Jimmy Beck1, Cameron L Randall2, Hannah K Bassett3, Kimberly L O'Hara4, Carla N Falco5, Erin M Sullivan6, Douglas J Opel7. 1. Department of Pediatrics, University of Washington (J Beck, EM Sullivan, and DJ Opel), Seattle, Wash. Electronic address: Jimmy.Beck@seattlechildrens.org. 2. Department of Oral Health Sciences, University of Washington School of Dentistry (CL Randall), Seattle, Wash. 3. Department of Pediatrics, Stanford University (HK Bassett), Palo Alto, Calif. 4. Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado (KL O'Hara), Aurora, Colo. 5. Department of Pediatrics, Baylor College of Medicine (CN Falco), Houston, Tex. 6. Department of Pediatrics, University of Washington (J Beck, EM Sullivan, and DJ Opel), Seattle, Wash; Seattle Children's Core for Biomedical Statistics (EM Sullivan), Seattle, Wash. 7. Department of Pediatrics, University of Washington (J Beck, EM Sullivan, and DJ Opel), Seattle, Wash.
Abstract
OBJECTIVE: Moral distress is increasingly identified as a major problem affecting healthcare professionals, but it is poorly characterized among pediatricians. Our objective was to assess the sources of moral distress in residents and pediatric hospitalist attendings and to examine the association of moral distress with reported burnout. METHODS: Cross-sectional survey from January through March 2019 of pediatric residents and hospital medicine attending physicians affiliated with 4 free-standing children's hospitals. Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals (MMD-HP). Burnout was measured using 2 items adapted from the Maslach Burnout Inventory. RESULTS: Respondents included 288 of 541 eligible pediatric residents (response rate: 53%) and 118 of 168 pediatric hospitalists (response rate: 70%; total response rate: 57%). The mean MMD-HP composite score was 93.4 (SD = 42.5). Residents reported significantly higher frequency scores (residents: M = 38.5 vs. hospitalists: M = 33.3; difference: 5.2, 95% confidence interval [CI], 2.9-7.5) and composite scores (residents: M = 97.6 vs hospitalists: M = 83.0; difference:14.6, 95% CI, 5.7-23.5) than hospitalists. The most frequent source of moral distress was "having excessive documentation requirements that compromise patient care," and the most intense source of moral distress was "be[ing] required to work with abusive patients/family members who are compromising quality of care." Significantly higher mean MMD-HP composite scores were observed among participants reporting that they felt burned out at least once per week (M= 114.6 vs M= 82.3; difference: 32.3, 95% CI, 23.5-41.2). CONCLUSIONS: Pediatric residents and hospitalists report experiencing moral distress from a variety of patient-, team-, and system-level sources, and this distress is associated with burnout.
OBJECTIVE: Moral distress is increasingly identified as a major problem affecting healthcare professionals, but it is poorly characterized among pediatricians. Our objective was to assess the sources of moral distress in residents and pediatric hospitalist attendings and to examine the association of moral distress with reported burnout. METHODS: Cross-sectional survey from January through March 2019 of pediatric residents and hospital medicine attending physicians affiliated with 4 free-standing children's hospitals. Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals (MMD-HP). Burnout was measured using 2 items adapted from the Maslach Burnout Inventory. RESULTS: Respondents included 288 of 541 eligible pediatric residents (response rate: 53%) and 118 of 168 pediatric hospitalists (response rate: 70%; total response rate: 57%). The mean MMD-HP composite score was 93.4 (SD = 42.5). Residents reported significantly higher frequency scores (residents: M = 38.5 vs. hospitalists: M = 33.3; difference: 5.2, 95% confidence interval [CI], 2.9-7.5) and composite scores (residents: M = 97.6 vs hospitalists: M = 83.0; difference:14.6, 95% CI, 5.7-23.5) than hospitalists. The most frequent source of moral distress was "having excessive documentation requirements that compromise patient care," and the most intense source of moral distress was "be[ing] required to work with abusive patients/family members who are compromising quality of care." Significantly higher mean MMD-HP composite scores were observed among participants reporting that they felt burned out at least once per week (M= 114.6 vs M= 82.3; difference: 32.3, 95% CI, 23.5-41.2). CONCLUSIONS: Pediatric residents and hospitalists report experiencing moral distress from a variety of patient-, team-, and system-level sources, and this distress is associated with burnout.
Authors: Charles E Mackel; Ron L Alterman; Mary K Buss; Renée M Reynolds; W Christopher Fox; Alejandro M Spiotta; Roger B Davis; Martina Stippler Journal: Neurosurgery Date: 2022-03-25 Impact factor: 5.315