Experience Of Distress Research Articles

Entrepreneurs’ thriving after venture distress: The role of self-compassion, learning, and venture failure

Well-being is important to entrepreneurs, yet entrepreneurship does not necessarily foster well-being. Stressful work conditions such as venture distress might put entrepreneurs’ well-being under pressure. Drawing upon self-determination theory, we investigate the conditions that enhance entrepreneurs’ thriving after experiencing venture distress. We test this model on a survey-based sample of 177 entrepreneurs in Belgium who either persisted with their distressed venture or started a new one after their distressed venture had failed. Our findings reveal that personal attributes of self-compassion and learning from venture distress can buffer the potential negative effects of venture distress experiences on entrepreneurs’ subsequent thriving. In addition, this protective capacity is not mitigated by the failure of the distressed venture. We further discuss the theoretical and practical implications of these findings. JEL CLASSIFICATION: L26, M13, I31

The relationship between teamwork and moral distress among NICU nurses

BackgroundIn the demanding environment of the neonatal intensive care unit (NICU), quality nursing care hinges on effective teamwork and communication among nurses. However, this requirement for close cooperation can expose nurses to significant levels of moral distress. This study aims to explore the connection between the quality of teamwork and the experience of moral distress among NICU nurses.MethodsEmploying a cross-sectional, multicenter descriptive correlational design, this study surveyed female NICU nurses across the cities of Khorramabad and Semnan. Census sampling was utilized over five months, from July to November 2023, resulting in the participation of 190 nurses. Tools for data collection included demographic questionnaires, the Team-STEPPS Teamwork Perception Questionnaire (T-TPQ), and the Moral Distress Scale-Revised (MDS-R) for nurses.ResultsThe findings revealed an average teamwork score of 3.73 ± 0.78, denoting an acceptable level, and an average moral distress score of 91.2 ± 56.7, indicating a low level. In multiple linear regression, marital status showed a direct positive correlation (β = 38.5, SE (β) = 9.3, p < 0.001), while the number of children (β = -14.6, SE (β) = 4.9, p = 0.003) and the teamwork score (β = -1.1, SE (β) = 0.12, p < 0.001) were inversely correlated with moral distress.ConclusionThe study’s results suggest that stronger teamwork among nurses correlates with reduced moral distress. Enhancing teamwork within NICUs could lead to policy development focused on the safety and quality of newborn care, also potentially alleviating moral distress experienced by nurses.

Claimant and clinician perspectives on sources of claimant distress in interactions with Australian compensation schemes: a qualitative study

Purpose Recovering from compensable injuries can be influenced by a variety of factors including the claimant’s experience of distress during the claims process. In order to develop cross-scheme, nation-wide strategies to improve claimants’ interactions with the compensation system, reduce claimant distress, and improve claimant outcomes, it is important to understand sources of claims-related distress from the perspective of both claimants and clinicians. Methods An exploratory qualitative design was undertaken using semi-structured interviews with 13 claimants and 26 clinicians from four injury compensation schemes in five Australian states. A collaborative and reflexive thematic analysis was undertaken with an inductive approach to coding, and themes were constructed for claimants and clinicians across compensation schemes. Results Claimants and clinicians interviews revealed four main sources of distress, including (1) complexity and delays in administrative processes, (2) interruptions to recovery caused by treatment delays, (3) non-individualised approaches to care, and (4) a lack of support for navigating the claims process. Conclusion Sources of claims-related distress identified by claimants and clinicians in the present study point to the urgent need for nationwide systems level changes to reduce claimant distress in the pursuit of better claimant outcomes.

