{"title":"“等级制度是你的约束:”对美国卫生系统社会工作者道德困境的定性调查。","authors":"Sophia Fantus, Rebecca Cole, Lataya Hawkins","doi":"10.1080/00981389.2022.2128156","DOIUrl":null,"url":null,"abstract":"<p><p>This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness.</p>","PeriodicalId":47519,"journal":{"name":"Social Work in Health Care","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":"{\"title\":\"\\\"The hierarchy is your constraint:\\\" a qualitative investigation of social workers' moral distress across a U.S. health system.\",\"authors\":\"Sophia Fantus, Rebecca Cole, Lataya Hawkins\",\"doi\":\"10.1080/00981389.2022.2128156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness.</p>\",\"PeriodicalId\":47519,\"journal\":{\"name\":\"Social Work in Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Social Work in Health Care\",\"FirstCategoryId\":\"90\",\"ListUrlMain\":\"https://doi.org/10.1080/00981389.2022.2128156\",\"RegionNum\":4,\"RegionCategory\":\"社会学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/10/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SOCIAL WORK\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Work in Health Care","FirstCategoryId":"90","ListUrlMain":"https://doi.org/10.1080/00981389.2022.2128156","RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/10/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SOCIAL WORK","Score":null,"Total":0}
"The hierarchy is your constraint:" a qualitative investigation of social workers' moral distress across a U.S. health system.
This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness.
期刊介绍:
Devoted to social work theory, practice, and administration in a wide variety of health care settings, this journal gives you the tools to improve your practice while keeping you up-to-date with the latest crucial information. Social Work in Health Care is edited by Gary Rosenberg, PhD, one of the most respected leaders in health social work. This creative, lively journal brings you the most important articles on research, leadership, clinical practice, management, education, collaborative relationships, social health policy, and ethical issues from the most respected experts in the field. The journal"s special issues comprehensively discuss a single pertinent health care theme.