Moral distress in intensive care unit professionals is associated with profession, age, and years of experience
Abstract Purpose To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. Methods We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each...
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| creator | Dodek, Peter M., MD, MHSc Wong, Hubert, PhD Norena, Monica, MS Ayas, Najib, MD, MPH Reynolds, Steven C., MD Keenan, Sean P., MD, MSc Hamric, Ann, RN, PhD Rodney, Patricia, RN, PhD Stewart, Miriam, RN, BSN, BA Alden, Lynn, PhD |
| description | Abstract Purpose To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. Methods We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. Results Response rates to the surveys were the following: nurses—428/870 (49%); other health professionals (not nurses or physicians)—211/452 (47%); physicians—30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: − 7.3 [− 13.4, − 1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. Conclusion Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job. |
| doi_str_mv | 10.1016/j.jcrc.2015.10.011 |
| format | Article |
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Methods We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. Results Response rates to the surveys were the following: nurses—428/870 (49%); other health professionals (not nurses or physicians)—211/452 (47%); physicians—30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: − 7.3 [− 13.4, − 1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. Conclusion Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2015.10.011</identifier><identifier>PMID: 26596697</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age ; Age Factors ; Attitude of Health Personnel ; British Columbia ; Confidence intervals ; Critical Care ; Delivery of Health Care - ethics ; Demographics ; Female ; Humans ; Intensive care ; Intensive care unit ; Intensive Care Units - statistics & numerical data ; Job Satisfaction ; Male ; Medical Staff, Hospital - ethics ; Medical Staff, Hospital - psychology ; Middle Aged ; Moral distress ; Morals ; Multivariate Analysis ; Nurses ; Pharmacists ; Physicians ; Polls & surveys ; Social workers ; Stress, Psychological ; Studies ; Surveys and Questionnaires ; Therapists</subject><ispartof>Journal of critical care, 2016-02, Vol.31 (1), p.178-182</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>2015. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-aae751a84103240a1c5530807d2d96ed46ad61233e8bb5a0a8d16bf18f383b673</citedby><cites>FETCH-LOGICAL-c542t-aae751a84103240a1c5530807d2d96ed46ad61233e8bb5a0a8d16bf18f383b673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883944115005407$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26596697$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dodek, Peter M., MD, MHSc</creatorcontrib><creatorcontrib>Wong, Hubert, PhD</creatorcontrib><creatorcontrib>Norena, Monica, MS</creatorcontrib><creatorcontrib>Ayas, Najib, MD, MPH</creatorcontrib><creatorcontrib>Reynolds, Steven C., MD</creatorcontrib><creatorcontrib>Keenan, Sean P., MD, MSc</creatorcontrib><creatorcontrib>Hamric, Ann, RN, PhD</creatorcontrib><creatorcontrib>Rodney, Patricia, RN, PhD</creatorcontrib><creatorcontrib>Stewart, Miriam, RN, BSN, BA</creatorcontrib><creatorcontrib>Alden, Lynn, PhD</creatorcontrib><title>Moral distress in intensive care unit professionals is associated with profession, age, and years of experience</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. Methods We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. Results Response rates to the surveys were the following: nurses—428/870 (49%); other health professionals (not nurses or physicians)—211/452 (47%); physicians—30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: − 7.3 [− 13.4, − 1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. Conclusion Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.</description><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Attitude of Health Personnel</subject><subject>British Columbia</subject><subject>Confidence intervals</subject><subject>Critical Care</subject><subject>Delivery of Health Care - ethics</subject><subject>Demographics</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Intensive care unit</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Job Satisfaction</subject><subject>Male</subject><subject>Medical Staff, Hospital - ethics</subject><subject>Medical Staff, Hospital - psychology</subject><subject>Middle Aged</subject><subject>Moral distress</subject><subject>Morals</subject><subject>Multivariate Analysis</subject><subject>Nurses</subject><subject>Pharmacists</subject><subject>Physicians</subject><subject>Polls & surveys</subject><subject>Social workers</subject><subject>Stress, Psychological</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Therapists</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk2LFDEQhoMo7uzqH_AgAS8e7DGVdNJpEEEWV4UVD-o5pJNqTdvTGZPu1fn3pp31gz0ohAQqT71U1VuEPAC2BQbq6bAdXHJbzkCWwJYB3CIbkLKptAJ5m2yY1qJq6xpOyGnOA2PQCCHvkhOuZKtU22xIfBuTHakPeU6YMw1TOTNOOVwhdTYhXaYw032KffkOcbJjgTK1OUcX7Iyefgvz57-AJ9R-wnJNnh7QpkxjT_H7HlPAyeE9cqcvEnj_-j0jHy9efjh_XV2-e_Xm_MVl5WTN58pabCRYXQMTvGYWnJSCadZ47luFvlbWK-BCoO46aZnVHlTXg-6FFp1qxBl5fNQthX1dMM9mF7LDcbQTxiUb0HWjdSNA_h8tlbQtcMUL-ugGOsQlrTNZKVED5wIKxY-USzHnhL3Zp7Cz6WCAmdU5M5jVObM6t8aKcyXp4bX00u3Q_075ZVUBnh0BLGO7CphMdj9H6kNCNxsfw7_1n99Id2OYgrPjFzxg_tOHydww837dnXV1QDIma9aIH8peviA</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Dodek, Peter