Ethical Distress and its Related Components in Emergency Department Employees: a Systematic Review
Iranian Journal of Emergency Medicine,
Vol. 9 No. 1 (2022),
,
Page e3
https://doi.org/10.22037/ijem.v9i1.37946
Abstract
Introduction: Moral distress is one of the hidden moral challenges in providing nursing care services that occurs in conditions of impossibility to perform the right job despite knowing its correctness. This challenge is greater among nurses in wards with more acute conditions, such as the emergency department. This study was conducted with the aim of systematically reviewing moral distress and its related components in studies conducted on emergency department employees.
Methods: This research is based on a systematic review that evaluates the quality of articles using the STROBE standard checklist. Preliminary studies were conducted through articles in Persian language databases; SID, Iranmedex, Magiran and English language databases; Science Direct, PubMed, ProQuest, Cochrane Library, Embase, Scopus and Google Scholar; was examined. In order to access the full text of articles containing Persian keywords; Moral distress, moral stress, moral stress, moral distress, moral anxiety, moral turmoil, and emergency-related phrases were used as a combination of words; Also includes boolean search methods and OR operators and Mesh keywords; Moral Distress, Ethical Distress, Ethical unease, Ethical disquiet, Emergency were used.
Results: In the initial stage, 466 studies were studied. The researchers then reviewed the articles that had been searched, and finally, after removing duplicate, irrelevant items, qualitative studies, narrative review, and a letter to the editor; 18 researches were used to write this research. Among the studies studied, 11 Iranian articles were conducted, which shows 61.11% of the total studies; other studies have been conducted in Taiwan, China, the United States, Indonesia and Switzerland. The average moral distress of emergency department nurses was moderate and there was a significant relationship with components such as background and workload of the findings of these studies.
Conclusion: The set of studies performed on emergency department nurses is a reliable number to show the level of moral distress, but this amount of study is not reliable to obtain a model of components and variables related to moral distress. For this purpose, in addition to further research on this group of nurses, by removing the characteristics of emergency department nurses, a systematic review of all studies conducted in the field of moral distress on the nursing community can be done to achieve more accurate results.
- Moral distress
- Nurse, Emergency department
How to Cite
References
Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. AWHONN's clinical issues in perinatal and women's health nursing. 1993;4(4):542-51.
BEIKRNORADI A, RABIEE S, KHATIBAN M, CHERAGHI MA. Nurses distress in intensive care unit: a survey in teaching hospitals. 2012.
Ulrich CM, Grady C. Moral distress in the health professions: Springer; 2018.
Rushton CH, Caldwell M, Kurtz M. Moral Distress. The American Journal of Nursing. 2016;116(7):40-9.
Hamric AB, Borchers CT, Epstein EG. Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research. 2012;3(2):1-9.
Corley MC, Elswick RK, Gorman M, Clor T. Development and evaluation of a moral distress scale. Journal of advanced nursing. 2001;33(2):250-6.
Huffman DM, Rittenmeyer L. How professional nurses working in hospital environments experience moral distress: a systematic review. Critical Care Nursing Clinics. 2012;24(1):91-100.
Jameton A. Nursing Practice: The Ethical Issues. 1984. Englewood Cliffs, NJ Prentice-Hall; 2017.
ICN. Positive Practice Environments for Health Care Professionals. 2008.
Ulrich B, Barden C, Cassidy L, Varn-Davis N. Critical care nurse work environments 2018: findings and implications. Critical Care Nurse. 2019;39(2):67-84.
Zavotsky KE, Chan GK. Exploring the relationship among moral distress, coping, and the practice environment in emergency department nurses. Advanced Emergency Nursing Journal. 2016;38(2):133-46.
Aghajani MJ. The professional burnout of nurses in different wards. Journal of Research Development in Nursing and Midwifery. 2013;9(2):97-104.
Corley MC. Nurse moral distress: a proposed theory and research agenda. Nursing ethics. 2002;9(6):636-50.
Robinson R, Stinson CK. Moral distress: A qualitative study of emergency nurses. Dimensions of Critical Care Nursing. 2016;35(4):235-40.
Wolf LA, Perhats C, Delao AM, Moon MD, Clark PR, Zavotsky KE. “It’sa burden you carry”: describing moral distress in emergency nursing. Journal of Emergency Nursing. 2016;42(1):37-46.
Fernandez-Parsons R, Rodriguez L, Goyal D. Moral distress in emergency nurses. Journal of Emergency Nursing. 2013;39(6):547-52.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bulletin of the World Health Organization. 2007;85:867-72.
Hou Y, Timmins F, Zhou Q, Wang J. A cross-sectional exploration of emergency department nurses’ moral distress, ethical climate and nursing practice environment. International Emergency Nursing. 2021;55:100972.
Abdolmaleki M, Lakdizaji S, Ghahramanian A, Allahbakhshian A, Behshid M. Relationship between autonomy and moral distress in emergency nurses. Indian J Med Ethics. 2018;6:1-5.
