Qualitative investigation of moral distress in Cypriot mental health nurses in Cyprus: preliminary results

Abstract

BACKGROUND: Empirical data provide evidence on the association between morally distressing experiences in healthcare professionals and diminished quality and safety of provided care. However, moral distress has not been sufficiently studied to date, particularly among mental health nurses (MHNs), both internationally and nationally. PURPOSE: The purpose of this qualitative research study was to investigate the experience of moral distress among Cypriot MHNs. METHODS: A qualitative and phenomenological study design was applied. Data collection was achieved through two focus groups according to a semi-structured interview guide. Following informed consent, 21 nurses participated through purposeful sampling. RESULTS: 11 males and 10 females (mean age=37.47 years), employed in both hospital and community settings participated. The most commonly reported morally distressing situations regarded safety of the provided care, unethical/ unideological behaviors towards patients, violation of patients’ human rights, and witnessing violation of nurses’ labor rights. The most important factors associated with these situations were limited work experience and low ranking; inadequate education and lack of skills of healthcare professionals; inadequate referral procedures and lack of particular types of services; administrative deficiencies; nurses’ and patients’ limited participation in clinical decision- making. CONCLUSIONS: Situations that are linked with morally distressing experiences among mental health nurses seem to be mainly related to the work environment. Interventions related to organizational empowerment of MHNs need to be developed, along with pre-graduate and postgraduate education on early dictation of moral distress symptoms, as well as work-related conditions which may lead to such experiences.