Dataset Information

Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

ABSTRACT:

Background

Moral distress has been studied widely in nursing but not in developing economies.

Aim

To investigate how moral distress is experienced by nurses working in neonatal intensive care and paediatric wards in Northern Ghana and to determine support measures offered by nurse managers.

Method

Qualitative descriptive method. Forty nurses and fourteen nurse managers working with children in four hospitals in Northern Ghana were interviewed. Thematic data analysis was carried out.

Results

Six themes were identified: nurses experience morally distressing situations due to a variety of causes; the impact of morally distressing situations on nurses; coping mechanisms of nurses who experienced morally distressing situations; recommendations made by the nurses to reduce the incidence of moral distress; inadequate support measures available to nurse managers and nurse managers experience moral distress too.

Conclusion

The causes of moral distress in developed and developing economies are similar. The frequency and intensity of moral distress is high in Northern Ghana. Consistent with other studies conducted in Africa, nurses and nurse managers relied on their religious faith as a form of resilience. No support measures are available to nurse managers to support nurses who experience moral distress.

SUBMITTER: Afoko V

PROVIDER: S-EPMC9634244 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

Afoko Vivian V Hewison Alistair A Neilson Susan S Newham Roger R

Journal of research in nursing : JRN 20221102 6

<h4>Background</h4>Moral distress has been studied widely in nursing but not in developing economies.<h4>Aim</h4>To investigate how moral distress is experienced by nurses working in neonatal intensive care and paediatric wards in Northern Ghana and to determine support measures offered by nurse managers.<h4>Method</h4>Qualitative descriptive method. Forty nurses and fourteen nurse managers working with children in four hospitals in Northern Ghana were interviewed. Thematic data analysis was car ...[more]

PMID: 36338924

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Project description:BackgroundNo systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress experienced by nurses in ICUs, as assessed by Corley's instruments on moral distress (the Moral Distress Scale and the Moral Distress Scale-Revised). Additionally, this systematic review aimed to summarize the correlates of moral distress.MethodsA systematic search and review were performed using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Library of Medicine (MEDLINE/PubMed), and Psychological Abstracts Information Services (PsycINFO). The review methodology followed PRISMA guidelines. The quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale.ResultsFindings showed a moderate level of moral distress among nurses working in ICUs. The findings of this systematic review confirm that there are a lot of triggers of moral distress related to patient-level factors, unit/team-level factors, or system-level causes. Beyond the triggers of moral distress, this systematic review showed some correlates of moral distress: those nurses working in ICUs with less work experience and those who are younger, female, and intend to leave their jobs have higher levels of moral distress. This systematic review's findings show a positive correlation between professional autonomy, empowerment, and moral distress scores. Additionally, nurses who feel supported by head nurses report lower moral distress scores.ConclusionsThis review could help better identify which professionals are at a higher risk of experiencing moral distress, allowing the early detection of those at risk of moral distress, and giving the organization some tools to implement preventive strategies.

Project description:AimThe present study is an attempt to investigate the relationship between Corley's model variables in mental health nurses.BackgroundBased on Corley's model, burnout and moral distress in nurses are, in retrospect, the consequences of the interplay of organizational and individual factors such as perceived organizational justice, moral sensitivity, and moral courage. The relationship between two variables or three variables of Corley's moral distress model has been investigated, but the test of Corley's moral distress model with more variables has not been done. Therefore, this research was proposed with the aim of investigating the relationship between the variables of moral courage and moral sensitivity (as characteristics of nurses), perceived organizational justice (as an antecedent), moral distress, and job burnout (as consequences of moral distress).MethodsThe study was conducted as a descriptive correlational study involving 500 nurses working in the mental health wards of hospitals. Data collection was conducted using perceived organizational justice scale, moral sensitivity scale, moral courage scale, moral distress scale, and burnout inventory.ResultsThe results showed a significant relationship between perceived organizational justice, moral sensitivity, moral courage, and moral distress (< 0.05). Moreover, perceived organizational justice and moral distress had an inverse relationship. Moral sensitivity and moral courage had a direct relationship with moral distress (< 0.05). Furthermore, the results showed inadequate model fitness.ConclusionsThis study adds to the existing knowledge about the experiences of mental health nurses and their interactions with both organizational and individual factors. It highlights that the connections between perceived organizational justice, moral sensitivity, moral courage, moral distress, and burnout are intricate and multifaceted. As we deepen our understanding of these relationships, it opens the door for the development of interventions and strategies to enhance nurses' well-being and the quality of care they deliver in mental health settings. Moreover, future research and ongoing refinement and expansion of Corley's model will be crucial in addressing the complex challenges within the healthcare sector.

Project description:Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes.

Project description:ObjectiveThis integrative review aimed to identify the common characteristics of moral distress in nursing and distinguish it from other types of distress by examining nurses' perspectives in the literature. These insights will help update existing tools and create new ones to capture moral distress better, guiding the development and implementation of strategies to support nurses in addressing this challenge.MethodsWhittemore and Knafl's integrative review method was employed to guide a systematic search for literature in three databases (EBSCO Medline, CINAHL, and PubMed). Additionally, two journals, Bioethics and Nursing Ethics, were manually searched to reduce search bias. The included studies were primary resources published in English between 2018 and 2023, utilizing quantitative, qualitative, or mixed methods to examine moral distress's characteristics, components, and definitions. All of identified studies were screened, extracted, and analyzed independently by two researchers.ResultsNineteen studies were included. The results were grouped into five themes shaping the main characteristics of moral distress: 1) experiencing a moral situation, with five ethically conflicted situations identified, including treatment plans, professional and personal moral values, team dynamics, complex contexts, clinical practices, and patient-centered care; 2) making a moral judgment, where nurses experience moral distress when they cannot act consistently with their values, ethical principles, and moral duties; 3) the presence of constraints, categorized at three levels: individual factors related to the nurse, patient, and patient's family; team factors related to the team or unit involved; and system factors, including institutional and policy elements; 4) moral wrongdoing, which occurs when nurses are unable to perform the right moral action; and 5) moral suffering, with studies showing that moral distress impacts physical, emotional, and psychological well-being.ConclusionThe findings enhance the understanding of moral distress characteristics among nursing staff, highlighting the concept of the crescendo effect, which underscores the cumulative and escalating nature of unresolved moral distress, emphasizing the need to address moral conflicts proactively to prevent the erosion of moral integrity and professional satisfaction.

Dataset Information

Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

Background

Aim

Method

Results

Conclusion

Publications

Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

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