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"Moral distress"

Maura Lusignani, Maria Lorella Giannì, Luca Giuseppe Re, Maria Luisa Buffon
AIM: To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. BACKGROUND: Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. METHODS: A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used...
October 11, 2016: Journal of Nursing Management
Susan B Williams, Michael D Dahnke
Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice...
October 2016: Critical Care Nurse
John McKinnon
Healthcare is in a turbulent place as society expects nurses to remain clinically robust while adapting to changes. That such changes have the potential to undermine care quality or nurses' health is too often a secondary consideration ( RCN 2013 ).
September 30, 2016: Nursing Management (Harrow)
Pei-Pei Chen, Hsiao-Lu Lee, Shu-He Huang, Ching-Ling Wang, Chiu-Mieh Huang
BACKGROUND: Moral distress occurs when nurses experience ethical dilemmas. Issues related to these dilemmas are addressed in some nursing education courses. Nurses' reaction to dilemma such as moral distress is relatively less noticed. OBJECTIVE: This study aimed to identify and describe the various types of perceptions of moral distress exhibited by nurses. RESEARCH DESIGN: This study applied Q methodology to explore the perspectives of nurses regarding moral distress...
September 28, 2016: Nursing Ethics
Rafaela Schaefer, Elma Lourdes Campos Pavone Zoboli, Margarida Vieira
This article proposes to identify risk factors for moral distress from the literature, validate them through expert analysis and provide the basis for a new tool to assess the risk of moral distress among nurses. Moral distress is related to the psychological, emotional and physiological aspects of nursing. It arises from constraints caused by various circumstances and can lead to significant negative consequences. A scoping review and validation through expert analysis were used. The research question guiding this study was as follows: What is known about risk factors for moral distress in nursing? The research was conducted using multiple sources including electronic databases and lists of references from relevant literature...
September 28, 2016: Nursing Inquiry
Natalie Susan McAndrew, Jane Leske, Kathryn Schroeter
BACKGROUND: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. OBJECTIVES: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. REVIEW METHODS: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies...
September 22, 2016: Nursing Ethics
Shahla Siddiqui
OBJECTIVES: We describe a case where a patient at the end of life with an advanced medical directive in place presents to the ED in distress. CASE REPORT: Our case is of a middle aged male with advanced cancer who presents in the ED with his family in respiratory distress requiring intubation. Even though his advanced medical directive states not for prolonged life sustaining support his wife and daughters plead with the physicians to save his life in order to end his suffering as well as prepare them for a more peaceful death...
September 19, 2016: Journal of Emergency Medicine
Lisa Wolf, Connie M Ulrich, Christine Grady
Excellent patient care within the emergency department requires interdisciplinary training, teamwork, and communication to manage the chaos of the environment. Specifically, invasive procedures required to manage airway, breathing, and circulation via intubation, chest compressions, and establishing intravenous access can provide a direct benefit to save lives but also have the potential to harm both patients and health care clinicians alike; emergency health care clinicians can be exposed to significant amounts of blood and body fluids as well as other threats of physical and psychological harm...
September 2016: Hastings Center Report
Cynda Hylton Rushton
Undisputedly, the United States' health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty-five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances...
September 2016: Hastings Center Report
Sean M Bagshaw, Dawn Opgenorth, Melissa Potestio, Stephanie E Hastings, Shelanne L Hepp, Elaine Gilfoyle, David McKinlay, Paul Boucher, Michael Meier, Jeanna Parsons-Leigh, R T Noel Gibney, David A Zygun, Henry T Stelfox
OBJECTIVES: Discrepancy in the supply-demand relationship for critical care services precipitates a strain on ICU capacity. Strain can lead to suboptimal quality of care and burnout among providers and contribute to inefficient health resource utilization. We engaged interprofessional healthcare providers to explore their perceptions of the sources, impact, and strategies to manage capacity strain. DESIGN: Qualitative study using a conventional thematic analysis...
September 15, 2016: Critical Care Medicine
Daniel Garros
No abstract text is available yet for this article.
2016: Frontiers in Pediatrics
Ann Gallagher
No abstract text is available yet for this article.
