Abstract
ABSTRACT Objective: to map the scientific evidence on strategies for coping with moral distress adopted by nurses in the context of health services in tertiary care. Method: this is a Scoping Review based on the PRISMA-ScR recommendations. The searches were performed in September 2020 in the MEDLINE®, National Library of Medicine, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane and Biblioteca Virtual en Saúde databases. The eligibility criterion was to include studies that discussed strategies for coping with moral distress adopted by nurses in tertiary care, finding 2,041 studies, which were organized and screened in the Endnote software. The data were organized in Excel spreadsheets and analysis of the results was performed using the ATLAS.ti software. Results: the final selected sample consisted of 23 studies, which were grouped in two axes: strategies and recommendations. Four articles were included in the “strategies” axis, which reported actions taken to face moral distress, detailing the intervention and their results. The others, included in the “recommendations” axis, are articles whose focus was the experience of moral distress, suggesting important aspects to face it. Conclusion: recognition of moral distress by nurses and the opportunity for collective discussion and exchange of experiences are ways of collectively facing the situations. In addition, the institution's active participation in carrying out interventions was recommended. However, gaps were noticed in the production of studies that actually go deeper into intervention actions to cope with moral distress.
Highlights
Moral Distress (MD) is a process that can be experienced when nurses are faced with a moral issue, make their judgment, but are unable to act in accordance with their values
Given the reality of the cause and effects of the MD experienced by nurses and the importance of coping with it in the hospital setting, the guiding question of this study arises: “which is the scientific evidence on the strategies for coping with MD adopted by nurses in the context of health services in tertiary care?”
In view of the above, the objective of this study was to map the scientific evidence on strategies for coping with MD adopted by nurses in the context of health services in tertiary care
Summary
Moral Distress (MD) is a process that can be experienced when nurses are faced with a moral issue, make their judgment, but are unable to act in accordance with their values. The MD experience, due to the procedural nature and to its development over time, can lead nurses not to position themselves, which is characterized, by the authors, as “stagnation in uncertainty”1:412 This occurs when the professionals are not able to position themselves according to their ethical-moral values, to morally deliberate and advocate for the patient or to face the moral issue[1], developing their practice in a mechanical and uncritical manner, producing invisibilities[2]. It is noted that the hospital scenario concentrates most of the publications on the theme[1], in addition to being an environment permeated by moral issues[2] It is not always possible for nurses to carry out practices consistent with their moral judgment, affecting quality of health care in these institutions. It is necessary to create ways for nurses to be able to recognize and deal with moral issues in their routine, acting in favor of their practice, that is, patient care[2,3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
