Psychological impact of working in paediatric intensive care. A UK-wide prevalence study

2019 ◽  
Vol 105 (5) ◽  
pp. 470-475 ◽  
Author(s):  
Gareth A L Jones ◽  
Gillian A Colville ◽  
Padmanabhan Ramnarayan ◽  
Kerry Woolfall ◽  
Yvonne Heward ◽  
...  
Keyword(s):  
Intensive Care ◽  
Moral Distress ◽  
Psychological Impact ◽  
Maslach Burnout Inventory ◽  
Paediatric Intensive Care ◽  
Junior Doctors ◽  
Post Traumatic Stress ◽  
Work Related ◽  
Transport Services ◽  
Distress Scale

ObjectiveTo determine the prevalence of work-related psychological distress in staff working in UK paediatric intensive care units (PICU).DesignOnline (Qualtrics) staff questionnaire, conducted April to May 2018.SettingStaff working in 29 PICUs and 10 PICU transport services were invited to participate.Participants1656 staff completed the survey: 1194 nurses, 270 physicians and 192 others. 234 (14%) respondents were male. Median age was 35 (IQR 28–44).Main outcome measuresThe Moral Distress Scale-Revised (MDS-R) was used to look at moral distress, the abbreviated Maslach Burnout Inventory to examine the depersonalisation and emotional exhaustion domains of burnout, and the Trauma Screening Questionnaire (TSQ) to assess risk of post-traumatic stress disorder (PTSD).Results435/1194 (36%) nurses, 48/270 (18%) physicians and 19/192 (10%) other staff scored above the study threshold for moral distress (≥90 on MDS-R) (χ2 test, p<0.00001). 594/1194 (50%) nurses, 99/270 (37%) physicians and 86/192 (45%) other staff had high burnout scores (χ2 test, p=0.0004). 366/1194 (31%) nurses, 42/270 (16%) physicians and 21/192 (11%) other staff scored at risk for PTSD (χ2 test, p<0.00001). Junior nurses were at highest risk of moral distress and PTSD, and junior doctors of burnout. Larger unit size was associated with higher MDS-R, burnout and TSQ scores.ConclusionsThese results suggest that UK PICU staff are experiencing work-related distress. Further studies are needed to understand causation and to develop strategies for prevention and treatment.

scholarly journals A survey of moral distress in staff working in intensive care in the UK

2018 ◽  
Vol 20 (3) ◽  
pp. 196-203 ◽  
Author(s):  
GA Colville ◽  
D Dawson ◽  
S Rabinthiran ◽  
Z Chaudry-Daley ◽  
L Perkins-Porras
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Female Gender ◽  
Intention To Leave ◽  
Post Traumatic Stress ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Distress Scale

Elevated rates of burnout and post-traumatic stress have been found in staff working in critical care settings, but the aspect of moral distress has been harder to quantify until a recent revision of a scale previously designed for nurses, was adapted for use with a range of health professionals, including physicians. In this cross-sectional survey, n = 171 nurses and physicians working in intensive care in the United Kingdom completed the Moral Distress Scale-Revised in relation to their experiences at work. Mean (SD) Moral Distress Scale-Revised score was 70.2 (39.6). Significant associations were found with female gender (female 74.1 (40.2) vs. male 55.5 (33.8), p = 0.010); depression ( r = 0.165, p = 0.035) and with intention to leave job (considering leaving 85.5 (42.4) vs. not considering leaving 67.2 (38.6), p = 0.040). These results highlight the importance of considering the moral impact of work-related issues when addressing staff wellbeing in critical care settings.

scholarly journals The Relationship Between Moral Distress With Level of Burnout on Nurses in Intensive Care Room at the dr. Soebandi Hospital Jember

2021 ◽  
Vol 5 (2) ◽  
pp. 273
Author(s):  
Siswoyo Siswoyo ◽  
Kholid Rosyidi Muhammad Nur ◽  
Faizatul Ulya
Keyword(s):  
Intensive Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Bivariate Analysis ◽  
P Value ◽  
Care Providers ◽  
Distress Scale ◽  
Spearman Test ◽  
The Relationship

Moral distress is defined as psychological disequilibrium and negative feelings that results from recognizing an ethically appropriate action, yet not taking it because of such barriers. This causes an increase workload of nurses in the intensive care room, resulting burnout that affects nurses, patients and health care providers. This study aimed to analyze the relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember. This study used a quantitative descriptive observational analytic with the approach cross sectional design selected 47 nurses as respondents used total sampling. Data collected by Measure of Moral Distress Scale - Healthcare Professionals (MMD-HP) and Maslach Burnout Inventory (MBI). The results revealed that most respondents experienced low moral distress (85.1%) and low burnout (61.7%). The bivariate analysis showed with spearman test that p-value was < 0.001 (α = 0.05; r = 0.531). There was a relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember with moderate and positive relationship strength. A healthy work environment plays an important role in the low level of moral distress and burnout, if there are staff skilled in communication, good collaboration between people or professions, effective decision making, proper staffing, recognition and leadership.

scholarly journals Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers?

2014 ◽  
Vol 22 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Graziele de Lima Dalmolin ◽  
Valéria Lerch Lunardi ◽  
Guilherme Lerch Lunardi ◽  
Edison Luiz Devos Barlem ◽  
Rosemary Silva da Silveira
Keyword(s):  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Burnout Syndrome ◽  
Bivariate Analysis ◽  
Rio Grande Do Sul ◽  
Weak Correlation ◽  
Professional Performance ◽  
Moderating Variables ◽  
Professional Fulfillment ◽  
Distress Scale

OBJECTIVE: to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. METHODS: this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. RESULTS: the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. CONCLUSION: the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

scholarly journals 973 Regional Paediatric Intensive Care (PIC) Transport Services: Benefits of 2 Becoming 1!

