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Measuring moral distress in pharmacy and clinical practice
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2006 (English)In: Nursing Ethics, ISSN 0969-7330, Vol. 13, no 4, 416-427 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2006. Vol. 13, no 4, 416-427 p.
Identifiers
URN: urn:nbn:se:uu:diva-95454OAI: oai:DiVA.org:uu-95454DiVA: diva2:169665
Available from: 2007-02-16 Created: 2007-02-16 Last updated: 2010-01-21Bibliographically approved
In thesis
1. Ethical Competence and Moral Distress in the Health Care Sector: A Prospective Evaluation of Ethics Rounds
Open this publication in new window or tab >>Ethical Competence and Moral Distress in the Health Care Sector: A Prospective Evaluation of Ethics Rounds
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities.

Ethics rounds are a widespread systematic method hypothesized to improve ethical competence, nurture a reflective climate, and help in ethical decision-making. Despite its popularity, its effects on moral distress have hitherto never been evaluated in a controlled study.

The purpose of this thesis was to evaluate the impact of an intervention, including ethics rounds; the hypothesis being that the intervention would decrease perceived moral distress. An additional aim was exploring the concept of moral distress in various health care establishments, including pharmacies.

Focus groups were conducted to explore the concept of moral distress. To evaluate the intervention a scale assessing staff-perceived moral distress was designed, validated, and implemented.

Results showed that moral distress is evident in diverse health care settings. Some factors associated with this were lack of resources, conflicts of interest, and rules that are incompatible with practice. An expanded definition of moral distress was presented.

The training program was much appreciated by participants. However, no significant effects on perceived moral distress were found. Reasons could be that the intervention was too short or otherwise ineffective, there is no association between ethical competence and moral distress, the assessment scale was not sensitive enough, or management was not sufficiently involved.

There is a need to further refine the various aspects of ethical dilemmas in clinical settings, and to evaluate the most efficient means to enhance skills for dealing with ethical dilemmas, for the benefit of staff, patients, institutions, and society.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 67 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 224
Keyword
Social medicine, Moral distress, Ethics rounds, Ethical competence, Professional ethics, Clinical practice, Pharmacy practice, Work organization, Sweden, Socialmedicin
Identifiers
urn:nbn:se:uu:diva-7493 (URN)978-91-554-6797-5 (ISBN)
Public defence
2007-03-09, Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2007-02-16 Created: 2007-02-16 Last updated: 2013-09-25Bibliographically approved

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Höglund, Anna T

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