Exploring moral distress in Australian midwifery practice.
Compromise
Ethics
Midwifery workforce
Moral
Moral distress
Workforce sustainability
Journal
Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
23
04
2021
revised:
11
07
2021
accepted:
06
09
2021
pubmed:
17
10
2021
medline:
15
6
2022
entrez:
16
10
2021
Statut:
ppublish
Résumé
Australian midwives are considering leaving the profession. Moral distress may be a contributing factor, yet there is limited research regarding the influence of moral distress on midwifery practice. Moral distress was first used to describe the psychological harm incurred following actions or inactions that oppose an individuals' moral values. Current research concerning moral distress in midwifery is varied and often focuses only on one aspect of practice. To explore Australian midwives experience and consequences of moral distress. Semi-structured interviews were used to understand the experiences of moral distress of 14 Australian midwives. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis and NVIVO12©. Three key themes were identified: experiencing moral compromise; experiencing moral constraints, dilemmas and uncertainties; and professional and personal consequences. Describing hierarchical and oppressive health services, midwives indicated they were unable to adequately advocate for themselves, their profession, and the women in their care. It is evident that some midwives experience significant and often ongoing moral compromise as a catalyst to moral distress. A difference in outcomes between early career midwives and those with more than five years experiences suggests the cumulative nature of moral distress is a significant concern. A possible trajectory across moral frustration, moral distress, and moral injury with repeated exposure to morally compromising situations could explain this finding. This study affirms the presence of moral distress in Australian midwives and identified the cumulative effect of moral compromise on the degree of moral distress experienced.
Sections du résumé
PROBLEM
OBJECTIVE
Australian midwives are considering leaving the profession. Moral distress may be a contributing factor, yet there is limited research regarding the influence of moral distress on midwifery practice.
BACKGROUND
BACKGROUND
Moral distress was first used to describe the psychological harm incurred following actions or inactions that oppose an individuals' moral values. Current research concerning moral distress in midwifery is varied and often focuses only on one aspect of practice.
AIM
OBJECTIVE
To explore Australian midwives experience and consequences of moral distress.
METHODS
METHODS
Semi-structured interviews were used to understand the experiences of moral distress of 14 Australian midwives. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis and NVIVO12©.
FINDINGS
RESULTS
Three key themes were identified: experiencing moral compromise; experiencing moral constraints, dilemmas and uncertainties; and professional and personal consequences. Describing hierarchical and oppressive health services, midwives indicated they were unable to adequately advocate for themselves, their profession, and the women in their care.
DISCUSSION
CONCLUSIONS
It is evident that some midwives experience significant and often ongoing moral compromise as a catalyst to moral distress. A difference in outcomes between early career midwives and those with more than five years experiences suggests the cumulative nature of moral distress is a significant concern. A possible trajectory across moral frustration, moral distress, and moral injury with repeated exposure to morally compromising situations could explain this finding.
CONCLUSION
CONCLUSIONS
This study affirms the presence of moral distress in Australian midwives and identified the cumulative effect of moral compromise on the degree of moral distress experienced.
Identifiants
pubmed: 34654667
pii: S1871-5192(21)00157-8
doi: 10.1016/j.wombi.2021.09.006
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
349-359Informations de copyright
Copyright © 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.