Strategies for Coping With Moral Distress Adopted by Nurses in Tertiary Care: A Scoping Review

Abstract

Objective: to map the scientific evidence on strategies for coping with moral distress adopted by nurses in the context of health services in tertiary care. Method: this is a Scoping Review based on the PRISMA-ScR recommendations. The searches were performed in September 2020 in the MEDLINE®, National Library of Medicine, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane and Biblioteca Virtual en Saúde databases. The eligibility criterion was to include studies that discussed strategies for coping with moral distress adopted by nurses in tertiary care, finding 2,041 studies, which were organized and screened in the Endnote software. The data were organized in Excel spreadsheets and analysis of the results was performed using the ATLAS.ti software. Results: the final selected sample consisted of 23 studies, which were grouped in two axes: strategies and recommendations. Four articles were included in the “strategies” axis, which reported actions taken to face moral distress, detailing the intervention and their results. The others, included in the “recommendations” axis, are articles whose focus was the experience of moral distress, suggesting important aspects to face it. Conclusion: recognition of moral distress by nurses and the opportunity for collective discussion and exchange of experiences are ways of collectively facing the situations. In addition, the institution's active participation in carrying out interventions was recommended. However, gaps were noticed in the production of studies that actually go deeper into intervention actions to cope with moral distress.

Nurses’ workload during the COVID-19 pandemic: potential for experiences of moral distress

“…In view of this, it is essential that health institutions carry out programs and strategies to combat MD, taking into account the work overload of nurses, and it is important to be carried out collectively, considering the team in the process, such as through the creation of spaces for discussion, empowerment programs, self-care retreat and educational intervention ( 37 ) .…”

Sobrecarga de trabalho de enfermeiros na pandemia de COVID-19: potência para vivências de sofrimento moral

“…Diante disso, torna-se fundamental que as instituições de saúde realizem programas e estratégias para o enfrentamento do SM com olhar para a sobrecarga de trabalho dos enfermeiros, sendo importante ser realizado de forma coletiva, considerando a equipe no processo, como, por exemplo, mediante a criação de espaços para discussão, programas de empoderamento, retiro de autocuidado e intervenção educacional (37) .…”