Cargando…
Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study
The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians’ experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory. We...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707852/ https://www.ncbi.nlm.nih.gov/pubmed/34948976 http://dx.doi.org/10.3390/ijerph182413367 |
_version_ | 1784622539515887616 |
---|---|
author | Lamiani, Giulia Biscardi, Davide Meyer, Elaine C. Giannini, Alberto Vegni, Elena |
author_facet | Lamiani, Giulia Biscardi, Davide Meyer, Elaine C. Giannini, Alberto Vegni, Elena |
author_sort | Lamiani, Giulia |
collection | PubMed |
description | The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians’ experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory. We recruited 15 emergency and critical care physicians who worked in six hospitals from the Lombardy region of Italy. Semi-structured interviews about their professional experience of moral distress were conducted from November 2020–February 2021 (1 year after the pandemic outbreak). The transcripts were qualitatively analyzed following open, axial, and selective coding. A model of moral distress was generated around the core category of Being a Good Doctor. Several Pandemic Stressors threatened the sense of Being a Good Doctor, causing moral distress. Pandemic Stressors included limited healthcare resources, intensified patient triage, changeable selection criteria, limited therapeutic/clinical knowledge, and patient isolation. Emotions of Moral Distress included powerlessness, frustration/anger, and sadness. Physicians presented different Individual Responses to cope with moral distress, such as avoidance, acquiescence, reinterpretation, and resistance. These Individual Responses generated different Moral Outcomes, such as moral residue, disengagement, or moral integrity. The Working Environment, especially the team and organizational culture, was instrumental in restoring or disrupting moral integrity. In order for physicians to manage moral distress successfully, it was important to use reinterpretation, that is, to find new ways of enacting their own values by reframing morally distressing situations, and to perceive a cooperative and supportive Working Environment. |
format | Online Article Text |
id | pubmed-8707852 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87078522021-12-25 Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study Lamiani, Giulia Biscardi, Davide Meyer, Elaine C. Giannini, Alberto Vegni, Elena Int J Environ Res Public Health Article The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians’ experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory. We recruited 15 emergency and critical care physicians who worked in six hospitals from the Lombardy region of Italy. Semi-structured interviews about their professional experience of moral distress were conducted from November 2020–February 2021 (1 year after the pandemic outbreak). The transcripts were qualitatively analyzed following open, axial, and selective coding. A model of moral distress was generated around the core category of Being a Good Doctor. Several Pandemic Stressors threatened the sense of Being a Good Doctor, causing moral distress. Pandemic Stressors included limited healthcare resources, intensified patient triage, changeable selection criteria, limited therapeutic/clinical knowledge, and patient isolation. Emotions of Moral Distress included powerlessness, frustration/anger, and sadness. Physicians presented different Individual Responses to cope with moral distress, such as avoidance, acquiescence, reinterpretation, and resistance. These Individual Responses generated different Moral Outcomes, such as moral residue, disengagement, or moral integrity. The Working Environment, especially the team and organizational culture, was instrumental in restoring or disrupting moral integrity. In order for physicians to manage moral distress successfully, it was important to use reinterpretation, that is, to find new ways of enacting their own values by reframing morally distressing situations, and to perceive a cooperative and supportive Working Environment. MDPI 2021-12-19 /pmc/articles/PMC8707852/ /pubmed/34948976 http://dx.doi.org/10.3390/ijerph182413367 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lamiani, Giulia Biscardi, Davide Meyer, Elaine C. Giannini, Alberto Vegni, Elena Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title | Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title_full | Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title_fullStr | Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title_full_unstemmed | Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title_short | Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study |
title_sort | moral distress trajectories of physicians 1 year after the covid-19 outbreak: a grounded theory study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707852/ https://www.ncbi.nlm.nih.gov/pubmed/34948976 http://dx.doi.org/10.3390/ijerph182413367 |
work_keys_str_mv | AT lamianigiulia moraldistresstrajectoriesofphysicians1yearafterthecovid19outbreakagroundedtheorystudy AT biscardidavide moraldistresstrajectoriesofphysicians1yearafterthecovid19outbreakagroundedtheorystudy AT meyerelainec moraldistresstrajectoriesofphysicians1yearafterthecovid19outbreakagroundedtheorystudy AT gianninialberto moraldistresstrajectoriesofphysicians1yearafterthecovid19outbreakagroundedtheorystudy AT vegnielena moraldistresstrajectoriesofphysicians1yearafterthecovid19outbreakagroundedtheorystudy |