Constructing a theoretical model of moral distress

Barlem, Edison Luiz Devos; Ramos, Flávia Regina Souza

doi:10.1177/0969733014551595

Cited by 75 publications

(111 citation statements)

References 40 publications

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“…Studies show that the team often creates realities that provide the experience of moral distress, given the prevalence of abusive hierarchical relationships, individualism, lack of integration of knowledge and lack of communication, which comes against the findings of this research [17,8,6]. In this way, the distance between the members of the multidisciplinary team is configured as technician, routine and fragmented work, which provides conflicts between professionals and moral distress experiences.…”

Section: Discussionmentioning

confidence: 87%

“…Considering that, in superficiality, moral distress is not seen as something that take away the subject from the protagonism of their doing, which oftentimes can be misunderstood as weakness in their competence. The nurse who experiences moral distress and that is the situation of invisibility for the loss of their role is susceptible to psychological distress, as Burnout, and, in more severe cases, the abandonment of the profession [8].…”

Section: Discussionmentioning

confidence: 99%

“…The moral distress of nursing professionals in Brazil have showed that among the main causes, there is highlight for the lack of material and human resources, difficulties in interpersonal relationships at work, disrespect for patients' rights, death, low pay and exhaustive workload [8]. So, the sources of moral distress encompass aspects of the management and organization of services, such as poor working conditions, lack of resources and personnel, lack of institutional support, weaknesses in the humanization of care and interpersonal relations, disrespect to the rights of patients and their autonomy, wrongful death and others [5,4].…”

Section: Introductionmentioning

confidence: 99%

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Experiences Of Moral Distress In Nurses’ Daily Work

et al. 2016

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Background: Moral distress in the work of nurses has been an emerging ethical problem in the different levels of complexity in the Brazilian scenario. Objective: raise the situations perceived by nurses working in different health services across the country, as generators of moral distress.Methods: This is a descriptive study of quantitative approach, of survey type. The study was developed with 771 nurses that working in health services of different levels of complexity in the Brazilian scenario. The data were collected in open instrument, they were asked to identify work situations triggering potential mental distress/suffering. Data were statistically analyzed using SPSS statistical software and later organized in tables at the 2010 version of Excel®. Findings:In the survey, were cited 2304 situations of Moral Distress.The situations involve Working Conditions; Professional Relations; Professional Competence; Quality of Care; Access; Labor Organization and Conflict. Conclusions: it becomes important to reflect on the role of the nurse and the development of an ethical and autonomous practice in their daily tasks, given that moral distress deprived nurses from their roles.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experiences Of Moral Distress In Nurses’ Daily Work

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“…O sofrimento moral ameaça à integridade moral dos enfermeiros, distanciando-os de sua prática profissional e afetando a qualidade do cuidado (14) . A prática profissional é uma atividade social baseada em princípios de cooperação entre sujeitos os quais assumem papéis diferenciados no conjunto da sociedade.…”

Section: Ahunclassified

Processo De Angústia/Sofrimento Moral Em Enfermeiros Da Estratégia Saúde Da Família

Caçador¹,

Ramos²,

Brito³

2017

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Objetivo: estudo qualitativo, realizado na região metropolitana de Belo Horizonte, cujo objetivo foi analisar o processo de angústia/sofrimento moral em enfermeiros da saúde da família. Dados coletados com 13 enfermeiros por meio de entrevista com roteiro semiestruturado. Realizada análise por método filosófico-conceitual. Evidencia-se a relação entre sofrimento moral, prática profissional do enfermeiro na ESF e implicações identitárias evidenciando contradições na prática profissional do enfermeiro decorrente de constrangimentos organizacionais que provocam rupturas identitárias e comprometem o bem interno da profissão. Necessário identificar situações geradoras de sofrimento moral, criar dispositivos gerenciais de enfrentamento, evitando sua ocorrência e atenuando seus efeitos. Descritores: Enfermagem; Sofrimento Moral; Estratégia Saúde da Família ThE PROCESS OF DISTRESS / MORAL SUFFERINg IN NURSES OF FAMILY hEALTh STRATEgY: SUBJECTIVITY AND IDENTITYObjective: A qualitative study aimed to analyze the process of distress / mental suffering in the nurse health of the family.Conducted in the metropolitan region of Belo Horizonte. Data collected with 13 nurses through interviews with semi -structured script. Analysis by philosophical-conceptual method. Evident the moral suffering and professional nursing practice in the family health strategy has identity implications highlighting contradictions in professional nursing practice due to organizational constraints that cause identity breaks and undertake the internal profession well. Required to identify situations that moral suffering, create management coping devices, preventing their occurrence and mitigating their effects.Situations that cause mental suffering to create coping strategies and management of ethical problems devices, preventing their occurrence and mitigating their effects. Estudio cualitativo el objetivo de analizar el proceso de angustia sufrimiento / mental en las enfermeras de salud de la familia.Realizado en la región metropolitana de Belo Horizonte. Los datos recogidos con 13 enfermeras a través de entrevistas con guión semiestructurado . El análisis por el método concepto-filosofico. Es evidente el sufrimiento moral y práctica profesional de enfermería en el la enfermera de la salud de la familia: implicaciones de identidad destacando contradicciones en la práctica profesional de la enfermería debido a limitaciones de la organización que causan roturas de identidad y que ejerzan la profesión , así interno. Requerido para identificar situaciones que el sufrimiento moral, crear dispositivos de gestión de afrontamiento, la prevención de su ocurrencia y mitigar sus efectos.