54 Efficacy of a quality improvement project in paediatric procedural pain management during needle procedures

Abstract Background In paediatric hospital settings, needle procedures significantly contribute to children’s experiences of pain and distress. A structured approach integrating preparation, comfort positions, distraction, relaxation techniques, and topical anesthetics can enhance children’s ability to cope with procedural discomfort. We developed a quality improvement (QI) initiative aiming to alleviate procedural pain and distress through a staggered implementation approach over a 3-year period. Objectives This study aimed to evaluate the impact of the first 2 years of an institutional QI initiative on managing procedural pain and distress in children undergoing needle procedures. The primary objective was to evaluate the use of multimodal strategies to reduce needle-related procedural pain/distress following the QI initiative. The secondary objective was to compare pain scores for needle procedures before and after the QI initiative. Design/Methods This observational study was conducted in a tertiary care university-affiliated paediatric hospital with an ongoing hospital-wide QI initiative aiming to alleviate procedural pain and distress in children undergoing needle procedures. The QI initiative consisted of mandatory sector-by-sector training of healthcare providers (HCP) on procedural pain/distress strategies to increase the use of multimodal pain care. Pain scores were measured during needle procedures (i.e. Numerical Rating Scale (NRS), Faces Pain Scale-R (FPS-R) or the FLACC scales, according to patient age) pre and 3-6 months post implementation of the QI initiative. Scheduled audits were conducted using a standardized questionnaire by a deployment champion nurse during needle procedures to document pain scales and pain/distress strategies used by the HCP during needle procedures in each of the hospital services. Results Throughout the first two implementation years (June 2021-June 2023), 363 audits were conducted on needle procedures for 363 children (Median age 7 yo (0month-18yo□). At this stage, audits took place in 14 different hospital services. The most frequent procedures were IV-line insertions (34%), venous blood draws (27%), and capillary blood sampling (26%). Parental presence and the use of distraction techniques were frequently used (90% and 80% of procedures, respectively). Of the 363 audits, 221 were pre-implementation and 142 post-implementation. Post QI initiative, an increased number of procedures were realized using multimodal strategies (4 or more strategies) to reduce pain/distress (from 60% to 78%). Pain scores were recorded for 203/221 audits pre and 134/142 post with a reduction in severe pain scores (7 or more) from 25% pre to 5% post-implementation. Conclusion The institutional QI initiative demonstrated both an increase in the number of strategies used to prevent pain/distress and a reduction in severe pain scores associated with paediatric needle procedures. This project emphasizes the significance of employing a multifaceted approach to managing procedural pain/distress in children undergoing needle procedures.

Higher levels of social support predict lower psychological distress for Pacific peoples living in Aotearoa New Zealand

Recent research indicates that rates of psychological distress are almost 1.5 times higher for adult Pacific peoples versus non-Pacific peoples1. Leveraging data from the New Zealand Attitudes and Values Study and utilising cross-lagged regression modelling, we examined changes in psychological distress across time for adult Pacific peoples in Aotearoa New Zealand (n = 514). Our study found that experiences of psychological distress were associated with a greater likelihood of experiencing psychological distress in the future. Additionally, experiencing higher levels of social support was associated with a lower likelihood of experiencing psychological distress in the future. Our research is vital because psychological distress is a serious mental health issue, and research that signals protective factors towards psychological distress for our Pacific peoples can help in creating better mental health outcomes for our Pacific communities. Preview on terminology: We use the term Pacific peoples, which are inclusive of a group of people in Aotearoa New Zealand that have ethnic roots from many Pacific nations. Unless a research study specifically uses the term mental illness or mental disorder, the study uses the terms mental distress and mental health issues/concerns to broadly refer to diagnosis of a mental illness or any other challenges or experiences with mental health. The choice in terminology is to shift the focus away from a deficit model of health, to those that are more consistent with Pacific views of health and wellbeing1.

A scoping review of the impact of eco-distress and coping with distress on the mental health experiences of climate scientists

IntroductionIn the face of a future predicted to be one defined by an increase in the Earth’s surface temperature, and the associated extreme weather events, distressing emotional responses are understandable. Climate scientists comprise a unique group, in that they are deeply and consistently faced with the current reality, and consequences of, climate change. ‘Ecological distress’, a term to describe climate-related emotional experiences, can include feelings of grief, anxiety, and hopelessness proportionate to the existential threat of climate change.MethodsThis review sought to scope the current literature into how ecological distress is experienced by this population, factors that mitigate or exacerbate these experiences, and the coping strategies that are used. This review used Interpretive Content Analysis to code the data and employed a narrative synthesis of the findings.ResultsThis paper demonstrates the significant emotional impacts associated with working as a climate scientist, along with an associated set of coping strategies. Climate scientists share experiences of emotional distress, involving both intra- and interpersonal processes, highlighting how people working in this profession may be vulnerable to unique pressures and psychological burdens related to their work.DiscussionClimate scientists have an essential role to play in helping society and policy makers understand the implications of climate change and identifying the most useful responses. As such, it is integral that the psychological wellbeing of this group is understood and cared for. This review is the first step in synthesising current knowledge, in preparation for developing helpful methods and strategies for keeping our climate scientists well, motivated, and engaged.

