Moral distress is associated with general workplace distress in intensive care unit personnel

Abstract

Purpose: To assess the association between moral distress and general workplace distress in intensive care unit (ICU) personnel.

Materials and methods: We administered the Moral Distress Scale Revised and the Job Content Questionnaire to all clinicians (870 nurses, 68 physicians, 452 other health professionals) in 13 ICUs (3 tertiary, 3 large community, 7 small community) in British Columbia, Canada. We used mixed effects regression, treating ICUs as clusters, to examine the association between the Moral Distress Score and each Job Content Questionnaire scale (decision latitude, psychological stressors, social support, psychological strain) after adjusting for age, sex, and years of experience of respondents; separate analyses were done for each profession.

Results: Overall response rate was 45%. Nurses and other health professionals had higher moral distress scores than physicians, but there were no differences in general workplace distress scores among professional groups. After adjustment for demographic characteristics, higher moral distress in nurses was associated with lower decision latitude and social support, and with higher psychological stressors and psychological strain. For physicians and other professionals, these relationships were similar.

Conclusions: Moral distress is associated with general workplace distress in ICU personnel. Interventions that ameliorate either type of distress may also ameliorate the other.

Keywords: Intensive care unit; Moral distress; Workplace distress.