Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review
DOI:
https://doi.org/10.5294/aqui.2019.19.1.3Palabras clave:
Angustia moral, enfermería oncológica, clima ético, problemas éticos, relaciones interprofesionalesResumen
Angustia moral, señal de problemas éticos en la práctica de enfermería oncológica: revisión de literatura
Angústia moral, sinal de problemas éticos na prática de enfermagem oncológica: revisão de literatura
Objetivo: describir los factores que influyen en el surgimiento de la angustia moral en enfermeras oncológicas. Metodología: revisión integradora de la literatura cuya búsqueda se realizó en las bases de datos Web of Science, CINAHL (EBSCO), Scielo, Proquest, Pubmed y PsycInfo, a partir del uso de las palabras clave moral distress y oncology nursing y sus símiles en español, sin restricción por años de publicación hasta 2017. Resultados: se clasificaron en tres grupos de factores, cada uno con subgrupos: 1) factores organizacionales: clima ético, cultura evasiva y los recursos para la ética que entrega la organización; 2) situaciones clínicas complejas: el manejo del dolor, la entrega de información, el tratamiento fútil, y la asistencia al paciente y su familia durante el proceso de muerte; 3) relaciones interpersonales: una comunicación deficiente, las relaciones de poder, la confianza en la competencia del equipo. Conclusión: los tres factores son desencadenantes de angustia moral en las enfermeras oncológicas. Cuando existen problemas éticos, y las enfermeras no participan del proceso de deliberación, estos pueden quedar ocultos y, así, disminuir la sensibilidad moral de los profesionales, así como la posibilidad de actuar como agentes morales. Es necesario explorar la relación entre la angustia moral y las implicancias en el cuidado del paciente.
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Vargas I, Concha CA. Moral Distress, Sign of Ethical Issues in the Practice of Oncology Nursing: Literature Review. Aquichan 2019; 19(1): e1913. DOI: 10.5294/aqui.2019.19.1.3
Received: 17/09/2018
Approved: 12/12/2018
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Jameton A. Nursing practice: The ethical issues. Englewood Cliffs: Prentice-Hall; 1984.
Kierkegaard S. El concepto de la angustia: una sencilla investigación psicológica orientada hacia el problema dogmático del pecado original. Madrid: Espasa-Calpe; 1967.
Barlem ELD, Ramos FRS. Constructing a theoretical model of moral distress. Nurs Ethics. 2015 Aug 22(5):608-615. DOI: 10.1177/0969733014551595
Lamiani G, Borghi L, Argentero P. When healthcare professionals cannot do the right thing: a systematic review of moral distress and its correlates. J Health Psychol. 2016 Jul. 10-2017 Jan 22(1):51-67. DOI: 10.1177/1359105315595120
Oh Y, Gastmans C. Moral distress experienced by nurses: a quantitative literature review. Nurs Ethics. 2015 Feb 22(1):15-31. DOI: 10.1177/0969733013502803
Woods M. Beyond moral distress: preserving the ethical integrity of nurses. Nurs Ethics. 2014 Mar 21(2):127-8. DOI: 10.1177/0969733013512741
Ganz FD, Wagner N, Toren O. Nurse middle manager ethical dilemmas and moral distress. Nurs Ethics. 2015 Feb 22(1):43-51. DOI: 10.1177/0969733013515490
McAndrew N, Laske J, Schroeter K. Moral distress in critical care nursing: the state of the science. Nurs Ethics. 2018 Sep 25(5): 552-570. DOI: 10.1177/0969733016664975
Mobley MJ, Rady MY, Verheijde JL, Patel B, Larson JS. The relationship between moral distress and perception of futile care in the critical care unit. Intensive Crit care Nurs. 2007; Oct 23(5):256-63. DOI: 10.1016/j.iccn.2007.03.011
Prentice T, Janvier A, Gillam L, Davis PG. Moral distress within neonatal and paediatric intensive care units: a systematic review. Arch Dis Child. 2016 Aug 101(8):701-8. DOI: 10.1136/archdischild-2015-309410
Johnstone M-J, Hutchinson A. “Moral distress”: time to abandon a flawed nursing construct? Nurs Ethics. 2015 Feb 22(1):5-14. DOI: 10.1177/0969733013505312
Rushton CH, Schoonover-Shoffner K, Shawn M. A Collaborative state of the science initiative : transforming moral distress. Am J Nurs. 2017 Feb 117(2):52-6. DOI: 10.1097/01.NAJ.0000512203.08844.1d
