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Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.ORCID iD: 0000-0002-4381-4288
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.ORCID iD: 0000-0001-8709-342X
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-6244-6401
2022 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 72, article id 103279Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic.

Design/Methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.

Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.

Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.

Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 72, article id 103279
Keywords [en]
COVID-19, Ethics, Intensive Care, Moral distress, Nursing
National Category
Nursing Social Work
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-91187DOI: 10.1016/j.iccn.2022.103279ISI: 000861045100011PubMedID: 35688753Scopus ID: 2-s2.0-85131831585OAI: oai:DiVA.org:ltu-91187DiVA, id: diva2:1667240
Note

Validerad;2022;Nivå 2;2022-06-30 (joosat);

Available from: 2022-06-10 Created: 2022-06-10 Last updated: 2022-11-09Bibliographically approved

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Andersson, MariaNordin, AnnaEngström, Åsa

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