Potential sources of moral distress during COVID-19: Perspectives of hospice interdisciplinary teams.
Potential sources of moral distress during COVID-19: Perspectives of hospice interdisciplinary teams.
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COVID-19 期间道德困扰的潜在来源：临终关怀跨学科团队的观点。
DOI：
10.1017/s1478951522000633
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发表时间：
2023
影响因子：
2.2
通讯作者：
Brody,AbrahamA
中科院分区：
文献类型：
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作者：
Jones,Tessa;Lin,Shih-Yin;Durga,Aditi;Luth,ElizabethA;Lassell,RebeccaKF;Brody,AbrahamA
本研究旨在探讨COVID-19对临终关怀跨学科团队（IDT）成员自我报告的压力的影响，并确定道德困扰的可能来源。MethodsA横断面调查使用Qualtrics进行，以了解COVID-19对质量改进倡议实施和临终关怀IDT成员的一般和痴呆症特定护理提供的影响。定向定性内容分析被用来分析临终关怀IDT成员的反应，从五个开放式的调查问题，表明压力和可能的道德distress.ResultsThe最后的样本包括101个独特的受访者和175评论分析。根据临终关怀IDT成员的调查答复，确定了与道德困扰来源相关的三个类别：（1）远程医疗、个人防护设备（PPE）和访问限制对关系的影响;（2）缺乏COVID-19特定技能;（3）组织氛围。结果的重要性本研究是首次记录和证实COVID-19期间临终关怀IDT成员潜在压力和道德困扰的证据之一。考虑到可能对患者护理和临床医生福祉产生的负面影响，未来的研究和干预措施必须纳入支持临床医生情感和道德协调的机制，并支持组织积极参与解决限制性环境（如COVID-19所必需的环境）导致的临床医生道德困扰的实践。
ObjectiveThis study aimed to examine the impact of COVID-19 on hospice Interdisciplinary team (IDT) members’ self-reported stress and identify possible sources of moral distress.MethodsA cross-sectional survey was conducted using Qualtrics to understand the impact of COVID-19 on quality improvement initiative implementation and hospice IDT members’ general and dementia-specific care provision. Directed qualitative content analysis was used to analyze hospice IDT members’ responses from five open-ended survey questions that were indicative of stress and possible moral distress.ResultsThe final sample consisted of 101 unique respondents and 175 comments analyzed. Three categories related to sources of moral distress based on hospice IDT member survey responses were identified: (1) impact of telehealth, personal protective equipment (PPE), and visit restrictions on relationships; (2) lack of COVID-19-specific skills; and (3) organizational climate. Sources of moral distress were categorized in 40% of all responses analyzed.Significance of resultsThis study is one of the first to document and confirm evidence of potential stress and moral distress amongst hospice IDT members during COVID-19. It is imperative given the possible negative impact on patient care and clinician well-being, that future research and interventions incorporate mechanisms to support clinicians’ emotional and ethical attunement and support organizations to actively engage in practices that address clinician moral distress resulting from restrictive environments, such as the one necessitated by COVID-19.