Morley G, Ives J, Bradbury-Jones C, Irvine F. What is “moral distress”? A narrative synthesis of the literature. Nurs Ethics. 2017 Oct 8;s.d.1-19. DOI: 10.1177/0969733017724354
McCarthy J, Gastmans C. Moral distress: a review of the argument-based nursing ethics literature. Nurs Ethics. 2015 Feb 22(1):131-52. DOI: 10.1177/0969733014557139
Tigard DW. Rethinking moral distress: conceptual demands for a troubling phenomenon affecting health care professionals. Med Heal Care Philos. 2017 Dec 15;21(4): 479-488. DOI: 10.1007/s11019-017-9819-5
Bartholdson C, af Sandeberg M, Lutzen K, Blomgren K, Pergert P. Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care. Nurs Ethics. 2016 Dec 23(8):877-88. DOI: 10.1177/0969733015587778
Cohen JS, Erickson JM. Ethical dilemmas and moral distress in oncology nursing practice. Clin J Oncol Nurs. 2006 Dec 10(6):775-82. DOI: 10.1188/06.CJON.775-780
Shepard A. Moral distress: a consequence of caring. Clin J Oncol Nurs. 2010 Feb 14(1):25-7. DOI: 10.1188/10.CJON.25-27
Boyle DA, Bush NJ. Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential. J Pediatr Nurs. 2018 May 40:63-73. DOI: 10.1016/j.pedn.2018.03.007
Cañadas-De la Fuente GA, Gómez-Urquiza JL, Ortega-Campos EM, Cañadas GR, Albendín-García L, De la Fuente-Solana EI. Prevalence of burnout syndrome in oncology nursing: A meta analytic study. Psychooncology. 2018 May 27(5):1426-1433. DOI: 10.1002/pon.4632
Neumann JL, Mau LW, Virani S, Denzen EM, Boyle DA, Boyle NJ. et al. Burnout, moral distress, work-life balance, and career satisfaction among hematopoietic cell transplantation professionals. Biol Blood Marrow Transplant. 2018 Apr 24(4):849-60. DOI: 10.1016/j.bbmt.2017.11.015
Luz KR da, Vargas MA de O, Schmidtt PH, Barlem ELD, Tomaschewski-Barlem JG, Rosa LM da. Ethical problems experienced by oncology nurses. Rev Latinoam Enferm. 2015 Nov-Dec 23(6):1187-94. DOI: 10.1590/0104-1169.0098.2665
Pavlish C, Brown-Saltzman K, Jakel P, Fine A. The nature of ethical conflicts and the meaning of moral community in oncology practice. Oncol Nurs Forum. 2014 Mar 1;41(2):130-40. DOI: 10.1188/14.ONF.130-140
Ganong LH. Integrative reviews of nursing research. Res Nurs Health. 1987 Feb 10(1):1-11. DOI: 10.1002/nur.4770100103
Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clin (Barc) [Internet]. 2010 Oct 9 [cited 2018 Dec. 21];135(11):507-11 Retrieved from: https://www.sciencedirect.com/science/article/pii/S0025775310001454?via%3Dihub
LeBaron V, Beck SL, Black F, Palat G. Nurse moral distress and cancer pain management an ethnography of oncology nurses in India. Cancer Nurs. 2014 Sep-Oct 37(5):331-44. DOI: 10.1097/NCC.0000000000000136
Lievrouw A, Vanheule S, Deveugele M, Vos M, Pattyn P, Belle V, et al. Coping with moral distress in oncology practice: nurse and physician strategies. Oncol Nurs Forum. 2016 Jul 1;43(4):505-12. DOI: 10.1188/16.ONF.505-512
Pavlish C, Brown-Saltzman K, Jakel P, Rounkle A-M. Nurses’ responses to ethical challenges. Clin J Oncol Nurs. 2012 Dec 16(6):592-600. DOI: 10.1188/12.CJON.592-600
Pavlish C, Brown-Saltzman K, Fine A, Jakel P. A culture of avoidance: voices from inside ethically difficult clinical situations. Clin J Oncol Nurs. 2015 Apr 19(2):159-65. DOI: 10.1188/15.CJON.19-02AP
Pye K. Exploring moral distress in pediatric oncology: a sample of registered practitioners. Issues Compr Pediatr Nurs. 2013 Dec 36(4):248-61. DOI: 10.3109/01460862.2013.812693
Ameri M, Safavibayatneed Z, Kavousi A. Moral distress of oncology nurses and morally distressing situations in oncology units. Aust J Adv Nurs. 2016 May 33(3):6-11. Available in: http://www.ajan.com.au/Vol33/Issue3/1Ameri.pdf
Bohnenkamp S, Pelton N, Reed P, Rishel C. An Inpatient Surgical Oncology Unit’s Experience with Moral Distress: Part I. Oncol Nurs Forum. 2015 May 42(3):308-10. DOI: 10.1188/15.ONF.308-310
Lazzarin M, Biondi A, Di Mauro S. Moral distress in nurses in oncology and haematology units. Nurs Ethics. 2012 Mar 19(2):183-95. DOI: 10.1177/0969733011416840
Maningo-Salinas MJ, Keefer A, Bundy RV, Tiffin C. Relationship between moral distress, perceived organizational support and intent to turnover among oncology nurses. Capella University; 2010.
