High prevalence of moral distress reported by oncologists and oncology nurses in end-of-life decision making

Psycho-oncology
Katja MehlisEva C Winkler

Abstract

Decisions to limit life-prolonging treatment (DLT) are often accompanied by psychological and ethical difficulties. The aim of the study is to investigate prevalence and intensity of moral distress (MD) as well as potential causes experienced by oncology physicians and nurses in DLT situations. This prospective study at a German university hospital included n = 100 advanced cancer inpatients with DLT. We surveyed their respective physicians and nurses to assess MD in DLT using an adapted distress thermometer and an open-ended question to specify reasons of MD. We also collected data on the decision-making process from the perspective of the clinicians. Physicians report MD in 67% (n = 51) and nurses in 74% (n = 67) of the cases. The MD level in nurses (mean 2.3; SD 2.3) is significantly higher (P = .005) than in physicians (mean 1.5; SD 1.4). Uncertainties concerning ethical aspects in DLT in a patient case are associated with MD in both physicians (P = .024) and nurses (P = .004). Involvement of nurses in DLT is the strongest predictor (P = .000) for MD as indicated by physicians. Nurses experience MD especially, if the patient has a low quality of life (P = .001). Moral distress is experienced by both oncologists and nurses i...Continue Reading

References

Jan 1, 1984·Social Science & Medicine·P Atkinson
Apr 12, 2001·Journal of Advanced Nursing·K Oberle, D Hughes
Mar 21, 2002·The Lancet Oncology·M Cullen
Apr 17, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Walter F BaileLorenzo Cohen
Nov 1, 2005·Dimensions of Critical Care Nursing : DCCN·Karen M Gutierrez
Mar 11, 2006·Nursing Ethics·Kim LützénAstrid Norberg
Sep 7, 2006·Oncology Nursing Forum·Betty R Ferrell
Feb 13, 2007·Journal of Advanced Nursing·A L GlasbergA Norberg
Apr 17, 2007·Health Policy·Joke LemiengreChris Gastmans
Mar 13, 2012·Critical Care Nursing Clinics of North America·Dolores M Huffman, Leslie Rittenmeyer
Apr 6, 2012·HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues·Ann B Hamric
Apr 25, 2012·HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues·Colleen VarcoeJanet Storch
May 23, 2012·Journal of Advanced Nursing·Lucia D Wocial, Michael T Weaver
Jan 3, 2013·JAMA : the Journal of the American Medical Association·Victor R Fuchs
Oct 5, 2013·Nursing Ethics·Younjae Oh, Chris Gastmans
Jun 5, 2014·Dimensions of Critical Care Nursing : DCCN·Jeanie SauerlandCatherine Robichaux
Sep 26, 2014·Clinical Journal of Oncology Nursing·Janet Sirilla
Dec 3, 2014·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Phyllis B WhiteheadJoan M Fisher
Jun 18, 2016·Oncology Nursing Forum·An LievrouwDominique D Benoit

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Citations

Jun 12, 2020·AACN Advanced Critical Care·Elizabeth G EpsteinMary Faith Marshall
Aug 14, 2020·Journal of Palliative Medicine·Tessie W OctoberRobert M Arnold
Jun 23, 2020·Psycho-oncology·Alys Wyn GriffithsClaire Surr
Jul 30, 2020·Journal of Palliative Medicine·Rose-Lima Van KeerJohan Bilsen
Feb 24, 2021·International Journal of Nursing Studies·J M MaaskantUNKNOWN FAM-Corona Group
May 4, 2021·Journal of Health Psychology·Alexandra KherbacheYvonne Denier
Jul 17, 2021·Clinical Journal of Oncology Nursing·Colleen McCrackenKatie Klink
Jul 13, 2021·Australian Journal of Primary Health·Diana GuzysCarey Mather

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