Addo Bright, Amoah Hannah A, Eshun Sophia A, Ocran Hannah N
Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Nursing and Midwifery, University for Development Studies, Tamale, Ghana.
Eur J Midwifery. 2020 Jun 1;4:24. doi: 10.18332/ejm/120117. eCollection 2020.
The existing literature on moral distress is replete with studies conducted among nurses. That on midwives is however lacking. The aim of this study was to explore and understand moral distress from the perspective of and as experienced by midwives.
This study involved an exploratory and qualitative case study design and adopted the interpretative phenomenological approach to collect data from 8 Ghanaian female midwives working in the labour ward of a public Hospital in Sunyani, Ghana, using individual in-depth interviews. The data obtained through audio-taped recordings were transcribed verbatim and analysed, adopting Colaizzi's qualitative analysis procedure.
Three major themes were generated: perceived knowledge about moral distress, perceived causes of moral distress, and perceived effects of moral distress. The midwives perceived moral distress as stress arising from situations where they knew the right thing to be done or how to save a life but due to reasons such as resource constraints and disrespect from their colleagues and superiors, they were unable to do so. Moral distress often impacted negatively on midwives work performance and psycho-emotional wellbeing. Effects that manifested in the form of problems such as stomach sickness, sleepless nights, frustration, and anger, were mentioned.
Efforts aimed at providing adequate logistics and resources, as well as improving communication, healthy interactions and interpersonal relationships among midwives and their colleagues should be intensified.
现有关于道德困扰的文献充斥着在护士中开展的研究。然而，关于助产士的此类研究却很匮乏。本研究的目的是从助产士的角度并基于她们的经历来探索和理解道德困扰。
本研究采用探索性定性案例研究设计，采用解释现象学方法，通过个人深度访谈，从加纳苏尼亚尼一家公立医院产房工作的8名加纳女性助产士那里收集数据。通过录音获得的数据逐字转录并进行分析，采用科莱齐的定性分析程序。
产生了三个主要主题：对道德困扰的认知、道德困扰的感知原因以及道德困扰的感知影响。助产士将道德困扰视为一种压力，这种压力源于她们知道正确的做法或如何挽救生命，但由于资源限制以及同事和上级的不尊重等原因，她们无法做到。道德困扰常常对助产士的工作表现和心理情绪健康产生负面影响。提到了以胃部不适、失眠、沮丧和愤怒等问题形式表现出来的影响。
应加大力度提供充足的后勤保障和资源，以及改善助产士与其同事之间的沟通、健康互动和人际关系。
