Moral Distress in Nursing and Its Contributors in the Context of Iran

Heydari, Abbas; Ahrari, Sajjad; Chaharsoughi, Narges Toghian

doi:10.29252/jhsme.5.3.44

Cited by 12 publications

(11 citation statements)

References 8 publications

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“…The experiences shared by the study participants also revealed that moral distress often impacted negatively on their wellbeing and work output. Effects that manifested in problems such as stomach problems, nightmares, loss of appetite, frustration, and anger, low work output, demoralization and dissatisfaction are in line with the extant literature 4 , 11 , 12 .…”

Section: Discussionsupporting

confidence: 83%

Moral distress among midwives working in the labour ward of a hospital in Ghana

Addo¹,

Amoah²,

Eshun³

et al. 2020

Eur J Midwifery

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INTRODUCTION The existing literature on moral distress is replete with studies conducted among nurses. That on midwives is however lacking. The aim of this study was to explore and understand moral distress from the perspective of and as experienced by midwives. METHODS This study involved an exploratory and qualitative case study design and adopted the interpretative phenomenological approach to collect data from 8 Ghanaian female midwives working in the labour ward of a public Hospital in Sunyani, Ghana, using individual in-depth interviews. The data obtained through audio-taped recordings were transcribed verbatim and analysed, adopting Colaizzi’s qualitative analysis procedure. RESULTS Three major themes were generated: perceived knowledge about moral distress, perceived causes of moral distress, and perceived effects of moral distress. The midwives perceived moral distress as stress arising from situations where they knew the right thing to be done or how to save a life but due to reasons such as resource constraints and disrespect from their colleagues and superiors, they were unable to do so. Moral distress often impacted negatively on midwives work performance and psycho-emotional wellbeing. Effects that manifested in the form of problems such as stomach sickness, sleepless nights, frustration, and anger, were mentioned. CONCLUSIONS Efforts aimed at providing adequate logistics and resources, as well as improving communication, healthy interactions and interpersonal relationships among midwives and their colleagues should be intensified.

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Section: Discussionsupporting

confidence: 83%

Moral distress among midwives working in the labour ward of a hospital in Ghana

Addo¹,

Amoah²,

Eshun³

et al. 2020

Eur J Midwifery

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“…Disregarding the patient's preferences [25], c) Shortage of resources and inappropriate resource allocation and utilization [25], d) Seeing the patient dying without having an opportunity to farewell their relatives and acquaintances [27]. All these factors are consistent with our ndings.…”

Section: Nursing Professionals' Responses To Situations Where Futile Care Is Providedsupporting

confidence: 84%

The Medical Futility Experience of Nursing Professionals in Greece

Voultsos

Tsompanian

Tsaroucha

2021

Preprint

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Background Providing futile medical care is an ever timely ethical problem in clinical practice. While nursing personnel are very closely involved in providing direct care to patients nearing the end of life, their role in end-of-life decision making remains unclear. Methods This is a prospective qualitative study conducted with experienced nursing professionals from December 2020 through May 2021. Individual in-depth qualitative interviews were conducted with sixteen participants. We performed a thematic analysis of the data. Results Importantly, many participants were half-hearted in their attitude towards accepting or defining futile medical care. Furthermore, interestingly, emerged a list of well-described circumstances, under which the dying process is most likely to be a “bad and undignified” process. These circumstances reflected situations revolving around: a) pain and suffering, b) treating patients with respect, c) the appearance and image of the patient body, and d) the interaction between patients and their relatives. Fear of legal action, lack of regulatory framework, physicians pressured from (mostly uninformed) family members and physicians’ personal motives were reported as important reasons behind providing futile medical care. It is highlighted the nursing professional’s role as participant in decisions on futile care and as mediator between physicians and patients (and family members). Furthermore, it is prioritized the patient’s role in decisions on futile care. It is highlighted the impact of patient’s effort to keep themselves alive on nursing professionals’ willingness to provide care. Providing futile care is a major factor that negatively affects the nursing professionals’ inner attitude towards performing their duties. Finally, the psychological benefits of providing a futile medical care are highlighted, and the importance of the lack of adequately developed end-of-life care facilities in Greece is emphasized. Conclusions These findings enforce our opinion that futile medical care should be conceptualized in the strict sense of the term, namely, as caring for a brain-dead individual or a patient in a medical condition whose continuation would most likely go against the patient’s presumed preference (strictly understood). For a great part, our findings were consistent with prior literature. However, we identified some issues that are of clinical importance.

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“…A positive correlation between turnover intention and moral distress was found by Hashemi et al [ 23 ]. Other factors can lead to moral distress, including heavy workload, poor communication with team members or patient and its relatives, limited resources (e.g., staff shortage) [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Levels of Moral Distress among Health Care Professionals Working in Hospital and Community Settings: A Cross Sectional Study

et al. 2021

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Moral distress is a concern for all healthcare professionals working in all care settings. Based on our knowledge, no studies explore the differences in levels of moral distress in hospital and community settings. This study aims to examine the level of moral distress among healthcare professional working in community or hospital settings and compare it by demographic and workplace characteristics. This is a cross-sectional study. All the professionals working in the hospitals or community settings involved received personal e-mail invitations to participate in the study. The Moral Distress Thermometer was used to measure moral distress among healthcare professionals. Before data collection, ethical approval was obtained from each setting where the participants were enrolled. The sample of this study is made up of 397 healthcare professionals: 53.65% of the sample works in hospital setting while 46.35% of the sample works in community setting. Moral distress was present in all professional groups. Findings have shown that nurses experienced level of moral distress higher than other healthcare professionals (mean: 4.91). There was a significant differences between moral distress among different professional categories (H(6) = 14.407; p < 0.05). The ETA Coefficient test showed significant variation between healthcare professionals working in community and in hospital settings. Specifically, healthcare professionals who work in hospital experienced a higher level of moral distress than those who work in community settings (means 4.92 vs. means 3.80). The results of this study confirm that it is imperative to develop educational programs to reduce moral distress even in those settings where the level perceived is low, in order to mitigate the moral residue and the crescendo effect.

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Moral Distress in Nursing and Its Contributors in the Context of Iran

Cited by 12 publications

References 8 publications

Moral distress among midwives working in the labour ward of a hospital in Ghana

Moral distress among midwives working in the labour ward of a hospital in Ghana

The Medical Futility Experience of Nursing Professionals in Greece

Levels of Moral Distress among Health Care Professionals Working in Hospital and Community Settings: A Cross Sectional Study

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