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Potential sources of moral distress during COVID-19: Perspectives of hospice interdisciplinary teams

Published online by Cambridge University Press:  16 May 2022

Tessa Jones Open the ORCID record for Tessa Jones [Opens in a new window] ,
Shih-Yin Lin ,
Aditi Durga ,
Elizabeth A. Luth ,
Rebecca K.F. Lassell  and
Abraham A. Brody
Tessa Jones*
Affiliation:
New York University, New York, NY
Shih-Yin Lin
Affiliation:
NYU Rory Meyers College of Nursing, New York, NY
Aditi Durga
Affiliation:
NYU Rory Meyers College of Nursing, New York, NY
Elizabeth A. Luth
Affiliation:
Department of Family Medicine and Community Health, Institute for Health, Healthcare Policy and Aging Research, Rutgers University, New Brunswick, NJ
Rebecca K.F. Lassell
Affiliation:
Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, NY
Abraham A. Brody
Affiliation:
Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, NY
*
Author for correspondence: Tessa Jones, New York University, 1 Washington Square N, New York, NY 10003, USA. E-mail. tmj271@nyu.edu
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Abstract

Objective

This study aimed to examine the impact of COVID-19 on hospice Interdisciplinary team (IDT) members’ self-reported stress and identify possible sources of moral distress.

Methods

A cross-sectional survey was conducted using Qualtrics to understand the impact of COVID-19 on quality improvement initiative implementation and hospice IDT members’ general and dementia-specific care provision. Directed qualitative content analysis was used to analyze hospice IDT members’ responses from five open-ended survey questions that were indicative of stress and possible moral distress.

Results

The final sample consisted of 101 unique respondents and 175 comments analyzed. Three categories related to sources of moral distress based on hospice IDT member survey responses were identified: (1) impact of telehealth, personal protective equipment (PPE), and visit restrictions on relationships; (2) lack of COVID-19-specific skills; and (3) organizational climate. Sources of moral distress were categorized in 40% of all responses analyzed.

Significance of results

This study is one of the first to document and confirm evidence of potential stress and moral distress amongst hospice IDT members during COVID-19. It is imperative given the possible negative impact on patient care and clinician well-being, that future research and interventions incorporate mechanisms to support clinicians’ emotional and ethical attunement and support organizations to actively engage in practices that address clinician moral distress resulting from restrictive environments, such as the one necessitated by COVID-19.

Keywords

COVID-19HospiceInterdisciplinaryMoral distressQualitative research
Type
Original Article
Information
Palliative & Supportive Care , Volume 21 , Issue 4 , August 2023 , pp. 644 - 650
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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