Interventions to mitigate moral distress: A systematic review of the literature

Morley, Georgina; Field, Rosemary; Horsburgh, Cristie Cole; Burchill, Christian N.

doi:10.1016/j.ijnurstu.2021.103984

Cited by 77 publications

(38 citation statements)

References 50 publications

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“…A descriptive, correlational study found job satisfaction, practice environment, and age as predictors of moral distress among a sample of US critical care nurses ( Hiler et al., 2018 ). The evidence is weak on interventions that reduce moral distress as a result of the different causes and effects of moral distress ( Imbulana et al, 2021 ; Morley et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice

et al. 2022

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Introduction The ongoing COVID-19 pandemic represents the largest contemporary challenge to the nursing workforce in the 21st century given the high stress and prolonged strain it has created for both human and healthcare supply resources. Nurses on the frontlines providing patient care during COVID-19 have faced unrivaled psychological and physical demands. However, no known large-scale qualitative study has described the emotions experienced by nurses providing patient care during the first wave of the COVID-19 pandemic in the US. Objective: Therefore, the purpose of this study was to qualitatively describe the emotions experienced by US nurses during the initial COVID-19 pandemic response. Methods One hundred individual interviews were conducted with nurses across the United States from May to September of 2020 asking participants to describe how they felt taking care of COVID-19 patients. All interviews followed a semi-structured interview guide, were audio recorded, transcribed, verified, and coded by the research team. Results Participants narratives of the emotions they experienced providing patient care during COVID-19 unequivocally described (1) moral distress, and moral distress related (1.1) fear, (1.2) frustration, (1.3) powerlessness, and (1.4) guilt. In sum, the major emotional response of nurses across the US providing patient care during the pandemic was that of moral distress. Conclusion Investments in healthcare infrastructures that address moral distress in nurses may improve retention and reduce burnout in the US nursing workforce.

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Section: Discussionmentioning

confidence: 99%

Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice

et al. 2022

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“…Although the MMD-HP is the most recent and comprehensive scale [ 25 ], we used Lamiani’s 14-item Italian MDS-R as the main reference [ 11 ]. The reasons for this decision are that it was already validated for Italian adult intensive care settings and because it derived directly from the MDS-R, which is, currently, the most used instrument in MD research worldwide [ 2 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, there is broad agreement that MD has a detrimental effect on both a personal and professional level [ 5 , 6 ], and many studies have focused on it, ranging from descriptive correlational to experimental research. However, most of these articles lack scientific rigor and present significant threats to internal and external validity; thus, measurable and methodologically rigorous studies are currently requested to build evidence-based literature in this field [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Moral Distress in Healthcare Providers Who Take Care of Critical Pediatric Patients throughout Italy—Cultural Adaptation and Validation of the Italian Pediatric Instrument

Grasso

Massidda²,

Maslak

et al. 2022

IJERPH

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Background: Although Moral Distress (MD) is a matter of concern within the Pediatric Intensive Care Unit (PICU), there is no validated Italian instrument for measuring the phenomenon in nurses and physicians who care for pediatric patients in Intensive Care. The authors of the Italian Moral Distress Scale-Revised (Italian MDS-R), validated for the adult setting, in 2017, invited further research to evaluate the generalizability of the scale to clinicians working in other fields. Our study aims to reduce this knowledge gap by developing and validating the pediatric version of the Italian MDS-R. Methods: We evaluated the new instrument for construct validity, then we administered it in a multicenter, web-based survey that involved healthcare providers of three PICUs and three adult ICUs admitting children in northern, central, and southern Italy. Finally, we tested it for internal consistency, confirmatory factorial validity, convergent validity, and differences between groups analysis. Results: The 14-item, three-factor model best fit the data. The scale showed good reliability (a = 0.87). Still, it did not correlate with the Emotional Exhaustion and Depersonalization sub-scales of the Maslach Burnout Inventory (MBI) or with the 2-item Connor-Davidson Resilience Scale (CD-RISC 2) or the Satisfaction with Life Scale (SWLS). A mild correlation was found between the Italian Pediatric MDS-R score and intention to resign from the job. No correlation was found between MD and years of experience. Females, nurses, and clinicians who cared for COVID-19 patients had a higher MD score. Conclusions: The Italian Pediatric MDS-R is a valid and reliable instrument for measuring MD among Italian health workers who care for critically ill children. Further research would be helpful in better investigating its applicability to the heterogeneous scenario of Italian Pediatric Critical Care Medicine.

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“…14 They also referred to the scientific challenge of evaluating the impact of its various interventions aimed at mitigating it. 15 Recent calls to abandon the concept of moral distress 16 or to revise it conceptually 17 represent some attempts to manage this conceptual gap. After all, it is the natural course of scientific development that models and theories are proposed, tested, and re-planned to better fit those elements they are missing and to adequately respond to their critique.…”

mentioning

confidence: 99%

“…14 They also referred to the scientific challenge of evaluating the impact of its various interventions aimed at mitigating it. 15…”

mentioning

confidence: 99%

Why we need to reconsider moral distress in nursing

Sperling

2022

Nurs Ethics

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Interventions to mitigate moral distress: A systematic review of the literature

Cited by 77 publications

References 50 publications

Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice

Moral Distress Experienced by US Nurses on the Frontlines During the COVID-19 Pandemic: Implications for Nursing Policy and Practice

Moral Distress in Healthcare Providers Who Take Care of Critical Pediatric Patients throughout Italy—Cultural Adaptation and Validation of the Italian Pediatric Instrument

Why we need to reconsider moral distress in nursing

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