Sirilla J. Moral distress in nurses providing direct care on inpatient oncology units. Clin J Oncol Nurs. 2014 Oct 18(5):536-41. DOI: 10.1188/14.CJON.536-541
Jodoin C, Molina E, Filipon K. Alleviating moral distress: a journey to create the most supportive environment. In: Mairead Hickey, Phyllis Beck Kritek, editores. Change leadership in nursing: how change occurs in a complex hospital system. New York: Springer publishing company; 2012. p. 172-4.
Pelton N, Bohnenkamp S, Reed PG, Rishel C. An inpatient surgical oncology unit’s experience with moral distress: part II. Oncol Nurs Forum. 2015 Jul 42(4):412-4. DOI: 10.1188/15.ONF.412-414
Kim K, Han Y, Kim J. Korean nurses’ ethical dilemmas, professional values and professional quality of life. Nurs Ethics. 2015 Jun 22(4):467-78. DOI: 10.1177/0969733014538892
Bartholdson C, Lützén K, Blomgren K, Pergert P. Experiences of ethical issues when caring for children with cancer. Cancer Nurs. 2015 Mar-Apr 38(2):125-32. DOI: 10.1097/NCC.0000000000000130
Carnevale F. Confronting moral distress in Nursing recognizing nurses as moral agents. Rev Bras Enferm. 2013; Sep 66 Spec:33-8. DOI: 10.1590/S0034-71672013000700004
Robaee N, Atashzadeh-Shoorideh F, Ashktorab T, Baghestani A, Barkhordari-Sharifabad M. Perceived organizational support and moral distress among nurses. BMC Nurs. 2018 Jan 10;17(2):1-7. DOI: 10.1186/s12912-017-0270-y
Haghighinezhad G, Atashzadeh-shoorideh F. Relationship between perceived organizational justice and moral distress in intensive care unit nurses. Nurs Ethics. 2017 Jan 1-11. DOI: 10.1177/0969733017712082
Burston AS, Tuckett AG. Moral distress in nursing: contributing factors, outcomes and interventions. Nurs Ethics. 2012 Dec 28-2013 May 20(3):312-24. DOI: 10.1177/0969733012462049
Ferrell BR. Understanding the Moral Distress of Nurses Witnessing Medically Futile Care. Oncol Nurs Forum [Internet]. 2006 Sep 1;33(5):922–30. Retrieved from: http://onf.ons.org/onf/33/5/understanding-moral-distress-nurses-witnessing-medically-futile-care
Coombs M. Concerns about care and communication are key causes of moral distress in intensive care staff. Aust Crit Care. 2017 Mar 30(2):107-8. DOI: 10.1016/j.aucc.2017.01.007
Hiler CA, Hickman RL Jr, Reimer AP, Wilson K. Predictor of moral distress in a US sample of critical nurses. Am J Crit Care. 2018 Jan 27(1):59-66. DOI: 10.4037/ajcc2018968
Choe K, Kim Y, Yang Y. Pediatric nurses’ ethical difficulties in the bedside care of children. Nurs Ethics. 2017 Jan 1-12. DOI: 10.1177/0969733017708330
Wolf LA, Perhats C, Delao AM, Moon MD, Clark PR, Zavotsky KE, et al. “It’s a burden you carry”: describing moral distress in emergency nursing. J Emerg Nurs. 2016 Jan 42(1):37-46. DOI: 10.1016/j.jen.2015.08.008
Pavlish C. Barriers to innovation: nurses’ risk appraisal in using a new ethics screening and early intervention tool. Adv Nurs Sci. 2013 Oct-Dec 36(4):304-19. DOI: 10.1097/ANS.0000000000000004
Musto LC, Rodney PA, Vanderheide R. Toward interventions to address moral distress: navigating structure and agency. Nurs Ethics. 2015 Feb 22(1):91-102. DOI: 10.1177/0969733014534879
Lachman VD. Moral resilience: managing and preventing moral distress and moral residue a case of moral injury and moral distress. Nursing, Med Surg. 2016 Mar-Apr 25(2):121-4. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/27323473
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