From Moral Distress to Moral Integrity: Qualitative Evaluation of a New Moral Conflict Assessment Tool

American Journal of Critical Care, Journal Year: 2025, Volume and Issue: 34(1), P. 52 - 59

Published: Jan. 1, 2025

Moral distress affects the well-being of health care professionals and can lead to burnout attrition. Assessing moral taking action based on this assessment are important. A new conflict (MCA) designed prompt was developed tested.

Language: Английский

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A Study of the Impact of the Teachings of the Quran on the Stress, Anxiety, Depression, and Resilience of Nurses Caring for COVID-19 Patients in Iran

Journal of Religion and Health, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 4, 2025

Language: Английский

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Missed nursing care and its causes and effects on moral distress in neonatal intensive care nurses

Nursing in Critical Care, Journal Year: 2025, Volume and Issue: 30(2)

Published: Feb. 28, 2025

Deficiencies emerge in the care provided by nurses because of complex treatment plans, shortage labour resources and communication problems neonatal intensive units (NICUs). Knowing how to provide quality patient but being unable maintain it individual or institutional issues can lead moral distress among nurses. This study aimed examine missed nursing NICUs its relationship with experienced was a cross-sectional study. included sample 153 NICU The data were collected online between January May 2024 using descriptive information form, Missed Care Survey-Paediatric Form, Moral Distress Scale-Revised for Paediatric Nurses. mean age participants 31.22 years, on average, they cared 3.42 ± 0.96 patients per day. medical condition child under (t = 2.954, p < .001), duration working (F 15.901, inadequate number 3.626, .029) job satisfaction 3.359, .037) listed as variables affecting reasons care. Communication (β .275, .018) .216, .021), subdimensions survey used study, predictive factors that positively affected distress. associated should be explored strategies reduce Managers focus integrating effective techniques into increasing care, thus improving levels Understanding developing related complement efforts managers, educators reducing

Language: Английский

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Persistent Changes of Nurses' Practices and Working Conditions in High Acuity Settings in the Post‐Pandemic Era: A Qualitative Meta‐Aggregation

Journal of Advanced Nursing, Journal Year: 2025, Volume and Issue: unknown

Published: March 18, 2025

ABSTRACT Aims To explore the persistent changes in working conditions and nursing practices high acuity settings post COVID‐19 pandemic era. Design A qualitative systematic review using meta‐aggregation design of Joanna Briggs Institute. Methods After screening by two authors based on inclusion exclusion criteria, 36 studies were included. Quality was appraised Institute Critical Appraisal Checklist for Qualitative Research. Data then extracted synthesised. Confidence findings assessed ConQual approach. Sources The electronic databases: MEDLINE, CINAHL, Embase, Scopus searched November 2023. Additional searches conducted preprint servers: medRxiv, Open Science Foundation, Social Research Network, Journal Medical Internet Results Synthesised ‘unfavourable changed practices’ ‘health concerns caused with eight categories identified. Significant included increased workloads; overwhelming use insufficient supply personal protective equipment; decreased communication between nurses patients, families, other healthcare workers; lack knowledge disease; adequate support from coworkers, but inadequate nurse managers physicians. Conclusion This study synthesised existing offered insight into during pandemic. Clinical need to actively take action those modifiable aspects their a future similar crisis. did not identify any focusing nurses' post‐pandemic kind research is urgently needed. Impact Nurse policy makers can this help construct better high‐acuity staff Frontline clinical may guide mitigate negative effects crisis practice health. Reporting Method reported according Enhancing Transparency Synthesis statement. Patient or Public Contribution No patient public contribution. Trial Registration International Prospective Register Systematic Reviews: CRD42023473414

Language: Английский

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Moral Distress Among Healthcare Providers: An Umbrella Review

Published: April 8, 2025

Background Moral distress among healthcare providers is a pervasive issue with significant implications for individual well-being, patient care, and organizational outcomes. This umbrella review synthesizes evidence from systematic reviews meta-analyses to examine the prevalence, causes, consequences, variations of moral worldwide, highlighting its impact on professionals care. Methods Following JBI methodology PRISMA guidelines, we searched PubMed, Scopus, Web Science, Google Scholar up March 10, 2025, using keyword combinations such as "moral distress" AND "healthcare providers" "systematic review." Eligible studies included (with or without meta-analysis) scoping focusing providers, published in English. Methodological quality was assessed Critical Appraisal Checklist. Due heterogeneity predominance qualitative data, narrative synthesis conducted. Results From 435 identified articles, 21 between 2009 2025 were included, covering nurses (predominantly), physicians, midwives, other roles globally. varied by country, notable severity Iran (e.g., mean intensity 2.23-3.43), Canada (mean 91.99 Intensive care unit (ICU)), USA 52.54 ICU). ICU (23.8% studies) reported moderate high distress, primarily due futile staffing shortages, while oncology emergency department exhibited lower but levels. Identified causes factors, situational triggers, interpersonal conflicts, factors. The COVID-19 pandemic intensified critical settings, despite an overall global decline (pooled = 2.55). Conclusions multifaceted challenge influenced role, setting, systemic variation across countries specialties. Targeted interventions, including support ethical training, are mitigating quality. Future research should address gaps non-nurse populations standardize measurement approaches.

