Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Carletto, Sara; Ariotti, Maria Chiara; Garelli, Giulia; Noto, L; Berchialla, Paola; Malandrone, Francesca; Guardione, Roberta; Boarino, Floriana; Campagnoli, Maria Francesca; Levet, Patrizia Savant; Bertino, Enrico; Ostacoli, Luca; Coscia, Alessandra

doi:10.3390/ijerph19148526

Cited by 14 publications

(6 citation statements)

References 82 publications

(134 reference statements)

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“…EVC induced by insufficient resources also showed a prospective negative effect on burnout symptoms. These results are in line with previous research highlighting insufficient resources as a source of ethical conflict ( 6 , 28 , 29 ) and indicating moral distress/moral injuries to be associated with burnout ( 1 , 2 , 7 , 30 , 31 ). In addition to this, in CU with more EVC induced by insufficient resources at T1, the CU team effectiveness was rated as lower at T2.…”

Section: Discussionsupporting

confidence: 92%

Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study

Larsman,

Pousette,

Skyvell Nilsson

et al. 2024

Scand J Work Environ Health

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OBJECTIVE: Moral distress emanating from value conflicts comprising ethical dimensions pose a threat to nurses’ health and retention, as well as to the quality of care. The aim of the present study was to investigate the relationships between the frequency of ethical value conflicts (EVC), and the perceived distress when they occur, respectively, and nurses’ work-related stress, burnout symptoms, turnover intent, team effectiveness, and patient safety. METHODS: A two-wave longitudinal cohort questionnaire study was performed among registered nurses at six hospitals in two Swedish regions. Cross-sectional analyses (T1) were based on 1817 nurses in 228 care units (CU), and longitudinal analyses (T1 – T2) on 965 nurses in 190 CU. Hypothesis testing was performed using multilevel controlled regression modeling. RESULTS: The results indicated that nurses who were often exposed to EVC also to a higher extent tended to report these conflicts as stressful. Frequent exposure to EVC induced by insufficient resources, inapt organizational structures or interpersonal staff relations were cross-sectionally associated with work-related stress, burnout symptoms, turnover intent, and team effectiveness. The longitudinal analyses indicated that EVC induced by a lack of resources primarily had negative effects on nurses’ health and well-being. At the CU level, such conflicts also impaired team effectiveness. At the individual level, EVC induced by organizational constraints or interpersonal relations negatively affected care effectiveness. CONCLUSIONS: EVC are related to negative consequences in healthcare, and such processes take place both on the individual and organizational levels.

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Section: Discussionsupporting

confidence: 92%

Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study

Larsman,

Pousette,

Skyvell Nilsson

et al. 2024

Scand J Work Environ Health

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“…In a study conducted by Ghasemi et al on a sample of neonatal and pediatric nurses in Iran, nurses were found to have low and moderate moral distress, while Carletto et al found that nurses working in neonatal intensive care units in Italy experienced low levels of moral distress. 10,30 In other studies, it was observed that nurses working in pediatric units experienced moderate and high levels of moral distress. [31][32][33][34] The result can be interpreted as pediatrics being a specific field, and those working in this field are ethically sensitive.…”

Section: Discussionmentioning

confidence: 96%

The Relationship Between the Moral Distress Levels and Support Perceptions of Pediatric Nurses

ÜNALDI BAYDIN,

TURAL BÜYÜK,

UZŞEN

et al. 2024

Turkiye Klinikleri J Med Ethics

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ABS TRACTThe development of supporting by organizations and supervisors may enable nurses to cope better with the moral distress they experience. The study aimed to determine the relationship between the moral distress experienced by pediatric nurses and their perceived organizational and supervisor support. A descriptive and correlational study was conducted with 124 pediatric nurses of public and university hospitals in Türkiye between May and June 2022. Personal information form, Perceived Organizational Support Scale, Perceived Supervisor Support Scale and the Moral Distress Scale for Pediatric Nurses-Revised were used to collect data. The data obtained from the study were evaluated in IBM SPSS 23.0 program. Pediatric nurses' mean Perceived Organizational Support Scale and Perceived Supervisor Support Scale scores were 34.93±7.46 and 30.20±11.16. Pediatric nurses' mean total scores for the frequency, intensity, and level of moral distress were found to be 27.08±13.09, 41.49±18.43, and 63.91±37.81. A weak negative correlation was found between the frequency of moral distress and the level of supervisor support (r: -0,220, p<0.05). In the study, nurses experienced low levels of moral distress. The study found that the organizational and supervisor support offered to the nurses was above average, and the level of organizational support was higher than the level of supervisor support. The support of supervisor and organization is important when pediatric nurses encounter ethical problems. The reduction in the level of moral distress experienced by nurses leads to an increase in the quality of care and patient/relatives and nurse satisfaction, and a decrease in job stress, burnout, and intention to quit the job/profession.

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“…Sources of burnout among physicians at hospitals include chronic work overload; lack of autonomy; lack of recognition; ineffective teamwork; perceived unfairness; clerical burdens; moral distress; and suboptimal relationships among health‐care workers (Carletto et al ., 2022; Johnson‐Coyle et al ., 2016; Lin, Lin, Hsia & Kuo, 2021; West, Dyrbye & Shanafelt, 2018). In addition, a gap between the values of physicians and work processes to deliver care, by which they may implement their values, makes physicians feel a sense of compromise between the work they aspire to do and the actual work they do.…”

Section: Introductionmentioning

confidence: 99%

Professional burnout among expert physicians, patient‐focused care, and trust in top management: Moving forward

Gabay

2024

Scandinavian J Psychology

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IntroductionProfessional burnout in physicians is perceived as an inevitable occupational hazard inhibiting patient‐focused care, the preferred approach of care, which enhances satisfaction of physicians with their work and improves clinical outcomes. Burnout jeopardizes the physical, mental, and emotional health of physicians, inhibiting high‐quality care. Most individual‐driven interventions and job‐level interventions to reduce burnout proved inefficient or reduced burnout for only a short term. The potential of organizational processes to reduce burnout was acknowledged but is yet to be empirically tested. Drawing on social exchange theory, this study investigates the role of an organizational phenomenon, organizational trust among physicians in top management, on burnout.MethodsData were collected across specialties in 10 out of 20 Israeli public general hospitals. The sample comprised 798 senior expert physicians. Measures were all previously published. Structural equation modeling was performed.ResultsResponse rates ranged from 17% to 77% across the 10 hospitals. Mean burnout was 4.7 (SD = 0.68), mean patient‐focused care was 3.9 (SD = 0.79), and mean organizational trust was 3.7 (SD = 0.84). Mean burnout for women was 5.6 and for physicians from internal medicine was 5.5. The structural equation modeling supported the proposed study model, which explained 45% of burnout. Organizational trust reduced burnout by 14%.DiscussionEfforts to reduce burnout should integrate effective individual‐level and job‐level interventions with building trust among physicians in top management through implementing the paramount professional value of patient‐focused care.ConclusionsPerceiving management, among physicians, as facilitating the value of patient‐focused care led to organizational trust in top management, which was negatively associated with burnout.

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Moral Distress and Burnout in Neonatal Intensive Care Unit Healthcare Providers: A Cross-Sectional Study in Italy

Cited by 14 publications

References 82 publications

Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study

Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety: a longitudinal questionnaire study

The Relationship Between the Moral Distress Levels and Support Perceptions of Pediatric Nurses

Professional burnout among expert physicians, patient‐focused care, and trust in top management: Moving forward

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