"I feel like I'm walking on eggshells": a qualitative study of moral distress among Chinese emergency doctors.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088680 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6939 (Electronic) Linking ISSN: 14726939 NLM ISO Abbreviation: BMC Med Ethics Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Qualitative Research* ; Physicians*/psychology ; Physicians*/ethics ; Morals* ; Emergency Service, Hospital*/ethics; Humans ; China ; Female ; Male ; Adult ; Attitude of Health Personnel ; Stress, Psychological/etiology ; Communication ; Physician-Patient Relations/ethics ; Middle Aged ; East Asian People

Background: While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency department, even leading to a reduction in human resources.
Aim: This study explored the experience of moral distress among emergency department doctors and analyzed the causes of its occurrence and the strategies for addressing it.
Method: Purposive and snowball sampling strategies were used in this study. Data were collected through in-depth, semi-structured interviews with 10 doctors working in the emergency department of a tertiary general hospital in southwest China. The interview data underwent processing using the Nvivo 14 software. The data analysis was guided by Colaizzi's phenomenological analysis method.
Study Findings: This study yielded five themes: (1) imbalance between Limited Medical Resources and High-Quality Treatment Needs; (2) Ineffective Communication with Patients; (3) Rescuing Patients With no prospect of treatment; (4) Challenges in Sustaining Optimal Treatment Measures; and (5) Strategies for Addressing Moral Distress.
Conclusion: The moral distress faced by emergency doctors stems from various aspects. Clinical management and policymakers can alleviate this distress by enhancing the dissemination of emergency medical knowledge to the general public, improving the social and economic support systems, and strengthening multidisciplinary collaboration and doctors' communication skills.
(© 2024. The Author(s).)

Front Public Health. 2022 Feb 07;10:793619. (PMID: 35198522)
BMC Med Ethics. 2022 Aug 12;23(1):80. (PMID: 35962434)
World J Emerg Med. 2021;12(1):5-11. (PMID: 33505543)
J Nurs Scholarsh. 2020 Mar;52(2):201-209. (PMID: 31837105)
Front Public Health. 2019 Sep 12;7:267. (PMID: 31572707)
Am J Emerg Med. 2019 Apr;37(4):744-745. (PMID: 30527916)
JAMA. 2013 Nov 27;310(20):2191-4. (PMID: 24141714)
J Crit Care. 2019 Oct;53:258-263. (PMID: 31301641)
Global Health. 2021 Mar 29;17(1):36. (PMID: 33781274)
Appl Nurs Res. 2006 Feb;19(1):38-42. (PMID: 16455440)
Int J Emerg Med. 2015 Dec;8(1):48. (PMID: 26667242)
BMC Med Ethics. 2024 Jan 3;25(1):2. (PMID: 38172849)
Soc Sci Med. 2004 Mar;58(6):1075-84. (PMID: 14723903)
BMC Health Serv Res. 2023 Nov 20;23(1):1279. (PMID: 37986078)
J Bioeth Inq. 2020 Sep;17(3):337-344. (PMID: 32394322)
J Clin Nurs. 2019 Sep;28(17-18):3210-3221. (PMID: 31017337)
Nurs Ethics. 2013 May;20(3):312-24. (PMID: 23275458)
Emerg Med Australas. 2018 Dec;30(6):740-742. (PMID: 30456792)
PLoS One. 2020 May 5;15(5):e0232076. (PMID: 32369511)
Oncol Nurs Forum. 2014 Jan 1;41(1):89-91. (PMID: 24368242)
Soc Sci Med. 2022 Jan;292:114523. (PMID: 34785096)
Bull World Health Organ. 2006 Oct;84(10):835-9. (PMID: 17128364)
Front Public Health. 2022 Jul 25;10:936861. (PMID: 35958859)
BMC Nurs. 2019 Feb 11;18:4. (PMID: 30792611)
Emerg Med J. 2015 Apr;32(4):263-8. (PMID: 25234290)
Int J Nurs Sci. 2022 Mar 09;9(2):230-235. (PMID: 35509693)
Heart. 2020 Oct;106(20):1586-1594. (PMID: 32371401)
Int J Nurs Stud. 2022 Nov;135:104343. (PMID: 36029550)
J Med Ethics. 2016 May;42(5):321-4. (PMID: 26969723)
J Med Philos. 2004 Apr;29(2):149-78. (PMID: 15371185)
J Med Ethics. 2020 Jul 28;:. (PMID: 32723760)
Cancer Manag Res. 2018 Jul 23;10:2173-2181. (PMID: 30087577)
BMJ Open. 2018 Aug 17;8(8):e022455. (PMID: 30121612)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
Qual Health Res. 2017 Mar;27(4):591-608. (PMID: 27670770)
J Adv Nurs. 2015 Sep;71(9):1973-85. (PMID: 25731727)
Gen Hosp Psychiatry. 2021 Nov-Dec;73:78-83. (PMID: 34687946)
J Glob Health. 2022 Feb 05;12:04005. (PMID: 35136597)
J Med Internet Res. 2018 Aug 09;20(8):e249. (PMID: 30093370)
J Med Philos. 2010 Oct;35(5):573-86. (PMID: 20855426)
Aust Fam Physician. 2005 May;34(5):389-92. (PMID: 15887946)
Dimens Crit Care Nurs. 2011 Nov-Dec;30(6):339-45. (PMID: 21983510)
BJPsych Open. 2021 Jul 19;7(4):e135. (PMID: 36043686)
Medwave. 2020 Apr 30;20(3):e7887. (PMID: 32428925)
Int J Qual Stud Health Well-being. 2024 Dec;19(1):2300151. (PMID: 38258523)
West J Nurs Res. 2021 May;43(5):442-451. (PMID: 32909515)
PLoS Med. 2020 May 15;17(5):e1003114. (PMID: 32413025)
Spartan Med Res J. 2018 Apr 27;3(1):6782. (PMID: 33655135)
Ann Fam Med. 2019 Jan;17(1):36-41. (PMID: 30670393)

2023GJZKP001 Clinical Key Speciality Construction Project Funding of Sichuan Province; SMUSS202219 Social Science Federation Project of Southwest Medical University

Keywords: Doctors; Emergency Department; Moral Distress; Qualitative research

Date Created: 20240620 Date Completed: 20240621 Latest Revision: 20240623

20240623

PMC11188161

10.1186/s12910-024-01074-4

38902648