Related Experiment Video
Updated: Mar 26, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Moral distress within neonatal and paediatric intensive care units: a systematic review
Trisha Prentice1, Annie Janvier2, Lynn Gillam3
1Neonatal Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Insights
Moral distress impacts neonatal and pediatric intensive care. Studies show technology use and powerlessness are key issues, but more multidisciplinary research is needed.
Area of Science:
- Medical Ethics
- Pediatric Critical Care
- Neonatal Intensive Care
Background:
- Moral distress is a significant concern for healthcare professionals in high-acuity settings.
- Understanding the nuances of moral distress in neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) is crucial for patient care.
Purpose of the Study:
- To systematically review existing literature on moral distress experienced by nursing and medical staff in NICUs and PICUs.
- To identify common themes and differing perspectives on moral distress within these specialized pediatric units.
Main Methods:
- Comprehensive literature search of major databases (PubMed, EBSCO, Scopus).
- Inclusion criteria focused on studies published between 1985 and 2015 concerning moral distress in intensive care settings.
- Analysis of 13 selected studies, noting the predominance of nursing perspectives.
Main Results:
- Overly burdensome technology and perceived powerlessness were primary themes contributing to moral distress.
- Discrepancies exist in how moral distress is conceptualized in nursing versus medical literature.
- Multidisciplinary studies were few, with nursing staff responses dominating the findings.
Conclusions:
- Moral distress negatively affects patient care in NICUs and PICUs.
- Current empirical data are limited by sparse multidisciplinary representation, inconsistent definitions, and small sample sizes.
- Further longitudinal research incorporating all stakeholders, including parents, is essential.
Objective:
To review the literature on moral distress experienced by nursing and medical professionals within neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs).
Design:
Pubmed, EBSCO (Academic Search Complete, CINAHL and Medline) and Scopus were searched using the terms neonat*, infant*, pediatric*, prematur* or preterm AND (moral distress OR moral responsibility OR moral dilemma OR conscience OR ethical confrontation) AND intensive care.
Results:
13 studies on moral distress published between January 1985 and March 2015 met our inclusion criteria. Fewer than half of those studies (6) were multidisciplinary, with a predominance of nursing staff responses across all studies. The most common themes identified were overly 'burdensome' and disproportionate use of technology perceived not to be in a patient's best interest, and powerlessness to act. Concepts of moral distress are expressed differently within nursing and medical literature. In nursing literature, nurses are often portrayed as victims, with physicians seen as the perpetrators instigating 'aggressive care'. Within medical literature moral distress is described in terms of dilemmas or ethical confrontations.
Conclusions:
Moral distress affects the care of patients in the NICU and PICU. Empirical data on multidisciplinary populations remain sparse, with inconsistent definitions and predominantly small sample sizes limiting generalisability of studies. Longitudinal data reflecting the views of all stakeholders, including parents, are required.
More Related Videos
11:50Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit
Published on: January 7, 2020
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018