scholarly journals Moral distress in medicine: An ethical analysis

2021 ◽  
pp. 135910532110145
Author(s):  
Alexandra Kherbache ◽  
Evelyne Mertens ◽  
Yvonne Denier
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Emotional Response ◽  
Moral Distress ◽  
Care Ethics ◽  
Ethical Analysis ◽  
Ethical Aspects ◽  
Ethical Theories ◽  
External Constraints

Moral distress is a negative emotional response that occurs when physicians know the morally correct action but are prevented from taking it because of internal or external constraints. Moral distress undermines a physician’s ethical integrity, leading to anger, poor job satisfaction, reduced quality of care and burnout. Scarce literature exists on the ethical aspects of moral distress in medicine. We conducted an ethical analysis of moral distress as experienced by physicians and analysed it from the literature using two predominant ethical theories: principlism and care ethics. Finally, we consider the emergence of moral distress in medicine during the COVID-19 pandemic.

scholarly journals Among equity and dignity: an argument-based review of European ethical guidelines under COVID-19

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marta Perin ◽  
Ludovica De Panfilis
Keyword(s):  
Decision Making ◽  
Quality Of Care ◽  
Health Care Professionals ◽  
Moral Distress ◽  
Ethical Aspects ◽  
Ethical Guidelines ◽  
Ethical Theories ◽  
Moral Relevance ◽  
Equity Principle

Abstract Background Under COVID-19 pandemic, many organizations developed guidelines to deal with the ethical aspects of resources allocation. This study describes the results of an argument-based review of ethical guidelines developed at the European level. It aims to increase knowledge and awareness about the moral relevance of the outbreak, especially as regards the balance of equity and dignity in clinical practice and patient’s care. Method According to the argument-based review framework, we started our research from the following two questions: what are the ethical principles adopted by the ethical guidelines produced at the beginning of the COVID-19 outbreak related to resource allocation? And what are the practical consequences in terms of 'priority' of access, access criteria, management of the decision-making process and patient care? Results Twenty-two ethical guidelines met our inclusion criteria and the results of our analysis are organized into 4 ethical concepts and related arguments: the equity principle and emerging ethical theories; triage criteria; respecting patient’s dignity, and decision making and quality of care. Conclusion Further studies can investigate the practical consequences of the application of the guidelines described, in terms of quality of care and health care professionals’ moral distress.

The effects of work factors on nurses’ job satisfaction, quality of care and turnover intentions in oncology

2018 ◽  
Vol 74 (5) ◽  
pp. 1208-1219 ◽  
Author(s):  
Nicolas Gillet ◽  
Evelyne Fouquereau ◽  
Hélène Coillot ◽  
Baptiste Cougot ◽  
Leïla Moret ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Turnover Intentions ◽  
Work Factors

Ethical Aspects of Talking to a Patient

2016 ◽  
pp. 203-235
Author(s):  
Roman Ossowski ◽  
Paweł Izdebski
Keyword(s):  
Quality Of Life ◽  
Medical Personnel ◽  
Ethical Principles ◽  
Ethical Aspects ◽  
Ethical Theories ◽  
Results Of Treatment ◽  
Modern Physics ◽  
The Subject

A very important role in the diagnosing process is played by the conversation with a patient, which should always have a diagnostic-therapeutic character. The subject of interest of this paper are the relations between medical personnel and patients. The chapter aimed to explain the application of main ethical theories in conversation with patients as a diagnostic-therapeutic instrument. As an example, a case study illustrates basic ethical principles of such a conversation. It as an instrument of diagnosis and therapy retained its value despite introducing numerous methods of diagnosis based on the findings of modern physics or electronics. In our view, the conversation should always aim at the benefit of the patient and the results of treatment as well as sustaining patient's subjectivity and hope for achieving a higher quality of life.

scholarly journals Relationships Between Managerial and Organizational Practices, Psychological Health at Work, and Quality of Care in Pediatric Oncology

