scholarly journals Conceptualising Work-Related Moral Suffering—Exploring and Refining the Concept of Moral Distress in the Context of Social Work

2019 ◽  
Vol 50 (3) ◽  
pp. 741-757 ◽  
Author(s):  
Maija Mänttäri-van der Kuip
Keyword(s):  
Social Work ◽  
Moral Agency ◽  
Moral Distress ◽  
Empirical Literature ◽  
Front Line ◽  
Complex Dynamic ◽  
Work Related ◽  
Conceptual Clarity ◽  
Valid Instrument ◽  
Nursing Literature

Abstract In the nursing literature, work-related suffering due to restricted moral agency is commonly considered under the concept of moral distress. This concept has resonated strongly amongst nursing scholars since the 1980s and has recently gained ground amongst social work scholars as well. However, the research on moral distress suffers from inadequate conceptual clarity; this has led to multiple and disparate ways of empirically studying the phenomenon. This article examines the conceptualisations of moral distress applied in the nursing and social work literature and identifies and discusses the challenges and potential problems related to them. The article sheds light on the complex, dynamic and relative nature of the phenomenon, which has not been sufficiently acknowledged in the existing empirical literature. Despite its complexities and defects, as highlighted in this article, the concept of moral distress can serve as an important tool for understanding and analysing experiences of moral suffering in front line social work. However, defining this experience in all its complexity and devising a valid instrument to measure it remain a major challenge.

Moral stress, moral climate and moral sensitivity among psychiatric professionals

2010 ◽  
Vol 17 (2) ◽  
pp. 213-224 ◽  
Author(s):  
Kim Lützén ◽  
Tammy Blom ◽  
Béatrice Ewalds-Kvist ◽  
Sarah Winch
Keyword(s):  
Mental Health ◽  
Moral Agency ◽  
Ethical Climate ◽  
Linear Regression Analysis ◽  
Theory Development ◽  
Future Research ◽  
Moral Sensitivity ◽  
Moral Stress ◽  
Work Related ◽  
Conceptual Clarity

The aim of the present study was to investigate the association between work-related moral stress, moral climate and moral sensitivity in mental health nursing. By means of the three scales Hospital Ethical Climate Survey, Moral Sensitivity Questionnaire and Work-Related Moral Stress, 49 participants’ experiences were assessed. The results of linear regression analysis indicated that moral stress was determined to a degree by the work place’s moral climate as well as by two aspects of the mental health staff’s moral sensitivity. The nurses’ experience of ‘moral burden’ or ‘moral support’ increased or decreased their experience of moral stress. Their work-related moral stress was determined by the job-associated moral climate and two aspects of moral sensitivity. Our findings showed an association between three concepts: moral sensitivity, moral climate and moral stress. Despite being a small study, the findings seem relevant for future research leading to theory development and conceptual clarity. We suggest that more attention be given to methodological issues and developing designs that allow for comparative research in other disciplines, as well as in-depth knowledge of moral agency.

scholarly journals Moral distress and injury in social work

2021 ◽  
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Moral Distress ◽  
Ethical Dilemmas ◽  
Moral Injury ◽  
Prevention Strategies ◽  
Moral Beliefs ◽  
Work Related

Among the most challenging ethical dilemmas in social work is what has become known as moral injury. Moral injury is ordinarily defined as the sort of harm that results when someone has perpetrated, failed to prevent, or witnessed acts that transgress deeply held moral beliefs. What these phenomena have in common are instances when social workers must decide how to handle work-related circumstances that are deeply troubling because they have caused, or have the potential to cause, harm. It is important for social workers to understand the nature of moral injury, the diverse causes of moral injury and the moral distress that often results, meaningful responses, and prevention strategies.

Moral distress

2014 ◽  
Vol 22 (1) ◽  
pp. 131-152 ◽  
Author(s):  
Joan McCarthy ◽  
Chris Gastmans
Keyword(s):  
Moral Agency ◽  
Quantitative Research ◽  
Moral Distress ◽  
Empirical Literature ◽  
Professional Lives ◽  
Healthcare Provision ◽  
Original Definition ◽  
Structural Inequities ◽  
Academic Search ◽  
Different Sources

Aim: The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. Data sources: CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers’ Index and Socindex. Review methods: A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. Results: We found that like the empirical literature, most authors in this review draw on Jameton’s original definition and describe moral distress in psychological–emotional–physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses’ moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses’ personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. Conclusion: We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and operationalization of moral distress also flag the need to proceed with caution.

Institutional betrayal in nursing: A concept analysis

2021 ◽  
pp. 096973302199244
Author(s):  
Katherine C Brewer
Keyword(s):  
Organizational Behavior ◽  
Moral Distress ◽  
Well Being ◽  
Concept Analysis ◽  
Ethical Culture ◽  
Negative Events ◽  
Moral Standards ◽  
Conceptual Clarity ◽  
Definition Of ◽  
Conceptual Relationships

Background: Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal. Research aim: The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal. Design: This analysis uses the method developed by Walker and Avant. Research context: Studies were reviewed using health literature databases with no date restrictions. Ethical considerations: Analysis was conducted using established guidelines for ethical research. Findings: Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic. Discussion: A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept. Conclusion: In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.

scholarly journals The job demands-resources model and the international work context – a systematic review

2014 ◽  
Vol 2 (3) ◽  
pp. 260-279 ◽  
Author(s):  
Lucy T.B. Rattrie ◽  
Markus G. Kittler
Keyword(s):  
Systematic Review ◽  
Empirical Studies ◽  
Domestic Work ◽  
Job Demands ◽  
Empirical Literature ◽  
Future Research ◽  
Content Type ◽  
International Work ◽  
Work Related ◽  
Work Contexts