Language: Английский

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A network analysis of moral distress among clinical internship nursing students: A cross-sectional study

Nursing Ethics, Journal Year: 2025, Volume and Issue: unknown

Published: April 16, 2025

Background Moral distress is a significant challenge faced by clinical internship nursing students. Most current studies investigate the impact of external factors on students’ moral distress. However, there lack in-depth exploration interactions between various items. Research objective This study aims to construct network structure among students, while exploring touchpoints sensitivity and resilience distress, identify potential targets for intervention. design A cross-sectional utilized acceptable validity scales. Network analysis was conducted using R (Version 4.4.0). Regularized partial correlation describe associations different nodes in network. Central were identified through centrality indices. Participants research context The participants this are 372 students undergoing internships at comprehensive teaching hospital Changsha, China. Ethical considerations approved ethics committee (Review Number: Express 241098). Written informed consent obtained from all participants. Results In network, connections MD3 “I provide life-sustaining treatment per family’s wishes” MD4 “Despite only extending survival, I implement life-saving measures” strongest. MD18 “Decline service quality due poor team communication,” MD19 ignore situations lacking adequate information consent,” MD17 collaborate with colleagues unable meet patient’s needs” central relational critical connection point linking resilience. Conclusion Future interventions could focus strongly related (MD3, MD4, MD18, MD19, MD20, MD17) mentioned study, develop scientific targeted reduce

Language: Английский

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Experiences of Moral Distress in Canadian Intensive Care Unit Professionals During and After the COVID-19 Pandemic: A Qualitative Exploratory Multiple Case Study in Ontario and Alberta, Canada

Journal of Intensive Care Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: April 18, 2025

Background: Since the beginning of COVID-19 pandemic, moral distress among healthcare workers in Intensive Care Unit (ICU) has garnered both media and academic attention. Moral been theorized as occurring when individuals are constrained from doing what they perceive morally right. This study sought to empirically examine lived experiences clinical administrative professionals a sample Canadian ICUs during pandemic. Methods: Qualitative case methodology was used overarching approach, collecting comparing data two distinct cases: one ICU Ontario Alberta. Data collection involved primary sources: semi-structured interviews with staff document review institutional government directives provide contextual data. analysis commenced concurrently collection, generated within- across-case themes, well allowed descriptive accounts distress. Results: Thirty-six across sites were interviewed. Participants described three categories constraints leading These were: 1) The rapidity opaqueness policy development, specifically pertaining 2) implementation family visitation treatment triage decisions, 3) resource shortages, which reduced patient interactions, shifted professional responsibilities. Each these yielded circumstances forced decisions that perceived wrong because compromised care quality outcomes. Conclusions: While sharing similarities growing literature on context this reveals new insights how provincial direct bearing Policies choose between actions considered most right least wrong. Understanding specific policy-driven highlights need for systems processes mitigate sustain our health workforce.

Language: Английский

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The challenges of compliance with sepsis management protocols in low and low-middle income countries − A cross-sectional study

Intensive and Critical Care Nursing, Journal Year: 2025, Volume and Issue: 90, P. 104032 - 104032

Published: April 21, 2025

Language: Английский

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Examining moral distress and injury resulting from the COVID-19 pandemic: Insights from the Ghanaian radiography workforce

Journal of medical imaging and radiation sciences, Journal Year: 2024, Volume and Issue: 55(4), P. 101448 - 101448

Published: July 9, 2024

Moral distress has been an issue under consideration in healthcare practice. The COVID-19 pandemic became a critical factor that contributed to heightened moral and injury among professionals, including radiographers. Despite the substantial engagement of radiographers management patients, consequent states experienced by this frontline workforce have not widely explored. This study investigated level coping mechanisms employed Ghana during provide valuable information support prepare better against any future pandemics.

Language: Английский

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Futile therapeutic nursing interventions in adult intensive care: A descriptive study

Nursing Ethics, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 28, 2024

Background: Despite the progress made in recent decades on phenomenon of futility adult intensive care, recognizing it during clinical care practice remains a complex and sensitive process, which questions are often raised for concrete answers difficult to find. Aims: To analyze frequency with futile nursing interventions implemented critically ill patients admitted specific situations how autonomous interdependent same population, as perceived by nurses. Research design: Cross-sectional, quantitative, descriptive study, employed questionnaire constructed specifically this research assess perception therapeutic care. Following an evaluation psychometric properties, was available electronic format EUSurvey platform between August October 2024. The data analyzed November 2023 March 2024 using statistical software packages SPSS R. Participants context: A simple random sample nurses working level II III units Portugal. Ethical considerations: ethical approvals were obtained, participants provided informed consent. Findings/results: Four hundred fourteen valid questionnaires obtained. results allow identification thirty-three statistically significant associations, inference intervals mean median 95% confidence interval, enable hierarchization according nurses’ their futility. Conclusion: There is balance nurses' analyzed. evidence that are, general, more frequently when compared interventions.

Language: Английский

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