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A278-A279
Author(s):  
B. Lakin ◽  
K. Parkins ◽  
C. Walker ◽  
R. Barber ◽  
S. Santo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Paediatric Intensive Care ◽  
Transport Services

scholarly journals Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses

2018 ◽  
Vol 27 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Krista Wolcott Altaker ◽  
Jill Howie-Esquivel ◽  
Janine K. Cataldo
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Ethical Climate ◽  
Moral Distress ◽  
Care Delivery ◽  
National Database ◽  
Palliative Care Teams ◽  
Intensive Care Unit Nurses ◽  
Distress Scale

Background Intensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance. Objectives To evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit. Methods Intensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed. Results Of 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P &lt; .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores. Conclusions Poor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.

Moral Distress of Staff Nurses in a Medical Intensive Care Unit

2005 ◽  
Vol 14 (6) ◽  
pp. 523-530 ◽  
Author(s):  
Ellen H. Elpern ◽  
Barbara Covert ◽  
Ruth Kleinpell
Keyword(s):  
Job Satisfaction ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Moral Distress ◽  
Medical Intensive Care Unit ◽  
Well Being ◽  
Individual Characteristics ◽  
Medical Intensive Care ◽  
Distress Scale

• Background Moral distress is caused by situations in which the ethically appropriate course of action is known but cannot be taken. Moral distress is thought to be a serious problem among nurses, particularly those who practice in critical care. It has been associated with job dissatisfaction and loss of nurses from the workplace and the profession.• Objectives To assess the level of moral distress of nurses in a medical intensive care unit, identify situations that result in high levels of moral distress, explore implications of moral distress, and evaluate associations among moral distress and individual characteristics of nurses.• Methods A descriptive, questionnaire study was used. A total of 28 nurses working in a medical intensive care unit anonymously completed a 38-item moral distress scale and described implications of experiences of moral distress.• Results Nurses reported a moderate level of moral distress overall. Highest levels of distress were associated with the provision of aggressive care to patients not expected to benefit from that care. Moral distress was significantly correlated with years of nursing experience. Nurses reported that moral distress adversely affected job satisfaction, retention, psychological and physical well-being, self-image, and spirituality. Experience of moral distress also influenced attitudes toward advance directives and participation in blood donation and organ donation.• Conclusions Critical care nurses commonly encounter situations that are associated with high levels of moral distress. Experiences of moral distress have implications that extend well beyond job satisfaction and retention. Strategies to mitigate moral distress should be developed and tested.

Moral distress and burnout in Iranian nurses: The mediating effect of workplace bullying

2018 ◽  
Vol 26 (6) ◽  
pp. 1834-1847 ◽  
Author(s):  
Fardin Ajoudani ◽  
Rahim Baghaei ◽  
Mojgan Lotfi
Keyword(s):  
Workplace Bullying ◽  
Moral Distress ◽  
Maslach Burnout Inventory ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Mediating Role ◽  
Distress Scale ◽  
The Relationship ◽  
Negative Acts

Background: Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse’s burnout. Aim: To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. Ethical considerations: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. Method: This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying. Results: The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly. Conclusion: Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.

Relationship between ICU nurses’ moral distress with burnout and anticipated turnover

2014 ◽  
Vol 22 (1) ◽  
pp. 64-76 ◽  
Author(s):  
Foroozan Atashzadeh Shoorideh ◽  
Tahereh Ashktorab ◽  
Farideh Yaghmaei ◽  
Hamid Alavi Majd
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Turnover Intention ◽  
Work Experience ◽  
Moral Distress ◽  
Statistical Correlation ◽  
Medical Sciences ◽  
Anticipated Turnover ◽  
Intensive Care Unit Nurses ◽  
Distress Scale

Background: Moral distress is one of intensive care unit nurses’ major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses’ personal and professional practice, recognizing moral distress is very important. Research objective: The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses. Research design: This study is a descriptive-correlation research. Participants and research context: A total of 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included “demographic questionnaire,” “ICU Nurses’ Moral Distress Scale,” “Copenhagen Burnout Inventory” and “Hinshaw and Atwood Turnover Scale.” Data analysis was done by using SPSS19. Ethical considerations: Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran. Findings: The findings showed intensive care unit nurses’ moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses’ age, their work experience and the fraction of nurses’ number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress. Discussion: Some of the findings of this research are consistent with other studies and some of them are inconsistent. Conclusion: Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses’ moral distress, burnout and their turnover intention are essential.

Clinicians’ moral distress and family satisfaction in the intensive care unit

2018 ◽  
Vol 25 (12) ◽  
pp. 1894-1904 ◽  
Author(s):  
Giulia Lamiani ◽  
Matteo Ciconali ◽  
Piergiorgio Argentero ◽  
Elena Vegni
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Emotional Support ◽  
Moral Distress ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Decision Making Process ◽  
The Family ◽  
Distress Scale ◽  
The Relationship

This study explored the relationship between clinicians’ moral distress and family satisfaction with care in five intensive care units in Italy. A total of 122 clinicians (45 physicians and 77 nurses) and 59 family members completed the Italian Moral Distress Scale-Revised and the Family Satisfaction in the ICU questionnaire, respectively. Clinicians’ moral distress inversely correlated with family satisfaction related to the inclusion in the decision-making process. Specifically, physicians’ moral distress inversely correlated with satisfaction regarding the respect shown toward the patient. Nurses’ moral distress inversely correlated with satisfaction regarding breathlessness and agitation management, provision of emotional support, understanding of information, and inclusion in the decision-making process.

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