Purpose – The purpose of this paper is to provide a synthesis and evaluation of literature surrounding the job demands-resources (JD-R) model (Demerouti et al., 2001) in the first decade since its inception, with particular emphasis on establishing an evidence-based universal application towards different national and international work contexts. Design/methodology/approach – The study uses a systematic review approach following the stages suggested by Tranfield et al. (2003). Based on empirical data from 62 studies, the authors systematically analyse the application of the JD-R model and queries whether it is applicable outside merely domestic work contexts. Findings – The authors find convincing support for the JD-R model in different national contexts. However, the authors also found an absence of studies employing the JD-R model in cross-national settings. None of the empirical studies in the sample had explicitly considered the international context of today’s work environment or had clearly associated JD-R research with the IHRM literature. Research limitations/implications – Based on the wide acceptance of the JD-R model in domestic work contexts and the increased interest in work-related outcomes such as burnout and engagement in the IHRM literature, the study identifies a gap and suggests future research applying the JD-R model to international work and global mobility contexts. Originality/value – This study is the first to systematically assess the application of the JD-R model in domestic and international work contexts based on a systematic review of empirical literature in the first decade since the inception of the model. The study identifies a lack of internationally focussed JD-R studies and invites further empirical research and theoretical extensions.

scholarly journals Moral distress: Ethically appropriate actions

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
E Maeckelberghe
Keyword(s):  
Moral Agency ◽  
Moral Distress ◽  
Original Description ◽  
Moral Integrity ◽  
Moral Question ◽  
The Right ◽  
The Given ◽  
Psychological Dimensions ◽  
Original Concept ◽  
Ethical Situation

Abstract Andrew Jameton in 1984 coined the concept of moral distress as: “knowing what to do in an ethical situation, but not being allowed to do it” This original description presupposes that the right moral act can be identified and precludes situations of doubt and uncertainty. The 1984 definition emphasizes barriers that make it impossible for someone to do what they ought to do. Whereas Jameton in a revision in 2013 of his original concept emphasized reduction of the psychological dimensions, Peter& Liaschenko stress the element of moral agency. Moral distress then is a threat to the moral integrity of the professional. This requires three-step ananlysis: first, what is the moral question?; two, what are morally adeguate answers to this question?; three, what ethically appropriate actions are under pressure in the given situation? This will be illustrated with examples from the COVID-19 pandemic.

scholarly journals Validation of the Copenhagen Burnout Inventory in Pharmacists

2021 ◽  
Vol 12 (2) ◽  
pp. 4
Author(s):  
Olajide O. Fadare ◽  
Michael Andreski ◽  
Matthew J. Witry
Keyword(s):  
Logistic Regression ◽  
Community Pharmacists ◽  
Measurement Model ◽  
Criterion Validity ◽  
Work Life ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Valid Instrument ◽  
Practice Methods

Objectives: This study aimed to 1) determine the validity of the Copenhagen Burnout Inventory (CBI) for use in the assessment of burnout in a sample of pharmacists using confirmatory factor analysis (CFA), and 2) use the CBI items and other measures of work-life to assess burnout in pharmacists employed in various types of practice. Methods: A cross-sectional survey was administered to a sample of 2,582 pharmacists in a single Midwestern US state. The survey included the three subscales of the CBI, each of which measures personal, work-related, and patient-related dimensions of burnout. Other items included demographics, practice type, workload, and work-life balance. CFA was used to measure fit, and Cronbach’s alpha was used to assess reliability. Correlation was used to assess criterion validity of the CBI. Logistic regression and bivariate analyses were used to assess pharmacist burnout based on demographics. Results: Following the removal of 2 items from the measurement model, a 17-item 3-factor CBI was found to possess satisfactory psychometric properties for use in pharmacists. The CBI correlated with measures of work-life demonstrating criterion validity. A logistic regression showed that younger pharmacists and community pharmacists experience higher burnout than older pharmacists and clinical pharmacists. Community pharmacists also more often reported high workloads and poorer work-life integration. Both community and clinic pharmacists desired more time providing patient care services and less time dispensing. Conclusion: The CBI is a psychometrically reliable and valid instrument for assessing burnout in pharmacists. Younger pharmacists and community pharmacists warrant attention due to their higher degree of burnout.

Qualitative Geographic Information Systems (GIS): An untapped research approach for social work

2016 ◽  
Vol 17 (1) ◽  
pp. 9-23 ◽  
Author(s):  
Samantha Teixeira
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Spatial Data ◽  
Geographic Information ◽  
Research Approach ◽  
Gis Technology ◽  
Social Work Research ◽  
Work Related ◽  
Introductory Overview ◽  
History Of

A Geographic Information System (GIS) is a digital technology that integrates hardware and software to analyze, store, and map spatial data. GIS allows users to visualize (i.e., map) geographic aspects of data including locations or spatial concentrations of phenomena of interest. Though public health and other social work related fields have embraced the use of GIS technology in research, social work lags behind. Recent technological advancements in the field of GIS have transformed what was once prohibitively expensive, “experts only” desktop software into a viable method for researchers with little prior GIS knowledge. Further, humanist and participatory geographers have developed critical, non-quantitative GIS approaches that bring to light new opportunities relevant to social workers. These tools could have particular utility for qualitative social workers because they can help us better understand the environmental context in which our clients reside and give credence to their assessments of strengths, weaknesses, and opportunities for intervention. This article provides an introductory overview of the history of GIS in social work research and describes opportunities to use spatially informed approaches in qualitative social work research using a case study of a participatory photo mapping research study.

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