2020 ◽  
pp. JOP.19.00583
Author(s):  
Julien Lejeune ◽  
Severine Chevalier ◽  
Evelyne Fouquereau ◽  
Denis Chenevert ◽  
Hélène Coillot ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Pediatric Oncology ◽  
Organizational Support ◽  
Psychological Health ◽  
Care Providers ◽  
Perceived Quality Of Care ◽  
Organizational Determinants ◽  
Psychological Health At Work

PURPOSE: Psychological health at work for care providers is an important issue, because they are directly involved in quality of patient care. Managerial and organizational determinants have been found to be indicators of psychological health at work. The main objective of this study was to explore the relationships between the psychological health at work of pediatric oncology care workers with managerial and organizational determinants and with quality of care. MATERIALS AND METHODS: We performed regression analysis between psychological health at work (quality of work life [QWL], job satisfaction, and so on), managerial determinants (transformational leadership, perceived autonomy support), organizational determinants (organizational support, organizational justice, and participatory approach), and perceived quality of care. RESULTS: Participants were 510 health care professionals working in French pediatric oncology centers. No significant differences in the psychological health at work of the participants were found based on age, sex, length of employment, or professional discipline. In simple regression, significant associations were found between psychological health at work with all managerial and organizational determinants. In multiple regression, a significant link was found between QWL and perceived organizational support (β = .21; P < .001), organizational justice (β = .20, P < .001), and overall participatory approach (β = .10; P < .02). Job satisfaction was also related to perceived organizational support (β = .16; P < .01). Finally, perceived quality of care was linked to QWL (β = .15; P < .01) and job satisfaction (β = .30; P < .001). CONCLUSION: These results emphasize the importance of the role of managers and the organization in psychological health at work of health care providers and also in the quality of patient care

scholarly journals Indian nurses’ views on a collaborative model of best practices: Evidence-based practice, job satisfaction, learning environment, and nursing quality

2018 ◽  
Vol 8 (9) ◽  
pp. 87
Author(s):  
Kaisa Bjuresäter ◽  
Sister Tessy Sebastian ◽  
Bhalchandra Kulkarni ◽  
Elsy Athlin
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Nursing Students ◽  
Learning Environment ◽  
Evidence Based Practice ◽  
Positive Impact ◽  
Evidence Based ◽  
Collaborative Model

Introduction: This study is a part of a project aimed at implementing and evaluating the Collaborative Model of Best Practice, (CMBP) to promoting evidence-based practice (EBP) in health care contexts. The aim of the study was to assess nurses’ interest, attitudes, utilisation, and views on promotors of and resources related to EBP before and after taking part in the CMBP project, and to investigate their views on the CMBP in relation to collaboration between the academy and clinical practice, the earning environment, job satisfaction, and nursing quality.Methods: A descriptive, comparative design was used with pre- and post-test measurements. The Research Utilization Questionnaire (RUQ) and study-specific questions were distributed to ward nurses (n = 67) in a rural Indian hospital.Results: Most of the nurses thought that the CMBP had a positive impact on quality of care, on their attitudes to, interest in, and knowledge EBP, and on their job satisfaction. They also considered that the collaboration between the nursing college and clinical practice had a positive impact on the learning environment and that more resources were available at the end of the project.Conclusions: The CMBP project was an attempt to improve the quality of care for patients and the learning environment for nursing students and nurses on the project wards. The results indicated fulfilment of these goals, which strengthens the usability of the model. Implementation of EBP is challenging and requires long-lasting activities and comprehensive support from leaders and facilitators. More studies are needed in which EBP is systematically implemented, accomplished, evaluated, and reported.

scholarly journals Professional nursing practice: environment and emotional exhaustion among intensive care nurses

2013 ◽  
Vol 21 (3) ◽  
pp. 765-772 ◽  
Author(s):  
Marcia Raquel Panunto ◽  
Edinêis de Brito Guirardello
Keyword(s):  
Job Satisfaction ◽  
Intensive Care ◽  
Quality Of Care ◽  
Emotional Exhaustion ◽  
Nursing Practice ◽  
Intention To Leave ◽  
Professional Nursing Practice ◽  
Nursing Practice Environment ◽  
Perception Of Quality

