Moral distress in neuroscience nursing: an evolutionary concept analysis

Area of Science:

• Nursing
• Neuroscience Nursing
• Bioethics

Background:

• Moral distress is recognized across various nursing fields, including critical care and end-of-life care.
• The specific attributes and nuances of moral distress, particularly in neuroscience nursing, require further clarification.
• Existing research has explored antecedents and consequences, but the concept's unique characteristics remain ambiguous.

Purpose of the Study:

• To clarify the concept of moral distress within nursing, with a specific focus on neuroscience nursing.
• To contribute novel insights into moral distress to the broader nursing discipline and its subspecialties.
• To advance nursing knowledge and practice by defining the core attributes of moral distress in neuroscience.

Main Methods:

• A comprehensive literature search was conducted using CINAHL and Google Scholar for articles published between 1987 and 2009.
• Eleven journal articles were selected for the final analysis.
• Rodgers' evolutionary model of concept analysis was employed to examine the concept of moral distress.

Main Results:

• Four key attributes of moral distress in neuroscience nursing were identified: negative feelings, powerlessness, conflicting loyalties, and uncertainty.
• These attributes are interconnected and derive meaning from their context and the philosophical underpinnings of nursing.
• The analysis highlights the fluid, complex, and multifaceted nature of moral distress.

Conclusions:

• The identified attributes of moral distress provide a framework for understanding and validating the experiences of neuroscience nurses.
• Enhanced conceptual clarity of moral distress can improve recognition and management within the neuroscience nursing community.
• This study contributes to the advancement of nursing knowledge and practice concerning ethical challenges in specialized care settings.