دورية أكاديمية
أعرض في EDS

A Systematic Review and Meta-analytic Evaluation of Moral Distress in Oncology Nursing.

التفاصيل البيبلوغرافية
العنوان: A Systematic Review and Meta-analytic Evaluation of Moral Distress in Oncology Nursing.
المؤلفون: Eche IJ; Author Affiliations: Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute (Drs Eche and Phillips); and Bone Marrow Transplantation and Hematologic Malignancies, Beth Israel Deaconess Medical Center (Dr Eche and Ms Alcindor), Boston, Massachusetts; School of Nursing, The University of Texas at Austin (Dr Phillips); and Survey and Data Management Core and Department of Data Science, Dana-Farber Cancer Institute (Dr Mazzola); and Biostatistics Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center (Dr Mazzola), Boston, Massachusetts., Phillips CS, Alcindor N, Mazzola E
المصدر: Cancer nursing [Cancer Nurs] 2023 Mar-Apr 01; Vol. 46 (2), pp. 128-142. Date of Electronic Publication: 2022 Mar 14.
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7805358 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-9804 (Electronic) Linking ISSN: 0162220X NLM ISO Abbreviation: Cancer Nurs Subsets: MEDLINE
أسماء مطبوعة: Publication: <2002->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York, Masson Publishing USA.
مواضيع طبية MeSH: Burnout, Professional*/psychology , Neoplasms*, Humans ; Stress, Psychological/psychology ; Oncology Nursing ; Cross-Sectional Studies ; Morals ; Surveys and Questionnaires
مستخلص: Background: Weighing implications of multiple intensive cancer-directed therapies over time, oncology nurses are more prone to intrinsic distress compared to nurses in non-oncologic settings. This vulnerability may give rise to moral distress. Yet, little is known about moral distress experiences of oncology nurses.
Objective: This systematic review and meta-analysis examined the frequency and intensity of moral distress among oncology nurses with an exploratory focus on nurse-level and work-related characteristics.
Methods: We conducted a systematic search of 7 electronic databases (2000-2020) supplemented by hand-search strategy. Means and standard deviations of moral distress scores in the included studies were extracted and pooled in our meta-analysis.
Results: Our sample of 8 cross-sectional studies consisting of 2686 participants with 1654 oncology nurses met criteria for inclusion. A random-effects model was used in our meta-analysis given considerable heterogeneity. Our results suggest that moral distress was of low to moderate frequency, but of high intensity. Moral distress among oncology nurses was a significant predictor for burnout, provider communication, decisions surrounding end-of-life care, work conditions (eg, patient assignment, type of unit), and inability to provide compassionate care.
Conclusion: Moral distress in oncology nurses is associated with burnout syndrome, compassion fatigue, and secondary traumatic stress syndrome, all of which are linked to poor patient care and outcomes. Robust psychological well-being is critical in minimizing unintended consequences of moral distress.
Implications for Practice: Oncology nurses are at high risk for moral distress due to the nature of their work. Future studies should examine the prevalence among oncology nurses to help inform targeted interventions.
Competing Interests: The authors have no funding or conflicts of interest to disclose.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
References: Shepard A. Moral distress: a consequence of caring. Clin J Oncol Nurs . 2010;14(1):25–27.
Rushton CH. Cultivating moral resilience. Am J Nurs . 2017;117(2, suppl 1):S11–S15.
Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. AWHONNS Clin Issues Perinat Womens Health Nurs . 1993;4(4):542–551.
Jameton A. The nurse: when roles ad rules conflict. Hastings Cent Rep . 1977;7(4):22–23.
Varcoe C, Pauly B, Storch J, Newton L, Makaroff K. Nurses’ perceptions of and responses to morally distressing situations. Nurs Ethics . 2012;19(4):488–500.
Sirilla J, Thompson K, Yamokoski T, Risser MD, Chipps E. Moral distress in nurses providing direct patient care at an academic medical center. Worldviews Evid Based Nurs . 2017;14(2):128–135.