Talebian F, Amouzad Mahdirejei H, Araghian Mojarad F, Yaghoubi T. Spiritual health of nurses' resilience missing link in the Corona pandemic: Findings of a conceptual review articlen. Razi Journal of Medical Sciences. 2021;28(5):60-71.
Widianti E, Arinda R, Prawesti A. Nurses’ Moral Distress in the Emergency Department. Journal of Nursing Care. 2019;2(3).
Mahdavi Fashtami S, Mohammadeh zadeh Zarankesh S, Esmaeilpour Bandboni M. Moral distress among emergency department nurses: frequency, intensity, effect. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2016;26(4):248-55.
Trautmann J, Epstein E, Rovnyak V, Snyder A. Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey. Advanced Emergency Nursing Journal. 2015;37(2):134-45.
Babamohamadi H, Katrimi SB, Paknazar F. Moral distress and its contributing factors among emergency department nurses: A cross-sectional study in Iran. International Emergency Nursing. 2021;56:100982.
Jalali K, Tabari-Khomeiran R, Asgari F, Sedghi-Sabet M, Kazemnejad E. Moral distress and related factors among emergency department nurses. Eurasian Journal of Emergency Medicine. 2019;18(1):23.
Naboureh A, Imanipour M, Salehi T, Tabesh H. The relationship between moral distress and self-efficacy among nurses in critical care and emergency units in hospitals affiliated to Ahvaz Jundishapur university of medical sciences in 2015. Journal of Rafsanjan University of Medical Sciences. 2015;14(6):443-54.
Anami K, Dadkhah B, Mohammadi M. Moral distress of nurses in emergency department of Ardabil hospitals in 1395. Journal of Health and Care. 2019;21(2):166-74.
Rahimzadeh M, Zafarnia N, Borhani F, Malekian L, Delshad V, Borzouei S. Barriers professional competence and its relationship with job satisfaction of nurses’ moral distress and pre-hospital emergency city of Bam and Jiroft in 1393. Int J Med Res Health Sci. 2016;5(5):47-51.
Hamedani I, Yekta ZP. Evaluation of Moral Distress of Nurses Working in the Emergency and Intensive Care Units of Medical Education Centers Affiliated with Zanjan University of Medical Sciences.
Shamsaei F, Jahani SNM, MOHAMMAD GMN, Ranjbar S, Khazaei M, Maghsoudi Z. Relationship Between Spiritual Health and Moral Distress of Nurses Working in Emergency Department of Hamadan University of Medical Sciences Hospitals. 2020.
Moghadam F, Pazokian M, AbbasZadeh A, Zadeh EF. The Relationship between Moral Distress and Safe Nursing Care in Emergency Wards Nurses. Journal of Nursing Education (JNE). 2020;9(4).
Clark P, Crawford TN, Hulse B, Polivka BJ. Resilience, moral distress, and workplace engagement in emergency department nurses. Western Journal of Nursing Research. 2021;43(5):442-51.
Ameri M, Mirhashemi B, Hosseini SS. Moral distress and the contributing factors among nurses in different work environments. مجله علوم پرستاری و مامایی. 2015;2(3):44-9.
Peter E, Liaschenko J. Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity. Nursing inquiry. 2004;11(4):218-25.
Corley MC, Minick P, Elswick R, Jacobs M. Nurse moral distress and ethical work environment. Nursing ethics. 2005;12(4):381-90.
Meltzer LS, Huckabay LM. Critical care nurses’ perceptions of futile care and its effect on burnout. American journal of critical care. 2004;13(3):202-8.
Pham JC, Story JL, Hicks RW, Shore AD, Morlock LL, Cheung DS, et al. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. The Journal of emergency medicine. 2011;40(5):485-92.
Borhani F, IsmailiAbdar M, Razban F, RoshanZadeh M. Ethical distress in nurses and its relation to burnout. Journal of Medical Ethics. 2013;7(25):123-44.
Atashzadeh Shorideh F, Ashktorab T, Yaghmaei F, Alavimajd H. Association of ICU nurses’ demographic characteristics and moral distress. Iranian Journal of Medical Ethics and History of Medicine. 2013;5(7):66-78.
Aft SLK. Moral distress in medical surgical nurses: Western Carolina University Cullowhee (US); 2011.
Rice EM, Rady MY, Hamrick A, Verheijde JL, Pendergast DK. Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital. Journal of nursing management. 2008;16(3):360-73.
Joolaee S, Jalili HR, Rafii F, Hajibabaee F, Haghani H. The relationship between ethical climate at work and job satisfaction among nurses in Tehran. Indian journal of medical ethics. 2013;10(4):238-42.
Fogel KM. The relationships of moral distress, ethical climate, and intent to turnover among critical care nurses: Loyola University Chicago; 2007.
- Abstract Viewed: 203 times
- pdf (فارسی) Downloaded: 100 times