Understanding moral distress among healthcare personnel in end-of-life care hospital settings

Abstract

Moral Distress (MD) refers to the negative experience that arise when a person cannot act in accordance with their values and principles when caring for patients, associated with individual, social or institutional barriers. This article presents the result of the qualitative research analyzing MD in health personnel of high complexity hospital in Bogotá, Colombia focusing in the attention of older patients with chronic or acute illnesses. The study used qualitative methods that included semi-structured interviews, focus groups and participant observation. The data was analyzed based on a theoretical matrix, considering how MD is configured, the way participants experience it, the contexts in which it happens, whether they consider consequences of this, and whether the education they have received provided them with tools to confront it. Findings include the constant presence of MD among healthcare personnel while confronting death and patient suffering. It is influenced by the level of education, previous work experience, and hierarchies within the healthcare system. Additionally, coping strategies such as emotional distancing and the of seeking knowledge are identified, although there is a noted lack of specific training in managing death and morbidity situations, as well as effective communication skills.

Keywords

• Moral distress
• death
• hospital services
• medical education
• qualitative research
• I10