Rushton CH, Batcheller J, Schroeder K, Donohue P. Burnout and resilience among nurses practicing in high-intensity settings. Am J Crit Care . 2015;24(5):412–420.
Baye Y, Demeke T, Birhan N, Semahegn A, Birhanu S. Nurses’ work-related stress and associated factors in governmental hospitals in Harar, Eastern Ethiopia: a cross-sectional study. PLoS One . 2020;15(8):e0236782.
Mark G, Smith AP. Occupational stress, job characteristics, coping, and the mental health of nurses. Br J Health Psychol . 2012;17(3):505–521.
Whitehead PB, Herbertson RK, Hamric AB, Epstein EG, Fisher JM. Moral distress among healthcare professionals: report of an institution-wide survey. J Nurs Scholarsh . 2015;47(2):117–125.
Keykaleh MS, Safarpour H, Yousefian S, Faghisolouk F, Mohammadi E, Ghomian Z. The relationship between nurse’s job stress and patient safety. Open Access Maced J Med Sci . 2018;6(11):2228–2232.
Sarafis P, Rousaki E, Tsounis A, et al. The impact of occupational stress on nurses’ caring behaviors and their health related quality of life. BMC Nurs . 2016;15:56.
Mason VM, Leslie G, Clark K, et al. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study. Dimens Crit Care Nurs . 2014;33(4):215–225.
Larson CP, Dryden-Palmer KD, Gibbons C, Parshuram CS. Moral distress in PICU and neonatal ICU practitioners: a cross-sectional evaluation. Pediatr Crit Care Med . 2017;18(8):e318–e326.
Karanikola MN, Albarran JW, Drigo E, et al. Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy. J Nurs Manag . 2014;22(4):472–484.
Henrich NJ, Dodek PM, Alden L, Keenan SP, Reynolds S, Rodney P. Causes of moral distress in the intensive care unit: a qualitative study. J Crit Care . 2016;35:57–62.
Pavlish C, Brown-Saltzman K, Jakel P, Fine A. The nature of ethical conflicts and the meaning of moral community in oncology practice. Oncol Nurs Forum . 2014;41(2):130–140.
Zheng RS, Guo QH, Dong FQ, Owens RG. Chinese oncology nurses’ experience on caring for dying patients who are on their final days: a qualitative study. Int J Nurs Stud . 2015;52(1):288–296.
Fruet IMA, Dalmolin GL, Bresolin JZ, Andolhe R, Barlem ELD. Moral distress assessment in the nursing team of a hematology-oncology sector. Rev Bras Enferm . 2019;72(suppl 1):58–65.
Sirilla J. Moral distress in nurses providing direct care on inpatient oncology units. Clin J Oncol Nurs . 2014;18(5):536–541.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev . 2015;4:1.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Reprint—preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther . 2009;89(9):873–880.
Piers RD, Van den Eynde M, Steeman E, Vlerick P, Benoit DD, Van Den Noortgate NJ. End-of-life care of the geriatric patient and nurses’ moral distress. J Am Med Dir Assoc . 2012;13(1):80.e7–80.e13.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev . 2021;10(1):89.
Moola S, Munn Z, Tufanaru C, et al. Chapter 7: systematic reviews of etiology and risk. In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual . The Joanna Briggs Institute; 2017. https://reviewersmanual.joannabriggs.org/ .
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ . 2019;366:l4898.
R Core Team. R: A Language and Environment for Statistical Computing . Vienna, Austria: R Foundation for Statistical Computing; 2018. https://www.R-project.org/ .
Mehlis K, Bierwirth E, Laryionava K, et al. High prevalence of moral distress reported by oncologists and oncology nurses in end-of-life decision making. Psychooncology . 2018;27(12):2733–2739.
Af Sandeberg M, Bartholdson C, Pergert P. Important situations that capture moral distress in paediatric oncology. BMC Med Ethics . 2020;21(1):6.
Marturano ET, Hermann RM, Giordano NA, Trotta RL. Moral distress: identification among inpatient oncology nurses in an academic health system. Clin J Oncol Nurs . 2020;24(5):500–508.