Comparison of Oliceridine to Remifentanil for Optimal Analgesia in Mechanical Ventilation (CO-ROAM): Study Protocol for a Multicenter Randomized Controlled Trial.

Critically ill patients often endure pain, a distressing experience that can trigger diverse pathophysiological consequences. While remifentanil, with its rapid kinetics, is commonly used for analgesia in intensive care units (ICU), it frequently leads to opioid-related adverse effects. A promising alternative has emerged in oliceridine, a novel G protein-biased μ-opioid receptor agonist. This new drug offers the potential for effective pain relief with fewer side effects. However, its efficacy and safety profile in mechanically ventilated ICU patients remain to be fully elucidated. This is a multicenter, prospective, randomized, single-blind, active-controlled trial conducted across 24 ICUs in China. A total of 292 mechanically ventilated patients requiring analgesia and sedation will be randomly assigned in a 1:1 ratio to either the oliceridine or remifentanil group. The oliceridine group will receive oliceridine (2-20μg/kg/h), while the remifentanil group will receive remifentanil (1.5-12μg/kg/h). Both groups will receive propofol for sedation if necessary. The target for analgesia is Critical-Care Pain Observation Tool (CPOT)<3, and for sedation is Richmond Agitation-Sedation Scale (RASS) -2 to 0. The primary outcome will be the percentage of time within target analgesia during study drug administration. Secondary outcomes will include gastrointestinal dysfunction, respiratory depression, sedative usage, mechanical ventilation duration, ICU stay length, extubation failure rate, etc. TRIAL REGISTRATION: NCT06454292. Registered on June 11, 2024.

Too much or not enough? Self-reported experiences of relational distress based on level of sexual desire

ABSTRACT The diagnostic of sexual desire disorders is based on not only physiological and psychological symptoms but also on the extent of distress about these symptoms. Using data from a 2022 national survey of 3,000 respondents in Austria, this paper explores the range of relational distress individuals experience about their level of sexual desire. Participants were asked, ‘Have you ever been ostracised or ridiculed in your life for feeling too much (not enough) sexual desire? If yes, in what way?’ Gender and sexual minorities were more likely than cisgender and heterosexual participants to report negative reactions to their level of desire. The paper presents the results of a thematic analysis of the 341 written answers to the latter question. The analysis identified three themes: a) harassment, such as mocking, bullying, or public humiliation; b) the pathologization of desire as a sexual disorder; and c) negative social classification with respect to gender, age, or sexual orientation. By investigating different types of negative social reactions that individuals experience with respect to their level of sexual desire, the paper critically questions an individualised notion of sexual distress that has often been the basis for biomedical and psychological interventions by highlighting social factors that produce distress in the first place.

The Buddhist Logic of Distress (Saṃvega): An Exploration of Early Abhidharma Sources

In the early Buddhist discourses, distressing experiences like fear and disgust are evaluated in contradictory modes. These upsetting emotions are considered both a detriment and an advantage for those seeking liberation from suffering. This ambivalence is reflective of the classical Buddhist conception of distress. The earliest scholastic Buddhist texts (i.e., Abhidharma sources) have sought to resolve the ambivalence surrounding this conception. The Abhidharma texts thus explain precisely how, when, where and for whom distress can prove favorable. By tracing this intellectual endeavor, I examine in this article the systematic and philosophical treatments of distress (saṃvega) in early Buddhist scholasticism. I outline the reasons for considering the experience of distress to be beneficial, unveiling the religious framework within which distress is rendered positive and even essential. My central claim is that early Abhidharma sources conceive of distress as a potential source of energy that facilitates one’s progress on the religious path and determines how rapidly one can understand the truth.

Mental distress and associated factors among undergraduate students: evidence from a cross-sectional study at the University of Dodoma, Tanzania

Mental distress is a common health problem facing university students worldwide. It manifests with varying levels of depression, anxiety, and somatic symptoms such as headache, backache, sleeping problems, and fatigue. University students are a high-risk group for mental distress than the general population. This study aimed to assess knowledge, the prevalence of mental distress, and its associated factors among undergraduate students. A cross-sectional study was conducted among undergraduate students at the University of Dodoma in Tanzania. Data were collected using pre-tested and self-administered questionnaires. Bivariate and multivariable logistic regression models were used to identify factors associated with mental distress. A total of 224 undergraduate students gave a complete response, of which the majority were aware of the common symptoms of mental distress. Self-reported mental distress experience was reported among 116/224 (51.8%) students. Multivariable logistic analysis showed that only alcohol consumption (aPR = 1.61, 95% CI 1.22–2.11, p = 0.001) was independently associated with mental distress among students. The findings of this study revealed that undergraduate students had adequate knowledge of the symptoms of mental distress. Our results show that the prevalence of self-reported mental distress was moderately high among undergraduate students. Furthermore, the study indicates a significant association between alcohol consumption and self-reported mental distress among these students. These results suggest that interventions aimed at reducing alcohol consumption may be beneficial in mitigating mental health issues among undergraduate students in Tanzania.

