Out-of-hours decision-making in deteriorating patients by foundation year doctors: Relationship to moral distress.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-12-01 Epub Date: 2023-10-24 DOI:10.1177/14782715231203941

Justin C Geddes, Margaret MacDougall, Robin D Taylor

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Abstract

Background: Moral distress (MD) refers to psychological unease when healthcare professionals identify morally correct actions to take but are constrained in their ability to take those actions.

Methods: This study evaluated the relationship between out-of-hours decisions and MD among 40 Foundation Year 2 (FY2) doctors. They were asked to choose the 'expected' and the 'right' management options for five out-of-hours scenarios and complete an adapted Measure of Moral Distress for Health Professionals (MMD-HP) questionnaire.

Results: 28/40 (70%) reported discordance between 'expected' and 'right' options more frequently than concordance. The mean total MMD-HP score was low: 64.9 (SD = 26.9), range 13-143, maximum 288. The association between decision-making discordance and MMD-HP score was weak.

Conclusion: Out-of-hours decisions by FY2 doctors were characterised by doing what is 'expected' rather than what is perceived to be 'right'. Providing guidance regarding decision-making in deteriorating patients is needed for patient safety and staff well-being.

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基金会年度医生对病情恶化患者的非工作时间决策：与道德困境的关系。

背景：道德困扰（MD）是指当医疗保健专业人员确定要采取的道德正确的行动，但他们采取这些行动的能力受到限制时的心理不安。方法：本研究评估了40名基金会二年级（FY2）医生的非工作时间决策与MD之间的关系。他们被要求为五种非工作时间情景选择“预期”和“正确”的管理选项，并完成一份经过调整的卫生专业人员道德痛苦测量问卷（MMD-HP）。结果：28/40（70%）报告“预期”和“正确”选项之间的不一致比一致更频繁。MMD-HP平均总分较低：64.9（SD = 26.9），范围13-143，最大288。决策不一致与MMD-HP评分之间的相关性较弱。结论：FY2医生的非工作时间决策的特点是做“预期”的事情，而不是认为“正确”的事情。为了患者安全和员工福祉，需要为病情恶化的患者提供决策指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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