Recommendations for navigating the experiences of moral distress: A scoping review

Deschenes, Sadie; Tate, Kaitlyn; Scott, Shannon D.; Kunyk, Diane

doi:10.1016/j.ijnurstu.2021.104035

Cited by 15 publications

(11 citation statements)

References 53 publications

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“…The participant recommendations from this study align with the findings by Deschenes et al. (2021), a paper that reviewed interventional studies designed to mitigate the effects of moral distress on nurses who are involved in direct patient care. Nurses were given a moral distress measurement tool, such as the Moral Distress Scale (Corley et al., 2001), to screen for levels of moral distress in study participants.…”

Section: Discussionsupporting

confidence: 69%

Moral distress in genetic counseling: A study of North American genetic counselors

Wadman

Conway

Garbarini³

et al. 2022

Journal of Genetic Counseling

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Moral distress is the phenomenon whereby healthcare providers experience the inability to take action or act in morally appropriate ways when encountering a morally compromising situation. The correlation of moral distress to burnout and resignation in nursing and other healthcare fields has led to increasing attention and concern among healthcare professionals to identify the sources of moral distress, as well as find ways to alleviate it. An online mix‐method survey was sent to NSGC members to gain information on (1) sources of moral distress, (2) emotions involved, (3) coping strategies, and (4) suggestions to alleviate it. The ProQOL 5 scale was included to measure genetic counselor compassion satisfaction, burnout, and secondary traumatic stress. Two hundred and thirteen genetic counselors from North America completed the survey. Forty‐eight percent of respondents experienced moral distress and five sources were identified. The sources were situations involving other providers, family members, professional responsibility, personal beliefs, and access. Those more likely to experience moral distress worked in a prenatal setting, were over the age of 50, and worked for more than 21 years. Genetic counselors were more likely to talk to a co‐worker for support, and seek social support, address the source of the problem, and sustain self through working with patients as coping strategies. Most genetic counselors recommended talking to another genetic counselor to alleviate moral distress. Moral distress did not correlate with genetic counselor burnout, but did correlate with higher levels of secondary traumatic stress (p < 0.01). Thirty‐two percent of genetic counselors considered leaving their specialty, and 23% considered leaving their profession based on their experience(s) with moral distress. Our study establishes the existence of moral distress in the genetic counseling field and supports the need for coping strategies and recommendations in order to alleviate future genetic counselor moral distress.

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Section: Discussionsupporting

confidence: 69%

Moral distress in genetic counseling: A study of North American genetic counselors

Wadman

Conway

Garbarini³

et al. 2022

Journal of Genetic Counseling

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“…Similarly, participants in our study described how organization-level policies implemented by their SSP managers and director benefited their mental health (e.g., normalization of taking breaks, paid sick leave, implementing "open door" policies to increase the accessibility of management and leadership, and providing regular psychological care). In addition, SSPs could aim to reduce staff moral distress with interventions such as normative staff education about moral distress and encouraging reflective debriefing about workplace experiences [46,47]. Strategies have been developed to decrease symptoms of secondary trauma including education, self-efficacy interventions, maintaining self-care, developing anxiety-reduction skills and having manageable workloads [48][49][50]; however, evidence on the efficacy of these interventions is limited [51].…”

Section: Discussionmentioning

confidence: 99%

“We were building the plane as we were flying it, and we somehow made it to the other end”: syringe service program staff experiences and well-being during the COVID-19 pandemic

et al. 2022

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Background Syringe service programs (SSPs) provide essential harm reduction and prevention services for people who inject drugs in the USA, where SSP coverage is expanding. During the COVID-19 pandemic, US SSPs underwent unprecedented shifts in operational procedures (e.g., closures of physical sites, staff redeployment into pandemic response efforts). Given the critical role of US SSP workers in the pandemic, we sought to explore the occupational experiences and well-being of SSP staff to inform future emergency response efforts. Methods From July–October 2020, we conducted semi-structured interviews with staff members of four SSPs in diverse regions of Massachusetts. Trained interviewers administered qualitative interviews virtually. Interviews were coded in NVivo v12 and thematic analysis identified common occupational experiences and related impacts on staff well-being in the context of the COVID-19 pandemic. Results Among 18 participants, 12 (67%) had client-facing roles such as harm reduction specialists and six (33%) worked in program management or leadership. We found that staff were frequently anxious about SARS-CoV-2 transmission, which contributed to staff turnover. SSPs rapidly adapted and expanded their services to meet increasing client needs during the pandemic (e.g., food distribution, COVID-19 testing), leading to staff overexertion. Simultaneously, public health measures such as physical distancing led to staff concerns about reduced social connections with clients and coworkers. Through these challenges, SSPs worked to protect staff well-being by implementing flexible and tangible COVID-19-related policies (e.g., paid sick leave), mental health resources, and frequent communication regarding pandemic-related operational changes. Conclusion SSPs in the USA adapted to the COVID-19 pandemic out of necessity, resulting in operational changes that threatened staff well-being. Despite the protective factors revealed in some narratives, our findings suggest that during prolonged, complex public health emergencies, SSPs may benefit from enhanced occupational supports to prevent burnout and promote wellness for this essential public health workforce.

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“… 11 , 12 , 13 , 14 These recent studies reveal a need for greater conceptual clarity and understanding in general and specifically in the military healthcare clinician population. The intent of this scoping review was not to repeat previous concept analyses on the individual topics of MD and MI 15 , 16 , 17 , 18 but rather to build from this work to evaluate what is known about the concepts and how MI is conceptually depicted in healthcare clinicians. The progressive development of concepts allows us to understand how these terms are applied in the literature.…”

Section: Introductionmentioning

confidence: 99%

Moral Distress and Moral Injury in Military Healthcare Clinicians: A Scoping Review

Wilson,

Shay,

Harris

et al. 2024

AJPM Focus

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Recommendations for navigating the experiences of moral distress: A scoping review

Cited by 15 publications

References 53 publications

Moral distress in genetic counseling: A study of North American genetic counselors

Moral distress in genetic counseling: A study of North American genetic counselors

“We were building the plane as we were flying it, and we somehow made it to the other end”: syringe service program staff experiences and well-being during the COVID-19 pandemic

Moral Distress and Moral Injury in Military Healthcare Clinicians: A Scoping Review

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