Concept Analysis of Moral Distress in Pain Management.

IF 1.6 4区医学 Q2 NURSING Pain Management Nursing Pub Date : 2024-11-14 DOI:10.1016/j.pmn.2024.10.014

Elizabeth A Byma

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Abstract

Objective: Managing pain continues to be a difficult issue worldwide. Pain management has ethical connotations, with the potential to result in moral distress in nurses. The aim of this concept analysis is to analyze moral distress in pain management.

Design: Walker and Avant's method of concept analysis was utilized to determine attributes, antecedents, and consequences of moral distress in pain management.

Methods: Literature searches in The Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, Web of Science, and Pub Med were performed. The search identified and utilized 16 articles in the concept analysis.

Results: Four major attributes of moral distress in pain management are discussed: (1) feeling of ownership of patient pain, (2) perceived powerlessness, (3) frustration, and (4) feelings of conflict between pain management situation, personal values, and professional values of nursing. Antecedents were patients experiencing pain, barriers, and having knowledge of the right thing to do. Consequences included nurse burnout, turnover and exit from the profession, compromised patient care, emotional withdrawal from patients, depersonalization of patients, and feelings of complicity and wrongdoing.

Conclusions: This concept analysis provides a foundation for future research examining moral distress in pain management.

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疼痛管理中道德压力的概念分析。

目的：在全球范围内，疼痛管理仍然是一个棘手的问题。疼痛管理具有伦理内涵，有可能导致护士的道德困扰。本概念分析旨在分析疼痛管理中的道德困扰：设计：采用 Walker 和 Avant 的概念分析方法来确定疼痛管理中道德困扰的属性、前因和后果：方法：在《护理与专职医疗文献累积索引》（CINAHL）、MEDLINE、Web of Science 和 Pub Med 中进行文献检索。搜索确定并在概念分析中使用了 16 篇文章：讨论了疼痛管理中道德困扰的四个主要属性：（1）对患者疼痛的主人翁感；（2）感知到的无力感；（3）挫败感；（4）疼痛管理情况、个人价值观和护理专业价值观之间的冲突感。前因包括患者的疼痛经历、障碍以及对正确做法的了解。后果包括护士职业倦怠、离职和退出护理行业、患者护理受损、情感上远离患者、患者人格解体以及共谋和错误行为感：这一概念分析为今后研究疼痛管理中的道德困扰奠定了基础。

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来源期刊

Pain Management Nursing 医学-护理

CiteScore

3.00

自引率

5.90%

发文量

187

审稿时长

>12 weeks

期刊介绍： This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing. Original and review articles from experts in the field offer key insights in the areas of clinical practice, advocacy, education, administration, and research. Additional features include practice guidelines and pharmacology updates.