A national survey of moral distress in paediatric intensive care practitioners

Abstract

Aims & Objectives: To measure moral distress in pediatric intensive care unit (PICU) health practitioners and its relationship with demographic factors, burnout and meaning in work. Methods Building on a pilot study, a survey of health practitioners was conducted in PICUs in Australia and New Zealand. The main outcome was moral distress, measured with the Revised Moral Distress Scale (MDS-R) (range 0-336). Secondary outcomes were depersonalisation measured with the Maslach Burnout Inventory sub-scale (range 0-30) and meaning in work measured using questions from the Work and Meaning Inventory (range 0-30). Results All PICUs in Australia and New Zealand participated (n=8). 673(95%) responses were analysable. The response rate was 60%. Respondents were nurses (RN, n=526, 78%), physicians (MD, n=112, 17%) and allied health (AH, n=34, 5%). Most respondents were female (83%), under 40 (62%) and full-time (65%). The median MDS-R score was 68(42-95), and 46% of respondents reported significant work-related moral distress. MDS-R scores differed by profession: RN 72.5(46-102), MD 59.5(36-76), AH 31(13-64) (p<0.001); by employment: full-time 70(44-99), part-time 65.5 (38.5-90) (p<0.001); and by sex: female 70(44-99), male 57.5(36-75.5) (p<0.001) which remained significant after adjusting for profession (p<0.001). Moral distress did not differ between trainees and non-trainees. The median depersonalisation score was 4(2-8). Those with high depersonalisation (n=135, 20%) had higher MDS-R scores 90(64-126) versus 63(39-88). The median meaning in work score was 24(21-28.5), and those in the lowest tertile had higher MDS-R scores 74(48-101) versus 64(39-92). Conclusions In this national survey of PICU practitioners, moral distress differed based on profession, sex, and those working full-time versus not.L6238163062018-09-13 <br />