Evaluation of Interventions to Address Moral Distress: A Multi-method Approach

Area of Science:

• Healthcare Ethics
• Nursing Research
• Psychological Well-being

Background:

• Moral distress is a significant issue for healthcare providers (HCPs).
• Understanding the impact of interventions on moral distress is crucial for improving HCP well-being and work environments.
• Previous research highlights the need for effective strategies to address moral distress.

Purpose of the Study:

• To measure and describe the impact of a two-phased intervention on healthcare providers' moral distress.
• To determine if the intervention could decrease moral distress, enhance moral agency, and improve perceptions of the work environment.
• To explore participants' perceptions of the intervention's effectiveness using qualitative methods.

Main Methods:

• A cross-over design was employed with quantitative instruments and semi-structured interviews.
• Participants included nurses and other clinical care providers from inpatient settings in a large urban healthcare system.
• Generalized linear mixed modeling was used for quantitative analysis, and thematic analysis for qualitative data.

Main Results:

• Quantitative outcome measures trended in the desired direction but did not reach statistical significance.
• Qualitative interviews indicated that intervention effectiveness stemmed from learning benefits, psychological support, and community building.
• A clear link between moral distress and moral agency was demonstrated.

Conclusions:

• Facilitated Ethics Conversations show potential for enhancing the work environment and promoting moral agency.
• Qualitative findings suggest that interventions can be effective through multifaceted benefits beyond statistical significance.
• The study provides insights for developing evidence-based approaches to mitigate moral distress in hospital nurses.