Women's Experience and Management of Cancer-Related Fatigue and Psychological Distress During Treatment for Gynaecological Cancer: A Qualitative Study.

To explore women's experience and management of cancer-related fatigue and psychological distress during treatment for gynaecological cancer. Qualitative descriptive study. Face-to-face semistructured individual interviews were conducted with 23 women in mainland China undergoing treatment for gynaecological cancer between July and October 2023. Data were analysed using content analysis. Three categories were identified: overwhelming experience of cancer-related fatigue, diverse experiences of psychological distress and strategies for managing cancer-related fatigue and psychological distress. Participants reported physical exhaustion and emotional fatigue, disrupting their normal lives. Psychological distress included distress due to cancer treatment, psychological burden associated with social relationships, frustration with being ill and worries about disease progression and recurrence. Strategies for managing symptoms were mainly nonpharmacological, with some unable to find suitable methods. This study found that participants had a complex experience of cancer-related fatigue and psychological distress, influenced by social expectations regarding women's roles and treatment impacts on reproductive health and femininity. These findings underscore the need for comprehensive interventions involving family members or fellow patients to reduce both symptoms. Nurses should focus on addressing cancer-related fatigue and psychological distress in women receiving treatment for gynaecological cancer, particularly in adolescents and young adults. It is essential to provide comprehensive care to improve their physical and psychological well-being. This study explored how women with gynaecological cancer experience and manage cancer-related fatigue and psychological distress. The findings highlight the need for holistic care that addresses physical and psychological symptoms. Nurses should consider the impact of reproductive health and femininity on symptom experiences and management. Furthermore, the findings could inform the development of evidence-based interventions to improve the physical and psychological well-being of women with gynaecological cancer. Standards for Reporting Qualitative Research checklist. No patient or public contribution.

Racial Discrimination, Social Support, and Psychological Distress Among Black Pregnant Women.

Black pregnant women who experience racial discrimination are at an increased risk of psychological distress. Studies have not adequately addressed if social support may moderate the association between experiences of racial discrimination and psychological distress among Black pregnant women. We sought to examine the moderating effect of social support on the association between experiences of racial discrimination and psychological distress among Black pregnant women. We report findings based on cross-sectional data collected from 599 Black pregnant women enrolled in a prospective cohort study prior to the COVID-19 pandemic. Women completed questionnaires about experiences of racial discrimination (Experiences of Discrimination), social support (MOS Social Support Survey), and psychological distress (Psychological General Wellbeing Index). Women had an average age of 26 ± 5 years and gestational age at data collection of 17 ± 6 weeks. Approximately 53% of women reported ever experiencing racial discrimination in at least one situation, and 54% reported psychological distress. After adjustment for covariates, racial discrimination was associated with a 2.2-fold increase in psychological distress (odds ratio [OR] = 2.24; 95% confidence interval [CI] 1.35-3.70; P = .002). Low social support (scores below the median) was associated with a 3.8-fold higher likelihood of psychological distress (OR = 3.84, 95% CI 2.27-6.48, P < .001). Social support did not moderate the association of lifetime experiences of racial discrimination with psychological distress. Findings of the study contribute to evidence that lifetime experiences of racial discrimination and low levels of social support relate to psychological distress among Black pregnant women.

The ties that bind: Understanding the mental health consequences of the Windrush Scandal and hostile immigration policies on survivors in the UK

The Home Office Windrush Scandal of 2018 has had major implications for the wellbeing of survivors and is thought to have affected more than 15,000 individuals. The Government led compensation scheme to provide retribution to those impacted has been consistently argued as insufficient, in part linked to under appreciation of mental health consequences of the scandal. However, there is limited evidence which documents the nature of mental health issues that survivors and families have faced. This need for further evidence intersects with the need to protect a highly vulnerable community from further traumatisation. Our study contributes to this gap through a content analysis of survivor testimonies (n= 96) published in publicly available media sources between 2018 and 2023. Analysis explored both pathways to the development of mental health distress and experiences of potential mental health consequences (conditions). Our analysis was informed by a complex trauma and racial trauma framework. Findings demonstrate that the scandal disrupted numerous social domains linked to livelihoods and positive wellbeing, driving survivors into homelessness, and experiences of dehumanisation within state systems. This shaped survivors’ experiences of emotional distress, resulting in symptoms linked to depression, chronic stress, and anxiety disorders. Our work illuminates new details about the nature of trauma faced by survivors. Findings support calls for support survivors systems that provide targeted mental health supports and address the disrupted social areas of individuals lives and if they are to fully respond to the harms created by the scandal.