Pergert P, Bartholdson C, Blomgren K, Af Sandeberg M. Moral distress in paediatric oncology: contributing factors and group differences. Nurs Ethics . 2019;26(7–8):2351–2363.
Newman AR, Callahan MF, Lerret SM, Oswald DL, Weiss ME. Pediatric oncology nurses’ experiences with prognosis-related communication. Oncol Nurs Forum . 2018;45(3):327–337.
Neumann JL, Mau LW, Virani S, et al. Burnout, moral distress, work-life balance, and career satisfaction among hematopoietic cell transplantation professionals. Biol Blood Marrow Transplant . 2018;24(4):849–860.
Lazzarin M, Biondi A, Di Mauro S. Moral distress in nurses in oncology and haematology units. Nurs Ethics . 2012;19(2):183–195.
Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ . 2011;343:d4002.
Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad-Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nurs Ethics . 2017;24(4):474–482.
Wocial L. Moral distress—the role of ethics consultation in the NICU. Bioethics Forum . 2002;18(1–2):15–23.
Elpern EH, Covert B, Kleinpell R. Moral distress of staff nurses in a medical intensive care unit. Am J Crit Care . 2005;14(6):523–530.
McAndrew NS, Leske J, Schroeter K. Moral distress in critical care nursing: the state of the science. Nurs Ethics . 2018;25(5):552–570.
Papathanassoglou EDE, Karanikola MNK, Kalafati M, Giannakopoulou M, Lemonidou C, Albarran JW. Professional autonomy, collaboration with physicians, and moral distress among European intensive care nurses. Am J Crit Care . 2012;21(2):E41–E52.
Maiden J, Georges JM, Connelly CD. Moral distress, compassion fatigue, and perceptions about medication errors in certified critical care nurses. Dimens Crit Care Nurs . 2011;30(6):339–345.
Dalmolin Gde L, Lunardi VL, Lunardi GL, Barlem EL, Silveira RS. Moral distress and burnout syndrome: are there relationships between these phenomena in nursing workers? Rev Lat Am Enfermagem . 2014;22(1):35–42.
Ozden D, Karagozoglu S, Yildirim G. Intensive care nurses’ perception of futility: job satisfaction and burnout dimensions. Nurs Ethics . 2013;20(4):436–447.
Shorideh FA, Ashktorab T, Yaghmaei F. Iranian intensive care unit nurses’ moral distress: a content analysis. Nurs Ethics . 2012;19(4):464–478.
Wiegand DL, Funk M. Consequences of clinical situations that cause critical care nurses to experience moral distress. Nurs Ethics . 2012;19(4):479–487.
Pye K. Exploring moral distress in pediatric oncology; a sample of registered practitioners. Issues Compr Pediatr Nurs . 2013;36(4):248–261.
Quattrin R, Zanini A, Nascig E, Annunziata MA, Calligaris L, Brusaferro S. Level of burnout among nurses working in oncology in an Italian region. Oncol Nurs Forum . 2006;33(4):815–820.
Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med . 2003;60(1):3–9.
Barrett L, Yates P. Oncology/haematology nurses: a study of job satisfaction, burnout, and intention to leave the specialty. Aust Health Rev . 2002;25(3):109–121.
Wu S, Singh-Carlson S, Odell A, Reynolds G, Su Y. Compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada. Oncol Nurs Forum . 2016;43(4):E161–E169.
Ko W, Kiser-Larson N. Stress levels of nurses in oncology outpatient units. Clin J Oncol Nurs . 2016;20(2):158–164.
Pavlish C, Brown-Saltzman K, Hersh M, Shirk M, Nudelman O. Early indicators and risk factors for ethical issues in clinical practice. J Nurs Scholarsh . 2011;43(1):13–21.
Prompahakul C, Epstein EG. Moral distress experienced by non-Western nurses: an integrative review. Nurs Ethics . 2020;27(3):778–795.
Morley G. What is "moral distress" in nursing? How, can and should we respond to it? J Clin Nurs . 2018;27(19–20):3443–3445.
