Moral distress and its contribution to the development of burnout syndrome among critical care providers

Abstract Background Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obli...

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Main Authors: Renata Rego Lins Fumis, Gustavo Adolpho Junqueira Amarante, Andréia de Fátima Nascimento, José Mauro Vieira Junior
Format: Article
Language:English
Published: SpringerOpen 2017-06-01
Series:Annals of Intensive Care
Online Access:http://link.springer.com/article/10.1186/s13613-017-0293-2
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author Renata Rego Lins Fumis
Gustavo Adolpho Junqueira Amarante
Andréia de Fátima Nascimento
José Mauro Vieira Junior
author_facet Renata Rego Lins Fumis
Gustavo Adolpho Junqueira Amarante
Andréia de Fátima Nascimento
José Mauro Vieira Junior
author_sort Renata Rego Lins Fumis
collection DOAJ
description Abstract Background Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists). Methods A survey was conducted from August to September 2015. For data collection, a self-administered questionnaire for each critical care provider was used including basic demographic data, the Maslach Burnout Inventory (MBI) and the Moral Distress Scale-Revised (MDS-R). Correlation analysis between MBI domains and moral distress score and regression analysis to assess independent variables associated with burnout were performed. Results A total of 283 out of 389 (72.7%) critical care providers agreed to participate. The same team of physicians attended both ICU and SDU, and severe burnout was identified in 18.2% of them. Considering all others critical care providers of both units, we identified that overall 23.1% (95% CI 18.0–28.8%) presented severe burnout, and it did not differ between professional categories. The mean MDS-R rate for all ICU and SDU respondents was 111.5 and 104.5, respectively, p = 0.446. Many questions from MDS-R questionnaire were significantly associated with burnout, and those respondents with high MDS-R score (>100 points) were more likely to suffer from burnout (28.9 vs 14.4%, p = 0.010). After regression analysis, moral distress was independently associated with burnout (OR 2.4, CI 1.19–4.82, p = 0.014). Conclusions Moral distress, resulting from therapeutic obstinacy and the provision of futile care, is an important issue among critical care providers’ team, and it was significantly associated with severe burnout.
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spelling doaj.art-74d780cabd4c4bc29bd850b0463494ac2022-12-21T19:53:19ZengSpringerOpenAnnals of Intensive Care2110-58202017-06-01711810.1186/s13613-017-0293-2Moral distress and its contribution to the development of burnout syndrome among critical care providersRenata Rego Lins Fumis0Gustavo Adolpho Junqueira Amarante1Andréia de Fátima Nascimento2José Mauro Vieira Junior3Intensive Care Unit, Hospital Sírio-LibanêsIntensive Care Unit, Hospital Sírio-LibanêsDepartment of Public Health, Faculdade de Ciências Médicas, Santa Casa de São PauloIntensive Care Unit, Hospital Sírio-LibanêsAbstract Background Burnout appears to be common among critical care providers. It is characterized by three components: emotional exhaustion, depersonalization and personal accomplishment. Moral distress is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. We aimed to estimate the correlation between moral distress and burnout among all intensive care unit (ICU) and the step-down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists). Methods A survey was conducted from August to September 2015. For data collection, a self-administered questionnaire for each critical care provider was used including basic demographic data, the Maslach Burnout Inventory (MBI) and the Moral Distress Scale-Revised (MDS-R). Correlation analysis between MBI domains and moral distress score and regression analysis to assess independent variables associated with burnout were performed. Results A total of 283 out of 389 (72.7%) critical care providers agreed to participate. The same team of physicians attended both ICU and SDU, and severe burnout was identified in 18.2% of them. Considering all others critical care providers of both units, we identified that overall 23.1% (95% CI 18.0–28.8%) presented severe burnout, and it did not differ between professional categories. The mean MDS-R rate for all ICU and SDU respondents was 111.5 and 104.5, respectively, p = 0.446. Many questions from MDS-R questionnaire were significantly associated with burnout, and those respondents with high MDS-R score (>100 points) were more likely to suffer from burnout (28.9 vs 14.4%, p = 0.010). After regression analysis, moral distress was independently associated with burnout (OR 2.4, CI 1.19–4.82, p = 0.014). Conclusions Moral distress, resulting from therapeutic obstinacy and the provision of futile care, is an important issue among critical care providers’ team, and it was significantly associated with severe burnout.http://link.springer.com/article/10.1186/s13613-017-0293-2
spellingShingle Renata Rego Lins Fumis
Gustavo Adolpho Junqueira Amarante
Andréia de Fátima Nascimento
José Mauro Vieira Junior
Moral distress and its contribution to the development of burnout syndrome among critical care providers
Annals of Intensive Care
title Moral distress and its contribution to the development of burnout syndrome among critical care providers
title_full Moral distress and its contribution to the development of burnout syndrome among critical care providers
title_fullStr Moral distress and its contribution to the development of burnout syndrome among critical care providers
title_full_unstemmed Moral distress and its contribution to the development of burnout syndrome among critical care providers
title_short Moral distress and its contribution to the development of burnout syndrome among critical care providers
title_sort moral distress and its contribution to the development of burnout syndrome among critical care providers
url http://link.springer.com/article/10.1186/s13613-017-0293-2
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