Moral distress in midwifery practice : A concept analysis
Journal article
Foster, Wendy, McKellar, Lois, Fleet, Julie-Anne and Sweet, Linda. (2022). Moral distress in midwifery practice : A concept analysis. Nursing Ethics. 29(2), pp. 364-383. https://doi.org/10.1177/09697330211023983
Authors | Foster, Wendy, McKellar, Lois, Fleet, Julie-Anne and Sweet, Linda |
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Abstract | Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting in eight articles for review. Data were analysed using NVivo12©. Three core attributes were identified: moral actions and inactions, conflicting needs and negative feelings/emotions. The antecedents of clinical situations, moral awareness, uncertainty and constraint were identified. Consequences of moral distress include adverse personal professional and organisational outcomes. A model case depicting these aspects is presented. A midwifery focused definition of moral distress is offered as ‘a psychological suffering following clinical situations of moral uncertainty and/or constraint, which result in an experience of personal powerlessness where the midwife perceives an inability to preserve all competing moral commitments’. This concept analysis affirms the presence of moral distress in midwifery practice and provides evidence to move towards a consistent definition of moral distress. |
Keywords | Concept analysis; maternity cares; midwifery; midwifery workforce; moral distres |
Year | 01 Jan 2022 |
Journal | Nursing Ethics |
Journal citation | 29 (2), pp. 364-383 |
Publisher | Sage Publications Ltd. (UK) |
ISSN | 0969-7330 |
Digital Object Identifier (DOI) | https://doi.org/10.1177/09697330211023983 |
PubMed ID | 34538155 |
Web address (URL) | https://journals.sagepub.com/doi/10.1177/09697330211023983 |
Open access | Published as non-open access |
Research or scholarly | Research |
Page range | 364-383 |
Publisher's version | License All rights reserved File Access Level Controlled |
Output status | Published |
Publication dates | |
Online | 19 Sep 2021 |
Publication process dates | |
Deposited | 02 Oct 2024 |
Additional information | © The Author(s) 2021. |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/90yz5/moral-distress-in-midwifery-practice-a-concept-analysis
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