M., MD, MHSc</creator><creator>Wong, Hubert, PhD</creator><creator>Norena, Monica, MS</creator><creator>Ayas, Najib, MD, MPH</creator><creator>Reynolds, Steven C., MD</creator><creator>Keenan, Sean P., MD, MSc</creator><creator>Hamric, Ann, RN, PhD</creator><creator>Rodney, Patricia, RN, PhD</creator><creator>Stewart, Miriam, RN, BSN, BA</creator><creator>Alden, Lynn, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Moral distress in intensive care unit professionals is associated with profession, age, and years of experience</title><author>Dodek, Peter M., MD, MHSc ; Wong, Hubert, PhD ; Norena, Monica, MS ; Ayas, Najib, MD, MPH ; Reynolds, Steven C., MD ; Keenan, Sean P., MD, MSc ; Hamric, Ann, RN, PhD ; Rodney, Patricia, RN, PhD ; Stewart, Miriam, RN, BSN, BA ; Alden, Lynn, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-aae751a84103240a1c5530807d2d96ed46ad61233e8bb5a0a8d16bf18f383b673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Attitude of Health Personnel</topic><topic>British Columbia</topic><topic>Confidence intervals</topic><topic>Critical Care</topic><topic>Delivery of Health Care - ethics</topic><topic>Demographics</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Intensive care unit</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Job Satisfaction</topic><topic>Male</topic><topic>Medical Staff, Hospital - ethics</topic><topic>Medical Staff, Hospital - psychology</topic><topic>Middle Aged</topic><topic>Moral distress</topic><topic>Morals</topic><topic>Multivariate Analysis</topic><topic>Nurses</topic><topic>Pharmacists</topic><topic>Physicians</topic><topic>Polls & surveys</topic><topic>Social workers</topic><topic>Stress, Psychological</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Therapists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dodek, Peter M., MD, MHSc</creatorcontrib><creatorcontrib>Wong, Hubert, PhD</creatorcontrib><creatorcontrib>Norena, Monica, MS</creatorcontrib><creatorcontrib>Ayas, Najib, MD, MPH</creatorcontrib><creatorcontrib>Reynolds, Steven C., MD</creatorcontrib><creatorcontrib>Keenan, Sean P., MD, MSc</creatorcontrib><creatorcontrib>Hamric, Ann, RN, PhD</creatorcontrib><creatorcontrib>Rodney, Patricia, RN, PhD</creatorcontrib><creatorcontrib>Stewart, Miriam, RN, BSN, BA</creatorcontrib><creatorcontrib>Alden, Lynn, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dodek, Peter M., MD, MHSc</au><au>Wong, Hubert, PhD</au><au>Norena, Monica, MS</au><au>Ayas, Najib, MD, MPH</au><au>Reynolds, Steven C., MD</au><au>Keenan, Sean P., MD, MSc</au><au>Hamric, Ann, RN, PhD</au><au>Rodney, Patricia, RN, PhD</au><au>Stewart, Miriam, RN, BSN, BA</au><au>Alden, Lynn, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Moral distress in intensive care unit professionals is associated with profession, age, and years of experience</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>31</volume><issue>1</issue><spage>178</spage><epage>182</epage><pages>178-182</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. Methods We distributed a self-administered, validated survey to measure moral distress to all clinical personnel in 13 ICUs in British Columbia, Canada. Each respondent to the survey also reported their age, sex, and years of experience in the ICU where they were working. We used multivariate, hierarchical regression to analyze relationships between demographic characteristics and moral distress scores, and to analyze the relationship between moral distress and tendency to leave the workplace. Results Response rates to the surveys were the following: nurses—428/870 (49%); other health professionals (not nurses or physicians)—211/452 (47%); physicians—30/68 (44%). Nurses and other health professionals had higher moral distress scores than physicians. Highest ranked items associated with moral distress were related to cost constraints and end-of-life controversies. Multivariate analyses showed that age is inversely associated with moral distress, but only in other health professionals (rate ratio [95% confidence interval]: − 7.3 [− 13.4, − 1.2]); years of experience is directly associated with moral distress, but only in nurses (rate ratio (95% confidence interval):10.8 [2.6, 18.9]). The moral distress score is directly related to the tendency to leave the ICU job, in both the past and present, but only for nurses and other non-physician health professionals. Conclusion Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26596697</pmid><doi>10.1016/j.jcrc.2015.10.011</doi><tpages>5</tpages></addata></record> |
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| ispartof | Journal of critical care, 2016-02, Vol.31 (1), p.178-182 |
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| subjects | Adult Age Age Factors Attitude of Health Personnel British Columbia Confidence intervals Critical Care Delivery of Health Care - ethics Demographics Female Humans Intensive care Intensive care unit Intensive Care Units - statistics & numerical data Job Satisfaction Male Medical Staff, Hospital - ethics Medical Staff, Hospital - psychology Middle Aged Moral distress Morals Multivariate Analysis Nurses Pharmacists Physicians Polls & surveys Social workers Stress, Psychological Studies Surveys and Questionnaires Therapists |
| title | Moral distress in intensive care unit professionals is associated with profession, age, and years of experience |
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