Oelhafen Stephan, Monteverde Settimio, Trachsel Manuel
Bern University of Applied Sciences, Switzerland.
University of Zurich, Switzerland.
J Health Psychol. 2025 Mar;30(4):638-651. doi: 10.1177/13591053241253233. Epub 2024 May 23.
Moral distress denotes a negative reaction to a morally challenging situation. It has been associated with adverse outcomes for healthcare professionals, patients and healthcare institutions. We argue that existing definitions, along with measures of moral distress, compromise the validity of empirical research. First, the definition and measurement of moral distress conflate moral events and psychological distress, even though they are distinct phenomena that should be assessed independently. Second, in many studies, there is a lack of clarity in distinguishing between moral and non-moral events. Finally, prior research on moral distress often overlooks the substantial body of evidence demonstrating the impact of diverse work-related factors, beyond moral events, on both distress and job retention. These challenges might undermine the effectiveness of interventions aimed at alleviating moral distress. We outline a comprehensive research agenda that encompasses conceptual clarifications, the refinement of data collection instruments, the design of studies and the application of appropriate statistical methods.
道德困扰是指对道德上具有挑战性的情况产生的负面反应。它与医疗保健专业人员、患者和医疗机构的不良后果有关。我们认为，现有的定义以及道德困扰的测量方法损害了实证研究的有效性。首先，道德困扰的定义和测量将道德事件和心理困扰混为一谈，尽管它们是不同的现象，应该独立评估。其次，在许多研究中，区分道德和非道德事件缺乏明确性。最后，先前关于道德困扰的研究往往忽视了大量证据，这些证据表明，除道德事件外，各种与工作相关的因素对困扰和工作保留率都有影响。这些挑战可能会削弱旨在减轻道德困扰的干预措施的有效性。我们概述了一个全面的研究议程，其中包括概念澄清、数据收集工具的完善、研究设计以及适当统计方法的应用。
