Addressing Moral Distress: lessons Learnt from a Non-Interventional Longitudinal Study on Moral Distress

Area of Science:

• Medical Ethics
• Clinical Psychology
• Neonatal Care

Background:

• Moral distress is a significant issue for neonatal intensive care unit (NICU) clinicians, impacting their well-being.
• Existing research focuses on causes and mitigation strategies for moral distress, but not the effects of study participation.
• The impact of engaging in research on moral distress within the NICU setting remains unevaluated.

Purpose of the Study:

• To assess the effects of participating in a longitudinal research study on moral distress among NICU clinicians.
• To understand the perceived impact of research participation on clinicians' ethical awareness and communication.

Main Methods:

• A longitudinal, non-intervention research study involving clinicians in two NICUs over 18 months.
• Participants completed surveys on predictions of death, disability, and moral distress intensity.
• A questionnaire evaluated the impact of participation, with free-text responses analyzed using inductive content analysis.

Main Results:

• 53% of eligible clinicians participated; 58% perceived participation positively.
• Articulating views was therapeutic for 76% and clarified opinions for 85%.
• Research stimulated reflection, validated feelings, and increased dialogue, though moral distress levels remained unchanged.

Conclusions:

• Participation in moral distress research enhances ethical awareness and clarifies personal views on patient care.
• Research engagement improved communication and provider satisfaction but did not significantly reduce moral distress alone.
• Regular reflection on attitudes toward fragile patients is a key benefit, influencing patient care decisions.