OBJECTIVE: to evaluate the characteristics of the professional nursing practice environment and its relationship with burnout, perception of quality of care, job satisfaction and the intention to leave the job in the next 12 months. METHOD: cross-sectional study with a quantitative approach to data. The sample was composed of 129 nurses working in adult Intensive Care Units from a region in the interior of São Paulo, Brazil. RESULTS: The structural equation modeling, using path analysis, revealed that characteristics of the environment influence job satisfaction, perception of quality of care, and having an intention to leave their job, when mediated by emotional exhaustion. Nurses with limited autonomy, poor control over their practice, and poor relationships with physicians, experience a greater level of emotional exhaustion, which can negatively influence their perception of quality of care, job satisfaction and an intention to abandon their jobs. CONCLUSION: the mediating role of emotional exhaustion may negatively influence care delivery. Therefore, there is a need to adopt strategies to minimize this condition among nurses.

Work-Related Burnout, Job Satisfaction, Intent to Leave, and Nurse-Assessed Quality of Care Among Travel Nurses

2011 ◽  
Vol 41 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Marcia S. Faller ◽  
Michael G. Gates ◽  
Jane M. Georges ◽  
Cynthia D. Connelly
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Intent To Leave ◽  
Work Related

scholarly journals Burnout, Moral Distress, and Job Turnover in Critical Care Nurses

2018 ◽  
Vol 3 (3) ◽  
pp. 108 ◽  
Author(s):  
Brooke A. Whittaker ◽  
Deborah R. Gillum ◽  
Judith M. Kelly
Keyword(s):  
Critical Care ◽  
Quality Of Care ◽  
Moral Distress ◽  
Nurse Retention ◽  
Critical Care Nurses ◽  
Ethnographic Study ◽  
Job Turnover ◽  
Nurse Turnover ◽  
Excessive Stress

Nurse turnover, shortages, and lack of nurse retention have all been linked to stress among nurses. This ethnographic study explored if burnout and moral distress, often a result of excessive stress, led to job turnover among critical care nurses in northern Indiana and southern Michigan. It also explored the factors that may cause burnout and moral distress in the identified population. Although burnout and moral distress have been studied in various professions and locales over the years, research specific to critical care nurses has been limited in the northern Indiana, southern Michigan area. In this study, 100% of the nurses felt that burnout and moral distress led to turnover. These same nurses attributed burnout and moral distress to affecting the quality of care given to patients. The guiding framework for this study’s design was Corley’s theory of moral distress.

RN Job Satisfaction and Retention After an Interprofessional Team Intervention

2018 ◽  
Vol 41 (4) ◽  
pp. 615-630 ◽  
Author(s):  
Dawon Baik ◽  
Brenda Zierler
Keyword(s):  
Job Satisfaction ◽  
Quality Of Care ◽  
Turnover Rate ◽  
Cross Sectional Study ◽  
Intervention Period ◽  
Post Intervention ◽  
Cross Sectional ◽  
Interprofessional Team ◽  
Interprofessional Teamwork

Despite continuing interest in interprofessional teamwork to improve nurse outcomes and quality of care, there is little research that focuses on nurse job satisfaction and retention after an interprofessional team intervention. This study explored registered nurse (RN) job satisfaction and retention after a purposeful interprofessional team training and structured interprofessional bedside rounds were implemented. As part of a larger study, in this comparative cross-sectional study, pre- and post-intervention data on RN job satisfaction and turnover rate were collected and analyzed. It was found that RNs had significantly higher job satisfaction after the interprofessional team intervention. The 6-month period turnover rate in the post-intervention period was slightly lower than the 6-month period turnover rate in pre-intervention period; however, the rate was too low to provide statistical evidence. Ongoing coaching and supportive work environments to improve RN outcomes should be considered to enhance quality of care and patient safety in healthcare.

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