Department of Critical Care Medicine, Dalhousie University, Queen Elizabeth II Hospital, 1276 South Park St., Halifax, NS, B3H 2Y9, Canada.
Department of Critical Care, Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Queen Elizabeth II Hospital, Halifax, NS, Canada.
Can J Anaesth. 2020 Nov;67(11):1541-1548. doi: 10.1007/s12630-020-01789-z. Epub 2020 Aug 26.
The purpose of this study was to explore personal and organizational factors that contribute to burnout and moral distress in a Canadian academic intensive care unit (ICU) healthcare team. Both of these issues have a significant impact on healthcare providers, their families, and the quality of patient care. These themes will be used to design interventions to build team resilience.
This is a qualitative study using focus groups to elicit a better understanding of stakeholder perspectives on burnout and moral distress in the ICU team environment. Thematic analysis of transcripts from focus groups with registered intensive care nurses (RNs), respiratory therapists (RTs), and physicians (MDs) considered causes of burnout and moral distress, its impact, coping strategies, as well as suggestions to build resilience.
Six focus groups, each with four to eight participants, were conducted. A total of 35 participants (six MDs, 21 RNs, and eight RTs) represented 43% of the MDs, 18.8% of the RNs, and 20.0% of the RTs. Themes were concordant between the professions and included: 1) organizational issues, 2) exposure to high-intensity situations, and 3) poor team experiences. Participants reported negative impacts on emotional and physical well-being, family dynamics, and patient care. Suggestions to build resilience were categorized into the three main themes: organizational issues, exposure to high intensity situations, and poor team experiences.
Intensive care unit team members described their experiences with moral distress and burnout, and suggested ways to build resilience in the workplace. Experiences and suggestions were similar between the interdisciplinary teams.
本研究旨在探讨导致加拿大学术性重症监护病房（ICU）医护团队产生倦怠和道德困境的个人和组织因素。这两个问题都会对医护人员、他们的家庭以及患者的护理质量产生重大影响。这些主题将被用于设计干预措施，以增强团队的适应力。
这是一项采用焦点小组的定性研究，旨在深入了解利益相关者对 ICU 团队环境中倦怠和道德困境的看法。对来自注册重症监护护士（RN）、呼吸治疗师（RT）和医生（MD）焦点小组的转录本进行主题分析，以了解倦怠和道德困境的原因、其影响、应对策略，以及增强适应力的建议。
共进行了六次焦点小组讨论，每次讨论有四到八名参与者。共有 35 名参与者（六名 MD、21 名 RN 和八名 RT）代表了 43%的 MD、18.8%的 RN 和 20.0%的 RT。主题在不同专业之间是一致的，包括：1）组织问题，2）暴露于高强度情况，3）团队体验不佳。参与者报告了对情绪和身体健康、家庭动态和患者护理产生的负面影响。增强适应力的建议被分为三个主要主题：组织问题、暴露于高强度情况和团队体验不佳。
重症监护病房团队成员描述了他们在道德困境和倦怠方面的经历，并提出了在工作场所增强适应力的方法。跨学科团队的经历和建议相似。
