학술논문

Coping With Moral Distress in Oncology Practice: Nurse and Physician Strategies.
Document Type
Article
Source
Oncology Nursing Forum. Jul2016, Vol. 43 Issue 4, p505-512. 8p. 2 Charts.
Subject
*JOB stress prevention
*ONCOLOGY nursing
*ACADEMIC medical centers
*PSYCHOLOGICAL adaptation
*AUTONOMY (Psychology)
*ETHICS
*INTERVIEWING
*INTUITION
*RESEARCH methodology
*PSYCHOLOGY of physicians
*RESEARCH funding
*WORK environment
*QUALITATIVE research
*NARRATIVES
*THEMATIC analysis
*RETROSPECTIVE studies
*DATA analysis software
*MEDICAL coding
*WORK experience (Employment)
*PSYCHOLOGY
RESEARCH evaluation
Language
ISSN
0190-535X
Abstract
Purpose/Objectives: To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting. Research Approach: Qualitative interview study. Setting: Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium. Participants: 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. Methodologic Approach: Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis. Findings: Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes: a tendency to internalize or externalize moral distress, and a tendency to focus on rational or experiential elements. Each of the ways of coping had strengths and weaknesses. Doctors reported a mainly rational coping style, whereas nurses tended to focus on feelings and experiences. However, people appeared to change their ways of handling moral distress depending on personal or work-related experiences and perceived team culture. Prejudices were expressed about other professions. Conclusions: Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding. Interpretation: Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress. [ABSTRACT FROM AUTHOR]