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  1. Moral distress among critical care nurses before and during the COVID-19 pandemic: A systematic review.Fatemeh Beheshtaeen, Camellia Torabizadeh, Sahar Khaki, Narjes Abshorshori & Fatemeh Vizeshfar - 2024 - Nursing Ethics 31 (4):613-634.
    Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding care provided to critically ill patients in critical care units. The ongoing COVID-19 pandemic has introduced new ethical challenges and changes in clinical practice, further exacerbating the experience of moral distress among these nurses. This systematic review compares the factors influencing moral distress among critical care nurses before and during the COVID-19 pandemic to gain a comprehensive understanding of the impact of (...)
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  • Moral distress among nurse leaders: A qualitative systematic review.Preston H. Miller, Elizabeth G. Epstein, Todd B. Smith, Teresa D. Welch, Miranda Smith & Jennifer R. Bail - 2023 - Nursing Ethics 30 (7-8):939-959.
    Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...)
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  • Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands.Trine-Lise Jansen, Marit Helene Hem, Lars Johan Dambolt & Ingrid Hanssen - 2020 - Nursing Ethics 27 (5):1315-1326.
    Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral (...)
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  • Psychosocial support for providers working high‐risk exposure settings during a pandemic: A critical discussion.Mechelle J. Plasse - forthcoming - Nursing Inquiry.
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  • Estimation of moral distress among nurses: A systematic review and meta-analysis.Zainab Alimoradi, Elahe Jafari, Chung-Ying Lin, Raheleh Rajabi, Zohreh Hosseini Marznaki, Mostafa Soodmand, Marc N. Potenza & Amir H. Pakpour - 2023 - Nursing Ethics 30 (3):334-357.
    Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. (...)
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  • Conceptualising moral resilience for nursing practice.Tiziana M. L. Sala Defilippis, Katherine Curtis & Ann Gallagher - 2019 - Nursing Inquiry 26 (3):e12291.
    The term ‘moral resilience’ has been gaining momentum in the nursing ethics literature. This may be due to it representing a potential response to moral problems such as moral distress. Moral resilience has been conceptualised as a factor that inhibits immoral actions, as a favourable outcome and as an ability to bounce back after a morally distressing situation. In this article, the philosophical analysis of moral resilience is developed by challenging these conceptualisations and highlighting the risks of such limiting perspectives. (...)
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  • Moral distress in Turkish intensive care nurses.Serife Karagozoglu, Gulay Yildirim, Dilek Ozden & Ziynet Çınar - 2017 - Nursing Ethics 24 (2):209-224.
    Background:Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by (...)
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  • Moral distress in correctional nurses: A national survey.Tiziano Lazzari, Stefano Terzoni, Anne Destrebecq, Luca Meani, Loris Bonetti & Paolo Ferrara - 2020 - Nursing Ethics 27 (1):40-52.
    Background: Moral distress is an increasingly documented problem in nursing and might foster nurses’ intention to leave their workplace. It has been studied in different settings, but no specific research has been conducted in Italian correctional facilities. A recent Italian study produced a preliminary validation of the Moral Distress Scale for Correctional Nurses, which needs to be completed. Objectives: To investigate the level of moral distress of nurses working in the Italian correctional setting, by completing the validation process of the (...)
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  • The severity of moral distress in nurses: a systematic review and meta-analysis.Masoud Mohammadi, Mohammad-Rafi Bazrafshan, Mohsen Kazeminia, Behnam Khaledi-Paveh, Shamarina Shohaimi & Nader Salari - 2022 - Philosophy, Ethics, and Humanities in Medicine 17 (1):1-14.
    BackgroundMoral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to (...)
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  • Effective interventions for reducing moral distress in critical care nurses.Amir Emami Zeydi, Mohammad Javad Ghazanfari, Riitta Suhonen, Mohsen Adib-Hajbaghery & Samad Karkhah - 2022 - Nursing Ethics 29 (4):1047-1065.
    Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well (...)
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  • Moral distress in critical care nursing: The state of the science.Natalie Susan McAndrew, Jane Leske & Kathryn Schroeter - 2018 - Nursing Ethics 25 (5):552-570.
    Background: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. Objectives: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. Review Methods: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies. (...)
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  • The effectiveness of narrative writing on the moral distress of intensive care nurses.Smat Saeedi, Leila Jouybari, Akram Sanagoo & Mohammad Ali Vakili - 2019 - Nursing Ethics 26 (7-8):2195-2203.
    Background: Nursing is a profession that has always been accompanied with common ethical concerns. There are some evidences which indicate that narrative writing on traumatic experiences may improve an individual’s emotional health. Objective: This study aimed to determine the effectiveness of narrative writing on moral distress of nurses working in intensive care unit. Research design: This study was a clinical trial with pre- and post-test design. The frequency and intensity of moral distress was measured by a valid and reliable questionnaire (...)
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  • Relationships among Climate of Care, Nursing Family Care and Family Well-being in ICUs.Natalie S. McAndrew, Rachel Schiffman & Jane Leske - 2019 - Nursing Ethics 26 (7-8):2494-2510.
    Background: Frequent exposure to ethical conflict and a perceived lack of organizational support to address ethical conflict may negatively influence nursing family care in the intensive care unit. Research aims: The specific aims of this study were to determine: (1) if intensive care unit climate of care variables (ethical conflict, organizational resources for ethical conflict, and nurse burnout) were predictive of nursing family care and family wellbeing and (2) direct and indirect effects of the climate of care on the quality (...)
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