Moral Distress in Family Health Strategy: experiences expressed by daily life

Abstract

Objective Understanding the Moral Suffering experiences expressed in the daily life of the Family Health Strategy. Method This is a case study with a qualitative approach, conducted between August and October 2014 in a municipality of Minas Gerais. The sample was represented by 28 professionals of family health teams. Data were collected through interviews with semi-structured questionnaires, observation, projective technique and submitted to thematic content analysis. Results The results indicate that routine issues of the health care system lead professionals to experience a challenging practice in dealing with daily situations that contradict their ethical precepts and can compromise the quality of work, becoming triggers of Moral Distress. Conclusions Social vulnerabilities such as domestic violence, poor socioeconomic conditions and organizational weaknesses of the health system were the main triggers of Moral Distress. Therefore, it is necessary to amplify this reflection by workers of the Family Health Strategy, aiming to encourage the minimization of suffering experiences, considering their ethical values.

Generating situations of Moral Distress in Primary Care Nurses

“…In addition, primary care specificities emerged in Brazil, not present in other MD studies, such as those pointed out to the conflicting relationships established between CHA and the nurse. The CHA is part of the community, has knowledge about its problems and existing vulnerability situations (26) . This professional may conflict with the nurse when she is forced to perform actions that are not part of her professional competence.…”

Nurses’ moral deliberation in the child care process

“…The suggestion is to exchange frustration and anger for learning and dialogue by creating a space where users and professionals find practical and targeted ways to reduce the vulnerabilities of women and children (12) . Nurses, as part of the FHS team, are responsible for their clientele and involvement with the life history of each user, hence, they face the challenge of an ethical professional practice (23) .…”

Conflito ético como desencadeador de sofrimento moral: survey com enfermeiros brasileiros [Ethical conflict as a trigger for moral suffering: survey of Brazilian nurses] [Conflicto ético como desencadenador de sufrimiento moral: encuesta con las enfermeras brasileñas]

“…SM é entendido como uma situação em que a pessoa sabe o que é correto e o que deveria ser feito, mas é impedida de fazê-lo por algum motivo, seja ele individual, institucional ou social 9,10 . E, considerando a abrangência das causas, a gravidade das consequências e o caráter subjetivo e pessoal do fenômeno, o SM passou a ser objeto de análise em diferentes realidades, países e tipos de unidades assistenciais onde atuam enfermeiros [11][12][13][14][15] .…”

“…Ainda, estudos sinalizam a identificação de níveis mais elevados de SM entre aqueles envolvidos no atendimento direto ao paciente, comparativamente aos médicos. Nesse sentido, diferenças apontadas entre profissionais se referem a escores superiores de SM entre enfermeiros e outros profissionais não médicos (em relação aos médicos), relação inversamente associada com idade para outros profissionais de saúde e diretamente associada com anos de experiência apenas em enfermeiras [11][12][13][14][15] .…”