Peter M Dodek1, Hubert Wong2, Monica Norena3, Najib Ayas4, Steven C Reynolds5, Sean P Keenan5, Ann Hamric6, Patricia Rodney7, Miriam Stewart8, Lynn Alden9. 1. Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, B.C., Canada; Division of Critical Care Medicine, University of British Columbia, Vancouver, B.C., Canada. Electronic address: peter.dodek@ubc.ca. 2. Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, B.C., Canada; School of Population and Public Health, University of British Columbia, Vancouver, B.C., Canada. 3. Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, B.C., Canada. 4. Center for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, B.C., Canada; Division of Critical Care Medicine, University of British Columbia, Vancouver, B.C., Canada. 5. Division of Critical Care Medicine, University of British Columbia, Vancouver, B.C., Canada; Department of Critical Care, Royal Columbian Hospital, New Westminster, B.C., Canada. 6. School of Nursing, Virginia Commonwealth University, Virginia VA, USA. 7. School of Nursing, University of British Columbia, Vancouver, B.C., Canada; Providence Health Care Ethics Services, Vancouver, B.C., Canada. 8. St. Paul's Hospital, Vancouver, B.C., Canada. 9. Department of Psychology, University of British Columbia, Vancouver, B.C., Canada.
Abstract
PURPOSE: To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. METHODS: We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. RESULTS: Response rates to the surveys were the following: nurses--428/870 (49%); other health professionals (not nurses or physicians)--211/452 (47%); physicians--30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: -7.3 [-13.4, -1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. CONCLUSION: Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.
PURPOSE: To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. METHODS: We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. RESULTS: Response rates to the surveys were the following: nurses--428/870 (49%); other health professionals (not nurses or physicians)--211/452 (47%); physicians--30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: -7.3 [-13.4, -1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. CONCLUSION: Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.
Authors: Lucia D Wocial; James E Slaven; Kianna Montz; Patrick O Monahan; Susan E Hickman; Christopher M Callahan; Paul R Helft; Greg A Sachs; Lev Inger; Emily S Burke; Alexia M Torke Journal: J Gen Intern Med Date: 2020-02-24 Impact factor: 5.128
Authors: Joyce L Neumann; Lih-Wen Mau; Sanya Virani; Ellen M Denzen; Deborah A Boyle; Nancy J Boyle; Jane Dabney; Alexandra De KeselLofthus; Marion Kalbacker; Tippu Khan; Navneet S Majhail; Elizabeth A Murphy; Pamela Paplham; Leslie Parran; Miguel-Angel Perales; Todd H Rockwood; Kim Schmit-Pokorny; Tait D Shanafelt; Elaine Stenstrup; William A Wood; Linda J Burns Journal: Biol Blood Marrow Transplant Date: 2017-12-02 Impact factor: 5.742