Exploring the Relationship Between Cyberbullying and Technology Addiction in Adolescents.

The present study aims to investigate the relationship between cyberbullying/victimization and technology addiction among Turkish adolescents. A descriptive cross-sectional study was conducted with 572 adolescents between the ages of 14 and 18. The study employed the Bullying and Cyber Bullying Scale for Adolescents (BCS-A) to evaluate cyber victimization (BCS-A VCSs) and cyberbullying (BCS-A BCSs) subdimensions, in conjunction with the Technology Addiction Scale (TAS). Among adolescents, 38.5% exhibited a moderate level of technology addiction. The results revealed positive and weak correlations between TAS scores and BCS-A VCSs (p < 0.001), as well as between BCS-A VCSs and BCS-A BCSs scores at a moderate level (p < 0.001). The study revealed that exposure to inappropriate content, encountering humiliating expressions on social media, sending inappropriate messages or videos to friends, and facing threats were significant predictors of BCS-A VCS scores. Furthermore, the transmission of inappropriate messages or videos, the encounter of cyberbullying victims, the exclusion of friends from online platforms, the experience of distress caused by humiliating expressions, and the sharing of private content were identified as significant predictors of the total BCS-A BCSs score. The study demonstrated a correlation between elevated technology addiction and involvement in cyberbullying or victimization among adolescents. Moreover, the study identified significant predictors of cyberbullying and cyber victimization. It is recommended that health professionals develop intervention programs for safe technology use and the prevention of cyberbullying and victimization. These programs should aim to raise societal awareness, particularly among parents and teachers.

„Schmerzlos sind wir und haben fast | Die Sprache in der Fremde verloren“ Hölderlin über Heimat und Heimatlosigkeit

Recent research has rightly emphasized the extent to which Hölderlin’s poetry opens up broad horizons of transcultural perspectives with a thoroughly cosmopolitan intention. However, these great drafts of ‘transtopias’ remain in the realm of speculative idealism, as long as one ignores the counterpoint that Hölderlin sets up with his contemporaneous texts about the experience of extreme individual danger and distress. Only against this background of struggle for self-preservation in hard and “godforsaken” times, Hölderlin’s ingenious, still hopeful rather than deconstructive intuitions gain real credibility and relevance.

Exploring marital safety: three South African wives living with HIV in nonmutual monogamous marriage

For wives who have been sexually monogamous, their being infected with HIV disrupts the cultural assumption of sexual safety in marriage. This phenomenological interview study shows how three married South African women, who were diagnosed with HIV and had reported being monogamous, experienced gendered distress while contemplating the failures of married coupledom in offering safety and familial stability. Constructionist thematic analysis showed three themes to represent changes in the marital unit. The first theme, HIV as Demarcation of Enduring Disruption, pointed to infection as the harbinger of distressing relational dynamics. The second theme, Feeling Controlled, reflected domains in which the wives felt trapped: restricted freedoms and obligatory intimacy. The third theme, Relational Deterioration, showed meanings about infidelity, fights or arguments, and distress about partner disengagement. Highlighted in this analysis is that, for two women, male control and disempowerment after having been infected with HIV added to their experiences of feeling trapped because they felt pressured into regressing into subservient spousal roles. They were required to retreat into household, mothering, and child care duties. The study’s practice implication is that, to address the aftermath of the discovery of HIV infection in heterosexual married couples, wherein sexual monogamy remains the unquestioned norm, health psychology and clinical interventions should incorporate a gendered approach in counselling formulation.

Climate change distress and impairment in Germany.

