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道德困扰的性别与种族经历:一项范围综述

Gendered and racial experiences of moral distress: A scoping review.

作者信息

Mũrage Alice, Morgan Rosemary, Samji Hasina, Smith Julia

机构信息

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.

Pacific Institute on Pathogens, Pandemics, and Society, Burnaby, British Columbia, Canada.

出版信息

J Adv Nurs. 2024 Apr;80(4):1283-1298. doi: 10.1111/jan.15901. Epub 2023 Oct 17.

Abstract

AIM

To inform efforts to integrate gender and race into moral distress research, the review investigates if and how gender and racial analyses have been incorporated in such research.

DESIGN

Scoping review.

METHODS

The PRISMA (Preferred Reporting Items for Systematic and Meta-Analysis) Extension for Scoping Reviews was adopted.

DATA SOURCES

Systematic literature search was conducted through PubMed, CINAHL and Web of Science databases. Boolean operators were used to identify moral distress literature which included gender and/or race data and published between 2012 and 2022.

RESULTS

After screening and full-text review, 73 articles reporting on original moral distress research were included. Analysis was conducted on how gender and race were incorporated in research and interpretation of moral distress experiences among healthcare professionals.

IMPACT

This study found that while there is an upward trend in including gender and race-disaggregated data in moral distress research, over half of such research did not conduct in-depth analysis of such data. Others only highlighted differential experiences such as moral distress levels of women vis-à-vis men. Only about 20% of publications interrogated how experiences of moral distress differed and/or explored factors behind their findings.

CONCLUSION

There is a need to not only collect disaggregated data in moral distress research but also engage this data through gender and race-based analysis. Particularly, we highlight the need for intersectional analysis, which can elucidate how social identities and categories (such as gender and race) and structural inequalities (such as those sustained by sexism and racism) interact to influence moral experiences.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Moral distress as experienced by healthcare professionals is increasingly recognized as an important area of research with significant policy implications in the healthcare sector. This study offers insights for nuanced and targeted policy approaches.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

为将性别和种族纳入道德困扰研究的工作提供信息,本综述调查了性别和种族分析是否以及如何被纳入此类研究。

设计

范围综述。

方法

采用系统综述和Meta分析的首选报告项目(PRISMA)扩展版进行范围综述。

数据来源

通过PubMed、CINAHL和科学网数据库进行系统文献检索。使用布尔运算符识别2012年至2022年期间发表的包含性别和/或种族数据的道德困扰文献。

结果

经过筛选和全文审查,纳入了73篇报告原创道德困扰研究的文章。对性别和种族如何纳入医疗保健专业人员道德困扰经历的研究和解释进行了分析。

影响

本研究发现,虽然在道德困扰研究中纳入按性别和种族分类的数据呈上升趋势,但超过一半的此类研究未对这些数据进行深入分析。其他研究仅强调了不同的经历,如女性与男性的道德困扰程度。只有约20%的出版物探讨了道德困扰经历的差异和/或其研究结果背后的因素。

结论

不仅需要在道德困扰研究中收集分类数据,还需要通过基于性别和种族的分析来处理这些数据。特别是,我们强调需要进行交叉性分析,这可以阐明社会身份和类别(如性别和种族)以及结构性不平等(如由性别歧视和种族主义造成的不平等)如何相互作用以影响道德体验。

对专业和/或患者护理的启示:医疗保健专业人员所经历的道德困扰越来越被视为一个重要的研究领域,对医疗保健部门具有重大政策影响。本研究为细致入微和有针对性的政策方法提供了见解。

患者或公众贡献

无患者或公众贡献。

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