Understanding burnout and moral distress to build resilience: a qualitative study of an interprofessional intensive care unit team

Hancock, Jennifer; Witter, Tobias; Comber, Scott; Daley, Patricia; Thompson, Kim M.; Candow, Stewart; Follett, Gisele; Somers, Walter; Collins, Corry; White, Janet; Kits, Olga

doi:10.1007/s12630-020-01789-z

Cited by 33 publications

(49 citation statements)

References 43 publications

(53 reference statements)

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“…Resilience might protect ICU workers from burnout, as reported in a Canadian qualitative study [ 18 ]. Resilience is described as the ability to face problems and adapt to adverse conditions [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 98%

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

Stocchetti

Segre

Zanier

et al. 2021

IJERPH

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The COVID-19 pandemic had a massive impact on the Italian healthcare systems, which became overwhelmed, leading to an increased risk of psychological pressure on ICU workers. The present study aimed to investigate the prevalence of distress (anxiety, depression and insomnia symptoms), burnout syndrome and resilience in healthcare workers during the COVID-19 pandemic and to detect potential factors associated with their psychological response. This cross-sectional, survey-based study enrolled 136 healthcare workers assisting COVID-19 patients in the new COVID-19 ward (Intensive Care Unit), at Milano Fiera, Lombardy. Participants completed an online survey that comprised different validated and standardized questionnaires: Maslach Burnout Inventory (MBI), Resilience Scale for adults (RSA), Hospital Anxiety and Depression scale (HADS) and Insomnia Severity Index (ISI). Socio-demographic and work characteristics were also collected. Out of 136 ICU specialists, there were 84 nurses (62%) and 52 physicians (38%). Over half (60%) met the criteria for burnout, with nearly the same percentages among nurses and physicians. Nurses reported significantly higher scores of anxiety and insomnia levels. Forty-five percent of participants reported symptoms of depression (of whom 13.9% in the clinical range) and most of the staff showed moderate to high levels (82.4%) of resilience. The COVID-19 pandemic can have a significant impact on ICU staff. Effective interventions are needed to maintain healthcare professionals’ mental health and relieve burnout. Follow-up and tailored procedures should be provided to alleviate the psychological burden in the frontline staff at highest risk.

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Section: Introductionmentioning

confidence: 98%

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

Stocchetti

Segre

Zanier

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Moral distress among healthcare professionals has been studied in various healthcare contexts including oncology [ 10 ], palliative care [ 3 ], psychiatry [ 11 ], pediatric care [ 12 ], surgical and medical care [ 13 ], emergency [ 14 ] and intensive care [ 15 – 17 ]. In a study Hancock et al [ 16 ] revealed three principal issues underlying the development of moral distress; namely, organizational issues, exposure to highly intense situations and poor team experiences. Several studies found that organizational constraints reduced the standard of patient care [ 18 ] and low staffing levels were found to be important sources of moral distress [ 11 , 16 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a study Hancock et al [ 16 ] revealed three principal issues underlying the development of moral distress; namely, organizational issues, exposure to highly intense situations and poor team experiences. Several studies found that organizational constraints reduced the standard of patient care [ 18 ] and low staffing levels were found to be important sources of moral distress [ 11 , 16 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Lack of competence in the healthcare team has also been considered an issue to moral distress [ 13 ]. Bullying, lack of inclusion [ 16 , 25 ] and struggling to share the troubled emotions associated with acting against one’s moral values have been described as giving rise to bad feelings and moral distress [ 26 ]. A positive ethical climate, however, [ 12 , 27 ] and professional independence at work [ 28 ] have been shown to reduce the frequency of morally distressing situations [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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The Swedish translation and cultural adaptation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP)

Grönlund

Brännström

2021

BMC Med Ethics

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Background Moral distress has been described as an emotionally draining condition caused by being prevented from providing care according to one’s convictions. Studies have described the impact of moral distress on healthcare professionals, their situations and experiences. The Measure of Moral Distress for Healthcare Professionals (MMD-HP) is a questionnaire that measures moral distress experienced by healthcare professionals at three levels: patient, system and team. The aim of this project was to translate and make a cultural adaption of the MMD -HP to the Swedish context. Methods The questionnaire comprises 27 items, rated according to frequency and intensity on a five-point Likert scale (0–4). The procedure for translating MMD-HP followed WHO guidelines (2020). These entailed a forward translation from English to Swedish, a back translation, expert panel validation, pretesting and cognitive face-to-face interviews with 10 healthcare professionals from various professions and healthcare contexts. Results The Swedish version of MMD-HP corresponds essentially to the concept of the original version. Parts of some items’ had to be adjusted or removed in order to make the item relevant and comprehensible in a Swedish context. Overall, the cognitive interviewees recognized the content of the items which generally seemed relevant and comprehensible. Conclusion The Swedish version of MMD-HP could be a useful tool for measuring moral distress among healthcare professionals in a Swedish healthcare context.

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“…Wellness is both a personal- and systems-level issue ( 11 ). Maintaining individual physical and mental health is usually taught at an early age or developed as part of a personal health strategy.…”

mentioning

confidence: 99%

The Societies’ Responsibility for Wellness: Healing for the Healer

Fox-Robichaud

2021

Annals ATS

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Understanding burnout and moral distress to build resilience: a qualitative study of an interprofessional intensive care unit team

Cited by 33 publications

References 43 publications

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

Burnout in Intensive Care Unit Workers during the Second Wave of the COVID-19 Pandemic: A Single Center Cross-Sectional Italian Study

The Swedish translation and cultural adaptation of the Measure of Moral Distress for Healthcare Professionals (MMD-HP)

The Societies’ Responsibility for Wellness: Healing for the Healer

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