Moral distress-associated sociodemographic and occupational aspects in nursing managers at federal university hospitals

Faraco, Michel Maximiano; Gelbcke, Francine Lima; Brehmer, Laura Cavalcanti de Farias; Ramos, Flávia Regina Souza; Schneider, Dulcinéia Ghizoni

doi:10.1590/1980-220x-reeusp-2021-0447en

Cited by 1 publication

(2 citation statements)

References 27 publications

(35 reference statements)

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“…Other studies have examined the impact of job (dis)satisfaction and the intention to leave the profession, focusing on nurses [6,[28][29][30][31] and physicians [32]. Furthermore, time-related variables, such as weekly working hours [16,23,[33][34][35][36][37] and years of employment [31,33,[38][39][40], may be related to MD.…”

Section: Introductionmentioning

confidence: 99%

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Critical Care Providers’ Moral Distress: Frequency, Burden, and Potential Resources

Hinzmann

Schütte‐Nütgen

Büssing

et al. 2022

IJERPH

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Background: Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards and may entail moral distress (MD). Aim: To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) and further clarify whether CCPs who rely on spiritual resources differ in their perception of MD from those who do not utilize these resources. Methods: A cross-sectional anonymous survey was administered using a modified version of the German language version of the Moral Distress Scale (MDS) with 2 × 12 items to assess the frequency and the respective perceived burden of specific situations by applying a 5-point Likert scale. Explorative factor analysis was performed and the sub-constructs of the respective items regarding MD frequency and burden were identified. Job burden and professional satisfaction were measured using visual analogue scales (VAS) and a four-point Likert scale, respectively. The 15-item SpREUK questionnaire was applied to measure spiritual attitudes and behaviours and to differentiate between religious and spiritual persons. Data from 385 German-speaking CCPs were included (55% physicians, 45% nurses). Results: Conflict situations are similar for physicians and nurses although they are perceived as more burdensome by nurses. Among physicians, the MDS factor Looking away/Resignation scores highest for assistant physician residents, whereas distress caused by looking away is more often perceived by specialist physicians without a managerial position. Work satisfaction is inversely associated with MD and emotional exhaustion is positively associated with it. Participants’ spirituality is marginally associated with MD. The best predictors of both MD frequency and burden are emotional exhaustion with further influences of work satisfaction, being a nurse, and being a non-believer on the frequency of MD perception. Being a nurse, participants’ experience in ICU/ED, and being of the male gender are further predictors of MD burden. Conclusions: MD is experienced differently by different groups of CCPs depending on their place in the hierarchy of responsibility. As MD perception is best predicted by emotional exhaustion, these situations should be avoided. Although some CCPs may rely on spiritual resources, all need individual and team support to cope with MD.

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Section: Introductionmentioning

confidence: 99%

“…Further, a person's level in hospital and ward hierarchies and a team's ethical climate can both contribute to MD perception [41][42][43][44]. This may depend on gender aspects [26,27,35] and a CCP's experience in the ED/ICU [30,33,45,46].…”

Section: Introductionmentioning

confidence: 99%