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  1. What outcomes of moral case deliberations are perceived important for healthcare professionals to handle moral challenges? A national cross-sectional study in paediatric oncology.Pernilla Pergert, Bert Molewijk, Isabelle Billstein & Cecilia Bartholdson - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundIn paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation, aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.MethodsIn this study, the perceptions held by healthcare professionals regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in Sweden. Healthcare professionals (...)
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  • Ethical concerns when recruiting children with cancer for research: Swedish healthcare professionals’ perceptions and experiences.Kajsa Norbäck, Anna T. Höglund, Tove Godskesen & Sara Frygner-Holm - 2023 - BMC Medical Ethics 24 (1):1-13.
    Background Research is crucial to improve treatment, survival and quality of life for children with cancer. However, recruitment of children for research raises ethical challenges. The aim of this study was to explore and describe ethical values and challenges related to the recruitment of children with cancer for research, from the perspectives and experiences of healthcare professionals in the Swedish context. Another aim was to explore their perceptions of research ethics competence in recruiting children for research. Methods An explorative qualitative (...)
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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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  • NICU nurses' moral distress surrounding the deaths of infants.Soojeong Han, Haeyoung Min & Sujeong Kim - 2023 - Nursing Ethics 30 (2):276-287.
    Background As Korean neonatal nurses frequently experience the deaths of infants, moral distress occurs when they provide end-of-life care to the infants and their families. Although they need to care for the patients’ deaths and consequently experience burnout and turnover due to moral distress from the situation, there is a lack of a support for nurses. Moreover, not much information is available on the moral distress of neonatal nurses. There is a need to better understand Korean neonatal nurses’ moral distress (...)
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  • Ethical climate and moral distress in paediatric oncology nursing.Päivi Ventovaara, Margareta af Sandeberg, Janne Räsänen & Pernilla Pergert - 2021 - Nursing Ethics 28 (6):1061-1072.
    Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: (...)
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  • Ethical challenges as perceived by nurses in pediatric oncology units.Fateme Mohammadi, Zeinab Naderi, Leila Nikrouz, Khodayar Oshvandi, Seyedeh Zahra Masoumi, Parisa Sabetsarvestani & Mostafa Bijani - 2024 - Nursing Ethics 31 (2-3):268-280.
    Background Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses’ perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated. Objective The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran. Research design The present study (...)
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  • Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care.Charlotte Weiner, Pernilla Pergert, Bert Molewijk, Anders Castor & Cecilia Bartholdson - 2021 - BMC Medical Ethics 22 (1):1-11.
    BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...)
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  • Moral distress and positive experiences of ICU staff during the COVID-19 pandemic: lessons learned.Mark L. van Zuylen, Janine C. de Snoo-Trimp, Suzanne Metselaar, Dave A. Dongelmans & Bert Molewijk - 2023 - BMC Medical Ethics 24 (1):1-17.
    Background The COVID-19 pandemic causes moral challenges and moral distress for healthcare professionals and, due to an increased work load, reduces time and opportunities for clinical ethics support services. Nevertheless, healthcare professionals could also identify essential elements to maintain or change in the future, as moral distress and moral challenges can indicate opportunities to strengthen moral resilience of healthcare professionals and organisations. This study describes 1) the experienced moral distress, challenges and ethical climate concerning end-of-life care of Intensive Care Unit (...)
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  • Important situations that capture moral distress in paediatric oncology.Margareta af Sandeberg, Cecilia Bartholdson & Pernilla Pergert - 2020 - BMC Medical Ethics 21 (1):1-9.
    The paediatric Moral Distress Scale-Revised was previously translated and adapted to Swedish paediatric oncology. Cognitive interviews revealed five not captured situations among the 21 items, resulting in five added items: 22) Lack of time for conversations with patients/families, 23) Parents’ unrealistic expectations, 24) Not to talk about death with a dying child, 25) To perform painful procedures, 26) To decide on treatment/care when uncertain. The aim was to explore experiences of moral distress in the five added situations in the Swedish (...)
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