Climate change has been widely recognized as one of the most challenging problems facing humanity and it imposes serious mental health threats. It is important, however, to differentiate between the affective experience of distress over climate change and the functional impairments associated with climate change. Such a distinction is crucial because not all negative affective states are pathological, and they might even motivate pro-environmental behavior. Functional impairments, like not being able to work or maintaining social relationships, however, might require immediate treatment. This study assesses climate change distress and climate change impairment within the population of Germany using a population-representative sample. The results identify vulnerable subgroups and thereby can help to facilitate the development of target group specific intervention programs. Furthermore, this study explores whether climate change distress and climate change impairment are associated with general health, physical health, mental health, and diverse health behaviors. Study participants were drawn from a panel which is representative of the German-speaking population in Germany with Internet access. Participants answered a series of questionnaires regarding their climate change distress, climate change impairment, general health, physical health, mental health, and diverse health behaviors. To evaluate differences between subgroups, Bayesian independent samples t-tests were calculated. To evaluate associations between constructs, Bayesian correlations were calculated. Especially women, younger people, people from West Germany, and people with a high level of formal education seem to experience higher levels of climate change distress. Regarding climate change impairment, the results suggest that especially women, older people, people from West Germany, people with a low level of formal education, people with a low or middle social status, and people with an inadequate/problematic health literacy seem to experience higher levels of climate change impairment. Furthermore, climate change distress and climate change impairment were weakly and differently associated with general health, physical health, mental health, and diverse health behaviors. Climate change distress and impairment are not evenly distributed within German society. The results of this study provide a starting point for the development of target group specific intervention programs.

The Anxiety Of The Millennial Generation And Its Solutions From The Perspective Of The Qur'an

In daily life, millennials have undoubtedly experienced distress, which can be interpreted as feelings of stress and anxiety. This research focuses on understanding distress from the perspective of the Qur'an, which serves as the primary guidance for Muslims. This study aims to explore the Qur'anic view on distress, the definition of distress in both language and the Qur'an, as well as understanding how millennials interpret distress, the terms used in the context of distress, and interpreting distress according to the Qur'an by providing solutions to improve the quality of life. This research adopts a qualitative descriptive approach that relies on literature study research, including Qur'anic verses, research publications, and related articles. In terms of interpretation, this research relies on the thematic interpretation method (tafsir maudhu’i). It also includes studies conducted by experts related to the phenomenon of distress, which encompasses stress and anxiety. In the context of the millennial generation, this research discovers solutions to overcome distress, which are further elaborated by the author through new ideas, especially by referring to relevant Qur'anic verses. The findings revealed in this research are 1) the Qur'anic view on stress as a test from Allah SWT, 2) that calamities are a source of stress, 3) the importance of having strong self-confidence, and 4) solutions for distress from the perspective of the Qur'an.

Narrating Trauma as Victims of Human Trafficking in China: A Study on Select North Korean Memoirs

The memoirs titled In Order to Live; A North Korean Girl's Journey, to Freedom and; A Thousand Miles to Freedom: My Escape from North Korea are written by Yeonmi Park and Eunsun Kim two women who managed to escape from North Korea. They went through an experience of being forced into labour in China as victims of trafficking. In their memoirs these authors vividly depict the pain that comes with being exploited. The main aim of this study is to analyse how memoirs can effectively address the issue of trafficking. These remarkable women skilfully use the memoir genre to make a personal plea for action. They strategically make choices appeal to readers emotions openly share their distressing experiences and support their stories with research and evidence that connect their experiences with the broader problem of human trafficking in China. This study clearly shows that both these memoirs emphasize the importance of the memoir genre in advocating for rights. It also highlights how survivor memoirs have the potential to inspire advocacy and involvement, in combating trafficking.

When Fulfilling a Professional Obligation Causes Moral Distress: A New Evaluative Approach.

The term 'moral distress' was coined by Andrew Jameton to name the anguish that clinicians feel when they cannot pursue what they judge to be right because of institutional constraints. We argue that moral distress in critical care should also be addressed as a function of the constraints of ethics and propose an evaluative approach to the experience considering its implications for professional identity. We build on a selective review of the literature and analyze a paradigmatic example of moral distress, namely, clinicians who feel compelled to perform procedures on patients that seem futile. Such cases are commonly cited by clinicians as among the most morally distressing. Our analysis shows that (1) physicians' experiences of moral distress can stem not only from toxic workplace cultures and institutional constraints on their time and resources for patient care but also from the limits of ethical reasoning and (2) an emotion-based evaluative approach to analyzing moral distress is needed to address its hazards for professional identity. We propose a new evaluative approach to moral distress with implications for professional identity and the need for institutional education and support.