Vicarious spiritual distress in intensive care unit healthcare providers: A qualitative study

Purpose in Life and Character Strengths as Predictors of Health Sciences Students’ Psychopathology During the COVID-19 Pandemic

“…However, other studies have opposite conclusions, stating that spirituality protects against the appearance of psychopathology (44)(45)(46). One of the possibilities for which this phenomenon could occur is "spiritual distress, " a state of suffering related to an impaired ability to experience purpose/meaning in life through connection with oneself, others, the world or a higher being (47). Spiritual distress frequently occurs in response to changes in health and life processes that disrupt a person's sense of purpose/meaning, just as it might happen in a pandemic.…”

Moral distress in critical care nursing practice: A concept analysis

“…Two attributes emerged in the literature: (1) emotional and psychological distress and (2) lack of power. Emotional and psychological distress was described as having the ability to torment and haunt nurses 7,19,22,23 . Arnold 22 uses the metaphor “valley of pain” to describe the symptomatic lows brought on by MD.…”

“…The nurse describes explaining to the family that medical intervention would prolong the patient's suffering; however, it was “clear that they just wanted everything done.” 25 It has been proposed that hierarchies within medicine, in which physicians and institutions dictate the course of treatment delivered, contribute to a nurse's perceived lack of power 27–30 . Nurses described themselves as powerless and hopeless when they are unable to elicit change or act on their moral agency 20,21,23,24,28,29 . The pandemic has exacerbated conditions contributing to nurses' perceived powerlessness and experiences of MD 28 .…”

“…Emotional and psychological distress was described as having the ability to torment and haunt nurses. 7,19,22,23 Arnold 22 uses the metaphor "valley of pain" to describe the symptomatic lows brought on by MD. This attribute was described by nurses when they were unable to act on their moral agency as barriers external to them existed 24 or when a patient's family members selected a medical intervention that they interpreted as inappropriate for the patient's prognosis.…”

“…[27][28][29][30] Nurses described themselves as powerless and hopeless when they are unable to elicit change or act on their moral agency. 20,21,23,24,28,29 The pandemic has exacerbated conditions contributing to nurses' perceived powerlessness and experiences of MD. 28 For example, in a study exploring the experiences of healthcare professionals working in the intensive care unit during the pandemic, a nurse stated that they felt powerlessness and experienced MD when required to "beg" for visitor restrictions to be eased to allow families to say goodbye to their loved ones.…”