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“…[1][2][3] Studies characterize it as a phenomenon that can be differentiate into types and phases (initial, reactive, persistent), 2,4 affecting moral integrity and leading to serious consequences for the professional, in addition to those generated by morally improper actions. [5][6] MD has become the object of analysis in different realities, countries and types of care units where nurses work. 7 Recent studies [8][9][10] amplify the concern about different health team professionals, detecting the presence of MD in professional groups and as a significant predictor of the intention to leave the profession or place of work.…”

Section: Introductionmentioning

confidence: 99%

Construção Da Escala Brasileira De Distresse Moral Em Enfermeiros - Um Estudo Metodológico

Ramos

Barlem

Brito

et al. 2017

Texto contexto - enferm.

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Objective: to develop an instrument called the Brazilian Scale of Moral Distress in Nurses, in order to measure the intensity and frequency of moral distress.Method: a methodological research described in three steps: 1) definition of the theoretical framework (Background); 2) Instrument design; and 3) instrument composition.Step 2 integrated the literature review and survey to identify elements / situations triggering moral distress. The sample consisted of 771 nurses, from the 27 states of Brazil, working in different services.Results: moral distress situations analyzed by the survey were analyzed in five rounds involving a group of researchers, producing an analytical matrix with nine categories and 72 subcategories, which subsidized the formulation of the initial questions, and improved and collated with the findings of the literature (validation of criterion). Three other rounds were performed for the composition of the instrument, with 57 questions and a double Likert scale, with successive revisions of the content, language, format and layout, including the evaluation by experts / judges and analysis of the results of the pre-test (face/content). Conclusion: explore specific conditions of the Brazilian context of nurses' work and the validation of the instrument produced will allow the understanding of the theme of moral suffering in the Brazilian nursing scenario. Constructing instruments capable of measuring expressions of moral distress can validate ethical problems already described with adapted instruments. DESCRIPTORS: Nursing research. Moral. Suffering. Scales. Validation studies. CONSTRUÇÃO DA ESCALA BRASILEIRA DE DISTRESSE MORAL EM ENFERMEIROS -UM ESTUDO METODOLÓGICO RESUMOObjetivo: desenvolver um instrumento denominado Escala Brasileira de Distresse Moral em enfermeiros, para medição da intensidade e frequência do distresse moral.Método: pesquisa metodológica descrita em três etapas: 1) definição do marco teórico (background); 2) concepção do instrumento; e 3) composição do instrumento. A etapa 2 integrou a revisão da literatura e survey para identificar elementos/situações desencadeadoras de distresse moral. A amostra consistiu de 771 enfermeiros, dos 27 estados do Brasil, atuantes em diferentes serviços.Resultados: foram analisadas situações de distresse moral apreendidas pelo survey, em cinco rodadas envolvendo grupo de pesquisadores, produzindo uma matriz analítica com nove categorias e 72 subcategorias, que subsidiaram a formulação das questões iniciais, aprimoradas e cotejadas com os achados da literatura (validação de critério). Outras três rodadas foram realizadas para composição do instrumento, com 57 questões e dupla escala Likert, em sucessivas revisões do conteúdo, linguagem, formato e layout, incluindo a avaliação por experts/ juízes e análise dos resultados do pré-teste (validação de face/conteúdo).Conclusão: explorar condições específicas do contexto brasileiro do trabalho de enfermeiros e a validação do instrumento produzido permitirá compreender o tema do sofrimento mora...

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Constructing a theoretical model of moral distress

Cited by 75 publications

References 40 publications

Experiences Of Moral Distress In Nurses’ Daily Work

Experiences Of Moral Distress In Nurses’ Daily Work

Processo De Angústia/Sofrimento Moral Em Enfermeiros Da Estratégia Saúde Da Família

Construção Da Escala Brasileira De Distresse Moral Em Enfermeiros - Um Estudo Metodológico

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