Exploring the experiences of nurses’ moral distress in long-term care of older adults: a phenomenological study

BMC Nursing

Ahmad Hasyim Wibisono¹  Yee Bit-Lian²  Kelly-Ann Allen³  Alireza Nikbakht Nasrabadi⁴  Ameneh Yaghoobzadeh⁵ 

[1] Medical Surgical Nursing Department, School of Nursing, Brawijaya University, Malang, Indonesia;Nursing Division, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia;School of Educational Psychology and Counseling, Faculty of Education, Monash University, Clayton, Australia;Centre for Wellbeing Science, University of Melbourne, Melbourne, Australia;School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran;School of Nursing, Arak University of Medical Sciences, Arak, Iran;

关键词: Moral distress;    Older adult;    Aging;    Nursing;    Qualitative research;    Intensive care;    Critical care;   

DOI  :  10.1186/s12912-021-00675-3

来源: Springer

【 摘 要 】

BackgroundMoral distress is a poorly defined and frequently misunderstood phenomenon, and little is known about its triggering factors during ICU end-of-life decisions for nurses in Iran. This study aimed to explore the experiences of nurses’ moral distress in the long-term care of older adults via a phenomenological study.MethodsA qualitative, phenomenological study was conducted with 9 participants using in-depth semi-structured interviews. The purpose was to gain insight into the lived experiences and perceptions of moral distress among ICU nurses in hospitals affiliated with Tehran University of Medical Sciences during their long-term care of older adults.ResultsFive major themes are identified from the interviews: advocating, defense mechanisms, burden of care, relationships, and organizational issues. In addition, several subthemes emerged including respectful end of life care, symptom management, coping, spirituality, futile care, emotional work, powerlessness, relationships between patients and families, relationships with healthcare teams, relationships with institutions, inadequate staffing, inadequate training, preparedness, education/mentoring, workload, and support.ConclusionsThis qualitative study contributes to the limited knowledge and understanding of the challenges nurses face in the ICU. It also offers possible implications for implementing supportive interventions.

【 授权许可】

CC BY