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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
nursing
Moral distress in end-of-life care in the intensive care unit
Journal of Advanced Nursing, Volume 69, No. 8, Year 2013
Notification
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Description
Aim: To explore moral distress in relatives doctors and nurses, in end-of-life care decision-making, in the adult intensive care unit. Background: Many deaths in intensive care involve decisions about withholding and withdrawing therapy, potentially triggering moral distress. Moral distress occurs when individuals feel constrained from acting in accordance with moral choice, or act against moral judgement, generating painful, unresolved emotions, and problems that continue long after an event. Prior research has focused mainly on nurses; less is known about doctors' experiences and occurrence and impact on relatives is unknown. Design: A narrative inquiry case study approach, funded by a Northern Ireland Health and Social Care Doctorate Fellowship Award (April 2011). Methods: In-depth digitally recorded interviews will be conducted with relatives, doctors, and nurses involved in end-of-life cases comprising: (1) withdrawal of therapy, including circulatory death organ donation; (2) non-escalation of therapy; and (3) brain stem death with a request for organ donation. Relatives will be offered the opportunity to share their experiences on 'Healthtalkonline' by copyrighting audio-visual interviews to the Health Experiences Research Group, Oxford University. Research Ethics Committee approval was obtained (April 2012). Discussion: This is the first time that moral distress is explored, in a case approach, among relatives, doctors, and nurses intimately involved in end-of-life decisions in intensive care. Dissemination of findings will make a large contribution to international knowledge and understanding in this area and alert healthcare professionals and relatives to an otherwise under-recognized, but potentially detrimental, experience. Findings will inform education, practice, and policy. © 2012 Blackwell Publishing Ltd.
Authors & Co-Authors
St Ledger, Una
United Kingdom, Belfast
School of Medicine, Dentistry and Biomedical Sciences
United Kingdom, Belfast
Belfast Health and Social Care Trust
Begley, Ann
Uganda, Kampala
Nexus International University
Reid, Joanne
United Kingdom, Belfast
Queen's University Belfast
Prior, Lindsay
United Kingdom, Belfast
Queen's University Belfast
McAuley, Daniel F.
United Kingdom, Belfast
School of Medicine, Dentistry and Biomedical Sciences
United Kingdom, Belfast
Royal Victoria Hospital Belfast
Blackwood, Bronagh M.
United Kingdom, Belfast
School of Medicine, Dentistry and Biomedical Sciences
Statistics
Citations: 65
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1111/jan.12053
ISSN:
03092402
e-ISSN:
13652648
Research Areas
Health System And Policy
Study Design
Narrative Study
Case Study
Study Approach
Qualitative