Moral distress in clinicians caring for critically ill patients who require mechanical circulatory support

Artem Emple, Laura Fonseca, Shunichi Nakagawa, Gina Guevara, Cortessa Russell, May Hua

Research output: Contribution to journalArticlepeer-review

Abstract

Background Although use of mechanical circulatory support is increasing, it is unclear how providing such care affects clinicians’ moral distress. Objective To measure moral distress among intensive care unit clinicians who commonly care for patients receiving mechanical circulatory support. Methods In this prospective study, the Moral Distress Scale-Revised was administered to physicians, nurses, and advanced practice providers from 2 intensive care units in an academic medical center. Linear regression was used to assess whether moral distress was associated with clinician type, burnout, or desire to leave one’s job. Clinicians’ likelihood of reporting frequent moral distress when caring for patients receiving mechanical circulatory support vs other critically ill patients also was assessed. Results The sample comprised 102 clinicians who had a mean (SD) score of 100.5 (51.6) on the Moral Distress Scale-Revised. After adjustment for clinician characteristics, moral distress was significantly higher in registered nurses than physicians/advanced practice providers (115.9 vs 71.0, P < .001), clinicians reporting burnout vs those who did not (114.7 vs 83.1, P = .003), and those considering leaving vs those who were not (121.1 vs 89.2, P = .001). Clinicians were more likely to report experiencing frequent moral distress when caring for patients receiving mechanical circulatory support (26.5%) than when caring for patients needing routine care (10.8%; P = .004), but less likely than when caring for patients with either chronic critical illness (57.8%) or multisystem organ failure (56.9%; both P < .001). Conclusion Moral distress was high among clinicians who commonly care for patients receiving mechanical circulatory support, suggesting that use of this therapy may affect well-being among intensive care unit clinicians. (American Journal of Critical Care. 2021;30:356-362).

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalAmerican Journal of Critical Care
Volume30
Issue number5
DOIs
StatePublished - Sep 1 2021
Externally publishedYes

ASJC Scopus subject areas

  • Critical Care

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