An Inpatient Surgical Oncology Unit’s Experience With Moral Distress: Part II

Pelton, Nicole; Bohnenkamp, Susan; Reed, Pamela G.; Rishel, Cindy J.

doi:10.1188/15.onf.412-414

Cited by 4 publications

(8 citation statements)

References 27 publications

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“…Of the 17 articles selected for this review, seven corresponded to qualitative studies (22,23,(26)(27)(28)(29)(30); six to quantitative studies (16,(31)(32)(33)(34)(35); two were reflections (36,37); and two were editorials (17, 18) (Figure 3). Eighteen percent of the articles were published between 2006 and 2011, and 82% between 2012 and 2016 (Figure 4).…”

Section: Resultsmentioning

confidence: 99%

“…Pelton et al (37) Describe the approaches used to alleviate moral distress of nurses in a surgical oncology unit and the challenges faced when addressing the complex factors contributing to that moral distress.…”

Section: Reflection Does Not Applymentioning

confidence: 99%

“…Lack of resources for ethics, like participation in specialized programs, funding for follow-up, and time for discussion also influence on the emergence of moral distress (17,27,37). Cohen and Erickson propose that the lack of recognition of the ethical dilemma and their appropriate discussion in the team lead to having moral distress; upon this, Sirilla adds that it is necessary to analyze the ethical problem through theoretical approaches that guide nurses (35).…”

Section: Resources For Ethicsmentioning

confidence: 99%

“…When these words were mentioned, a discussion was begun in that respect; thus, the physician reported how decisions were made in light of different processes of the disease, and this permitted the nurses to understand the steps of the treatment to facilitate their care role. Additionally, in this study, the participants worked in inter-professional groups, developing solutions for stressing factors in the unit, and this allowed them an emotional bond to open communication opportunities (37).…”

Section: Resources For Ethicsmentioning

confidence: 99%

“…The health staff in oncology is comprised of members from various disciplines, and lack of communication among them lead to important problems being misinterpreted or misunderstood, which could provoke moral distress in its members (37). The qualitative research conducted by Pye indicates that poor communication and scarce dynamics within the team and within the decision-making process can influence the appearance of moral distress in nurses (30).…”

Section: Poor Communicationmentioning

confidence: 99%

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Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review

Celis

Méndez

2019

Aquichan

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Objective: To describe the factors that influence the emergence of moral distress in oncology nurses. Methodology: integrative review of the literature whose search will be performed in Web of Science databases, CINAHL (EBSCO), Scielo, Proquest, Pubmed and PsycInfo using the keywords moral distress and oncology nursing and their similes in Spanish, without restriction for years of publication until 2017. Results: The results of this review were grouped into three groups of factors each with subgroups: 1) Organizational factors: ethical climate, evasive culture and resources for ethics delivered by the organization. 2) Particular clinical situations: pain management, information delivery, futile treatment, and assistance to the patient and their family in the process of death, 3) Interpersonal relationships: poor communication, power relations, trust in the team’s competence. Conclusion: the three factors described are triggers of moral distress in oncology nurses. When there are ethical problems and the nurses do not participate in the deliberation process, these problems can be hidden and be normalized, which can diminish the moral sensitivity of the professionals, as well as the possibility of acting as moral agents.

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Section: Resultsmentioning

confidence: 99%

Section: Reflection Does Not Applymentioning

confidence: 99%

Section: Resources For Ethicsmentioning

confidence: 99%

Section: Resources For Ethicsmentioning

confidence: 99%

Section: Poor Communicationmentioning

confidence: 99%

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Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review

Celis

Méndez

2019

Aquichan

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Acute Care Contexts

Jones-Bonofiglio

2020

The International Library of Bioethics

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Experiences of moral distress among health care professionals in oncology and palliative care in Australia: a qualitative investigation

Ratcliffe,

Rosenberg,

Stafford

et al. 2024

Journal of Psychosocial Oncology Research and Practice

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Background: Cancer care involves challenging clinical problems requiring expertise of multiple disciplines and frequently necessitates nuanced decision-making. When decision-making and patterns of care conflict with the values of health care professionals (HCPs), moral distress may arise. Moral distress is defined as the unease resulting from the perceived violation of professional or personal values and ethical principles. It has been associated with increased burnout and lower workforce retention among HCPs. This study aimed to investigate moral distress among Australian oncology and palliative care HCPs to understand how, when, and why it is experienced. Method: We conducted a qualitative interview study, with an online survey to collect demographic, practice-related characteristics, and level of moral distress. Interviews were conducted with oncology and palliative care HCPs in Australia to explore participants' experiences of moral distress. Interviews were audio-recorded and transcribed. A thematic analysis was conducted using a framework analysis approach. Results: We interviewed 33 participants, who were predominantly female (78%) and nurses (42%) with 50% having 15 years or more experience in oncology/palliative care. Thematic analysis revealed one meta-theme, Power and Hierarchy, and four themes: (1) values and their conflicts; (2) moral distress and the system; (3) moral distress and interpersonal interactions; and (4) internalized moral distress. At the core of HCPs' experiences of moral distress were patient-centered and care-centered values and the imperative to not violate the oath to “Do No Harm.” Moral distress was perceived to be covert, primarily arising in response to day-to-day clinical dilemmas and resulted from interactions with other HCPs and structural factors. Moral distress appeared to be cumulative over time. Conclusion: Moral distress arises when there are conflicts between an individual's values and organizational culture, within teams, and within the HCPs themselves. Power and hierarchy within health care are critical elements contributing to moral distress where poor communication and limited recognition of differing views are present. There is a need for interventions facilitating open discussion of ethical concerns to reduce likelihood of moral distress and retain an experienced oncology and palliative workforce.

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An Inpatient Surgical Oncology Unit’s Experience With Moral Distress: Part II

Abstract: To characterize patient-reported and objective sleep assessments and provide a preliminary examination of the relationships among sleep, quality of life, and demographic or treatment factors. Design: A secondary data analysis using a descriptivecorrelational design.

Cited by 4 publications

References 27 publications

Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review

Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review

Acute Care Contexts

Experiences of moral distress among health care professionals in oncology and palliative care in Australia: a qualitative investigation

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