September 2016: Nursing Ethics
Eleonora Canciani, Daniela Spotti, Loris Bonetti
AIM: Moral distress (MD) is a painful feeling and/or psychological disequilibrium, which may lead to negative consequences into the wellness of a nurse's working life. Nurses who work in psychiatry are more likely to experience a different type of MD compared with nurses of other contexts. In Italy a tool to evaluate MD in nurses who work in psychiatry doesn't exist. The aim of this study is to validate the Moral Distress Scale for Psychiatric Nurses (MDS-P) in Italian language. METHOD: For translation the forward and back-translation has been used; the effectiveness regarding content and face validity of the translated scale has been analyzed through a focus group with experts of the field...
April 2016: Professioni Infermieristiche
Wu Xiaoyan, Zhan Yufang, Ci Lifeng, Sun Congcong
OBJECTIVE: The purpose of this study was to describe the current situation of moral distress and to explore its influencing factors among Chinese nurses. METHODS: This is an exploratory, descriptive design study. A total of 465 clinical nurses from different departments in three Grade-III, Level-A hospitals in Jinan, Shandong Province, completed the questionnaires, including demographics questionnaire, Chinese version of Moral Distress Scale-Revised, and Job Diagnostic Survey...
September 1, 2016: Nursing Ethics
R P Spijkerboer, J C van der Stel, G A M Widdershoven, A C Molewijk
Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation (MCD) is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question...
August 17, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
Michiyo Ando
BACKGROUND: Since moral distress affects psychological aspects of psychiatric nurses, it is an important theme. Previous studies showed relationships between moral distress and job satisfaction; however, there are few studies which investigate relationships between moral distress and other effective variables and then we highlighted relationships among these variables. OBJECTIVE: This study aimed to (1) examine relationships among moral distress, sense of coherence, mental health, and job satisfaction and (2) clarify the most predictive variable to job satisfaction...
August 16, 2016: Nursing Ethics
Maxxine Rattner, Joan Berzoff
The dilemma so central to the work of providers of palliative and end-of-life care is the paradox of their professional and ethical duty to try to relieve suffering and the limitations of so doing. While the capacity to sit with suffering at the end of life is critical to clinical work, the idea that some intrinsic suffering cannot necessarily always be relieved may model for patients and families that suffering can be borne. Clinicians who encounter unrelievable suffering may feel a sense of failure, helplessness, moral distress, and compassion fatigue...
July 2016: Journal of Social Work in End-of-life & Palliative Care
Trine-Lise Jansen, Ingrid Hanssen
AIM: The aim of this study was to explore psychiatric nurses' experiences and perspectives regarding patient participation. Patient participation is an ambiguous, complex and poorly defined concept with practical/clinical, organisational, legal and ethical aspects, some of which in psychiatric units may cause ethical predicaments and moral stress in nurses, for instance when moral caring acts are thwarted by constraints. METHODS: An explorative quantitative pilot study was conducted at a psychiatric subacute unit through three focus group interviews with a total of nine participants...
July 21, 2016: Scandinavian Journal of Caring Sciences
James D Harrison, Tea Logar, Phuoc Le, Marcia Glass
The aim of this study was to identify global health ethical issues that health professional trainees may encounter during electives or placements in resource-limited countries. We conducted a qualitative study involving focus groups and an interview at the University of California San Francisco. Participants were multi-professional from the Schools of Medicine, Nursing and Pharmacy and had experience working, or teaching, as providers in resource-limited countries. Eighteen participants provided examples of ethical dilemmas associated with global-health outreach work...
2016: Healthcare (Basel, Switzerland)
Cecília Maria Lima Cardoso, Maria Odete Pereira, Danielle de Araújo Moreira, Hanna Beatriz Bacelar Tibães, Flávia Regina Souza Ramos, Maria José Menezes Brito
OBJECTIVE: Understanding the Moral Suffering experiences expressed in the daily life of the Family Health Strategy. METHOD: This is a case study with a qualitative approach, conducted between August and October 2014 in a municipality of Minas Gerais. The sample was represented by 28 professionals of family health teams. Data were collected through interviews with semi-structured questionnaires, observation, projective technique and submitted to thematic content analysis...
June 2016: Revista da Escola de Enfermagem da U S P
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