McDermott A, Brook I, Ben-Isaac E. Peer-debriefing after distressing patient care events: a workshop for pediatric residents. MedEdPORTAL . 2017;13:10624.
Ireland S, Gilchrist J, Maconochie I. Debriefing after failed paediatric resuscitation: a survey of current UK practice. Emerg Med J . 2008;25(6):328–330.
Tan H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care . 2005;33(6):768–772.
Maben J, Leamy M, Taylor C, et al. An organisational guide: understanding, implementing and sustaining Schwartz Rounds®. 2018. https://www.surrey.ac.uk/sites/default/files/Schwartz-rounds-organisational-guide.pdf . Accessed September 10, 2021.
Vaclavik EA, Staffileno BA, Carlson E. Moral distress: using mindfulness-based stress reduction interventions to decrease nurse perceptions of distress. Clin J Oncol Nurs . 2018;22(3):326–332.
Hossain F, Clatty A. Self-care strategies in response to nurses’ moral injury during COVID-19 pandemic. Nurs Ethics . 2021;28(1):23–32.
Silverman HJ, Kheirbek RE, Moscou-Jackson G, Day J. Moral distress in nurses caring for patients with Covid-19. Nurs Ethics . 2021;28:1137–1164.
Tsehay M, Belete A, Necho M. Factors associated with psychological distress and brief resilient coping level during the COVID-19 pandemic among health-care professionals in Dessie, Ethiopia. Psychol Res Behav Manag . 2020;13:1213–1221.
Tiete J, Guatteri M, Lachaux A, et al. Mental health outcomes in healthcare workers in COVID-19 and non-COVID-19 care units: a cross-sectional survey in Belgium. Front Psychol . 2020;11:612241.
Laurs L, Blaževičienė A, Capezuti E, Milonas D. Moral distress and intention to leave the profession: Lithuanian nurses in municipal hospitals. J Nurs Scholarsh . 2020;52(2):201–209.
Ameri M, Kavousi A, Safavibayatneed Z. Moral distress of oncology nurses and morally distressing situations in oncology units. Austr J Adv Nurs . 2016;33(3):6–12.
Jones GAL, Colville GA, Ramnarayan P, et al. Psychological impact of working in paediatric intensive care. A UK-wide prevalence study. Arch Dis Child . 2020;105(5):470–475.
Epstein EG, Whitehead PB, Prompahakul C, Thacker LR, Hamric AB. Enhancing understanding of moral distress: the measure of moral distress for health care professionals. AJOB Empir Bioeth . 2019;10(2):113–124.
Søvold LE, Naslund JA, Kousoulis AA, et al. Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Front Public Health . 2021;9:679397.
Kavalieratos D, Corbelli J, Zhang D, et al. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA . 2016;316(20):2104–2114.
Vanbutsele G, Pardon K, Van Belle S, et al. Effect of early and systematic integration of palliative care in patients with advanced cancer: a randomised controlled trial. Lancet Oncol . 2018;19(3):394–404.
Amano K, Morita T, Tatara R, Katayama H, Uno T, Takagi I. Association between early palliative care referrals, inpatient hospice utilization, and aggressiveness of care at the end of life. J Palliat Med . 2015;18(3):270–273.
Adams M, Chase J, Doyle C, Mills J. Self-care planning supports clinical care: putting total care into practice. Prog Palliat Care . 2020;28(5):305–307.
Mills J, Ramachenderan J, Chapman M, Greenland R, Agar M. Prioritising workforce wellbeing and resilience: what COVID-19 is reminding us about self-care and staff support. Palliat Med . 2020;34(9):1137–1139.
تواريخ الأحداث: Date Created: 20220314 Date Completed: 20230222 Latest Revision: 20230225
رمز التحديث: 20231215
DOI: 10.1097/NCC.0000000000001075
PMID: 35283474
قاعدة البيانات: MEDLINE
الوصف
تدمد:1538-9804
DOI:10.1097/NCC.0000000000001075