Moral Distress and Intention to Leave Current Position Among Registered Dietitians: A Cross-Sectional Study

Moral distress has been widely studied across healthcare professions, but registered dietitians [RDs] remain underrepresented in this research. The aims of this study were to describe moral distress among RDs, explore differences across healthcare contexts and examine the association between moral distress and current intention to leave a position.

A cross-sectional study was conducted using a web-based survey among RDs working in primary and specialist care in Sweden. Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals (MMD-HP; total score range 0-432), including four dimensions: system level, patient level, team/staff-level and team/patient-level moral distress. Descriptive and regression analyses were employed to examine moral distress and its association with intention to leave the current position. The study was approved by the Swedish Ethical Review Authority (reference number 2023-03151-01 and amendment 2026-00124-02).

A total of 211 RDs were included. Participants reported a median total moral distress score of 71 (44-113). System-level moral distress showed the highest standardised scores among the four dimensions of the MMD-HP. No significant differences in total moral distress were observed between primary and specialist care. Higher levels of moral distress were associated with an increased likelihood of considering leaving the current position (OR = 1.016, 95% CI 1.008-1.023, p < 0.001).

The findings contribute to the limited literature on moral distress among RDs and suggest that moral distress may be relevant not only as an ethical issue but also in relation to turnover intention within dietetic practice.