Clinicians’ moral distress and family satisfaction in the intensive care unit

Lamiani, Giulia; Ciconali, Matteo; Argentero, Piergiorgio; Vegni, Elena

doi:10.1177/1359105318781935

Cited by 19 publications

(39 citation statements)

References 43 publications

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“…Finally, the results of our study demonstrate that commitment to quality leadership, implementing quality improvement, and hand-off communication significantly predicted family members' satisfaction. This is in accordance with the findings in other studies where communication between the healthcare professionals and the patient and their family were shown to play a key role in patients' assessment of their hospitalization experience (Clark et al, 2016;Ferrando et al 2019;Hwang et al, 2014;Lam et al, 2015;Lamiani, Ciconali, Argentero, & Vegni, 2020;Schleyer & Curtis, 2013;van den Broek et al, 2015).…”

Section: Discussionsupporting

confidence: 92%

The Association Between Quality and Safety Climate of a Hospital Ward, Family Members’ Empowerment, and Satisfaction With Provided Care

Burlakov

Rozani

Bluvstein

et al. 2021

J of Nursing Scholarship

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Purpose: This study was designed to examine the perceptions of ward quality and safety held by family members and nurses, and investigate its impact on family members' empowerment, and satisfaction with patient hospitalization. Design: A cross-sectional study on two study groups was conducted at a large public hospital in Israel. The first group comprised 86 family members of patients hospitalized for more than 72 hours in acute critical condition in intensive care units (ICU) or general wards (GW). The second group included 101 registered nurses who treated the patients in the ICU or GW. Methods: Data were collected by a validated self-administered structured questionnaire. All participants voluntarily signed an informed consent and answered questions related to their demographic characteristics, perceptions, and attitudes toward quality and safety climate, empowerment, and satisfaction with the patients' hospitalization. Pearson correlations coefficient, t-test for independent samples, and a multiple regression model were performed to analyze the data. Findings: The mean age of family members was 51.4 ± 14.1 years and of nurses was 40.9 ± 9.9 years. A significant positive association was found between ward quality and safety climate and empowerment of the family member (r = .716; p < .001); empowerment of the family member and family members' satisfaction with the patients' hospitalization (r = .695; p < .001); and ward safety and quality climate and family members' satisfaction with the patients' hospitalization (r = .763; p <.001). Family members ranked ward quality and safety climate (M = 4.20 ± 0.60 vs. M = 3.61 ± 0.40), and their satisfaction with the patients' hospitalization (M = 4.49 ± 0.69 vs. M = 4.07± 0.54), which were significantly (p < .001) higher than the nurses' estimate. The significant predictors for family members' satisfaction with patients' hospitalization were commitment to quality leadership (b = .210; p = .027); implementing a quality improvement (b = .547; p < .001); and hand-off communication (b = .299; p = .001). Conclusions: Positive relationships between quality and safety climate, empowerment, and satisfaction with patients' hospitalization suggest that by improving the ward quality and safety climate, and family empowerment, we may also improve family satisfaction. Although family members reported being satisfied with hospitalization in the ICU and GW, quality leadership and implementing a quality improvement among the nurses and hand-off communication between nurses and patients' families, will be targeted to improve family satisfaction with the patients' hospitalization.

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Section: Discussionsupporting

confidence: 92%

The Association Between Quality and Safety Climate of a Hospital Ward, Family Members’ Empowerment, and Satisfaction With Provided Care

Burlakov

Rozani

Bluvstein

et al. 2021

J of Nursing Scholarship

View full text Add to dashboard Cite

show abstract

“…Additionally, low perceived empowerment and autonomy represented vulnerability factors for MD. Concerning professional attitudes, low work satisfaction and engagement were associated with experiencing MD [60,61].…”

Section: Vulnerability Indicators For Moral Distress and Moral Injury In Healthcare Workersmentioning

confidence: 99%

“…In this context, lacking support from colleagues or supervisors [66]-represented as low professional [62] and social support [67]-posed vulnerability factors for MD [68]. Low informal and formal support may also be present in poor and unclear communication within the team [61] as well as in poor cooperation between different occupational groups of doctors, nurses, and students [5,61].…”

Section: Vulnerability Indicators For Moral Distress and Moral Injury In Healthcare Workersmentioning

confidence: 99%

A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19

Riedel

Kreh

Kulcar

et al. 2022

IJERPH

129

134

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Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.

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“…Indeed, studies have shown that healthcare professionals are exposed to frequent conditions causing moral distress. For example, performing painful procedures or futile care, following physicians’ prescription or family wishes which are considered inconsistent with the patient’s good, perceiving unsafe or incompetent staffing [ 20 , 21 ].…”

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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Clinicians’ moral distress and family satisfaction in the intensive care unit

Cited by 19 publications

References 43 publications

The Association Between Quality and Safety Climate of a Hospital Ward, Family Members’ Empowerment, and Satisfaction With Provided Care

The Association Between Quality and Safety Climate of a Hospital Ward, Family Members’ Empowerment, and Satisfaction With Provided Care

A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19

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

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