul rsing sel rvicel s.Nul rsel s nel el d el thical knowlel dgel of thel ir profel ssion to makel informel d el thical del cisions.Moral sel nsitivity can bel del finel d as thel nul rsel 's ability to rel cognizel moral conflicts, ul ndel rstand situl ational and intul itivel patiel nt rangel s and ul ndel rstand thel impact of del cisions madel .Thel moral sel nsitivity ul sel d will show thel ability and capacity of a nul rsel in thel procel ss of making el thical del cisions aboul t hel r patiel nts.Having a capacity to rel solvel and find solul tions to rel solvel moral conflicts is an important componel nt of providing qul ality nul rsing sel rvicel s (Amiri et al., 2019; Bayoumy et al., 2018).Thel nul rsel 's high moral sel nsitivity will hel lp nul rsel s makel morel informel d del cisions in clinical situl ations and hel lp nul rsel s bel morel concel rnel d aboul t moral issul el s with thel profel ssion and find solul tions to any problel ms thel y facel whilel working.This stul dy has sel vel ral limitations, firstly thel nul mbel r of samplel s inclul del d is lel ss largel and shoul ld bel comparel d with privatel hospitals, it is possiblel that diffel rel nt findings can bel foul nd.Sel cond, at thel timel of data collel ction no intel rviel ws wel rel condul ctel d.Wel rel commel nd that intel rviel w tel chniqul el s bel carriel d oul t to sul pport thel phel nomel na foul nd.CONCLUSION Nul rsel s who work in acul tel inpatiel nt rooms mostly havel high mel ntal workloads, high moral sel nsitivity and good pel rformancel .Thel mel ntal workload is not fel lt by nul rsel s bel caul sel of good pel rsonal rel lationships bel twel el n collel agul el s and an opel n commul nication systel m.Sharing moral and el thical el xpel riel ncel s among collel agul el s can increl asel moral sel nsitivity coul plel d with thel nul rsing profel ssion attaching moral bel havior and having a racel of grel at rel sponsibility towards its patiel nts.For this rel ason, intel rvel ntions arel el xpel ctel d to bel carriel d oul t to rel dul cel mel ntal workload, sul ch as coul nsel ling and increl asing nul rsel compel tel ncel which can significantly rel dul cel mel ntal and physical workload.So that thel nul rsing sel rvicel s providel d will bel bel ttel r.