Moral distress in Iranian pediatric nurses

Ghasemi, Elham; Negarandeh, Reza; Janani, Leila

doi:10.1177/0969733017722824

Cited by 31 publications

(51 citation statements)

References 29 publications

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“…In studies of non-ICU nurses, root causes generally centered on team and system problems such as witnessing medical students perform treatments only to improve their skills, being unqualified to care for patients, feeling pressure to alter practice in order to reduce costs, and encountering conflict with administration. 27,33 However, in their study of non-ICU nurses, Wenwen et al 31 found that the most problematic causes of moral distress were initiating and continuing life-sustaining treatment when it is believed that these are pointless.…”

Section: Experiences Of Moral Distressmentioning

confidence: 99%

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Moral distress experienced by non-Western nurses: An integrative review

Prompahakul

Epstein

2019

Nurs Ethics

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Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced by non-Western nurses. Review method: Whittemore and Knafl’s integrative review methodology was used to structure and conduct the review of the literature. Research context and data sources: Key relevant health databases included the Ovid MEDLINE, CINAHL, Web of Science, and Google Scholar databases. Two relevant journals, Nursing Ethics and Bioethics, were manually searched. Ethical consideration: We have considered and respected ethical conduct when performing a literature review, respecting authorship and referencing sources. Findings: A total of 17 primary studies published between 1999 and 2019 were appraised. There was an inconsistency with regard to moral distress levels and its relationship with demographic variables. The most commonly cited clinical causes of moral distress were providing futile care for end-of-life patients. Unit/team constraints (poor collaboration and communication, working with incompetent colleagues, witnessing practice errors, and professional hierarchy) and organizational constraints (limited resources, excessive administrative work, conflict within hospital policy, and perceived lack of support by administrators) were identified as moral distress’s stimulators. Negative impacts on nurses’ physical, psychological, and spiritual well-being were also reported. Conclusion: Further research is needed to investigate moral distress among other healthcare professions which may further build understanding. More importantly, interventions to address moral distress need to be developed and tested.

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Section: Experiences Of Moral Distressmentioning

confidence: 99%

“…Participants in the studies varied, including intensive care unit (ICU) nurses, 8,28,32,34,37,38,40 mixed wards, 27,[29][30][31]36,41 HIV nurses, 35 oncology nurses, 39 and pediatric nurses. 33…”

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confidence: 99%

Moral distress experienced by non-Western nurses: An integrative review

Prompahakul

Epstein

2019

Nurs Ethics

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“…In the pediatrics department, studies have shown that due to limited professional authority on the part of nurses, moral distress leads to impairment in safe patient care. The most important contributor to moral distress in the pediatric ward is to observe medical students performing painful procedures on children to acquire skills (18,22). Table 1 presents an overview of the included articles.…”

Section: Organizational Barriersmentioning

confidence: 99%

Moral Distress in Nursing and Its Contributors in the Context of Iran

Heydari

Ahrari

Chaharsoughi

2018

Health Spiritual Med Ethics

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Background and Objectives: Among ultimate goals in the nursing profession are health promotion, disease prevention, and respect for patient rights. In case they are not fulfilled, it can lead to nurses' moral distress, which can have adverse effects on nurses, patients, and the health system. On the other hand, awareness of this concept and its management can help nurses to solve and manage ethical issues in order to be able to continue nursing. Therefore, this study was conducted to obtain the necessary knowledge and to investigate the factors affecting moral distress among nurses in the context of Iran.. Methods: This narrative review was conducted using English and Persian keywords separately and in combination in valid domestic and international databases. Among the retrieved articles, 31 articles with accessible full-texts published in Persian and English that specifically focused on the context of Iran were incorporated. Results: Some of the factors associated with moral distress included organizational and institutional barriers, communication problems, medical and treatment errors and malpractice, neglect and irresponsibility in treatment, and inappropriate allocation of responsibilities, resources, and competencies. Conclusion: Managers can control and resolve this problem through modifying and enhancing organizational policies and taking measures such as nurse support, stress management training, and sessions to recount stressful events.

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“…Several studies have shown that nursing staff shortages in Iran are caused by multiple factors. In particular, low wages and poor working environments characterized by moral distress have been implicated as causal factors of nursing shortages in Iran (Azimian, Negarandeh, & Fakhr‐Movahedi, ; Dehaghani, Akhormeh, & Mehrabi, ; Ghasemi, Negarandeh, & Janani, ; Mosadeghrad, ; Tabatabaee, Nekoie‐Moghadam, Vafaee‐Najar, & Amiresmaili, ; Valizadeh et al., ; Zarea, Negarandeh, Dehghan‐Nayeri, & Rezaei‐Adaryani, ).…”

Section: Introductionmentioning

confidence: 99%